Work Incentives Planning and Assistance National Training and

Work Incentives Planning and Assistance National Training and Data Center Tips & Tools for Developing Individualized BS&As

Training Objectives Upon completion of this training, participants will: • Describe what a BS&A report is and why it’s necessary. • Identify and describe the core components of a BS&A. • Identify for whom a BS&A should be developed. • Describe strategies for developing an individualized BS&A. • Describe how to effectively organize information within the BS&A. • Describe how to review BS&As with beneficiaries and other concerned parties. 2

What is Benefits Analysis? • A PROCESS of examining the unique benefits status of an individual as it relates to a specific employment and earnings goal. • Includes examination of ALL public benefits, not just Social Security benefits. • Requires verification of benefits status from authoritative sources. • Includes specific advice and recommendations for future action. 3

What is a Written Benefits Summary and Analysis or BS&A? • Comprehensive report summarizing information gained during the benefits analysis process. • A BS&A provides a clear and concise explanation of: – the individual’s current benefits status – impact of employment/earnings goal on all public benefits – use of work incentives to date with specific recommendations about using work incentives in the future – potential problem areas with possible solutions 4

What is the Purpose of the BS&A? • Provides a clear and accurate “snap-shot” of the person’s benefits at a point in time. • Documents your discussions with the beneficiary about how achieving a specific employment and earnings goal will affect benefits. • Describes applicable work incentives and how they may be applied to ease the transition from benefits to greater financial independence through employment. • Provides basis of common understanding the impact of employment on benefits for beneficiary, parents, VR, and other involved parties. 5

Important Point • Don’t confuse the BS&A report with the act of providing work incentives counseling. • The BS&A documents the counseling you provide over a series of contacts with the beneficiary. • The BS&A doesn’t replace the counseling you provide – it simply summarizes it in writing. 6

Who receives a BS&A? • It’s impossible (and not necessary) to develop a BS&A for every eligible beneficiary who contacts you. • Beneficiaries who would benefit from BS&A development are primarily individuals who: – Have a clear employment and earnings goal, and – Need individualized benefits counseling that is specifically customized to the employment & earnings goal. 7

Priority Groups as a Guideline for BS&A Development Beneficiaries who meet the criteria for Priority Groups 1 and 2 are good candidates for BS&A development. By definition, members of these priority groups would all – Have a clear employment and earnings goal, and – Need individualized benefits counseling that is specifically customized to the employment and earnings goal. 8

More about Priority Groups and BS&As Would all members of Priority Group 1 and 2 be required to have BS&As? • This isn’t specifically required by Social Security. • Current benchmarks require the development of BS&As for 60% of WIPA service enrollees. • High priority beneficiaries make the best candidates for BS&A development, but it’s possible that not all would need a BS&A, at least initially. 9

I&R Services and BS&A Development • Beneficiaries who only require I&R services would typically not be good candidates for BS&A development. • Remember, beneficiaries who only receive I&R services are not pursuing employment in any way and may not have made the decision to work. • By definition, a beneficiary who meets the criteria for I&R services only would not meet the criteria for BS&A development. 10

Does this person need a BS&A? • Robin receives $415/month of SSDI, $352 in SSI, and has Medicaid, Medicare, the part D Low Income Subsidy and QMB. • She just applied for a job that would pay her $8/hour for 20 hours a week, but she is unsure whether she can handle working. She hasn’t worked since being on benefits. • Her husband also receives SSI, and wants her to work so they have more household income. He isn’t interested in working at all. 11

Does this person need a BS&A? • Jason receives $733/month of SSI, has Medicaid due to receiving SSI, and gets $152/month of SNAP. • He has just applied for services with Vocational Rehabilitation and is scheduled for a vocational evaluation prior to development of his IPE. He is not sure what type of work he wants to do or what he is able to do. His VR counselor suggested he get a BS&A so that he’ll know how much he can earn without risking his benefits. 12

Does this person need a BS&A? • Melissa is 22 years old and receives $950/month of CDB. She is enrolled in Medicare with assistance from the low income subsidy and a Medicare Savings Program. She is 22 years old. • She has an open case with VR and is going to college studying to become a physical therapist. Melissa will graduate in three years. • Melissa hasn’t worked since becoming entitled to benefits and doesn’t feel that she can manage working while in school. She wants information about how working as a physical therapist will affect her benefits. 13

Steps in the BS&A Development Process Gather information and identify the presenting problems, needs or questions Verify all benefits Analyze benefits in relation to the employment/earnings goal Outline the BS&A using the BS&A planning sheet Write the BS&A Report 14

Getting Started - BS&A Planning Begin by organizing the information to be presented in the BS&A by utilizing the following tools: • Information gathering tool and benefits verification documents. • BPQY and additional information from Social Security as needed. • Sort the information into the appropriate sections using the BS&A Planning Sheet. 15

What must be included in a BS&A? 1. 2. 3. 4. 5. 6. Listing of verified benefits; Description of current employment situation and/or future employment/earnings goal; Analysis of how the identified employment/earnings goal will impact the beneficiary’s benefits - including specific work incentives the beneficiary can use; Identification of benefit issues not related to employment (if applicable); Recommendations for employment services and supports the beneficiary could access to meet needs; and Identification of issues that require immediate attention. 16

Listing of Verified Benefits • List all benefits that could be affected by employment. • Don’t list things that are NOT benefits (like VR involvement) or are not relevant to working. • Be concise – just the facts! • Be accurate – watch the terminology you use! • Don’t forget all the Medicare information including QMB/SLMB & Part D low-income subsidy. 17

Example 1 – List of Current Benefits Sam reports that he receives $816/month in SSDI, has Medicare with assistance in paying premiums, and receives $23 in SNAP. He has not worked since receiving benefits. Upon verifying this information, the CWIC lists the following in the Summary of Current Benefits section of the BS&A: • • You receive $816 monthly in Title II benefits You are enrolled in Medicare You receive SNAP No earnings are posted since entitlement 18

Example 1 Revised • You receive $816 each month in Social Security Disability Insurance (SSDI) cash benefits. • You are enrolled in Medicare Parts A, B & D. • You receive assistance with your Part B premium and other out-of-pocket expenses as a Qualified Medicare Beneficiary (QMB), a special limited form of Medicaid. • You receive 100% low income subsidy (LIS) to cover your Medicare Part D premium and out-of-pocket expenses. • You receive $23 in SNAP benefits each month. 19

Example 2 – List of Current Benefits Rachel reports that she receives $524/month in SSI. She also has Medicaid. She isn’t currently working but she did work in the past and got overpaid because she didn’t report her wages to SSA. Rachel lives with her parents and pays a little bit toward the cost of food and shelter. Upon verifying this information, the CWIC lists the following in the Summary of Current Benefits section of the BS&A: • You receive $524 each month in Supplemental Security Income (SSI). • You receive Medicaid due to being eligible for SSI. • You reported that no other benefits are received. 20

Example 2 Revised • You receive $524 each month of Supplemental Security Income (SSI). • Your SSI check is being reduced because SSA is withholding $73 each month to recover a previous overpayment. • Your SSI check is also being reduced by $136 each month because your parents are helping you pay your food and shelter costs. Social Security calls this in-kind support and maintenance or ISM. • You receive Medicaid due to being eligible for SSI. 21

Current Employment or Future Employment Plans • Be specific! Identify type of job, number of hours per week and estimated wage. Provide a monthly earnings estimate. • If the person is currently working, document start date, job title, wages, hours and average monthly earnings. • If past work is relevant, describe it here. • No need to include non-employment goals or information. • Don’t discuss employment services and supports in detail in this section. • Don’t get into usage of work incentives here. Stay focused on what this section is asking for and ONLY include that information! 22

What’s wrong with these examples? • Jane, you told me that you were interested in parttime employment in the retail sales field. • Brian, you recently began employment as an elementary school librarian earning an annual salary of $27, 000. • Patricia, you are currently working part-time at Walmart, but you are going to school to become a radiology technician. You hope to earn enough in the future to fully replace your benefits. 23

Analysis of How Employment May Affect Benefits • This portion of the BS&A links the Listing of Verified Benefits section with the Beneficiary’s Current Employment / Future Employment Plans section, by providing an individualized analysis for the beneficiary given his/her specific circumstances. • In developing this section, CWICs need to resolve three basic questions: – What information should be included in this section? – Is it okay to use standard descriptions of work incentives? – How should this information be organized? 24

What Information needs to go in this section? 1. How the beneficiary’s specific employment plans may affect the existing Social Security cash benefits: • Title II and SSI information should be kept separate - don’t bounce back and forth between the two. • Begin with Title II and address applicable work incentives before moving on to SSI. • Focus on presenting timely work incentives information applicable to the person based on their circumstances and employment plans. • If the beneficiary has already used up a work incentive (TWP), don’t provide lengthy explanation of it. 25

What information needs to go in this section? 2. How the beneficiary’s specific employment plans may affect health insurance: Medicare and Medicaid information should be kept separate. • Provide information about EPMC. • Clearly explain how the employment goals may affect Medicare Savings Programs and Low Income Subsidy, if appropriate. • Provide all eligibility criteria for 1619(b), if applicable. • Identify other potential health insurance options, including Medicaid buy-in and employer sponsored coverage. 26

What information needs to go in this section? 3. How the beneficiary’s specific employment plans may affect other federal or state benefits: • Not every beneficiary will have other benefits. If applicable, address potential eligibility and provide referral info, or indicate no other benefits are being received at this time. Don’t delete this section of the analysis! • Benefits such as SNAP, HUD rental subsidies, Unemployment Compensation, Veteran’s Benefits and Workers’ Compensation should be addressed here, if applicable for the beneficiary. Be as specific as possible! 27

Is it okay to use standard descriptions of work incentives? • Standard work incentive descriptions are designed to save you time - no need to “re-invent the wheel” every time a work incentive is referenced in the BS&A. • It’s fine to use these descriptions as long as that is not ALL you provide! Information provided in the BS&A must be individualized for the beneficiary’s specific situation. • Provide a general description of the work incentive or provision, then explain how the beneficiary’s earnings goal relates to that work incentive. Be specific! 28

How should I organize the information in this section? • There is no specific writing style/format that must be used for a BS&A. There is no right or wrong method – whatever you choose must fit the person and their circumstances! – Chart formats – Bulleted points – Narrative – Question and Answer – Combination of formats 29

Benefits Issues Not Related to Employment • Lots of things besides employment can affect benefits – especially SSI. Provide specific information in this section about things to be aware of now or in the near future. • If you see problems with the benefits this is where you address them – offer SOLUTIONS! • Answer any questions the beneficiary asked about benefits unrelated to employment – provide information! • Don’t forget about family members – anything that needs to be discussed related to them? 30

Examples of Issues Not Related to Employment • • • Changes in living arrangements - ISM may apply Excess resources Changes in spouse or parent income Future entitlement to other benefits Change in marital status Overpayments Changes with Representative Payee Changes in child support or alimony payments Student loans and/or scholarships 31

Employment Services and Supports • Verify what services the person is already getting – VR involvement, supported employment, etc. List those services here. • Ask beneficiaries about unmet needs and perceived barriers to employment. Don’t assume all needs are met if the beneficiary is already working with an agency – ask! • Provide specific information about services agencies provide that might meet needs and offer referrals. 32

Employment Services and Supports • When making referrals, think about what makes sense for the individual. • Include PASS and Ticket to Work in this section if applicable to the person. Remember – these provisions don’t fit everyone. Don’t discuss them if they aren’t applicable. • Be sure to check on need for peripheral services like transportation, childcare, help with housing, etc. Not every barrier to employment is disability related. 33

Issues Requiring Immediate Attention This is where you discuss anything that is time sensitive – urgent issues that need to be dealt with right away. That may include: – Important dates or deadlines – Things the beneficiary needs to report to Social Security or other agencies Be sure to provide clear and specific instructions (don’t forget to carry these over to the WIP!) 34

Special Situations CWICs Encounter • Family members who also get benefits that could be affected by the beneficiary’s employment. • Beneficiary has an earnings goal that will result in less disposable income or loss of irreplaceable health insurance (duty to warn) • Beneficiary is facing immediate termination of benefits. 35

Maintaining a Positive & Encouraging Tone • Choose the words you use to describe the impact of work on benefits very carefully. • Reiterate to the 4 points of the WIPA message. • Always follow potentially negative news with positive news. • Help beneficiaries with very low employment and earnings goals see the possibilities. • Always help the beneficiary see the bigger picture of increased financial independence. 36

Tips for Writing a High Quality BS&A • Write the BS&A for a specific individual. Always write to answer the beneficiary’s question – how does this apply to me? • Organize the BS&A logically. Think carefully about the order in which you present information. • Keep the narrative as short as possible while still covering all relevant points • Break up the text with bullet points or short paragraphs whenever possible. 37

More Tips • Use clear and concise language – avoid jargon and acronyms. Keep sentences short and avoid complex vocabulary. • Watch out for redundancy in your writing. • Focus on what the person needs to know NOW in order to move to the next step along the employment continuum. • Answer any questions the beneficiary poses. • Watch out for the “Too Much Information” (TMI) Syndrome! 38

“Just in Time” Benefits Counseling • Based on the idea that when people are provided information at the time they most need it, they are more likely to retain it and use it. • When information is provided too early, the beneficiary may not be ready to hear it and it may be ignored. • When information is provided too late, it’s not relevant. • Providing the right amount of information at the right time helps the beneficiary move forward along the employment continuum. • “Just in time” counseling is different for each person, depending on their individual circumstances. 39

What NOT to Include in BS&As • Anything you don’t want in the official record. • Information about work incentives that would NOT apply to the individual. • Any info based on assumptions or conjecture. • Medical or disability related information unless it is relevant to the benefits. • Personally identifying information (PII) like birthdate, SSN, etc. 40

What happens after the BS&A is developed? Services don’t end with the drafting of a BS&A. Instead, this is a starting point to define services moving forward, and you should begin with the following steps: 1. Identify who needs to be involved in the BS&A presentation. 2. Schedule a meeting date & time. 3. Review the BS&A with the beneficiary and others, if appropriate. 41

Reviewing the BS&A • Consult with the beneficiary to determine who should be invited to participate in the review of the BS&A. • The beneficiary may have a “team” of people providing services and supports including: – – • Case managers Supported employment professionals Employment specialists VR counselors Send the BS&A to the beneficiary (and all other involved parties) in advance and include any additional documents that will be reviewed, such as SSI calculation sheets and TWP/EPE calendar. 42

Reviewing the BS&A • Present all available options and discuss pros/cons of each: – You shouldn’t exclude an option simply because you think the beneficiary wouldn’t choose it for themselves. – It’s the beneficiary’s decision as to what option he/she will pursue - you can provide suggestions and recommendations, but the decision rests with the beneficiary. • Speak directly to the beneficiary. • Be sensitive to the beneficiary’s level of comprehension. • Go over additional documents supporting the BS&A. 43

Reviewing the BS&A • Be patient! • Be aware that people have different learning styles. You may have to explain a concept in several different ways before it is understood. • Avoid simply reading the BS&A to the beneficiary focus on the main concepts and key points. • Encourage questions throughout the presentation. 44

Updating Benefits Summaries • BS&A reports have a very limited shelf life. • BS&A reports should include an explanation of when updates will be needed. • Updates are necessary whenever critical changes occur – this will vary for DI/SSI beneficiaries. • Use either a separate benefits update format or rewrite the entire BS&A. 45

Final Words • Writing effective BS&As is HARD! It takes time and experience to master this skill. • The value in a BS&A is the individualized analysis and advice you provide. • Accuracy and completeness are critical. • Every BS&A is a demonstration of your professional competence. Make each report reflect your best work! 46