Transcript Document

Developing Written
Benefits Analysis Summaries
VCU YTD Technical Assistance Office
October 17, 2005
What is Benefits Analysis?
An intensive benefits counseling service that
entails :
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gathering benefit and other information specific
to a YTD participant
analyzing the various options or paths
available
providing advise regarding the impact of these
options
Benefits Analysis Summary…
is the written report which documents the information
gathered, analysis results, and advice provided to the
individual.
The centerpiece of the summary is individualized,
case-specific information and advice on current
benefits status, the effect of earnings on benefits, and
the use of relevant work incentives.
Why have a written analysis?
To document:
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What the beneficiary told you
What you told the beneficiary
What you uncovered through verification
What changes will affect benefits
What the beneficiary must do to report
changes
Analysis serves to…
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Take a snapshot of current situation
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Help build understanding of benefits issues
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Provide a resource for beneficiaries, their
families, and the support team
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Keep the communication clean and clear
When is it Necessary to Develop a
Written Benefits Analysis Report?
Information and Referral Services
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Providing general information on all Federal,
State, and Local benefit programs.
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Initial and continuing eligibility
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Impact of employment & other changes
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Work incentive provisions
Information & Referral
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Can you tell me what the current SGA amount is?
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How does a PASS work?
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What is this ticket & will I get in trouble if I don’t
use it?
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I have a disability and would like to work. Do you
know of anyone who can help me?
Problem Solving
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Answer questions specific to the
beneficiary/recipient, but relevant to only a
small piece of their situation.
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Gather, verify and analyze information to solve
the particular issue at hand.
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Advise on options, but not a complete analysis.
Problem Solving
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I didn’t get my SSI check. Can you help me
figure out why?
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I reported my earnings, but my check wasn’t
adjusted.
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I’ve just found out that my benefits are going to
stop.. . Can you help me with Section 301?
Benefits Analysis & Advisement
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Research and provide verification of complete
benefits picture.
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Inform beneficiary of options/outcomes.
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Provide advise to support informed choice.
Benefits Analysis & Advisement
Jill is 20 and has never worked. She is
considering work when she leaves school next
year and wants to understand what would
happen to her benefits.
As a General Rule…
…a written benefits analysis report is needed
whenever individualized, case specific benefit
information and advice is given
This means anything beyond basic information
and referral services!
When to write the analysis…
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As a base point, when the youth enters the project
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After major life changes, such as
 change in employment status
 residence change
 graduation
 Marriage
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Within a year of reaching the 17th Birthday
When to Write the Analysis
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Within a year of reaching the 17th Birthday
For SSI Beneficiaries:
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Age 18 Redetermination Process
Parental Deeming Stops at 18
Inkind Support & Maintenance Starts at 18
Potential Changes in unearned income
Access to new resources
Continued Access to Medicaid
Work and Work Incentives
Marriage – Couple FBR
When to Write the Analysis
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Within a year of reaching the 17th Birthday
For Title II Beneficiaries:
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Potential loss of Child’s Benefit
Potential eligibility for Childhood Disability Benefit
Special Medicaid Beneficiary Status for CDBs
Impact of Marriage on CDB
Work and SSDI eligibility on own record
Title II disability work incentives (TWP, EPE)
Other Work Incentives – IRWE, PASS
When to Write the Analysis
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Within a year of reaching the 17th Birthday
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Not Previously Eligible for Disability Benefits
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Representative Payee-ship
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Post-Secondary education
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Asset Development
When to Write the Analysis
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As a periodic update when other changes have
been gradual
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When the person leaves the project
What Should a Written
Benefits Analysis Report
Look Like???
Suggested format
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Introduction
Current benefits
Priorities and intentions
Impact of work
Outstanding issues
Reminders
Disclaimer
I. Introduction
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Person’s status in project
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Purpose of analysis
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Where you gathered information
Introduction example
Dear Sam,
This is a letter for you to use for your records.
It gives information about your benefits, and
how work will affect them. We met on
October 5th…
II. Current benefits
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Types and amounts of benefits received
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Can be chart, list or paragraph
Current benefits example
According to the Social Security Administration,
you receive SSI in the amount of $579.00. You
also have Medicaid…
III. Priorities and Intentions
This section should outline:
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What the youth plans to do
and
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What benefits are most essential in the youth’s
life
Priorities example
You told me that you plan to take a part-time job
as soon as you find one.
You also said that you were very concerned
about losing your Medicaid.
IV. Impact of Work
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Impact of employment goal and earnings on various
benefits received
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Outline applicable work incentives
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Use examples specific to the individual
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Refer to supplemental material rather than rewriting
existing basic material
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Remember the waivers!
Impact example
If you go to work next month and bring home $425.00
in gross wages, you will receive less money in your
SSI.
Your SSI check will be $$$ beginning in December
2005…
If you decide to accept a full time job and your
earnings increase to $$$, you will no longer receive an
SSI check each month… But your Medicaid will
continue…
Impact example
SSI is a benefit that is reduced when you
receive other income. Not all of your wages
will affect your SSI, however. In fact, because
you are in the Youth Transition
Demonstration…
Impact of YTD Waivers Example
SSA will look at how much money you make in a
different way. You can make $65 per month
without a change in your SSI benefit. For
every $4 you earn over $65 per month, SSA
will reduce your benefits by $1. This is
different than what they usually do. This allows
you to make more money without it reducing
your benefit.
Impact of YTD Waivers Example
While you are in the Project, you can have a
Plan for Achieving Self-Support (PASS) that
has going to school after high school as a goal.
You can have a PASS that says you want to
look at different types of work. This is different
than what is usually allowed with a PASS.
Impact of YTD Waivers Example
While you are in the Project, you may be
reviewed by SSA. This is true even if you are
not in the Project. SSA may find during this
review that you are not eligible to continue
getting benefits. If that happens, you will still
get your benefits as long you don’t earn so
much money that your benefits will stop.
V. Outstanding issues
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Some issues take a while to resolve. If
something is pending, simply write it into the
summary, rather than waiting forever for it to be
corrected.
Outstanding issues example
When we first met, we discussed the possibility
of your applying for Food Stamps. As you
know, we completed the application on
September 5th. The Food Stamp office said
they would notify you by…
VI. Reminders
Bulleted list that:
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Gives phone numbers for contact
Lets person know when to report changes
Let’s person know what you are doing next,
and that you are available
Reminds person of important dates, actions
Reminder example
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You need to let me know as soon as you start
your new job
You need to contact me when you are ready to
set your earnings aside in your Individual
Development Account
You may reach the Food Stamp office at 555666-7777….
VII. Disclaimer
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Limits your liability for information contained in
summary
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Indicates who has final authority for benefit
determinations
Disclaimer example
The accuracy of the information provided
above depends upon ….
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Accuracy and completeness of info you provided
about past and current benefits
Accuracy and completeness of info you provided
about other relevant factors (earnings, resources…)
Current laws and regulations on effect of work…
Current SSA policies and procedures Re work
incentives
Benefits Analysis Summary
Pointers
Organization Tips:
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Start with on outline
Think and write sequentially
Group related concepts together
Use bolded headings or boxes, bullets…
Benefits Analysis Summary
Pointers
Tips on What to Include:
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Only info on benefits, impact of earnings, and use of
work incentives!
Limit to benefits that are relevant & current
Specific solutions or options for resolving problems
Include / Attach calculation sheets, charts,
calendars lists…
Attach SSA Spotlights, pamphlets…
Benefits Analysis Summary
Pointers
Writing Tips:
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Individualized and Directed to YTD participant
Brief, but complete – not overwhelming!
Accessible in language and format
 be organized
 Simple, understandable language - avoid
acronyms
 limit sentences to one or two concepts
Use templates cautiously!
Benefits Analysis Summary
Pointers
The summary is for documentation, but it can be
a great learning tool as well…
Use time with the participant to review and
make sure they get the most out of the
information you provide!
Case Records
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Intake sheet with contact information
Case notes
Copies of any release of information forms
used to access benefits information from SSA
or other agencies
Copies of BPQYs, statements of benefits
More on Case Records
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Copies of any written Benefits Analyses,
summaries of advisement
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Copies of correspondence to or from other
agencies
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Copies of any work incentive information
The Benefits Analysis Process
First Steps…
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Provide explanation of YTD services
Obtain informed consent to gather data
Gather benefits and contact information
Ascertain problem & info needed to resolve
Get release forms signed and submit
Benefits Analysis Next Steps…
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Gather Information -- Verify all relevant
benefits
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Research and analyze issues
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Meeting/counseling on presenting and
related issues
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Written Benefits Analysis
Gathering Beneficiary Information
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Contact information and personal
demographics
Presenting problem, issue, question, or need
Future outlook – employment goals
Benefits received and amounts
Health insurance received and future needs
Monthly income and resources
Gathering Beneficiary Information
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Employment information – past and current
Past use of work incentives and current work
incentives status
Indicators of potential work incentives (IRWEs,
PASS, BWE, Ticket to Work)
Other agency involvement
Disability information
Information Gathering
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Assess the presenting problem, need or
question
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Determine what information is needed to
resolve the problem or meet the need
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Do not gather information that is not necessary
or relevant!
Guidelines for Gathering
Disability Information
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Only ask if it meets the “compelling needs” test
Limit to disability “benefits assistance” related
information
Provide for private setting
Ensure Beneficiary’s understanding
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Why info is needed
How it will be used
Their choice
Verification
It is essential to verify directly from the benefits
source whatever benefit the YTD participant
receives before writing the analysis.
That means…
Contacting…
the SSA and all other benefits providers to
assess impact of work on current or future
benefits
Don’t guess!!!
Requesting Information from
Other Sources
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SSA Form 3288
SSA BPQY Request Form
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Other release of information forms
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What information
From whom
Expiration date
Signed by beneficiary / payee
Use the VCU – YTD TA Office…
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Help in developing customized format
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Assistance in reviewing benefits analysis
summaries
Benefits Analysis Summary Exercise
Enrique, 2005