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Wisconsin Disability Benefits Network Newsletter For Your Benefits

Vol. 7, Issue 32, August, 2009

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For Your Benefit – Introduction

The Wisconsin Disability Benefits Network (WDBN) is a statewide system that provides direct assistance to benefits counseling practitioners and seeks ways to reach out to and better serve people with disabilities, their supporters, and professional service providers in Wisconsin. This newsletter provides current program news, important notices and updates, and upcoming training and educational opportunities. Check out past editions of this newsletter!

2009 WDBN Calendar

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What's New

Long-Term Care Summer Camp Recap

Long-Term Care Summer Camp Group PhotoThanks for attending the Long-Term Care Summer Camp - a Disability Rights Wisconsin and Wisconsin Disability Benefits Network sponsored event focusing on gaining an understanding of the services and programs that touch the lives of people with disabilities accessing Long Term Care.

A number of very helpful materials were shared during the training and are included below:

Photo from Long-Term Care Summer Camp Photo from Long-Term Care Summer Camp Photo from Long-Term Care Summer Camp Photo from Long-Term Care Summer Camp

What did people take away from this event? Here's some comments from attendees:

"Good overview of Family Care programs. Helpful printed materials."

"Very interesting, dynamic speakers! Thanks."

"The income limit categories, income exceptions, assets, divestment, and spousal impoverishment session was very interesting and beneficial."

"Keep doing what you're doing, always good trainings."

"Good refresher, good new info. I feel more knowledgeable about the ADRC's and healthcare options."

"This is a good snapshot of long-term care reform and how it functions."

"I obtained a better understanding of financial eligibility for LTC programs and the difference between Group A, B, and C.

New Medicare Part D Numbers for 2010

The final Medicare Part D costs have been released. Following are Handouts A, B, & C from the Disability Rights Wisconsin Medicare Part D Booklet that show these new costs. The new "benchmark" amount is $38.20 for Wisconsin—this means that any "basic" plan with a premium below $38.20 will be on the low cost plan list.

Medicare Part D Booklet Handouts Update for 2010 (WORD)

MSP and extra help asset levels have not yet been released. In addition, we are still waiting for the Wisconsin plan lists and premiums for 2010, the 2010 low cost plan list, and the mailing calendar for 2010.

Summary of the Mental Health Parity and Addiction Equity Act

This historic legislation requires that health insurance equally cover both mental and physical health. The Paul Wellstone and Pete Domenici Mental Health Parity and Addiction Equity Act of 2008 (The Wellstone- Domenici Parity Act), enacted into law on October 3, 2008, will end health insurance benefits inequity between mental health/substance use disorders and medical/surgical benefits for group health plans with more than 50 employees. The law becomes effective on January 1st, 2010. Under this new law, 113 million people across the country will have the right to non-discriminatory mental health coverage, including 82 million individuals enrolled in self-funded plans (regulated under ERISA), who cannot be assisted by State parity laws.

More about the New Parity Law

DHS Develops Plan To Cut About $600 Million From Medicaid Spending

From the Wisconsin Council on Children and Families Health Care Coverage – Aug. 27 (2009 Issue # 7)

The biennial budget bill directed the Dept. of Health Services (DHS) to find $625 million in savings to the Medicaid program (including $205 million from state GPR dollars). DHS involved providers, managed care companies, and members of the public in an effort to identify those savings and convened a number of meetings over the past several months.

On July 15, DHS released its list of recommended savings. The department said that its goals in developing the recommendations were to maintain current coverage levels, continue expansion of coverage to the uninsured, and avoid across-the-board cuts to providers. The department's current plan falls a little short of the target, but it contains close to $600 million in cuts or deferred payments - from the following sources: 

A complete listing of the sources of the savings and additional background information can be found in a DHS PowerPoint presentation,

Childless Adult Plan Adds More Than 10,500 Individuals

From the Wisconsin Council on Children and Families Health Care Coverage – Aug. 27 (2009 Issue # 7)

DHS began taking applications on June 15 for the BadgerCare Plus Core Plan, which provides basic health insurance coverage to adults without dependent children.  Coverage began on July 15, and as of Saturday, Aug. 22, DHS had approved the applications of 10,556 individuals seeking to enroll in the Core Plan.  That's on top of nearly 12,000 still enrolled after the conversion of GAMP in January, so the total Core Plan enrollment as of Aug. 22 was roughly 22,500.

The new enrollment figures indicate that the department has begun to make a dent in the huge volume of Core Plan applications it has received, but it still has a long way to go.  According to the latest DHS numbers, more than 43,000 people have applied since June 15, and almost 33,000 of those have paid the application fee.  As of Aug. 22,slighltly over 800 applications had been denied.

DHS Seeks Input On Changes To Managed Care In Southeast WI

From the Wisconsin Council on Children and Families Health Care Coverage – Aug. 27 (2009 Issue # 7)

The Dept. of Health Services (DHS) is planning to make substantial changes in the Medicaid managed care system in Southeast WI.  As noted under item #1, the department has to generate more than $600 million in MA savings, and it plans to get almost $40 million of those savings from changes in managed care rates that are intended to reduce costs while improving performance.

As of July 2010, DHS will probably end all existing BadgerCare Plus contracts with HMOs in Milwaukee, Waukesha, Washington, Ozaukee, Racine and Kenosha counties.  The tentative plan is that early next year DHS would solicit bids on new contracts - possibly contracting with just one or two HMOs to serve those counties.  The department cites the following goals of the changes:  improving care coordination; reducing inappropriate uses of services, such as unnecessary ER visits; lowering health care costs; and improving healthcare outcomes in areas such as childhood immunizations, blood lead screening, tobacco cessations, asthma management, diabetes management and healthy birth outcomes. 

DHS is soliciting comments and suggestions regarding the proposal to restructure the Medicaid managed care delivery system in southeast WI.  Please take a few moments to complete their online survey and provide feedback, including what works well and what might be improved in the delivery of managed health care services to the BadgerCare Plus population. The survey will be available until September 11, 2009.

Cool Resources


DisabilityInfo.gov

The U.S. Department of Labor has re-named and re-launched DisabilityInfo.gov as Disability.gov. Disability.gov is federal Web site that contains disability-related resources on programs, services, laws and regulations to help people with disabilities lead full, independent lives. With just a few clicks, visitors can find critical information on a variety of topics, including benefits, civil rights, community life, education, emergency preparedness, employment, housing, health, technology and transportation. On the site, you can choose to locate information by subject matter for a particular state. You can also stay connected to new resources and information by signing up to receive e-mail updates and/or subscribing to the newsletter.

CareerOneStop Worker ReEmployment Portal

A great influx of job seekers are coming into One-Stop Career Centers seeking unemployment benefits and looking for new jobs, and sometimes new skills and the CareerOneStop Worker ReEmployment Portal is a great tool that can be used for targeted assistance.

The ReEmployment Portal offers the following online tools and the following categories:

The site also includes a link to "Find State Resources" by clicking on the Resources by State link on the top menu bar (or by clicking on any of the links to the four major topic areas) to access state-specific resources including:


Benefits News Roundup

Benefits News Roundup

SSI Overpayments Due to Excess Resources

The Social Security Administration (SSA) has two unique waiver rules that are applicable to only Supplemental Security Income (SSI) overpayments which result from excess resources. 

First, when an SSI overpayment is caused solely by excess resources of $50 or less in a month (this includes resources deemed to the recipient), SSA will consider the recipient to be without fault in causing the overpayment and waive recovery. A recipient does not have to request waiver when this provision applies. SSA considers each month separately in using this policy.

For example, an individual who has countable resources of $2,045 at the beginning of a month will be ineligible for that month so that the entire federal SSI payment is an overpayment. However, since the countable resources exceeded the allowable limit by $50 or less, SSA will waive the overpayment.

Note that this waiver would not apply if the recipient willfully and knowingly failed to report the value of the resources accurately and timely. And if a recipient incurred a similar overpayment in the past and received an explanation of both the cause of the overpayment and reporting responsibilities, SSA normally will consider the recipient to be at fault. POMS SI 02260.035

Second, even if a recipient’s resources exceed the limit by more than $50, SSA will consider the recipient without fault and it against equity and good conscience to recover the full amount of the overpayment when the total overpayment (excluding months in which the $50 rule resulted in a waiver) is greater than the amount by which the resources exceeded the resource limit. SSA waives that part of the overpayment that is more than the difference between the countable resources and the resource limit applicable to that month.

For example, when an individual has countable resources of $2,100 the first of a month, he/she is ineligible for that month because the resources exceed the $2,000 limit. If the recipient’s monthly federal SSI payment is $300, the overpayment would be the entire $300. However, under this provision, SSA takes the amount of the excess resources, $100, and compares it to the SSI federal payment, $300; since the overpayment is greater than $100, SSA waives $200, that part of the overpayment that is more than the difference between the countable resources and the resource limit ($300 minus $100 = $200 waived.) SSA will seek recovery of the $100.

When multiple months are included in a period of overpayment, SSA determines which single month in the overpayment period had the largest difference between the countable resources and the resource limit. If the total overpayment balance in such months is greater than the maximum amount of the excess resources determined in that single month, SSA waives the difference between the overpaid amount and the excess resources in just that month. POMS SI 02260.025D

Of course, an SSI recipient always has the right to appeal and request a waiver on the full amount of any overpayment.

SSI Conditional Payments

Until this year (2009) to be eligible for Supplemental Security Income (SSI) conditional benefits an individual’s or couple’s countable liquid resources could not exceed three times the applicable Federal Benefit Rate (FBR). In January 2009, for the first time, three times the FBR exceeded the statutory SSI resource limits of $2,000 for an individual and $3,000 for a couple.

So beginning January 2009, individuals or couples who have liquid resources exceeding the statutory $2,000/$3,000 resource limits are not eligible for conditional benefits. All other criteria for conditional benefits remain the same.

An individual or a couple can qualify for SSI conditional payments when they would be eligible for regular SSI except for excess resources. If all eligibility requirements other than resources are met, and the resource limit is exceeded due solely to excess non-liquid resources, the person or couple can receive SSI benefits conditionally for a limited period of time while they attempt to sell the non-liquid resource(s).

The purpose of conditional payments is to provide an individual or couple with money to live on while attempting to dispose of non-liquid property that otherwise makes them ineligible. Once the non-liquid resources are disposed of, the conditional payments are considered an overpayment to be repaid from the proceeds of the sale or liquidation (which then may allow the payment of regular SSI payments if the resource limit is met.)

To receive conditional payments, the person must agree in writing to sell the excess non-liquid resources at their current market value (CMV) within a specified period and to refund all SSI money received. The length of the disposal period depends on the type of non-liquid resource: generally the basic period is three (3) months for personal property and nine (9) months for real property. Conditional benefits provisions may apply to deemors as well as applicants and in post-eligibility situations as well as in initial claims.

Liquid resources are any resources in the form of cash or in any other form that can be converted to cash within 20 workdays. Cash is always liquid, and, in addition, certain non-cash items are nearly always liquid including stocks, bonds, and mutual fund shares, checking and savings accounts and time deposits, United States Savings Bonds and Treasury bills, notes and bonds, and mortgages and promissory notes.

Non-liquid resources are any resources that are not in the form of cash and that cannot be converted to cash within 20 workdays. Non-liquid resources would be household goods and personal effects, automobiles, trucks, tractors and other vehicles, machinery and livestock, buildings, land and other real property rights, and non-cash business property. Source POMS SI 01150.200 for more information.

SSI Eligible Couple and 1619(b)

Under the section 1619(b) work incentive provision, an SSI disabled recipient who has earned income that makes his/her income too high to receive an SSI payment can still be eligible for Medicaid coverage. To qualify for 1619(b) a recipient must have been eligible for an SSI payment for at least one month, still be disabled, need Medicaid coverage to work, have gross earned income that is insufficient to replace SSI, Medicaid, and any publicly funded attendant care (that is, less than the year’s threshold amount), and meet all other SSI eligibility rules including the resource test. An SSI recipient who is age 65 or older may be eligible for section 1619(b) provided that he/she is determined to be either blind or disabled.

In couple cases in which both members of the couple are disabled, 1619(b) may apply depending on the couples’ work situation. If only one member of an eligible couple is working and his/her earned income makes them ineligible for a payment, then 1619(b) provides Medicaid protection for only the working individual. A non-working SSI eligible spouse has no protection under 1619(b) and loses Medicaid when the earned income of his or her SSI spouse causes ineligibility for a 1611 or 1619(a) payment.

However, both members of an SSI couple will be eligible for continued Medicaid coverage if they are both working and their total combined income causes ineligibility for payment, even if individually each person's earned income would not be enough to trigger non-payment status.

Source: POMS SI 02302.010 Section C Number 2.

Ben Spec

Ben's schedule continues to be busy this summer but he has checked in to answer a number of questions from all of you…here's a recent question...

Hi Ben,

I have a question about 1619b, earning and CIP1b funding. If a single adult on SSI earns approximately $20,000 per year and has the option of taking company “private” insurance would this person be ineligible for Medicaid (1619b)? Let’s consider this person meets all other eligibility requirements for MA. Also, If this person private insurance covers all medical costs, but MA is needed to cover CIP1b waiver services would he be in jeopardy to loose his waiver services?

I want to make sure my client does not loose his CIP1b waiver services if he would receive private insurance through his employer.

Thank you,
Brian

(Ask Ben a question: askben@eri-wi.org | Visit Ben's Blog )

Training and Educational Opportunities:


ABC's of the ADA: Employment

ABC's of the ADA: Employment

If you are a consumer and/or a disability professional involved in employment services (Vocational Rehab counselors, employment specialists, job coaches, etc.), you cannot miss this training!

Sponsored by ADA Wisconsin Partnership, DBTAC-Great Lakes ADA Center and WorkSource, WI

Date: Wednesday, September 23, 2009 Time: 8:30 a.m. to 2:45 p.m.
Where: The Radisson Hotel of Greater Milwaukee
N14 W24140 Tower Place | Pewaukee, Wisconsin 53072 | Phone: 262-506-6300

Fees: $59 per person with Lunch included - limited scholarships are available for consumers. Contact Stacey Mochnick about scholarships or other event information (email: mochnick@eri-wi.org or phone: 608-246-3444 x226).

Registration: More event information

Training for Professionals who work with Medicare Part D Beneficiaries on the Medicare Part D Drug Benefit

This training is designed so that each section is more complex than the previous section. The training will be offered in multiple locations statewide and is also available as a webcast.

Training & Registration Information: Medicare Part D Trainings Fall 2009

Presented by: Eva Shiffrin, Disability Rights Wisconsin

Wisconsin Aging and Disability Resource Center Conference 2009

Date: September 21-22

Location: Stevens Point Holiday Inn & Convention Center
Mark your calendar for the Wisconsin Aging and Disability Resource Center Conference 2009 from the Office for Resource Center Development. We look forward to seeing you and stay tuned for more information.

Puzzled By Brain Injury? Enhance your skills to improve the lives of those you work with.

Dates & Locations:

  1. October 8, 2009 in Eau Claire at Chippewa Valley Technical College.
  2. October 26, 2009 in LaCrosse at Western Technical College.
  3. November 6, 2009 in Appleton at  Fox Valley Technical College.
  4. November 10, 2009 in Madison at Madison Area Technical College (Truax Campus).
  5. November 13, 2009 in Milwaukee at Milwaukee Area Technical College (Oak Creek Campus).

Presenters:
Wisconsin based and Nationally Certified Brain Injury Specialist Trainers (CBIST)

This training utilizes a national curriculum recommended by the Academy for the Certification of Brain Injury Specialists (ACBIS) for entry-level staff and experienced professionals. A sampling of the topics included in the training manual are:

Following a day long training, a written exam will follow (optional) to earn a nationally recognized credential- Certified Brain Injury Specialist (CBIS).

For More Training Information Contact Myrt Sieger, TBI Training Coordinator at:
608-442-0317 or email her at siegerfam@gmail.com.

For More Registration Information Contact Brenda Jackson, Administrative Assistant at:
262-790-9660 or email her at admin@biaw.org.

Registration Information Coming Early August! Register early as each session is limited to 30 attendees.

Systematic Instruction

Dates & Locations:

  1. October 20-21, 2009 in LaCrosse.
  2. December 7-8, 2009 in Waukesha.
  3. December 9-10, 2009 in Fond du Lac.

Sponsored By: WI Pathways to Independence, WI Division of Vocational Rehabilitation, Western Wisconsin Cares, Waukesha Training Center, and Creative Care Options.

Hotel Accommodation provided free of charge for those traveling to attend on the following days:
October 20, December 7, and December 9.

This two day training course will provide an overview of systematic instruction procedures based on Marc Gold's timeless Try Another Way approach. The information provides job coaches with the perspectives necessary to understand the teaching of essential job tasks in integrated community workplaces. Topics covered will include a brief retrospective on the evolution of supports in community work sites and a discussion of a "road map" strategy called the Seven Phase Sequence that helps explain how to start and how to proceed with training and supports that are built on the natural features and natural supports uniquely present in each workplace.

The course will also provide overview discussion of the tools of systematic instruction that includes a range of organizational strategies. Training strategies will also be discussed that reference the use of formats for presenting information, demonstration, verbal assists, gestural and modeling cues and physical assists. The role of natural motivation in lieu of reinforcement will also be discussed.

Space is Limited.  Register Early. 
Registration Deadline: Thirty(30) days before the training date you select.
Priority given to those placed on waiting list in 2008 and those directly involved in job coaching.

For More Information Contact Lisa Mills at:
608-225-4326 or email her at lisa.mills@dhs.wisconsin.gov.

National Summit on Disability Policy 2010 Website

National Council on Disability

Date: July 25-27, 2010

Location: Renaissance Hotel, Washington, DC

This event is hosted by the National Council on Disability. The theme, ADA 1990-2010 Retrospective and Future Policy Directions, will include a comprehensive dialogue to shape the national disability agenda.

Anyone hoping to become a delegate to the summit in July of 2010 should review the Website and complete the application as quickly as possible. A delegate selection will be done later this fall, but people should assure that they do not miss any deadlines.

Ongoing Training:

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