Captioned Text This is Michelle at the enter work Institute collaborative for distance learning at San Diego State University and I want to welcome you all. We are excited to have you here, Arthur webinar for the California -- for the California health incentives improvement project.We have Karla Bell with us today. Carla joined the chips came in October and she is working as a Project specialist, focusing on planning initiatives. She is based here in San Diego and the interwork Institute and has previously worked at the San Diego one-stop career centers as a community work incentives coordinator and also as a disability program navigator. Providing training and counseling to consumers, family members, and service providers that federal and state work incentives and benefits. We are excited to have Carla with us today and I am sure you will learn much from her presentation which will be 90 minutes. Carla will leave some time for questions and what we find seem to work well the last time was, if you had questions that she wanted to type into the chat will she is presenting, she can address those when there is a break in her presentation. So we can do that and we can also have more questions at the end of her presentation. With that, I am going to turn the microphone over to Karla Bell . Thank you so much. If you have any difficulties, please contact, Tong, tech support, at the top of the people window and double click on that and you can send him a question regarding technical difficulties if that comes up. To get started, I am going to go ahead -- if there is a phone number that you have questions for for technical difficulties only, or regarding the logistics of this webinar, you can call Thong at 619-594-0740. I will go ahead and type it into the chat window right now. Meanwhile, give us a second to turn the mike overto Karla Bell . Good afternoon.This is Karla Bell , or presenter. Thank you so much for joining us for the 250% working disabled program at options to maintain Medi-Cal while working for people with disabilities webinar. As Michelle said, I am going to posit different times during the presentation for questions. The place where you can enter your question, there is a blank space right below the public chat area. In the middle of the right side of the screen, where you can enter your questions. We had some issues with the audio. We are going to get started in just a minute. We went to check the audio very quickly. Sorry about that. Sorry about that we are going to work on the audio while I continue talking. So first I would like to tell you a little bit about the California health incentives improvement project. We are headed by a Medicaid infrastructure grant from the federal centers for Medicare and Medicaid services. Our goal is to increase the employment rate of people with disabilities by making sure necessary supports are in place, such as access to health care and the ability to use personal assistant services that work. We provide outreach and education on the working disabled program, other benefits and employment supports. We will continue to offer free webinars. I anticipate the next one will be in February. I anticipate the next one will be in February 2010. We will send out a survey after this webinar. So please let us now. What other topics you would like to see covered in future webinars. All of our webinars will be archived on our website www. talent knows no limits.info. There is a link to that in the resources later in the presentation. Have a question to the folks listening. How is the audio? Is it louder now? This is Karla Bell . We are going to move on now. Here is an overview of today's webinar. I will start by describing the two other programs were a person with a disability can continue Medi-Cal while working. Then I will go into detail about the 250% Medi-Cal working disabled program. I will be covering a little about the history, eligibility for the program, premiums, how they are determined, benefits of this program, enrollment, future changes and some resources. When a person with a disability goes to work, there are three options for them to continuewith their Medi-Caleli ligibility. Those are supplemental security income us. Or SSI for sure, the 1619 the program, the aged and disabled federal poverty level program. In the 250% working disabled program. First was discussed the 1619 b program. 1619 b Is a funny name but a provision to the SSIlinked Medi-Cal . It allows working SSIrecipients to keep full-scale Medi-Cal . Let me give you a little bit of background before it began with the information on the sly. The SSI is a Social Security disability benefit. You have to do to the Social Security office to apply for it. It provides monthlyy cash assistance for people who are disabled, blind or age, who have little to no income for basic needs such as food and housing. In California, if you receive SSI , you are also automatically, let me say that again. In California, if you receive SSI , he also automatically receive Medi-Cal . The SSI has an asset limit of $2000 for an individual. And $3000 for a couple. The current payment for individual is $145 a month. But payment -- $845 a month. Payment can vary on living arrangements and other issues as well. There are different payment rates for individuals and couples. In most cases, if you receive SSI you'll be better off if you work. You will have more money than if you didn't because SSI does not reduce your check dollar for dollar when you had earnings from work. The general idea is that your SSI check will be reduced to one dollar for every two dollars you earn. The SSI check is reduced to about one dollar for every two dollars you earn. A lot of people mistakenly believe that they are SSI check stops due to wages. A lot of people mistakenly believe that there SSI check stops due to wages that their Medi-Cal will stop as well. That is where 1619 b comes in.The Medi-Cal is retained money SSI payment is reduced to zero dollars a month due to wages. You can keep your Medi-Cal if you're SSI payment goes to zero. You can keep indefinitely, if you meet certain criteria such as you are disabled, you need Bennett -- you need Medi-Cal , you continue to meet -- you continue to need the SSI asset limits and needs to not have earnings that exceeded the earned income threshold. The California earned income threshold is a number that you'll see on the sly. It changes each year. If you are a disabled individual and your earned income does not exceed $34,346 in 2009, you can keep Medi-Cal wit h 1619 bb and if you are blind you can earn up to $36,348 in 2009. So you can earn up to $34,000 a year if you are disabled, $36,000 a year if you are blind and still keep your Medi-Cal . This is very exciting. And 2010, the threshold amounts will change. It will be $34,324 for a disabled individual and $37,252 for a blind individual. The disabled individual a mountain went down due to recent California budget cuts. That affectedthat unfortunately. The blind amount is higher and does go up this year. I am often asked why the blind amount is higher. This is due to the fact that individuals who are blind have a very successful lobby. Now, if your earnings go about the California threshold, there may be a way for you to have a higher individualized threshold. You can work with a SSI claims representative at your Social Security office to have miscalculated. Some indicators that you might qualify for a higher individualized earnings threshold include the following. If you have blind work expenses, which are anything that reduces a blind person's gross income such a service animal costs, lunch, taxes that you pay, union dues, visual and sensory aids, transportation to and from work and attentive care services. If you are a person who is blind, there are a lot of different expenses you can use as a blind work expense. You also can use impairment related work expenses or IRWEs for short and Social Security can use as we are calculating your threshold. And IRWEs I think she paid for out of their own pocket that are related to your disability. You need them to work. Such is the cost of medications, and supplements, modifications to your home or vehicle, transportation such as the cost of a driver or taxi cabs. Or a cost related to the service animal. When I was working at the career center, I helped a lady with a psychiatric service dog. She was able to use the cost of that bills, grooming, training, dog food and many other things as impairment related work expenses. I helped her set up a way to track these expenses, save your receipts in a binder and get them ready to send to her SSI claims representative with a written request that they consider her impairment related work expenses. Also, another place to learn more about repent -- impairment related work expenses, the Social Security Redbook has a great list of IRWEs and I have a link to the online version of the Redbook later on in this presentation as well. They have a whole list of deductible and impairment related work expenses. Also, a past plan is considered when calculating an individual is threshold and a past plan, or you can plan to achieve cell support is a SSI work incentive you can use to set aside income our resources to save up for something you need to go to work and become self-sufficient. You can set aside your own money for things like training and education, starting a business, modifying a banner paying for a job coach to help you place of work. The cost of publicly funded personal attendant will also be considered when documenting individualized threshold such as in-home supportive services, which is personal care assistance in the home or workplace. The house with things such as meals, personal care, transportation and cleaning. Also if you have high medical expenses, that are above the state average, these are included in the calculation. Now, if your earnings do the above the threshold you can request the Social Security calculator and individualized threshold for you, taking into account all the different things I just listed. The Social Security field offices did not do this calculation on a regular basis. You may need a little help. If you do, you get help from a benefits plan our such as a community work incentives coordinator, the work incentives planning and assistance project. They are certified benefits planners, trained in the work incentives and they can help you prepare to request this. We do have a link later on to find a project in your area. He claims representative we spoke to was not familiar with the individualized threshold pack elation at all. Well he had to do next was the duty SSI supervisor . The person that was overseen a multiple SSI claim representatives. We worked with them to get things going. If you have any blind her impairment related work expenses, you'll need to provide Social Security with original receipts or canceled checks of the expenses, they must be all verified before they are approved. Always keep copies of anything to eat into Social Security. If you want to learn more about how earned income ita tax SSI submitted a brief overview of this, they stick out are archived webinars on the talent knows no limits websites. There is a webinar I did in October on a Social Security work incentives to cover this and other work incentives in more detail. Were you can also go to the disability benefits one-to-one website for more information or talk to a benefits plan. So before I go further, I am going to stop and take some questions. Does anyone have any questions about 1619 b? Any questions about 1619 (b) that you would like to type in? We had a question, how are publicly funded in-home supportive services factored into 1619 (b) ? I think the question is relating to the threshold calculation. Yes? Okay. So will it when they do they threshold peculation, we use a set of calculation steps. Were they plug in the different values. So what they are going to do is, they are going to need to contact in-home supportive servicesand Medi-Cal to find out what the value is , how much is being spent on the publicly funded personal attendant services so they can plug the value and, when we do the individualized threshold pack elation. It is going to take some coordination between the SSI claims representative to contact Medi-Cal or to contact in-home supportive services to get those numbers. And if this attitude the threshold amount? Yes. When they person's individualized threshold is being casually to, all the things I mentioned, the rate or cost of the publicly funded are still attendant, the medical expenses above the state average, the value of the impairment related work expenses, these are all added to the threshold amount. For example, a person I know has a threshold that is about $60,000. That is their individualized threshold. If you remember, right now, the California threshold for a person with a disability is $34,000. This person's case, they use in-home supportive services, their individualized threshold is calculated is approximately $60,000 a year. So they can be significantly higher when they take into account the cost of those different services. Good question. You are welcome darling. Really good question. Okay. Let's talk about the aged and disabled federal poverty level tranIV program. This program provides free. Medi-Cal for disabled are aged individuals who meet the income and asset requirements for the program. Aged is defined as 65 years or older. Disabled is defined using Social Security's definition of disability. This definition requires that you, excuse me, this definition requires you to show that you can't work or you are not earning above what is called substantial gainful activity. Due to the medically determined physical or mental impairment which is expected to result in death or that has lasted or is expected to last for a continuous period of not less than 12 months. Now substantial gainful activity, that is a number. In 2009, if a person earns more than $980 a month, their earnings are greater than substantial -- gainful activity. If you are blind, the blind substantial gainful activity amount is 1000 gainful activity amount is $1640 a month. In 2009. You also qualify as disabled for this program if you do currently receive a Social Security disability insurance or childhood disability benefit from Social Security. The income threshold for this program is $1133 a month for individual. And 1500 And $1525 a month for a married couple. If you're -- if you're accountable income is a little over this threshold, one strategy is to buy a supplemental dental or vision plan and your premium payment can be used as a desertion from you're accountable income. If the threshold is $1133 a month and you're accountable income is $1150 a month try buying a vision or dental plan to use that as a deception. If you buy it online -- deduction. If you buy online you can print at the receipt and our-- handed over to your Medi-Cal medical worker. Also for the aged and disabled, federal poverty program. There is an asset program to qualify, your assets cannot exceed $2000 for individual a $3000 for a couple. The home you live in a one car is exempt. Other exemptions include items necessary for self-employment such as inventory for your business, our business bank account. And things you use on the job such as tools for a second card. Assets can include checking and savings accounts, stocks, bonds, dressed eat, additional cars, recreational vehicles, a promise. Note our lawn that you have that are payable to you. Now the income threshold for this program is not very high. But I have worked with people who are working and still continued with this program. I worked with a man on Social Security disability insurance who worked very very hard time. As a plumber. He never earned more than $200 a month. So his accountable income never went over $1133 a month. It was not for lack of trying. He was having a hard time finding jobs due to the economy. But as I told him, it is intended exceed the threshold for this program, there are no worries about keeping Medi-Cal because of the working disabled program. But we bet -- but before we talk about that, let's see if anybody has any questions about the aged and disabled federal poverty level. We have a question from Antoinette. Do you discount programs -- to discount programs can't towards a ohc, were you referring to other health-care expenses and can you give more information on the discount Romance you are referring to. -- Discount programs you are referring to. Antoinette, I am not sure if discount programs count. I am not sure what they are. And impairment related work expenses that you have, things that you pay for out-of-pocket related to your disability that you need to work, anything that qualifies as that, could be used as a deduction. When determining accountable income for this program. And also, health insurance premiums can be used as a deduction. But if there is a question that I am not sure about the answer, I am definitely jotting down all these questions and I will do research and would be followed by standout with the presentation, after the presentation, I'll ascend a list of all the questions and answers as well. -- I also sent a list of all the questions and answers as well. Okay. Now let's talk about the Medi-Cal working disabled program. This programm is for anyone with a disability who is working. It is not just for people on a Social Security disability benefit. But of course, many people receiving Social Security disability insurance or childhood disability benefits are also on this program. If you can show you have a medically determined physical or mental disability, and you are working, you can qualify for this program. This program provides a choice and opportunity to Californians with disabilities who would otherwise be an eligible -- an eligible for no share of cost, full scope Medi-Cal coverage due to earned income and work activity. So here is a brief bit of history. The 1997 balanced budget act created a new optional category -- categorically needy group or employed disabled individuals with income below 250% of the federal poverty level. California then adopted this option. So the working disabled program came about with assembly Bill 155 and was implemented in April 2000. When in 2008, assembly Bill 1183 1180 the sunset date so this program will not end and can run indefinitely. The working disabled program is a county administered program. The state provides technical assistance and oversight. Our organization,provides outreach and education about the working disabled program. Let's learn more about the program. So some unique features of this program include the individuals can earn up to $55,188 gross income per year. Or $73,884 gross income per year for a couple. And so qualifiedfor Medi-Cal . Yes, you can earn up to $55,000 a yearand still keep your Medi-Cal . That really shocks people when I tell them that. Higher gross rages are also possible when a person has impairment related work expenses that I mentioned earlier, things that you pay for out of your pocket. Do you need to work that are related for your disability. And to receivefull scope Medi-Cal , EP and affordable premium it is between $20 and $250 for individual and $30-$375 for a couple. Another unique feature is that all IRS approved retirement products are allowed. Not counted towards a $2000 or $3000 asset limit. These include individual retirement accounts, 401(k)s, and for a three-piece. Also, -- for a 3-D. Also, -- it is not counted as accountable income when determining eligibility and premium amount. I will be showing you an example of the calculation is used to determine accountable income and a little bit. Examples of disability income include Social Security disability insurance, SSDI, state visit -- state disability insurance, Chris, station, childhood disability -- workers compensation, childhood disability benefits. In case you don't know what that is, it is another so security disability benefit that is for adults but they had to have been disabled before age 18 and they also, we qualify based on a parent's record. Their parent has to be retired, deceased or disabled to qualify for Social Security disability benefits on their record. It is an adult benefit, but you qualify it through a parent record. Other types of disability income that are exempt include private disability insurance and veterans benefits. Must talk about eligibility and how you qualify to get enrolled in the program. You must be a United States resident and living in California. You must meet Social Security's definition of disability. The medical definition only. It does not count, the part that considers the ability to earned income. Just remember, you don't have to currently be receiving Social Security disability insurance are another type of Social Security disability benefit to enroll in the working disabled program. This program is for anybody with a disability. So one of the main qualifications is that you are working. Individuals must be employed full-time or part-time and this does include self-employment. With countable earnings below tonight to percent of the federal poverty level. He can be employed by another person, or a business. You can be self-employed, like I said I'd be an independent contractor. And work is undefined. There is no set amount of hours required. So some examples would be walking a neighbors dog, pet sitting, domestic support services, research activities, clerical work, for example, if you have a friend who has to watch his business three times a week while they run errands and pays you, that you can't does work. -- That can count as work. You can be paid as little as $20 a week and still qualify for this program. You will need to show proof of employmentto the Medi-Cal eligibility worker. This would include providing pasteups, or written verification of employment from an employer or business and if you're self-employed, you can show a contract, or your W-2 or if you are an independent contractor, a 1099 IRS form can also be used. So before I talk about eligibility in more detail, are there any questions on what I have gone over so far? Velma asked in regards to the 401(k), how much can they have in their 401(k) or does it matter? Good question, with the working disabled program, it doesn't matter how much they had, there is no cap or limit to how much you can have in a retirement account. Our retirement accounts that are IRS approved are exempt and the amount and then does not factor in. Just generally, all retirement accounts that are IRS approved are exempt and we do not take into consideration how much is. There is no cap or limit our minimum amount you should have in a 401(k). Really good question. Any other question is to mark -- any questions? Okay. Let's talk in more detail about eligibility for this program. There are three eligibility test that are used. The asset test, the unearned income test and the earned income test. The asset test. Assets must be less than $2000 for individual and $2000 for a couple. Assets, like the home you live in and one car, they are not counted for this program. Also, as I said before, all IRS approved retirement accounts are exempt. The second test is the unearned include is true to income test. They're checking to see if you have any undead income and if you do it must be less than the current SSI or SSP amount. The current standard they are using would be $845 for an individual. Or $1407 for a couple. So if you are a individual, if you have unearned income, it has to be less than $845. Remember, all disability income is excluded. So SSDI, CDD benefits, disability pension, state disability insurance, all those are excluded and cannot come into play the unearned income test. If you have any other type of unearned income, a $20 general income exclusion is applied to the unearned income. They're going to subtract $20 from your unearned income and they are going to look and see if it is less than the current SSI SSP amount and if it is, you have passed the unearned income test. Examples of unearned income our unemployment insurance, retirement, if you get a survivors of Social Security benefits or net income from property. Said the third test, is the earned income test. For this test, you are accountable income must be below 250% of the federal poverty level. The countable income limits are equal to 250% , to have thousand $257 a month for the individual and $3036 a month for couples. A calculation is used to determine if your income is below 200% of the federal poverty level. Also, was look at the gross earned income limits. The of the individual you can turn up to $4599 a month or for a couple, you can earn up to $6157 a month. So how do we determine if the countable income is below 250% of the poverty level? Let's take a look. Countable income is calculated using SSI methodology. This was Mrs. Garrity uses to figure out a person's SSI payment. This calculation is used to determine your countable income for both eligibility and premium amount of the working disabled program. Here is the adulation. -- Calculation. They are figuring out the net countable income. They're going to take any unearned income that you haven't subtract $20 from that. Remember, all disability income recruit -- is exempt. They're not going to use at all for this calculation. Unearned income minus $20 is going to be added to any unearned income you have from at $65 has been subtracted from admin is divided by two. -- And then is divided by two. If you don't have any unearned income the $20 income exclusion will be applied to your earned income. If you're somebody with just earned income, the calculation is going to look like earned income minus $20 minus $65 divided by two. Also, any impairment related work expenses that you have can also be used as the actions so any medications or supplements you pay for out-of-pocket, medical equipment, attendant care services, things like that. I've -- I find a lot easier to understand and the countable income calculation with an example. So in this example, we have Mary. Mary just went to work. She is earning $1500 a month in gross and income on her job. Mary has been getting $900 a month in Social Security disability insurance. Because as a disability benefit, that is exempt. For an evacuation. Mary also pays $100 a month in impairment related work expenses herself. She is paying for some medications and supplements. Every month. Here's a calculation steps we are going to use. First, they're going to start with her $1500 in earned income. Then they are going to subtract a $20 general income exclusion. Then a $65 earned income exclusion. Then subtract $100 in impairment related work expenses. So the remainder is $1350 and divide that by two. Mary's countable income is $657.50. So if you remember, $2257 is the 250% of the federal poverty level. At $657, Mary's countable income is definitely less than 250% of the federal poverty level. Her countable income is low enough to qualify. So let's find out what her monthly premium will be. I just paused there for a moment to look at some questions. Velma asked, regarding impairment related work expenses, do they have to be approved by Social Security? How does an individual that is receiving SSI reported ? If a person is on supplemental security income, and they want to make sure the impairment related work excuses are taken into account when a person is working, to figure outthe SSI payment, if they receive one or not, and also as a part of the individual threshold adulation, yes they do have to be approved by Social Security. They will have to provide proof, receive that they pay for it out of their pocket. How do they report it was to mark what I would do when I worked with clients, we talked about what kind of impairment related work expenses they had, I would go to the impairment related work expenses list and figure out what they have that might qualify because like I mentioned in the red but, there is a list of impairment related work expenses. Even if it is not in there, if it would meet those qualifications, that it is related to a disability and you need it to work, you can still submit it to Social Security. They just want to hang onto all the receipts or the invoices that they have. Ellis recommends keeping a binder or a folder to keep track of those -- I recommend keeping a binder or folder to keep track of those. One client kept a spreadsheet to keep track of the expenses, you don't have to go that far. When you go to the Social Security office, you're going to want to provide them with copies of those receipts. And also a letter requesting that you would like those impairment related work expenses considered. I recommend providing and writing even if you talk to the SSI claim representative as well. Antoinette had asked about spousal support. It would be counted under unearned income and I believe that is correct. If you have spousal income, for this program, we are going to take a look at it. They are going to see if the spousal income is greater or less than the SSI , SSP MM but I mentioned earlier. If it is less than the SSI SSP and out then it doesn't count. But if it is over that, if it is high enough it can be deemed. Part of that will count. Ill be taken as per the countable income consideration the calculation. Sherry Rogers asked what if a client collects cans for income? Is it considers self-employment? That is a good example. It is considered employment. I have worked with clients that have collected cans, got written proof of that and use that to show that they are employed, to enroll in the working disabled program. Sorry for getting off track with questions. I'm going to move along and pause a little bit for more questions. We were doing the countable income example. We saw Mary's countable income was six under $57 and cents. -- $657.50. Now we are going to figure out what her premium is. There is a great premium charge. -- Chart. Barry's income is between the range of six under one in $700 so her premium is going to be $25 a month. Now I want to talk a little bit about the medically needy share of cost versus the two empty percent working disabled program. A lot of people are stuck in that accounts medically needy share of cost program. In this program we cannot use Medi-Cal until they meet their monthly share of cost. That means most people never get to use their Medi-Cal in this program. Just this week I heard somebody with a $3000 share of cost. In Mary's example, her total gross income is $2400 a month. With the working disabled program, she has immediate accessto full scope Medi-Cal while paying a small $25 a month premium. If the working disabled program did not exist, she would be stuck in a share of cost program and assuring cost would be $950 a month. Which means she would have to spend another $50 on her healthcare each month before Medi-Cal would even start. That takes a big chunk out of her total income leaves her with less than $1500 to live on. So with Medi-Cal working disabled program she did not have a share of cost. That leaves her more money to spend on what she wants. And she can even save for her future with a retirement account. Remember, you don't have to earn as much as Mary did. You can watch a neighbors dog while they are out. And asked them to pay you $10 a week and get full scope Medi-Cal by paying a $20 premium which is pretty cool. I am going to cause again to take some questions on what I went over so far. Matalin, your question about somebody who has as SDI and Medicare, I am going to, and the next slides I am going to adjust your questions so I'm going to hang onto that until I go or the next few slides and asked if I definitely answered your question. Were there any other questions before you move on? Are disabled widow's benefits countable unearned income? Good question: do. If a person gets disabled widows or widower's benefits, those are not countable unearned income because that is a disability benefit. Good question. It is not countable unearned income because it is against disability benefit. -- Amy asks if somebody can meet disability guidelines and not collect SSI or as SDI? Somebody, if somebody is disabled, and there could be situations where they are not eligible for Social Security disability insurance, what the Social Security disability insurance program you have to have earned enough credits for your own past work history or through the childhood disability benefits through the record of a parent, so you have to have collected enough credits and qualify through that. If somebody has not gotten enough credits or can't qualify for the childhood disability beneficiary or as a disabled widow or widower's beneficiary, then they might not be eligible for Social Security disability insurance, even if they are severely disabled. Also somebody is disabled, many people don't qualify for supplemental security income because of other reasons but disability such as I mentioned Tran-- SSI has a $2000 or $3000 asset limit. They might be over the asset limit. That causes them not to qualify. I hope I answered your question Amy. Any other questions before you move on? Let's talk about the benefits of the working disabled program. One of the big benefits is the ability to work and maintain affordable health care coveragethrough Medi-Cal . Time and time again, doing benefits counseling, the number one concern is losing health care coverage if a person goes to work. The fear of losing are going to work means they are going to lose the disability benefit and lose the Medicare or the Medi-Cal . It is a real here. With this program, it is great because you can continue an affordable type of healthcare coverage and work. That is really exciting. Most people don't know about this program. But this is available to them that they can't continue Medi-Cal and her $55,000 a year. And do it without any kind of shared cost. That is a big selling point to. No large shares of cost for both Medi-Cal or in-home supportive services. If you are in the working disabled program you can have in-home supportive services as well and that would eliminate the share of cost for both of those programs by enrolling in this program. Let me tell you about a gentleman and this goes along with the collecting cans question. A gentleman who came to the career center where I work.He was flabbergasted because he had applied for Medi-Cal and he had received his notice and found that he had been put in the medically needy share of cost program. And he had a share of cost that was over $100. -- $800. He was upset at not sure what to do. We worked together with their disability program navigator at the center talk to him about the working disabled program. He wasn't sure he could work. Our navigator asked him what he did every day. What did his day look like. Was there anything that he gets paid for our could be paid for. He mentioned that he collects cans every day and takes them to the recycle. Our navigator called up our local Medi-Cal advocate at our legal aid program. Together they worked with him to get proof of the income he gets from the recycling center. Which was a letter that the person at the recycling center signed to show how much money he was getting from turning into cans every week. -- Turning into cans every week. With this letter a with the advocacy of our legal aid advocate, we went to the Medi-Cal office and he was enrolled in the working disabled program. He was so excited because he went from $800 share of cost to a $20 premium. And full scope Medi-Cal. So I've been exposed to it, this program has a very liberal definition of employment. Take some time, on the surface of it looks like somebody is not working, find that there is something we are doing day to day that they can get paid for, if they are collecting cans at things like that, to help them qualify for this program to get off the share of cost. Also, once again, disability related income to workers compensation is exempt in determining eligibility and premium. When we just don't know, just because the earning income may impact cash benefits. It is really great, somebody comes to you and is getting multiple benefits, giving Social Security disability insurance, getting workers compensation, Medicare, Medi-Cal , you want to make sure that you are familiar with the rules and the work incentives that go along with those programs. Have the amount of money you are going to be earning is going to affect those benefits, if it will or not, the definitely encourage people to work with benefits counselor. If you are somebody who receives Social Security disability insurance are supplemental security income, you can get free benefits counseling to the work incentives incentive programs of Social Security funds I have a link later on to find a work incentives planning and assistance Project in your area. Also I recommend, if you're going to work, go to disability benefits one-to-one website for more information about how work affects different disability benefits. They also have great disability, benefits to work calculators were you can put information about all kinds of different benefits, Social Security benefits, Medi-Cal , section 8 housing, and find out how work is going to but -- affect all of those benefits in the short and long-term. Also, check out our archived webinar on the SSI incentives on our calendars no limit website as well. Affirmation is power. So you have a rude awakening -- information is power. Other benefits, as we mentioned before, you can build retirement accounts. Build for the future. I can't get that message across enough that this program can allow personal -- persons with disabilities to build for a future by having a retirement account. Also, as I mentioned, you can maintain in-home supportive services at home and in the workplace. Something a lot of people don't know, you can actually transfer some of those in-home supportive services hours into the workplace. So if you need some help with the lunch hour, you can use some of those hours and have a personal assistant, help you at work. Also, if you are someone who is enrolled in the working disabled program, there is a program called the health insurance premium payment program. The H. a PP program. If you have Medi-Cal, the state may pay for the premium of other health coverage under certain conditions. This program does have a lot of conditions about, that you have to have a high cost medical condition, such as cancer or HIV AIDS or paralysis. If you do have that, this might be a program where the state to help pay for the premium of other healthcare coverage and that can be cobra, employer-sponsored health insurance or other private insurance. Disability benefits one-to-one website, is a great place to find more information about the HIPP program. Now, let's talk about if you are on Medicare. A lot of people are duly eligible. They're receiving both Medicareand Medi-Cal met -- benefits. If you are somebody who is dually eligible, the working disabled program has a lot of benefits for you. One of the benefits is, you automatically qualify for Medicare part D. low income subsidy. So Medicare part D., that is your Medicare prescription plan. The low income subsidy that provides you with lower-cost premium for benchmark plans and then also your cape -- or co-pays or less, between $1.10 and six dollars right now. That helps you out with your cost of your prescriptions. Also a second way of the working disabled program helps people on Medicare is if you are enrolled in a working disabled program, Medi-Cal will pay for your Medicare part B. premium. It is $96 back into your pocket right there. I worked with a lady that received Social Security disability insurance and she came to me for benefits counseling and we had our first appointment together and she was awesome. She brought in everything I need it, all of the letters with a different benefits you got, the letters from SSD I, her Medi-Cal letter the show she was enrolled in the working disabled program. The first thing she wanted to talk about. She said I am in the working disabled program, and she works part-time as a home health care worker. She sat on her own but is worth it to stay in the program because I have to pay $20 a month premium and I have to mail it in. I was thinking of letting it go. What do you think? I was like let me tell you what I think. Definitely keep the program. I laid it down about how the state is going to pay for her Medicare part B. premium. Just one of the great benefits in the low income subsidy and say what you rather pay? $96 a month or $20 a month? And she was like oh, okay. I think I will keep it. A lot of bang -- a lot of times people are thinking, extra premiums, we do want to deal with that but there are a lot of benefits for somebody who has Medicare and Medi-Cal . Also, you are eligible for Medi-Cal co-pay and premium payment programs for qualified Medicare beneficiaries. Also, important you can access in-home support services, because if you have Medicare those personal assisted services are not covered by Medicare. You can continue to have that covered with the working disabled program. Madeleine had asked a question aboutMedicare and Medi-Cal . Did this section answer your question that you had? If anybody else has any questions so far, I'm going to pause right after some more questions. Matalin, you are mentioning there are several other ways to pay for part D. premiums. You are correct. There are different Medicare savings programs. As you mentioned, qualified Medicare beneficiary programs that help a poor that only part B. but part D. premiums. There is also a specified low income Medicare beneficiary program that helps people pay for the part B. premium and also, the qualified individual or Q. I program that helps pay for part D. In addition to if you were involved in the disabled program the state will pay for the part B. premium also if you are in the aged disabled federal poverty program and you also have Medicare the state will pay for the part B. premium and for people who have share of cost and your share of cost is below $500, the state will still pay for the part B. premium but it is about the 500 they recently stopped paying for the part B. premium. Tonia is asking where we get the working, application. I'm going to cover that next. Great question. Let's move on to that. One other thing I wanted to mention before I talk about enrollment, if you do have more questions about the Medicare savings programs that I mentioned, great source of information for that is the high cap website, high cap offers free counseling to people have Medicare and that website is see a health advocates.org. Let me type that in -- ca health advocates.org. Let me check that it really quick. I just type that website in. It has really great information and I am also going to give you the phone number as well. I'm going to type that in really quick. So there is a phone number and that provides free Medicare counseling and I really found it helpful to , as a benefits plan are to be in touch and make connections with the counselors. They really did help me out when I had tough questions. It is hard to understand the different Medicare savings programs. So there are a great resource for yourself and your clients and my clients were thrilled that their services were free. Okay. I'm going to talk about enrollment now. To enroll in the Medi-Cal disabled program you must be receiving disabled that does is to qualify for this program. If you are already receiving Medi-Cal , what you can do next is contact your Medi-Cal eligibility worker and asked them to enroll you. And if you don't know who your eligibility worker is, you contact your local Medi-Cal County office and we can provide you with the name of your worker is or, I know some offices , anybody that you talked to on the phone should be able to help you as well. Sometimes you're a signed it particular eligibility worker in some offices but in some offices that is not the case and is supposed to be in the eligibility worker can help you. The county offices , just to know they are very different how they do things. They could be different how they do things. Stay heads-up about that. -- Just a heads up about that.If you're not currently receiving Medi-Cal , don't want to stop you. You're going to need to apply for Medi-Cal at your local Medi-Cal County office. Once you have been approved by Medi-Cal , you can apply for the working disabled program. And Madeleine had asked, can a person who has received only Medicare apply for the 260% program or is it the criteria they must be first receivingany time of Medi-Cal ? Bottom line, in the person you're working with right now only has Medicare, have been givenan apply -- have been given an apply for Medi-Cal and see if they get approved an apply for the working disabled program. Tonya had asked about the applicationfor working disabled program are for Medi-Cal . My understanding is it is not a separate application for the working disabled program,when you apply for Medi-Cal , you can get the general Medi-Cal application, at your County office, you can find your application online in a lot of places, in San Diego County, or Health and Human Services have the application online. You can mail your application in or take it to the office in person. Also, your local office can help you complete your application. When you complete your application, your general Medi-Cal application, it should be submitted , if you get a Social Security disability benefit, include your latest award letter that confirms your medical disability determination is still active. Also provide two of your most recent payroll checks or steps or a letter from an employer. Also provide copies of two most recent bank statements. As I said, it is not a separate application for the working disabled program, but some strategies that help, if you are applying for the first time,to Medi-Cal , right 250% working disabled program across the topof the Medi-Cal application . Other things to help,, the CHIIP , we have the free working disabled program brochure that helps. You can take that and attach it to the general Medi-Cal application . When you apply. Or, if you're somebody who is alreadyon Medi-Cal and you want to get into the working disabled program, you can use the brochure to talk to your eligibility worker. Back to China's question, she asked if there was a separate application or form for the working disabled program. If you're somebody who is alreadyenrolled in Medi-Cal anyone to change to the working disabled program, I recommend writingg, in any benefit program, writing a letter to request is always a good idea. Attach the CHIIP working disabled for sure to it. And provide that to your eligibility worker when you request the program. So our brochures are free and later on in the PowerPoint I do have information on how to request our brochures. If you have difficulty when you are trying to enroll the eligibility worker, the next thing to do is speak to a supervisorat the Medi-Cal office . If that doesn't work the next step is to contact 250% County coordinators. There is a link later on to any presentation. Our CHIIP website has a list of these 250% County coordinators. The County coordinators, act as policy liaison. They address complaints from individuals our representatives that are having issues, such as lack of knowledge of the working disabled program, at the local office. Or indirect eligibility determination. Any kind of problems trying to get on the working disabled program, if you are not having luck with your eligibility worker or supervisor, contact your county coordinator. Another option, is of course to contact a local advocacy agency that can help you. This could be somebody from your local legal aid or disability rights California as our state's protection and advocacy agency. I will have links later on in the PowerPoint to both of those agencies as well. To enroll in the program,if you are already on Medi-Cal , you need to talk to and eligibility worker you can just give them a letter, add the CHIIP disable brochure to that . There is information at the end of the PowerPoint or you can request brochures from us. I will get to that in a little bit.If you are not on Medi-Cal at all, you'll need to complete the application, the general Medi-Cal application, write working disabled program across the top. Also you can use our brochure. There are resources like the County coordinators or logo -- local advocacy agencies. They can help you as well. If you have, come against any barriers. Before, I'll going to hold off on questions. I'm going to go into, since we had just a little bit of time on, I am going to go into our final area. Future changes to the program. Assembly Bill 1269was signed into law by Governor. Schwarzenegger on October 11 of this year.. This means new rules for the working disabled program will go into effect sometime next year. We are not sure of the exact time yet but we are going to keep you posted. You can check back with CHIIP whenever you like for an update. This is how 1269 is going to be improving the working disabled program. First thing, which is really exciting. It is going to eliminate the asset limit what money is placed in a separate account. Once you get enrolled in this program, and the working disabled program, the changes brought about by 1269 will make it that you will no longer have an asset limit. As long as your money is saved in a separate account. We do know the details yet about what the separate account is going to look like but as soon as we know, we will give you more information. Another improvement, the working disabled program today, we don't have an age limit. There is a limit that says if you are 65, you can be in the program. -- You can't be in the program. There is a big barrier to reach the retirement age, they are getting retirement. As it stands right now, retirement income is not exempt. Like the merry example, she was getting $900 a month in SSD I. Let's say she converted to retirement. Her $900 a Social Security disability insurance now becomes retirement income. Take that $900 minus $20 income exclusion, so her countable unearned income is $880 if she converts to retirement, which is greater than the current SSI SSP amount of $845 per --. People have converted from SSD I to retirement have not been able to be in the working disabled program. The 1269 is going to change that. For individuals previously on Social Security disability insurance, a regional retirement age, their Social Security retirement income will now be examined for eligibility, but not premiums. -- Will be exempt for eligibility but not premiums. This is going to help people who are on SSD I, regional retirement, convert retirement and income is going to be exempt. When 1269 goes into effect. This is going to eliminate the age of 65 restriction for many people. Some other changes, each individual will pay a monthly premium is equal to 5% of his or her individual or spousal countable income. The premium will keep the same minimum and maximum range that we already have. $2250 for individuals and $30 to create or $75 for couples. $20-$250 for individuals. The premium is going to be catalytic, it is going to be 5% of a person's countable income. Disability income will continue to be exempt for eligibility but not for premiums. Anymore with 1269. So that is going to mean that some people are going to see a little increase in the premiums. The same three eligibility tests are going to apply that I went over earlier. To enroll the program, to get on, you're going to have to show that you passed the acid test, the Internet and contest, and the income test. -- The asset test, the unearned income test and income test. Once you are on, there is no limit, so that is great. Any questions with the changes of 1269? Steve asked if individuals might have a bank account and is unable to establish an account at a poor credit history, what would you suggest in the enrollment of the working disabled program? That is a good question. I have to think about this one. An answer that comes to mind is, finding a organization that will work with you, like in San Diego we have a faith-based credit union that was very liberal and easy and understanding of people have had problems in the past. Looking for alternative banking places. To help establish the bank account. I am going to have to think about that? To get back to you. That is a good question. Any other questions about the changes with 1269? Darlene asked if there are any disability related expenses that can be added to the individual earnings limit for the 250% program. When they are calculating eligibility, when they are doing the countable income calculation, what they're looking to see if her countable are and income is less than 250% of the federal poverty level, you can use impairment related work expenses asked his actions at that point. Our blind work expenses. Any kind of expenses that you are paying for yourself, that are related to your disability can be used at the point that can be detected from your accountable earnings. To help you get on the program. Ultimately the part of the calculation for countable income. I am hoping I answered your question their darling. It is good to see you tiny. -- Tonya. The next webinar is going to be in February -- Tonya. The next webinar is going to be in February 2010. We have five minutes left. I'm good -- I'm going to go to these resources really quick. Disability benefits one-to-one, which I mentioned. I just want to point out, can people see the webpage I just brought up for disability benefits one-to-one? -- 101 -- 101? They have more informationon Medi-Cal coverage . Frequently asked questions, a lot of details about all of these and more, Medi-Cal programs I mentioned today. Doesn't have calculators. They have one -- they have calculators, we have one for the working disabled program that will show your possible eligibility. And your premium as well. Also be benefits to work a calculator that I mentioned. It takes all benefits into consideration to show how work will affect them. Image of the county coordinators, if you're having any difficulty with enrollment. Our CHIIP website, tran5.work has a list of the county coordinators do you can see here. For example, I will scroll down. If you are in San Diego like myself, Katherine is the county coordinator that a person on Medi-Cal ca n contact, that advocate can contact, problems with enrollment, contact your county coordinator. Also, if you need benefits planning counseling, and I mentioned that youreceived SSI are SSD I come there is a work of planning and assistance programs that are located up and down the state that provide free benefits counseling. Here is a Social Security website that has a list of all the California work incentives were -- planning and assistance projects. If you click on them we will show you the different counting is that they serve. And to -- different counties that they serve it to the contact person is. One more slide with resources. The consumer, health consumer alliance. Advocates for your local legal aid services at this website. This website also has really great pressures for consumers and advocates. They have some really great issues priest. -- Briefson the working disabled program another Medi-Cal programs . This is a great resource for information as well as finding an advocate in your area that can help you get on the working disabled program. Also, another resource for advocacy, disability rights California. They have a program that helps beneficiaries of theof SSI an d SSD I., they assisted you're having problems with in-home supportive servicesas well as Medi-Cal programs as well. Their website has contacts for your local area office or you can find advocates. The toll-free number that is right here, on the first page, you can call it and they will connect you with a local office in your area. If you need advocacyand you are having problems with Medi-Cal or Social Security or in-home supportive services. The Social Security Redbook is the guy to work incentives. That is where you can get more information on the work expenses, plan to achieve some support, 6019 B. -- Tran7. Last, we are almost done. Thank you so much. Thank you Steve. Sorry. This is unfortunate. Our talents knows no limits website is not available. This is great. Steve, thank you for including your contact information. Steve Stover is the work incentives for Nader for the county through Project Independence. He is correct. His contact information is not listed on the up-to-date list. So if you're in San Diego and 80 benefits planner, be sure to get Steve's information. Our talent knows no limits website, that is where all of these webinars are archived. If you want to find the webinars, good to job seekers or service providers. We keep having problems with the website. If you go to job seekers are service providers, there are links in the middle and on the sides of the page to get to our archives webinars. Since we have granted time, the working disabled program is for anyone with a disability. You have to be on Social Security benefits, you can earn up to $55,000 a year to keep. Tran4 by paying a monthly premium. I highly urge people with Medi-Cal and SSI to not be afraid of work. You can have more money and keep your benefits. If you are in share of cost, take some part-time work and a roll of the working disabled program to get rid of the share of cost. Don't forget, you can save for the future with a retirement account. Even more so with the changes of 1269 going into effect. I have this presentation helped open your eyes to the many options for people on Medi-Cal to work and continuee with their health insurance. Being on disability does not mean you cannot work. Please don't let that stop you. Talk to a benefits planner about your options. Once a person goes on benefits, we should not have to resign themselves to life of poverty. The working disabled program can be a powerful tool to help a person with a disability change their life and their future. Thank you so much for taking the time out of your busy day to join us on this webinar. If you have any questions, my contact information appears here. A phone number, my e-mail. Please don't hesitate to contact me. If you want to order our free brochures, you can contact Nicholas more. We have his phone number and e-mail here as well. We will be announcing future webinars. We have any knowledge to make announcements on an old be on our talent knows no limits website and are -- and on our Facebook page. We are on Facebook. I will be sending out a survey to you via e-mail to follow. I have sent out the PowerPoint that I will attach it again. Thank you people who have been sharing their e-mails with me. If you don't think I have your e-mail, please feel free. If you're okay with it but in the chat right now. I will get all those e-mails. If for some reason you don't do the survey, and you don't get the follow-up information I am going to send, please don't hesitate to e-mail or call me. And our webinar will be available on our website in the next two weeks. We will also include all of your questions that you had in answers and there a few it wanted to do it research on I will get the information out to you. Once again, you are an awesome group. Awesome group. Awesome questions. Thank you so much and have the best holidays to all of you. I will stay a little longer if anybody has any questions. Thank you so much for joining us today on the webinar. [Event concluded]