New York Makes Work Pay

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2 New York Makes Work Pay Title: Overview of the Plan For Achieving Self Support Presenter: Edwin J. Lopez-Soto New York Makes Work Pay is a Comprehensive Employment System Medicaid Infrastructure Grant (Contract No. #1QACMS030318) from the U.S. Department of Health and Human Services, Center for Medicaid and Medicare Services to the Office of Mental Health on behalf of New York State. It is a joint effort of the Burton Blatt Institute at Syracuse University and the Employment and Disability Institute at Cornell University with the collaborative support of the Employment Committee of the New York State Most Integrated Setting Coordinating Council to remove barriers to employment and 2 develop pathways to work for New Yorkers with disabilities.

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5 p.124 What Is A PASS 1? PASS is an SSI work incentive under which persons with disabilities can set aside income (earned, deemed or in-kind) and/or resources to be used to achieve specific work goals. A PASS can be established to cover the costs of obtaining an education; receiving vocational training; starting a business; or, purchasing support services.

6 What is a PASS 2? The PASS is a special SSI rule for not counting income or resources that support a work goal. If approved the PASS can result in: Retained SSI eligibility A larger SSI check SSI eligibility when none existed before Establishing Medicaid eligibility or retaining Medicaid eligibility 6

7 SSI s Income Rules New York s SSI payments typically based on 2009 SSI rates: $761 living alone $697 (living with others) If individual has income, other than SSI, part of that income is subtracted from base rate to determine monthly SSI payment. 7

8 The Case of Joan SSI Check Calculation Joan, age 33, lives alone and receives Social Security Disability Insurance (SSDI) of $680 per month based on a mental illness. SSI disregards $20 and the remaining $660 is subtracted from the $761 SSI base rate, giving Joan a $101 monthly SSI check. Her total monthly income is $781 ($680 SSDI, $101 SSI). Since Joan gets SSI, she also qualifies for automatic Medicaid. 8

9 Calculation w/out PASS STEP ONE: Unearned Income $ General Income Exclusion (GIE) = Countable Unearned Income $ STEP TWO: Gross Earned Income $ - SEIE $ = Remainder $ - GIE if not used above $ = Remainder $ - Earned Income Exclusion $ = Remainder $ - IRWE $ Remainder $ Divide by 2 / 2 = Remainder $ - BWE $ = Total Countable Earned Income $ STEP THREE: Countable Unearned Income $ Countable Earned Income $ = Countable Income $ PASS $ 0 = Total Countable Income $ STEP FOUR: Base SSI Rate: $ Total Countable Income $ = SSI Payment $

10 Joan s Need for a PASS SSI Rule: If income or resources are used in a PASS to support a work goal, the income/resources will not count when determining SSI eligibility. Example. Joan plans to attend a two year community college program to become an occupational therapy assistant. VESID will pay for tuition, transportation to college, and books. Will still need: $700 for laptop; $10,800 for a used car to travel to work; and $650 for six months of car insurance. Joan proposes to set aside $450 of her SSDI check each month, for 27 months, to save for these items to meet her work goal. 10

11 Calculation with PASS STEP ONE: Unearned Income $ General Income Exclusion (GIE)$ = Countable Unearned Income $ STEP TWO: Gross Earned Income $ - SEIE $ = Remainder $ - GIE if not used above $ = Remainder $ - Earned Income Exclusion $ = Remainder $ - IRWE $ Remainder $ Divide by 2 / 2 = Remainder $ - BWE $ = Total Countable Earned Income $ STEP THREE: Countable Unearned Income $ Countable Earned Income $ = Countable Income $ PASS $ = Total Countable Income $ STEP FOUR: Base SSI Rate: $ Total Countable Income $ = SSI Payment $

12 Joan s Approved PASS With PASS approval, SSI no longer counts $450 of SSDI Countable income is reduced to $210. SSI check increased to $551. PASS savings = $12,150 (27 months x $450) Savings will pay for computer, car, and insurance. PASS starts in July 2009 and continues through August 2011: Can purchase car and insure it in August Until then, will borrow mother s car to travel to internships and job interviews. Will graduate in May Joan still has $781 for living expenses ($551 SSI, $230 SSDI). 12

13 Criteria for PASS Approval Must be in writing using Form SSA 545 Must contain: Specific work goal A feasible work goal A savings and spending plan A list of items and services needed and their cost A timetable for achieving the goal Work goal must increase prospect for self support 13

14 Will PASS Increase Prospect for Self PASS policy requires: Support? If SSI received before PASS approval, work goal must significantly reduce the SSI payment amount. If only SSDI received before PASS approved, work goal must be expected to eliminate SSDI check (i.e., through work at the substantial gainful activity level $980 per month in 2009). Joan s goal is a job making $22,000 per year ($1,833 per month) upon graduation. She meets the first criteria as this would eliminate her SSI eligibility. If SSDI were her only income before PASS approval, she would meet the criteria, as she will earn more than $980 per month. 14

15 The Feasible Work Goal Must specify a job or profession. Must have reasonable chance of attaining the goal, in light of disability. Goal could be for full time or part time work, sufficient to significantly reduce SSI or eliminate SSDI. Goal could be to move from part time to full time work. If VESID states that the work goal is feasible, SSA will typically grant the PASS. 15

16 What Money Goes Into a PASS? Earned income Wages from a job Income from a business Unearned income Such as a Social Security check or VA pension Resources Savings Personal injury award Inheritance Lump sum Social Security or SSI award 16

17 Allowable PASS Expenses All reasonable and necessary expenses, such as: College or training costs Transportation, including vehicle lease or purchase Vehicle insurance, maintenance, repairs, warranty costs Computer, software and Internet costs Work clothes, professional clothing Business start up costs Dues, fees, licenses Child care Anything reasonably tied to the work goal 17

18 PASS Time Limits General Rule: A PASS can be approved for whatever period of time is needed to achieve the goal. SSA will conduct progress reviews as needed. Application to Joan s PASS: Her PASS should go for 27 months, through August 2011, to allow her to save for the computer, car, and car insurance, find a job, and start working. Are there other items or services Joan may need? Internet costs Professional clothing Vehicle maintenance charges 18

19 PASS Amendments A PASS Can Be Amended as Necessary To add things that were not anticipated in the original PASS To address personal changes a job loss, a change in income Could be needed to allow extra time to reach milestones For example, an individual may realize it will take five years, rather than four years, to complete a college program. 19

20 Joan s Need to Amend her PASS Additional Items Needed to Achieve Goal Five months into her PASS, Joan realizes she will have $2,200 of additional expenses: Professional clothing $500 Computer software $200 Internet services for schoolwork and job search $1,000 Car maintenance costs until she finds employment $500 20

21 Joan s Amended PASS Joan s amendment adds $2,200 in additional costs. Will save an extra $100 per month for each of remaining 22 months. PASS will still be for 27 months, with $14,350 saved in total. SSI check will increase by $100 to $651 per month. 21

22 Calc: Amended PASS STEP ONE: Unearned Income $ General Income Exclusion (GIE)$ = Countable Unearned Income $ STEP TWO: Gross Earned Income $ - SEIE $ = Remainder $ - GIE if not used above $ = Remainder $ - Earned Income Exclusion $ = Remainder $ - IRWE $ Remainder $ Divide by 2 / 2 = Remainder $ - BWE $ = Total Countable Earned Income $ STEP THREE: Countable Unearned Income $ Countable Earned Income $ = Countable Income $ PASS $ = Total Countable Income $ STEP FOUR: Base SSI Rate: $ Total Countable Income $ = SSI Payment $

23 Joan s Amended PASS Joan s amendment adds $2,200 in additional costs. Will save an extra $100 per month for each of remaining 22 months. PASS will still be for 27 months, with $14,350 saved in total. SSI check will increase by $100 to $651 per month. 23

24 Suspension of A PASS The PASS will be suspended when: the plan is abandoned, the conditions of the plan are not followed, or the goal is achieved. 24

25 Termination of A PASS The PASS will be terminated if: SSA approves a new PASS application, eligibility for SSI is terminated, or 12 consecutive months elapse after a PASS is suspended without it being resumed. 25

26 Questions / Answers

27 New York Makes Work Pay Partnering Organizations New York Makes Work Pay is a Comprehensive Employment System Medicaid Infrastructure Grant (Contract No. #1QACMS030318) from the U.S. Department of Health and Human Services, Center for Medicare and Medicaid Services to the Office of Mental Health on behalf of New York State. It is a joint effort of the Burton Blatt Institute at Syracuse University and the Employment and Disability Institute at Cornell University with the collaborative support of the Employment Committee of the New York State Most Integrated Setting Coordinating Council to develop pathways and remove obstacles to employment for New Yorkers with disabilities. 27