coweta county schools workshop series - #2 medicaid waivers, ssi, estate planning and advocacy
DESCRIPTION
Coweta County Schools Workshop Series - #2 Medicaid Waivers, SSI, Estate Planning and Advocacy. Coweta County Schools Workshop Series - #2 Medicaid Waivers, SSI, Estate Planning and Advocacy. Judy Floyd Parent Mentor, Coweta County School System 770-254-2810 x219 - PowerPoint PPT PresentationTRANSCRIPT
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Coweta County SchoolsWorkshop Series - #2
Medicaid Waivers, SSI,Estate Planning and Advocacy
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Coweta County SchoolsWorkshop Series - #2
Medicaid Waivers, SSI,Estate Planning and Advocacy
• Judy FloydParent Mentor, Coweta County School System
770-254-2810 x219
• Linda WilsonPartners in Policymaking Graduate
Coweta Supporters
770-463-1658
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Medicaid eligibility
• As a result of receiving SSI– Family income for children under age 18– Based on individual’s income at age 18
• Medicaid Deeming Waiver (also known as the Katie Beckett Waiver)
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Deeming Waiver
• Not based on family income
• Eligible if child requires– Skilled nursing care– Hospitalization– Intermediate care facility – active treatment
with a deficit in 3 self help areas
• Apply through DFACS
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Deeming Waivers
• Many denials for new and renewals• Be sure that your paper work is complete• Appeal decision• Be specific about things that need supervision –
safety issues, health issues, detailed level of care and support
• Being addressed by GAO (Georgia Advocacy Office) and GCDD (Governor’s Council on Developmental Disabilities)
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SSI
• Supplemental Security Income
• Eligible when child becomes adult according to law at age 18
• Parent income no longer considered
• Less than $2000 in the bank
• Can own home and auto
• Income limits apply
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SSI
• Needs based program• Maximum of $579/month in 2005 • Will increase to $603 in 2006• Automatically receive Medicaid for
medical, therapies, and waivers• Can earn up to $22,192 per year and still
retain Medicaid although payments maybe reduced
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SSIHow to Apply
• Contact SSA (Social Security Administration) at 1-800-772-1213
• Set up an appointment (phone or in person in LaGrange)
• Provide requested information
• Parent can be designated the payee
• Yearly report on how funds are spent
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SSIBenefits Navigator
• Benefits Navigator Project – work with individuals who are eligible for Social Security based on a disability
• Will assist you in making informed decisions when you work and have Social Security benefits
• If an individual is still in school, he may qualify for a Student Earned Income Exclusion
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SSIBenefits Navigator
• Contact Division of Rehabilitation Services (GROUP) at 866-489-0001
• Help with transition from school to work
• Will attend IEP meetings
• Help DD population become informed consumers
• No cost
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SSDI
• Social Security Disability Insurance
• Entitlement program
• Medicare included
• May jeopardize SSI benefits
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SSDI
• Based on child’s or parent’s work record• For a child to receive benefits on a parent’s
work record– Disability must have started prior to age 22– Must meet definition of disability for adults– Parent must become disabled, retired, or die
• If received SSI and Medicaid, may be able to retain Medicaid
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Trusts
• Setup to prevent assets from disqualifying child for SSI
• Legal arrangement regulated by state law in which one party holds property for the benefit of another
• Often called “special needs” trusts• Better than relying on others to use funds
appropriately
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Trusts
• Funds must be paid by someone to provide you with items other than food and shelter
• Supplemental discretionary trust – specifies that funds are not to be used for items covered by Medicaid or SSI
• Discretionary trust – more freedom to use funds. Must be careful to not provide goods or services (shelter or food) which are covered by Medicaid or SSI
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Trusts
• Setting up a trust– Testamentary – sets up in a will
– Inter vivos (or Living) – sets up a trust before dying
• Funding the trust– Family’s assets
– Assistance and inheritance from friends and family
– Life insurance
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Wills
• Legal document that is a statement of what you want to have happen after your death
• A Will can provide– Property distribution– Naming a guardian– Creating a trust
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Wills
• If you do not have a Will, your property is distributed to your heirs according to the laws of the state
• It is important that a child with developmental disabilities not receive funds as they may jeopardize their government benefits
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Wills
• Should indicate that a family member has a disability
• Relatives should consider making arrangements to not leave property to an individual with developmental disabilities. This includes life insurance.
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Guardianship
• Court-approved legal relationship between a competent adult and a minor or adult with a disability
• Limits a person’s independence and rights
• At age 18, individuals are considered to be adults. Personal, medical and financial decisions should be made by the individual
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Guardianship
• Parents are legal guardians of a minor child
• Only the court can make one person the guardian of an adult
• Need for guardianship varies for each individual with disabilities
• Handled by the Probate Court
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Guardianship
• Types– Person – personal issues including living
arrangements, medical treatment, signing for services
– Property – money or property– Full or Plenary - person’s personal and
property
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Guardianship
• Annual report required • If receiving SSI, consider Person only since
will be doing a financial report for SSA• Alternatives
– Representative Payee– Joint accounts– Durable power of attorney for health care,
property or advocacy
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Medicaid Waivers
• MHDDAD – Division of Mental Health, Developmental Disabilities, and Addictive Diseases – part of DHR (Department of Human Resources)
• Regions have been reduced from 7 to 5
• Coweta County is in Region 1
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Medicaid Waivers
• To contact Region 1Charles Fetner, Regional Coordinator
1305 Redmond Circle, Building 401
Rome, GA 30165
Phone 706-802-5272
Fax 706-802-5280
Toll Free 1-800-646-7721
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Medicaid Waivers
• To Apply for Waiver ServicesColumbus Community Services
Phone 706-494-5929
Toll Free 1-800-579-7609
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Medicaid WaiversTypes
• ICWP – Independent Care Waiver – physical disability or traumatic brain injury
• Deeming Waiver – Katie Beckett – chonic medical condition, under age 18
• CHSS – Community Habilitation Support Services – moving individuals out of institutions
• MRWP – Mental Retardation Waiver Program – developmental disabilities
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Medicaid WaiversTypes
• CCSP – Community Care Services Program – elderly and DD who need nursing home level care
• SOURCE – Service Options Using Resources in a Community – care management – not available in Coweta
• GAPP – Georgia Pediatric Program – medically fragile under age 21
• Autism Family Support
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Medicaid WaiversMRWP
• 7079 being served
• 3200 on short term waiting list
• 3126 on long term waiting list
• 700 age out of the school system annually
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Medicaid WaiversMRWP
• Residential Options– Residential Training and Supervision
• Group home/personal care home
• 24x7
• Training tailored for individual – self care, independent living skills, communication skills, leisure skills
– Personal Support• Similar to Residential Training
• Occurs in family’s or individual’s home
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Medicaid WaiversMRWP
• Day Services Options– Day Habilitation
• Offered in a facility or community, non-work, training in areas of communication, social, leisure, and self help skills
– Supported Employment• Opportunity for individuals to work a minimum of 80 hours
per month, provides job development, coaching and follow-up
– Day Support Services• Provides for facility day habilitation, prevocational, and
supported employment
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Medicaid WaiversMRWP
• Specialized Medical Supplies• Specialized Medical Equipment• Personal Emergency Response Systems• Environmental Modifications• Vehicle Adaptation• Respite Care• Home Based Services• Natural Support Enhancements• Natural Support Therapies• Consumer Directed Natural Support Enhancements
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New Medicaid Waivers
• Proposed by Dr. Stephen Hall, Director of the Department of Developmental Disabilities, DHR
• Recognize that parents are the primary service providers – always!
• Current waivers established in 1987• Medicaid is a states program that is federally funded• Will take advantage of the flexible Federal Medicaid Rules
Template• Will send to federal govt in Dec, 2005 • Plan to implement starting July, 2006
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New Medicaid Waivers
• Bring fairness, choice, accountability and self-determination to the system
• Assessment process will be the same statewide using SIS (Supports Intensity Scale) – www.aamr.org
• More flexibility on what services are obtained by individual’s funding
• Will not provide more funding• Will provide more choice• Money will follow the individual
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New Medicaid Waivers
• Reduce current waivers to two waivers– Supports Waiver
• Live in own home or family’s home• Participate in community life
– Comprehensive Waiver• More intense, urgent and extensive out of home
residential services
• Funding will be based on level of support that is needed
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New Medicaid Waivers
• Individualized budgeting– can spend dollars where you want
• Community Connection/Community Guide/Brokerage Services – help connect to community activities
• Dental services will be available• Transportation services• Behavioral Support Services
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New Medicaid Waivers
• Participant Direction – same as Consumer-Directed Natural Supports Enhancements Services. – Choose and direct services to extent desired– Can be employer of record and pay providers
• Support Coordination – monitoring of supports and services as necessary
• Extenuating Circumstances Payment – Payment to family member for services when providers
not available and is cost effective
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New Medicaid WaiversProviders
• Group Providers – same as today
• Individual Providers – expedited process to establish small providers that support 1-3 individuals
• Specific Providers – a particular specialty such a dental, health, behavior
• Will result in increased number of providers
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New Medicaid Waivers
• Gradual move to new services – must be selected by the family
• Current waiver will be converted on individual’s birthday
• Process– Determine eligibility– Assess needs– Choice of services
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New Medicaid Waivers
• Will use Utilization Management– Ensure efficient and effective use of funds– Outcomes that lessen dependence on funding– Shifts from program funding to individualized
budgeting that controls costs
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Unlock the Waiting Lists!
• We must reduce the number of individuals on the waiting lists for services
• Georgia’s annual budget determines how many additional people receive services
• We need to tell our elected officials and state officials how important this issue is!
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Unlock the Waiting Lists!Budget Process
• DHR and DCH submit proposed budget to the Governor in September
• Governor develops budget and submits to the legislature in January
• Legislators debate, modify, and approve budget
• Returns to the Governor for approval
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Unlock the Waiting Lists!
• Previously (2004-2005) budget – 10 waivers funded
• Last year (2005-2006) budget – 925 additional waivers were funded
• This year (2006-2007) budget – DHR is asking for 1500 additional waivers
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Unlock the Waiting Lists!Goals
• Funding, with new money, for at least 1,500 services for people who want and need alternatives to institutions and nursing homes.
• Funding, with new money, an increase for provider rates that ensures direct service professionals for disability supports are given fair and livable wages, provided training and assure quality services
• Implementation of a multi-year funding plan for home and community-based services
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Unlock the Waiting Lists
• Go to www.unlockthewaitinglists.com for more information
• Write/call/visit the Governor and your Legislators
• Attend Disability Day at the Capitol – February 23, 2006