By Donald M. Fitch, MS
Center for Career Freedom
Jennifer, an MSW Discharge Planner at a large psychiatric hospital logged onto the Social Security Administration’s (SSA) website, www.ssa.gov to download form #3368, SSA’s primary application form for SSI and SSDI. To her surprise the response to her search was “your search did not match any documents.” She knew that wasn’t right and tried a number of different searches, to no avail. She wasted thirty minutes, couldn’t find the form and the patient, his family and her supervisor were waiting.
Sharon’s client Steve had received SSA’s Ticket to Work, a program that encourages people who receive disability benefits back into the workforce. He had heard if he enrolled it would prevent a medical disability review for five years. Sharon called SSA’s Helpline 1-800-772- 1213 for verification. After a ten minute wait Sharon spoke to the operator who told her “the Ticket to Work does not prevent a medical disability review.” Confused, Sharon called Maximus, the Ticket administrators, who told her that “the Helpline operator was incorrect and to go ahead and apply.” Who was Sharon to believe; SSA or Maximus? What should she advise her client to do?
Harvey’s boss wanted to give him a $1,000 Christmas bonus, but Harvey was on SSDI and was already earning near the $830/mo. limit. He was worried that if he accepted the bonus he’d trigger a review and lose his SSDI. Kelly, his caseworker, checked SSA’s Redbook but found no mention of a bonus. She then checked SSA’s website and again found nothing. What should she advise Harvey to do; accept or turn down the $1,000?
Mary, a caseworker with five years experience at a large community agency was frustrated and confused: she had referred three needy SSI recipients for food stamps and each had been awarded a different amount; $10/mo., $54./mo. and $149/mo. All were single adults living alone and receiving SSI of $666/mo., Medicaid, and did not work. How could she help her hungry clients? The local government units’ caseworker wasn’t available to explain.
Peter’s counselor, Carolyn, had read that Peter was a “dual eligible,” he would have to choose from dozens of Medicare Prescription Drug Plans, then, screen thousands of drugs to see which were covered, call his doctor for substitute scripts, and visit his pharmacy to see if they participated in the plan. The counselor understood there could be penalties for not enrolling by January 1st and Peter may not be allowed to change plans. Carolyn, Peter and his parents spent weeks sifting thru websites, booklets, articles, and attending seminars. There were countless phone calls and emails and the more they learned, the more confused and frustrated they became.
These five case histories actually happened in 2005. They are just a small indication of the countless frustrating incidents that happen to providers and consumers every day, all across the country.
Legislated changes in Government Social Service Programs in 2005 included eligibility, procedure, privatization and consolidation. The rules are likely to become more complex in 2006. Timely, accurate and easy to understand information for providers has become critical if they are to help persons in need acquire basic services.
At the Center for Career Freedom, we believe the ideal solution is a provider guide to government programs. A Toolkit, which would enable case managers to negotiate the complexity of federal, state, and local benefits and back to work programs. A Toolkit that would promote client stabilization in the community and when ready, return to self-sufficiency.
We began our search for a comprehensive resource of federal, state and local benefits and back to work services with an internet search, a provider survey of case managers, government agency personnel, academics, consumers and their families, and a literature survey of the leading vocational research authorities; Bond, Becker, Anthony, Drake and Mowbrey.
While we found a number of sites which contained benefit forms or links to forms, a simple summary of the essential programs for the majority of clients, which contained precise eligibility criteria, benefit amounts, earnings caps, exceptionsand allowances from the consumer’s perspective and in plain English, were not found.
Thru the internet search and surveys we learned the following:
- The overwhelming majority of consumers, their families, professionals, educators and government officials simply do not know enough about the majority of critical services available to optimize timely treatment. Our surveys of over one-hundred case managers’ knowledge of basic benefits (their Benefits IQ) among community, federal, state and local government agencies averaged a grade of only 26 percent !
- Government agencies have different program eligibility criteria, earned income penalties and language which makes it very difficult to comprehend, compare and evaluate.
In response to this universal need for an easy to use quick reference source of accurate, up to date information of the essential benefits, forms and economics of recovery, we developed the Center for Career Freedom - Case Managers Toolkit. It consists of three Guides:
- The Quick Reference Guide to Government Benefits: A hard copy portable case management aide summarizing the essentials of some thirty Government benefits programs for single adults living alone who may be eligible to receive SSI, SSDI, TA (welfare), Medicaid, HUD, and more
- Form-Link: A compilation of over five hundred Federal, State and local application forms for essential benefits
- The Quick Reference Guide to the Economics of Recovery: A Guide- Worksheet to assist recipients of SSI, SSDI, and TA to transition off their benefits to self-sustaining employment.
Derived from the latest Government websites, the Toolkit demystifies the essential Federal, State and County benefit and back to work programs. It empowers tens of thousands of people in New York with psychiatric or physical disabilities, and people with substance abuse problems and who are homeless, to finally have a user-friendly resource to help them understand their own benefits and program opportunities.
The Toolkit is also a must-have for the provider community who interface with consumers and families seeking benefits information on a daily basis.
The Toolkit has been reviewed and verified by state, federal and local government agencies and recently completed a ten month field test. The field test was given to over one-hundred case managers, counselors, social workers, and peer counselors and housing advocates at a dozen sites including two hospitals; White Plains Health Center’s Methadone Clinic, and St. Vincent’s Hospital’s Intensive Case Management Unit in Westchester. It has also been reviewed by numerous community agencies, including: Westchester Independent Living Center, JAWONIO, NAMI-Westchester, The Jewish Board of Family and Children Services, the Hudson Valley Dept. of Labor, the Westchester County Department of Community Mental Health’s ACT Team, the White Plains office of VESID, and the Westchester County Department of Social Service’s One-Stop Program. The response has been excellent. Some comments from the field test include:
“Summarizing the essential facts and figures of so many government aid programs into one easy to read and easy to understand guide is a common sense idea that helps caseworkers navigate the maze of numerous government aid programs. Having easy and reliable access to it on one page will help caseworkers to more reliably identify the services available to their clients.”
“What impresses me most about the Toolkit is the wide range of support it has received from the community. A product that draws support from so many service providers deserves special attention.”
“Our case managers recently completed a twelve week field test of the Toolkit and the overwhelming majority found the Toolkit: definitely increased their understanding of government benefits, was easy to understand and use, and case managers learned more from the Guides than they would have from a three day seminar.”
“About half of our caseworkers reported the Guides resulted in fewer errors, reduced the stress of acquiring benefits, increased their job satisfaction, increased their professional skills and value to their employer. Over one-third said: “I would definitely spend my own money to have this Toolkit.”
“The Guide promotes communication, service integration and teamwork across private and public human service systems. In turn, this benefits the recovery and rehabilitation of the over six hundred-thousand people with severe and persistent mental illness in New York.”
The “Quick Reference Guide to the Economics of Recovery” section of the Toolkit addresses the final phase of recovery; how to meet the challenge of selfsufficiency. This last section provides the case manager with a tool for aiding most clients (SSDI, SSI, and TA) to leave the very benefits that stabilized them in the community. It includes:
- A summary of fifty Employment Opportunities from the NYS Department of Labor’s “Workforce New York - 2005 Data Base,” including: average earnings, qualifications, working conditions and outlook, to help clarify the job choice.
- Individual Employment Plan: a worksheet enabling the counselor and the consumer to create the specific steps required to reach the job goal.
- Benefits Estimation Worksheet: an aide which calculates the total value of benefits to be replaced thru employment, in order to achieve self sufficiency.
- Maximum Income Scenarios: a money management tool designed to educate the consumer about the economics of recovery.
- To build upon the successful field trials by expanding distribution of the Toolkit to community and local government agencies throughout Westchester and the lower Hudson Valley of New York State.
- To produce two 30 minute webcasts for caseworker training.
- To adapt the toolkit for New York City providers, field test and refine for citywide pilot test distribution in 2007.