Transcript Poverty Reduction Programs

Vocational
Rehabilitation & Asset
Building
Abby Cooper
[email protected]
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Overview of Poverty Concepts
What is Asset Development
Disability and Poverty
Attitudes about Money
Tension Systems
Credit Score and Rehabilitation
Behavioral Economics
Integrating Asset Development into the
Rehabilitation Process
Helpful Tools
Asset Building approaches
ABLE & ACA
Next steps
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What is
Poverty?
And what does it have to do
with Vocational
Rehabilitation?
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How the Federal Government
Defines it:
Federal Poverty Guidelines: Typically, in January or February of
each year the federal government releases an official income
level for poverty called the Federal Poverty Income Guidelines,
often informally referred to as the "Federal Poverty Level." The
benefit levels of many low-income assistance programs are
based on these poverty guidelines.
Poverty Threshold : poverty thresholds is based on the "thrifty
food plan," which was the cheapest of four food plans
developed by the Department of Agriculture. It assumes that
1/3rd of your after taxes income is based on food. This
calculation has not changed since 1965.
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Federal Poverty
Rate 2012
1
$11,170
2
15,130
3
19,090
4
23,050
5
27,010
6
30,970
7
34,930
8
38,890
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Problems in how poverty is
viewed.
Types of income - By failing to include income that many lowincome people receive in the form of public assistance, some
critics maintain that the extent of poverty is over-stated.
Calculation is Flawed - assuming that families spend one-third of
their income on food. Food now accounts for something closer to
one-sixth of the family budget. Housing, transportation and utilities
are much larger components of family spending.
Crucial Expenses -are simply excluded from consideration in the
poverty calculation.
Most attempts to establish a new measure of poverty would result
in higher numbers of people being counted as poor.
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Living Wage
In recent years there have been more fundamental challenges
to the poverty measure.
Concerned that the poverty rate is far too low, community-based
organizations around the country have advocated for "living
wages."
Policy and research institutes around the country have
developed living wage budgets that take into account the full
range of costs required for families of different sizes to maintain a
decent standard of living.
http://www.thecalculator.org/
http://www.dcmassc.org/
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Consulting
http://www.dol.gov/whd/minwage/america.htm#Kentucky
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Europe looks at social
exclusion
Irish :What is poverty?
People are living in poverty if their income and
resources (material, cultural and social) are so
inadequate as to preclude them from having a
standard of living which is regarded as acceptable
by Irish society generally. As a result of inadequate
income and resources people may be excluded
and marginalized from participating in activities
which are considered the norm for other people in
society.
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Causes of Poverty
Behaviors of the Individual
Behaviors of
the Individual-
Human and Social Capital in the
community –
Exploration
Human and
Social Capital
in the
community
Exploration
All vantage points have validity. But each will frame how we deal
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with poverty and clients differently.
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ASSETS
 A resource of economic
value that an
individual, owns or
controls with the expectation
that it will provide future
benefit. Such as stock of
capital, including savings,
financial securities, owning a
business or property. Other
less tangible forms of assets
include educational
achievement, job skills,
training and access to credit.
But what is
Asset Building?
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 The wealthiest Americans (those earning over $1 million
annually) receive more than $95,000 in tax benefits.
 Middle income families receive a few hundred dollars
 Poor families relying on public benefits actually face
penalties for saving.
 Eight out of 10 of the wealthiest families saved
approximately one-third of their household income in
2009.
 A full one-third of low-income households earned too little
to make ends meet, much less save for the future.
 About 80% of the value for mortgage and property tax
deductions accrued to the top 20% of taxpayers.
 In fact, many homeowners don’t take the mortgage
deduction because they do not earn enough income or
incur enough of a tax liability to warrant itemizing their
deductions
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Tax codes created
the middle class
 GI bill
 Land Grant System,
 Creation of the Federal Housing
Administration,
 The Home Mortgage Deductions,
 College aid.
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Persons with disabilities were not part of
the Asset Building Community
 Many people with disability are unemployed and don’t pay taxes.
Those who do work frequently do not take advantage of options like
the Earned Income Tax credit .
 Welfare policy for the poor and disabled has tended to focus nearly
exclusively on income support.
 Sometimes even discouraging assets -Supplemental Society Income
(SSI)-prevents an individual having more than $2000 in resources.
 Asset Development programs are trying to help individuals leave
poverty. So how is Vocational Rehabilitation part of Asset
Development?
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 For individuals without disabilities,
12.8% had income below the
poverty level over the past 12
months
 For individuals with disabilities, more
than 2x that rate - 27.3% had
income below the poverty level.
 69% of people with disabilities do not
have a checking account, and 50%
did not have a savings account.
• 75% of persons with disabilities do not
have any loans with financial
institutions
• 10% of persons with disabilities own
their own home
• 39% of persons with disabilities
indicate that lack of financial
resources is the most serious problem
they face
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 Federal poverty level for an
individual is $930 a month.
 The average monthly
payment for someone on SSI
in July was $532.00, SSDI was
$1,111.44.
 People with significant
disabilities are frequently the
poorest of the poor
Many
individuals
believe they
will always be
poor. And
many are right
unless we
believe there is
another way.
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Kentucky
One of the 11 states that have over
30% of its population living in
poverty areas.
CFED Score Card
Financial Assets &
Income- F rank 47th
Tax Burden by Income
Five of the 11 are in SE TACE region
Businesses &
Jobs – D rank 40th
Housing &
Homeownership- C rank 28th
Health Care – B rank 20th
Education – C rank 35th
Http://scorecard.assetsandopportunity.org/2012/state/ky
https://www.census.gov/hhes/www/poverty/data/index.html
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 Protect Consumers in the Financial
Marketplace: To address high
unbanked and underbanked rates,
increase credit scores and lower
bankruptcy rates, Kentucky should help
ensure residents have access to fair
and appropriate financial products
by capping payday loans at 36% APR.
 Increase Incomes and Encourage
Savings:
 Kentucky should enact a state Earned
Income Tax Credit to maximize income
for low-wage workers,
 remove the disincentive to save for
very low-income families by lifting asset
limits in two public benefit programs:
TANF and family Medicaid,
 create a state Individual Development
Account program.
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Everyone should be
a part of the
financial mainstream
This needs to be an
underlying
assumption of our
services
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The Assumption was Work will be the
Answer
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 Where someone is in his or her
life will directly impact what
information they need or want.
 Need to assess what the
person is able to hear and
understand and what
information should wait until a
later time.
 Helping someone think about
what they need to establish
the desired lifestyle is not just
about obtaining employment
and budgeting.
Money is
Emotional
 It is also about understanding
the emotional connection to
money, i.e. self-image. The
emotional connections to
money are far difficult to think
and talk about honestly
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 Past financial behavior can inhibit
certain vocational dreams
 Myths and misunderstandings may
inhibit a participant’s vocational
aspirations
 Attitudes = subconscious thoughts
and feelings
 Habits = unconscious patterns of
behavior that are acquired through
frequent repetition over time
How Does
money play a
role in
successful
closures?
 Attitudes and habits determine your
behavior and actions
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shelter
basic needs, food, clothing and
adequate retirement funds
greater variety
Attitudes
about
Money
vacation, travel, hobbies
express affection by giving
generously to others
means of controlling
approval and influence
skills
fairness
money to learn new
self-supporting
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A penny saved is a penny
earned …
Waste not, want not …
You deserve the best …
If I could just win the lottery
everything would be okay …
Easy come, easy go …
Do you think money grows on
trees …?
She is living beyond her means
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 Customers should work at
SGA if _____________?
 Working under the table is
_______ ?
 Receiving full benefits when
you can work full time is
______?
 Expecting the system to pay
when you can is
____________?
 Debt is ________________?
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 Pick a partner & Tell them
 Your earliest memory about
money
 Who earned the money in
your household
 Who handled the money in
your household
 Did you have money
 What did you hear about
people who didn’t have
money
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Tension Systems
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Kurt Lewin’s theory on tension system
Environments are complex and layered
• There are behaviors that pull us away and towards certain behaviors.
These are “tension systems”
Small changes can make a desired behavior easier to obtain
Dieting:
Smaller plates
Remove the temptation
Push back from the table
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Mapping Tension
Systems
Ladders are the
small changes that
make the desired
behavior easier to
act on.
Chutes are
forces
propelling us
away from
those
behaviors.
Can be very
subtle
Comments
Missing a bus
Self-doubt
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What are the chutes your
customers face?
What are the ladders we
need to create?
 As a system
 In counseling and
guidance
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Some
ladders
to think
about
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 RISK. A risk is
something one can
gauge or has a sense
of the possible
outcomes based on
past experience and
knowledge. When a
risk is taken the risk
taker has a
reasonable idea of
the expected
outcome.
Uncertainty
however, means
one is unclear
what will happen
and has no way
to project
possible
outcomes.
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Credit Scores
Impact
How they are
calculated
Plan
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Bad credit score
can impact:
 Getting a job
 What a person pays in
insurance
 Getting a loan or credit
card
 If approved pay higher
interest rates
 Renting an apartment
 Utility companies may
request a higher deposit
 Self-image
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 Thinking about how to
combine credit scores with
benefits planning and
vocational counseling?
 How do you currently use or
talk about credit scores?
 Do you help customers get
their credit scores?
 Is improving credit scores
part of any planning?
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 Credit
repayment
history
 Balances on
credit
 Rate at which
they are using
credit versus the
amount of credit
they have
available
 Depth of credit
history
 Length of credit
history
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 There is a million ways to
wreck your credit and
only one way to improve
you credit.
 Bring active past due
accounts current and
keep them current
 Keep credit card debt
below 30% of credit limit
 Request correction in
writing for any errors
 Do not close existing
accounts
 Limit applications for new
revolving debt – credit
cards
At what point do we talk
about this? And how?
Assist participant in
obtaining credit report ?
(www.annualcreditrepor
t.com)
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Get payday
loan
Not enough $
to pay bills
Receive
paycheck
Pay back entire
loan plus fees
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The APR for a two-week loan valued at $100 is
459%.
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New Research on Pay Day Loan
http://www.pewstates.org/uploadedFiles/PCS_Assets/2012/Pew_Payday_Lending_Report.p
df
 •57% higher for renters than for homeowners
 •62% higher for people earning less than $40,000 than for those
earning more
•
 82% higher for people without a college degree than for those with
a four-year degree or higher
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Loan Usage
12% Disabled Individuals have used pay day storefronts
12% African American
13% separated or divorced
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How Do We Talk
about Money in
Counseling and
Guidance?
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We are under the illusion that we make rational
decision.
We take short cuts in our thinking without even
knowing it.
Yellow
Red
Green
Purple
Orange
Black
Pink
White
Gray
Rose
Brown
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Behavioral Economics
Probability Judgment- is central to everyone’s
economic life.
 Frequent questions: Will I get a raise? Can I afford to buy that
car? Will I loss my job?
 The likelihood of an event occurringis usually not based on careful cognitive thought, or
logic.
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Availability – How our memories
sequence information distorts
probability judgment people tend
overestimate the likelihood of easy
to recall events and underestimate
the likelihood and impact of less
familiar by more likely events.
Anchoring- People estimate of the
size or value of something based on
what they start out comparing it to
or what has been paid in the past.
“Sticker Shock” or thinking you are
getting a deal.

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 Status quo bias- People tend
to do what they have always
done. Change is hard, need
to think about how we
create options that have the
desired behavior as the
default
 Loss aversion- Adam Smithpeople are far more concern
about what they will loss then
what they will gain.
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 People will respond
differently to the same
information in either a
positive or negative
way depending on how
it is framed.
 We have financial
literacy classes
every Monday
night.
 Every Monday
night we have
classes that
present proven
strategies to
increase your
income.
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 People impose patterns
where they do not exist
based on a stereotypes
drawn form experience with
a few member of a group, or
a hypothesis. It is a shortcut
in thinking.
 Example: When software
engineers refused to believe
people were having
problems with their software.
Microsoft installed a test
room with one-way mirror so
the engineers could see
people struggling. (Hearth, Larrick &
Klayman 1998)
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 People may change
subsequent behavior when
asked what they intend to
do.
 Too many or too much
information of any product or
services impedes a person’s
ability to sort through choices
rationally.
 Fairness- people want their
actions to appear fair.
Priming &
Complexity
 Dan Ariely- Behavioral
Economics
 http://www.youtube.com/w
atch?v=9X68dm92HVI
 http://www.youtube.com/w
atch?v=JH1GBX4ohMw
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All this is
interesting but
what does it
have to do with
my job?
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Current
System
No Financial
stability
Focus on
Employment
• Counseling &
Guidance
• Limited
conversations
on financial
stability
• Sometimes
the job is a
good fit.
• Sometimes it
is what the is
found
Job
Obtained
Case
closed
•Usually earning
under SGA
•Limited
guidance on:
•Wages in terms
of need,
•Taxes,
•Benefits,
•Community
Resources
•Being banked
•Credit scores &
debt
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What we want
• Conversation about money,
wages, hours., benefits,
taxes
• what financial stability
means to them, plan
includes financial
independence
• credit scores, banking
Impact of earnings on a
person’s life,
Plan
•Knows where in the
community to go for
support and information on
financial issues
Closure
Living
wages
New Partnerships
created
•Job obtain that
•Reflects both
contributions and
financial need
•Increased # earning
SGA
Counseling and Guidance
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Vocational Counseling
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 We need to provide
information not solutions
 We need to assist not direct
 Acceptance of what the
individual cannot say about
their situation
 Help the person separate
themselves from the issue
 Identify options related to
available resources
Money in
Vocational
Counseling
Is Tricky
 If we can do this- creates
relationships and trust
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 What information about
earnings, asset development
or financial stability can be
added to you webpage?
 Websites
 Could have the living wage
calculator for Kentucky
http://livingwage.mit.edu/
 http://ndi-inc.org/FinancialEducation/FinancialWellness-Webinar-Series.aspx
 Financial literacy
 http://www.mymoney.gov/
 http://www.360financiallitera
cy.org/
Real Question
is:
How Do We
Want to Frame
Vocational
Rehabilitation
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Lay the foundation that a job alone is
not enough. VR wants you to be
financially stable. Which means we will:
 Assist you in thinking about a career
that both meets your unique strengths
and abilities and puts you on the
pathway to financial stability
Ask you to think about how much
money you will need now and in the
future to be financial stable. And what
are you willing to do to achieve that.
Information
that could be
added to
Orientation
Information on how to use your public
benefits as a tool to support that goal
Provide resource information on
financial literacy training and
community resources
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 Add questions –
 Related to desired salary
 Supports wanted in
understanding benefits
 Do they have a bank
account
 If unbanked – for how long
 Credit issues,
 Level of debt
Application
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 Allow participant to set the
pace
 Allow participants to discuss
financial fears and worries
 Be available
 Inform participants of their
options,
Setting the
stage
 Help them to use their own
knowledge and experience
to make decisions regarding
their financial situation
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 What does financial security
look like for the individual
person?
 What does financial
independence look like?
 When does the person engage
in risky and/or impulsive
financial behavior?
 What does status mean and
how does it play out in
financial behavior?
What a VRC
needs to know
 What financial goals does the
person have?
 Are these goals addressed in
the vocational plan?
Adapted from Thomas Jensen Vaerdi Financial,
LLC, power point Talking about money
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 You will be providing information
on one of the most personal
topics – money
 A topic that holds a lot of risk and
uncertainty for many individuals
 Need to understand how
great the risk is
 What questions need to be
answered
 If the risk can be controlled ?
How? Is it reversible?
Counseling
&
Guidance
 To be effective you need to
establish a relationship
 Use language that people understand
 Check out assumptions and don’t sell
people short
 Try to talk less than the person
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If you had a little bit more
money:
What would change in your life
What would you buy
Would you be willing or want to save for that
What has been your relationship with banks
or credit unions
 How would more money help you or harm
you
 Who would you help if you had more money
 What are your concerns




Make it
Real.
Is there anything you like to know
about
 Credit or credit scores
 Budgeting getting
 Getting out of debt
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Financial security:
 What does being secure
mean to you?
 When would you know you
had enough money?
 What would you do if you
desperately needed money
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 Spontaneous behavior:
 When do you find it the most
difficult to say “no”?
How did you spend money
the last year that added
value to your life?
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Goals:
 What does a targeted goal
mean to you?
 Where did your goals come
from? Have they changed?
 Have you put off doing
things that are important to
you until you reach specific
goals?
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
Ask the participant to
make a list of top three
financial concerns

Ask the participant to
articulate how the
vocational plan can address
these concerns
Create a personal action plan
for what to do immediately,
within 30 days,
within 2-3 months,
within 6 months, etc.
Have the person mail the plan
to him/er self
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 Counselor and
Client need to
consider how
these factors will
impact:
 Successful
employment
 Financial
stability
 And what
strategies
need to be
in place.
Living arrangement,
Fear of losing benefits
Expectations,
Lack of transportation,
Low credit score,
Money as a trigger
Criminal record
Level of debt
Past overpayments
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 Financial education
 Getting banked
 Banking tools that work for
them
 Credit repair
 Managing credit and debt
 Tax Credits and Tax Filing
Assistance
 Savings Accounts
 IDAs
 Ability to use benefits as an
asset building tool
 Credit building loans
 Emergency loans (not
payday)
Need new
partnerships &
resources
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 How a person defines
financial stability and how to
achieve that should be part
of his or her planning
PLAN
 Financial support could be
incorporated into the
Individual Plan for
Employment
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CRPS Need To Be On The Same
Page
Need to have conversations that help job seekers and their
supporters thinks about:
 What type of wage is needed?
 What would that wage change in the person’s life?
 What is the person willing to give up or do to obtain that
earning?
 Are there supports or assistance need to help manage earned
income?
CRPS need to be willing to negotiate wages and hours up not
just down with employers.
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 Clients employed at wages
that at least meet expenses,
 Knows how to report earned
income to SSA,
 Knows how to apply for Earn
Income Tax credit,
 Has a bank account,
 Information on Individual
Savings Accounts (if
appropriate)
 Who in the community can
assist with budgeting,
financial literacy etc.
At Closure
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IEP
IPE
• Expectation that the
person will be part of
the financial
mainstream
• Counseling and
guidance includes
money issues
connected to
vocational planning –
• A plan when a
student will have
paid work.
• To use work
incentives as a asset
building tool
• Conversations on
money and wages
•BANK Account
• how much does the
person need to earn
now & in the future,
• what would that
provide his or her life,
Closure
• Earns a living
wage,
• Has work
incentives in place
• Knows community
resources
• Has a financial
plan
• What community
supports are needed
to achieve financially
stable.
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Hazel Joyce Wiley
Career & Financial
Literacy Institute, Inc
P.O. Box 71
Shelbyvile, KY 40066
The Center for Women
and Families
P.O. Box 2048
Louisville, KY 40201-2048
(502) 581-7200
Jewish Family & Career
Services of Louisville
2821 Klempner Way
Louisville, KY 40205
(502) 452-3641
IDA’s in
Kentucky
The Race For Education,
Inc.
1818 Versailles Road
Kentucky Domestic
Lexington, KY 40504
Violence Association,
(859) 252-8648
Inc.
111 Darby Shire Circle
United Way of the
Frankfort, KY 40601
Bluegrass
(502) 209-5382
2480 Fortune Drive
Lexington, KY 40509
(859) 281-1516
New Directions Housing
Corporation
1000 E. Liberty Street
Louisville, KY 40204
(502) 589-2272
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
What are IDAs?

Matched savings accountsmatches range form $1.00 to
$9.00

The match comes from Asset
for Independence (AFI) and
private donations

Federal IDAs can save for
education, homeownership,
or starting own business.
Account holders receive
financial literacy training and
counseling.

Who Qualifies for an Individual
Development Account?

In Federal IDAs it must be
Earned income

200% of poverty level

Other requirements (vary by
program)
http://idaresources.org/afigrantees
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 Federally funded IDAs are
exempt from asset
calculations on ALL benefit
programs- SSI, Medicaid,
food stamps, etc…
 Contributions deduct from
countable income
 Non-federally funded IDAs
count as a resource unless
included in a custodial
account
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IDAs
•Stronger, healthier families
•Long-term thinking and planning
•Enhanced self-esteem
•Sense of pride
•More community involvement
•Hope for the future
•Not for everyone
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Misconceptions about IDAs
 People on Social Security
cannot work.
 People with cognitive issues
cannot save or manage their
money.
 To serve people with
disabilities requires special
expertise.
 Providing accommodations is
expensive.
IDAS are another funding
stream.
It can be a way to fund
items services cannot
The IDA provider can
take care of all financial
issues for the person.
Asset development does
not require any changes
to disability services
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Bank On Louisville
 “Bank On Louisville” initiative, described as: “a comprehensive
network of community partners focused on serving the unbanked
and underbanked by increasing access to mainstream financial
services, products and tools and financial education resources in
order to decrease their reliance on expensive, alternative services
and increase financial stability.”
 In 2011, “Bank On Louisville reported over 5,900 new accounts
opened across the Louisville community—representing 24% of the
estimated unbanked households.
 Rose to 10,144 in their second year, with a steady increase being
realized each quarter and the average quarterly balance on the
accounts hovering at $818.”
 How is the disability community involved with Bank On efforts?
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Resources for Financial Literacy
 CARE Program - http://care4yourfuture.org/
CARE is a free financial literacy program which makes
bankruptcy professionals available to educators, students and
the public to illuminate the dangers of credit abuse. CARE has
a presence in all 50 states and the District of Columbia.
 The Kentucky Council on Economic Education –
http://www.econ.org/ Training around the areas of financial
and economic literacy.
 Kentucky Jump$tart – http://jumpstart.org/stateskentucky.html
 http://www.fdic.gov/consumers/consumer/moneysmart/adult.
html
 – The National Council on Economic Education (NCEE)
http://www.councilforeconed.org/
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What work incentives can be an asset
building tool?
What new partnership do we need?
.
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Trial Work Period (TWP)
 The Trial Work Period applies to
you only if you receive SSDI or
SSDAC.
 Trial Work Period is a nine
month period with three
additional months called the
cessation and grace period.
 For a full year you can try
working without losing your
benefits. During the Trial work
period you can earn as much
money as you can and still
receive your full Social Security
check.
 How is this an asset tool?
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The majority of people we work
with lack control over economic
resources. Are working poor even
after we close their case
A PASS plan can give people
control over their economic
resources – A way out of poverty.
Can be paired with other asset
building tools.
Limited counseling and guidance
on fiscal issue:
 The amount of money people need to
make to be economically
independent. Or how to use their
benefits strategically to become
economically independent.
 PASS Plan will give an opportunity to
have these conversations
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 It can enhance the plan
 Can build ownership
 It can reduce fear of losing
Medicaid
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 Washington Access Fund
provides the state’s assistive
technology (AT) IDAs and is
also a CDFI that provides
low interest loans for AT and
this can improve individuals
credit score if they have a
loan with WAF.
 The program aims to
combine IDAs and low
interest loans to build
economic self-sufficiency.
 Received permission for
Dept of Education to use
telework funds to create
IDAs for business
equipment
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Funded a study creating a
private IDA for individuals with
disabilities.
 Purpose to increase
economic security for
persons with disabilities
 Increase communication
and collaboration between
the disability and asset
development communities
 Higher match rate
 Expanded what people
could save for
 Shorter saving time
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 CASA of Oregon, Innovative Change and
Community Vision established financial portfolios
for individuals with disabilities including:
 IDAs federal and state
 Low interest loans
 IDAs and low interest loans
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 Individual Mandates
 Requires most people maintain a
minimum level of coverage and
dependents each month
beginning in 2014
 What satisfies coverage- employer
sponsored insurance,
grandfathered health plan,
Medicare or Medicaid, individual
plan
 Who is exempt – undocumented
immigrants, religious objectors,
people incarcerated
Health Insurance Exchanges
health plans
advanced payment of
premium tax credits
amount of tax credits varies
based on income
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 A person with income between
100% and 133% is responsible for
paying premiums of 2% of his/her
income and is eligible for a tax credit
 Tax credit is based on the second
lowest cost exchange
 Provide cost sharing to incomes
between 100% and 250% of FPL
($23,050-$57,625 per year for a family
of four)
 Don’t satisfy mandate- financial penalty




$95 or 1% of income in 2014
$325 or 2% of income in 2015
$695 or 2.5% of income in 2016
Penalty dollars are subject to an annual cost of
living adjustment
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 Exempt from penalty
 Premiums would exceed 8% of their
household adjusted gross income
 Members of American Indian tribes
 Financial hardship waivers
 Income below the tax filing
threshold
 Lacked insurance for less than
three months during a given year
Medicaid Expansion-Beginning
2014
Nearly all people under age 65
with household incomes at or
below 133% of FPL ($14.856
individual, family of four $30,657)
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 To fund the expansion
ACA provides that
the federal
government will
cover:
 100% of the states’ cost of the
coverage expansion in 2014-16
 Gradually decreasing to 90% in
2020 and thereafter
 Newly eligible Medicaid population
– essential health benefits
 Medicaid expansion would cover
an estimated 17 million uninsured,
low-income individuals
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 Leaves the Medicaid
Expansion intact

 Restricts the Secretary’s
enforcement authority
 Also leaves intact-increase in
primary care provider
payments, new option to
expand home and
community-based services
 Gradual reduction in
disproportionate share
hospital payments
 States maintain the eligibility
standards until the Secretary
certifies exchange readiness
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 Affordable Insurance Exchanges
 http://www.healthcare.gov/law/fe
atures/choices/exchanges/index.h
tml
Kentucky has received $66.5 million
in grants for research, planning,
information technology
development, and implementation
of Affordable Insurance
Exchanges.
 $1 million in Planning Grants: This
grant provides Kentucky the
resources needed to conduct the
research and planning necessary
to build a better health insurance
marketplace and determine how
its exchange will be operated and
governed.
 $65.5 million in Exchange
Establishment Grants: These grants
are helping States continue their
work to implement key provisions of
the Affordable Care Act.
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Each person has index cards with a numbers from 1-8.
Form two teams
Write a next step question on the card
I will Click the Spin Button.
When the wheel hits the number on the index card, you
choose who will receive the next step question on your card.
 That team will get a point it they can suggest how that step will
be implemented effectively
 If they can not then the other team get a point if they can say
how it will be implemented.
 The team with the most points wins





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[email protected]
206-851-5371
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