By Donald M. Fitch, MS
Center for Career Freedom
The purpose of this column is to assist providers and consumers to be more effective when negotiating with local government agencies for income, health care, housing, food, transportation, job training, employment and other social services.
The focus is on single adults (18-64) with a mental and/or physical disability, substance abuse issues and the homeless. The information is gleaned from government websites and local, state and federal government offices.
Tips for accessing benefits are based on assisting over nine hundred persons at the Center. Our experience is supplemented by regular mystery shopper, provider and consumer surveys.
Q. What are the changes in essential Government benefits for 2007?
A. Consumers can expect a few more dollars through cost of living adjustments (COLA).
Food Stamps: $155.00 ($152.00)
Personal Needs Allowance: $137.10 ($137.10)
SSI Income: $710.00 ($690.00)
SSDI Income Cap: $900.00 ($860.00)
Providers will again be challenged to adapt to new legislation:
- Governor elect Spitzer has stated – “our system is broken” and has pledged to “cut fraud in the Medicaid program, expand health – insurance coverage, reduce the cost of prescription drugs and make it easier for the disabled to live outside of nursing homes.” (www. spitzerpaterson.com)
- Federal support for these initiatives will be provided by the Deficit Reduction Act of 2006 and CMS grants to transform (“rebalance”) Medicaid incentives away from institutional care to at home options. (www.cms.gov)
- About half the states expect to reduce Medicaid expenses by instituting new citizen documentation requirements and tightening asset-transfer provisions for Nursing Home eligibility. (www.kff.org)
- New York State, is the top Medicaid spender at almost $50 billion/year. Longterm care accounts for over $20 billion. The average disabled Medicaid recipient receives about $30,000 in Medicaid funds each year. Nationally, three entitlement programs: Social Security, Medicaid & Medicare account for about one trillion dollars annually—almost half the total 2.2 trillion Federal budget. (www.hhs.gov)
- Privatization of the Medicare Drug Benefits (Part D) program resulted in substantial savings in 2006 which may be passed along in the form of lower premiums in 2007. Copays; $1 generic & $3 branded, are expected to remain the same. CMS states the Federal Government is saving “billions of dollars annually.” (www.cms.gov)
- 38 million persons are enrolled in the Part D program and fill 3 million prescriptions daily (CMS). 81% are “very or somewhat satisfied with their plan.” (www.kff.org)
- CMS is reportedly planning to tighten regulations under the Medicaid Rehab Option and Targeted Case Management through “clarification” of allowable services in the1st quarter of 2007.
- Social Security Administration tightens Christmas bonus definition: Several years ago, SSA allowed working SSDI recipients to exempt their bonus, even if the bonus exceeded their Substantial Gainful Activity (SGA); $860/Mo in 2006. SSAs’ current policy is to count the bonus as “wages” subject to SGA limits. (www.ssa.gov)
- SSA is testing a new centralized Medical-Vocational Expert System (MVES) in the Boston Region which will eventually replace the current local appeals’ process with a national network of experts. The new appeals process will meet qualification standards set by the Commissioner and reportedly incorporates Video Conferencing.
- Passage of Timothy’s Law in January 07 would provide “a minimum of twenty outpatient visits for mental illness and thirty inpatient days a year.” (www.timothyslaw.org)
Q. I read that California voters passed a tax on personal income to fund programs for adults and children with severe mental illness. How much money has the tax raised?
A. The 1% tax on personal incomes in excess of $1 million is projected to generate an additional $690 million in funds for FY 2006-07 programs. The California Department of Mental Health pledges to use the new revenue stream to create “a state-of-the-art system to promote recovery/wellness.” 55% of the annual monies have been earmarked for Community Services and Supports (CSS), 20% for prevention, 10% for capital facilities and 5% for State Administration.(www.dmh.cahwnet.gov)
Please send your questions firstname.lastname@example.org. If your questions are used in the column you will receive a complimentary copy of Form-Link CD, a compilation of over sevenhundred pages of Government Benefit application forms.