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© 2019 Empire Justice Center

Returning to Work with HIV: Effect on Government Benefits

Presented by: Doris Cortes, Empire Justice Center

Saima Akhtar, Empire Justice CenterFiona Wolfe, Empire Justice Center

Sally Friedman, Legal Action CenterOctober 28, 2019

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Technical difficulties?

Email Michelle Peterson at mpeterson@empirejustice.org

OR

Click on the “Chat” box on your control panel and send us a message

10/28/2019

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Who are Your Trainers?

Doris Cortes, Empire Justice Center

Saima Akhtar, Empire Justice Center

Fiona Wolfe, Empire Justice Center

Sally Friedman, Legal Action Center

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Who is the Empire Justice Center? Empire Justice Center is a not-for-profit law firm.

Our mission is to make the law work for all New Yorkers, especially those who need its protection the most. We do this through systems change advocacy, training and support to other advocates and organizations, and high quality direct civil legal representation.

Website: www.empirejustice.org

Visit Empire Justice on Facebook and Twitter!

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Who is the Legal Action Center?Nonprofit law & policy work: HIV,

substance use, criminal justice

Website has many resources! www.lac.org

• Free publications, free webinars and more

Free legal services: privacy, discrimination (HIV/AIDS, substance use, criminal record) (212) 243-1313. lac.org/what-we-do/hivaids/

Visit LAC on Facebook and Twitter5

Community Health Access to Addiction and Mental Healthcare Project (CHAMP) can help you:

KNOW your insurance rightsFIGHT insurance denials for mental health and addiction careCHALLENGE insurance barriers & discriminationGET the most from your coverageRECEIVE fair reimbursementLEARN about options for low-cost care for the uninsuredAND MUCH MORE!

So you can access treatment for mental health & substance use disorders, including medication.

CALL our Helpline (888) 614-5400Helpline Hours: Monday-Friday, 9 a.m. – 4 p.m.

Do You Need Help Accessing Addiction or Mental Health Care?

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Today’s training

How employment can affect government benefits for:

SSI/SSDI

Public Assistance

Health Insurance

HASA (New York City)7

Why Employment Matters

Employment:

Key social/economic determinant of health (CDC & WHO)

Central to “Ending the Epidemic By 2020: NYS’s Blueprint Plan to End the AIDS Epidemic”

Facilitates long-term adherence & viral suppression (27% higher odds of optimal adherence to antiretroviral meds in studies of over 8,000 people)

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Why Employment Matters

Benefits to mental health through employment:

Improved psychosocial and psychological functioning

Increased self-esteem

Decreased psychological distress

Decreased depression

Lower depressive affect

Higher general morale

Lower anxiety

Higher perceived quality of life 9

ACCES-VR

Good employment resource:

ACCES-VR: NYS vocational rehabilitation agency

• Serves people with disabilities

• 15 District Offices

• Additional satellite

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Overall Objective of Webinar

How can people living with HIV/AIDS work while maximizing government benefits?

Will explain how a paycheck (“earned income”) affects eligibility for different benefits programs.

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Common Themes in Webinar

Most benefits programs discussed today have different rules, but similar themes:

Limits on income – earned & unearned

Programs to incentivize returning to work. Some “earned income” is not counted toward income limits for a period of time. Called an income “disregard.”

Amount of income “disregarded” and for how long varies.

Can be complicated and technical. Get help (next slide).

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Return to Work & Benefits Resources Work Incentive Planning & Assistance (WIPA) Agencies – benefits

counseling for people returning to work http://www.chooseworkttw.net/findhelp/

Independent Living Centers – independent living and benefits counseling and advocacy http://www.acces.nysed.gov/vr/independent-living-centers

New York Employment Services System (NYESS) – information on resources and incentives to return to work https://www.nyess.ny.gov/customer-information.html

The Red Book - A Guide to Work Incentives – SSA publication on work incentives for people on SSI/SSDI https://www.socialsecurity.gov/redbook/ 13

How Will Employment Affect SSI/SSDI?

Presented by: Doris Cortes, Empire Justice Center

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SSI Work Incentives

SSI is a needs based program

Eligibility requirements

• Categorical eligibility

• Technical eligibility

• Financial eligibility

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Categorical & Technical Eligibility for SSI Categorical

• Aged – age 65 and above

• Blind – same criteria as social security

• Disabled – same criteria as social security

Technical

• Citizen or qualified alien

• Residency

• Must apply for any other benefits

• Cannot be fugitive felon, escaped prisoner, or probation/parole violator

• Cannot be a resident of non-medical public institution, including prison

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Financial Eligibility

Income – any money claimant receives (earned, unearned, gifts, lottery winnings, welfare, etc.) and free or below‐cost food or shelter (subsidized by private sources or in‐kind) 

Resources ‐ assets claimant owns that could be converted to cash or used to buy food or shelter (e.g., bank accounts, life insurance, real property, stocks, bonds, etc.) 17

Financial Eligibility, Continued

SSI eligibility and payments are based on income and living arrangements (LAs)

Any earned or unearned income is deducted from maximum possible benefit level to determine eligibility and monthly payment

See http://otda.ny.gov/programs/ssp/#benefits

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SSI Benefit Levels FBR = Federal Benefit Rate 2019

• Living alone and with others:               

o $771.00 (Individual)               $1,157.00 (Couple)

• Living in the household of another

o $514.00 (Individual) $771.34 (Couple)

‐ Living in Medicaid certified Institution:

o $ 30.00 (Individual) $ 60.00 (Couple)

SSP = State Supplement Payment – NY 2019

• Individual ‐ $87 or $23

• Couple ‐ $104 or $46 19

Income Counted

Earned income: wages (including earnings from sheltered and supported work)or self‐employment income (including royalties on published  work)

Unearned income: anything not wages: pensions, benefits, dividends, interest, in‐kind support, etc. 

Deemed income: from parent to child, spouse to spouse and sponsor to alien

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Earned Income Exclusions

Any portion of $20 general exclusion not applied to unearned income

$65/month earned income

Impairment‐related work expenses [IRWEs]

1/2 of remaining earned income

Blind work expenses (for blind persons only) [BWEs]

Income set aside in a Plan for Achieving Self‐Support [PASS plan] 

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Calculating Earned Income

Exclude the first $65 (or the first $85, if no unearned income has been counted); 

Deduct 1/2 the rest

The remainder is countable against the SSI benefit that would have been paid if there were no countable income. 

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Example

James begins earning gross wages of $485 per month

He lives alone and has no other income from any source

His usual SSI benefit in NY in 2019 was $858/month 

$485 ‐ $85 (earned and unearned disregards) = $400 ÷2= $200 countable income

$858 (2019 “living alone” rate in NYS) ‐ $200 = $658 

$658 = James’s 2019 SSI benefit

$1143 = James’s total monthly ($658 SSI + $485 wages)

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SSDI Incentive Earnings Program

Eligibility for Social Security Disability Insurance (SSDI/Title II) depends on disability and “insured status,” based on amount of FICA contributions deducted from pay checks

SSDI monthly benefits are calculated based on wage earner’s FICA contributions

Unearned income and resources generally do not affect eligibility or level of benefits

BUT, earned income does…. 24

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Substantial Gainful Activity (SGA)

Earnings above SGA generally preclude eligibility 

SGA levels are set annually by Congress

SGA in 2019 = $1220 monthly

See: http://www.socialsecurity.gov/OACT/COLA/sga.html

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Trial Work Period (TWP)

BUT… SGA is NOT counted during any 9‐month period, within 60 months, in which an SSDI recipient’s gross earnings are more than $880/month in 2019 (will increase to $910 in 2020) 

• TWP amount adjusted annually

• http://www.socialsecurity.gov/OACT/COLA/twp.html

Beneficiary can work and earn above the SGA limit without the earnings affecting SSDI eligibility

Months in which earnings are less than $880 (2019) are not counted towards TWP 26

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Extended Period of Eligibility (EPE)

EPE is a period of eligibility that starts with the month after the TWP ends and continues for the next 36 months.

For any month during this period that the beneficiary’s countable earned income is less than the SGA level ($1220 in 2019),  full SSDI benefits continues.

When countable earned income is more than the SGA level, SSDI benefits will be discontinued

• But benefits will continue for “grace period” of current month plus two more months before checks are stopped

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SSDI Incentive Earnings Caveat

Despite the availability of work incentives, SSDI (post TWP) remains an all or nothing program

Careful planning will allow most recipients to utilize work incentives until they are secure in their ability to maintain employment.

Professional benefits planners may be available

To find local benefit planners, see http://www.nymakesworkpay.org/rny‐benefits.cfm 

See also www.ssa.gov/redbook/documents/TheRedBook2019.pdf

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Incentive Earnings Caveat

SSA work incentives ‐ under either SSI or SSDI ‐ are available as long as the individual remains disabled according to SSA standards.

A finding of medical improvement will terminate all work incentive availability.

The assignment of a Ticket to Work can protect from medical Continuing Disability Reviews (CDRs) during the return to work process. 29

Ticket to Work

Ticket to Work and Work Incentives Improvement Act of 1999 

After 24 months on disability , beneficiary eligible for a ticket to obtain vocational rehabilitation employment services from an approved employment network of his/her choice

Ticket protects beneficiary from losing benefits under a medical Continuing Disability Review (CDR) during the return to work process

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Questions?

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How Will Employment Affect Public Assistance andSNAP?

Presented by: Saima Akhtar, Esq., Empire Justice Center

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Temporary Assistance (TA) Overview• Temporary Assistance is the general name of direct monetary assistance from the department of social services.  These are ongoing monthly benefits to help pay for housing and basic needs, not one‐time grants.

– Family Assistance

– Safety Net Assistance33

Financial Eligibility for TA

• To be eligible for TA, the household needs to have income and resources below the limits allowed by regulation.

• The rule on counting earned income is different for applicants and recipients of TA.

• Income (either earned or unearned) must be under the “standard of need” for a household to be eligible to get a TA grant from the DSS.

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How to Determine the Standard of Need?• The standard of needs has several parts that

are added together to determine the TA grant. The allowable maximum amount of each part is in regulation or statute.

• What are the parts of the standard of need?– Rent paid, up to the level of the rent allowance (also

called shelter allowance);– Living or basic needs allowance (sometimes called

Pre-add);– Home energy allowance (HEA) and Supplemental

Home Energy Allowance (SHEA);– Fuel for heating allowance if recipient pays separately

for heat;35

Treatment of Income in Determining Eligibility for TA• Household income, excluding SSI, can

not exceed 185% of the standard of need OR the poverty level.

• In determining household income for TA, all income counts, including unearned income (e.g. – unemployment benefits), except the first $100 of child support ($200 if more than 1 child). 36

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TA Income: Stipend to an HIV Peer Educator• The Temporary Assistance Sourcebook, Chapter 18, states that stipends provided to HIV peer educators are not considered income for purposes of determining a TA budget.

• Administrative hearings have held that this income exemption only applies to stipends, and not wages.  See FH# 6237679P (New York City, February 8, 2013). 37

TA Budget with Earned Income –Recipient Household with Children• The Rule: In households with children,

$90 disregard of gross earnings and then 53%* of remaining income IF parent has been on assistance 4 of the last 6 months before becoming employed.

• Once the initial $90 + 53% of the earnings have been disregarded, each dollar of earnings reduces the TA grant by $1.

* This number is revised effective June 1 every year and issued annually in an Administrative Directive by OTDA.

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TA Budget with Earned Income –Applicant Household with ChildrenAn applicant’s eligibility for TA is

determined without the 53% earned income disregard unless the applicant has received TA in any one of the four months preceding the date of the current application. 09-ADM-05.

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TA Budget with Earned Income –No children• The Rule: Only the first $90 is disregarded

• Once the first $90 of earned income are disregarded, additional earned income results in a dollar for dollar reduction in the public assistance grant.

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TA Resource Exemptions

• Automobiles:– $12,000 fair market value

• General resource exemption:– $2000, or– $3000 if there is a household member

over the age of 60.

• Burial plot• Earned Income Tax Credit

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TA Resource Exemptions, Continued• Funeral agreement worth up to $1500;

• Clothes, household furniture and appliances;

• Personal property necessary for employment purposes;

• Individual Development Accounts

• 529 educational savings accounts42

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TA as a Route to Eligibility for Other Benefits• Almost all individuals who are eligible for TA will be categorically eligible for both SNAP and Medicaid.

• In the event that someone on TA has a case that closes due to increased earnings, the SNAP, subsidized child care, and Medicaid will continue.

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Emergency Shelter Budgeting OptionsAs a result of a statutory change in 2018

and subregulatory guidance subsequently issued by OTDA (18 ADM-05), local social services districts have the option to limit the amount paid by homeless individuals with HIV or AIDS to 30% of their monthly gross income.

This is different from the Emergency Shelter Allowance available to individuals with HIV or AIDS pursuant to 18 N.Y.C.R.R § 352.2(k).

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SNAP Overview

• SNAP is the Supplemental Nutrition Assistance Program, formerly known as the food stamp program.

• In New York, SNAP benefits are generally available:

– Up to 130% of poverty for all households;

– Up to 150% of poverty for households with earned income; and

– Up to 200% of poverty in households with elderly or disabled members, or dependent care costs.  

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Non-Financial Eligibility Factors for SNAPHousehold Composition

Eligible/Ineligible Household Members

Student Status

Immigration Status

Work Requirements

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SNAP Work Requirements

• Are voluntary by district—some departments opt in, while others do not.

• For the DSS’s that have a SNAP work requirement, individuals between the ages of 16 and 60 can be required to work 30 hours per week unless they fall under an exemption, including if they are “physically or mentally unfit to work.”

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What Income Counts for SNAP Budgeting?• Earned Income;

• Self‐employment income;

• Unemployment Benefits;

• Unearned Income;

• Public Assistance;

• SSI, SSD, Retirement, Survivor’s Benefits;

• Income from Boarder or Lodger;

• Worker’s Compensation; and

• Spousal and Child Support. 48

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What Does Not Count as Income for SNAP Budgeting?• Educational loans, grants or scholarships for tuition and fees;

• Reimbursements for other than normal living expenses;

• HUD or other designated housing subsidies;

• Vendor payments to 3rd parties;

• Legally obligated child support paid to non‐household members;

• Income tax refunds; 

• Loans49

HIV Peer Educator Stipend for SNAP Budgeting

The HIV Peer Educator Stipend is nottreated as income for SNAP. See SNAP Sourcebook at page 275; also FH#7752319K (New York City, November, 28, 2018).

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Questions?

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How Will Employment Affect Health Insurance?

Presenter: Fiona Wolfe, Esq., Empire Justice Center

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What health insurance can I have while working?

HIV Uninsured Care Programs*

Medicare

Medicaid

Employer/Union Sponsored

Essential Plan & Other Subsidized Insurance

Full Pay Qualified Health Plan or Direct Purchase

Some Combination of the Above! 53

*Not comprehensive health insurance

HIV UNINSURED CARE PROGRAMS

What health insurance can I have while working?

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HIV Uninsured Care Programs

AIDS Drug Assistance Program (ADAP)• Medication to treat HIV/AIDS, opportunistic infections,

and some other conditions

ADAP Plus (Primary Care)• Primary care and outpatient services at select

locations

HIV Home Care Program • Home care services and durable medical equipment

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HIV Uninsured Care Programs (cont.)ADAP Plus Insurance Continuation Program

(APIC)• Can pay health insurance premiums

• Policies must be comprehensive and provide full prescription and primary care coverage

Pre-Exposure Prophylaxis Assistance Program (PrEP-AP)• For HIV negative individuals at high risk of HIV

exposure

• Includes screening, testing, counseling and other services 56

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Eligibility for Programs

Not eligible for Medicaid (but can use ADAP to meet Medicaid spenddown)

HIV-infection or at risk of acquiring

Gross income at or below 500% FPL

• Exclude withholdings for Medicare and Social Security, and cost of health care coverage paid by applicant

No resource limit! 57

Eligibility & Background of Program

Health Insurance? HIV Uninsured Care Programs ARE NOT

Comprehensive Health Insurance

• No emergency and inpatient care, rehabilitative therapy, MRI / CT scan / X-ray

• Do not meet requirement to have health insurance under the Affordable Care Act

• Not a way to avoid Medicare late enrollment penalties

Programs can work with other insurance

• May pay your health insurance premium

• May provide homecare to supplement insurance

• ADAP pays Medicare Part D copays and deductibles (for ADAP covered drugs) 58

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MEDICARE

What health insurance can I have while working?

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Impact of Work on Medicare

Medicare interacts with employer insurance in complex ways.

Before making any decisions about what to do with Medicare when you return to work, talk to a work incentives or independent living counselor!

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Medicare for Age 65+

If receive Medicare based on age (65+)

• Entitlement to Medicare DOES NOT change when you work

• If receive health insurance through employer, whether you should (or must) keep/enroll in Medicare depends on the size of your employer and the coverage

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Medicare for People who have or had SSDI If return to work, earn above SGA and continue

to meet Social Security definition of disabled:

• Trial work period – 9 months (Part A continues automatically)

• Extended Medicare coverage - additional 93 months (Part A continues automatically)

• Indefinite access to Medicare

If also have employer insurance, make sure Medicare and employer insurance co. know

• Whether employer or Medicare pays as primary depends on employer size 62

Medicare + SSDI info

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MEDICAID

What health insurance can I have while working?

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Different Paths to Medicaid

All SSI recipients eligible to receive Medicaid

Recipients of cash public assistance

• Includes Emergency Housing Assistance

• Does not include food stamps

MAGI Medicaid

Non-MAGI Medicaid

Medicaid Buy-In for Working People with Disabilities (MBI-WPD)

Section 1619(b) Medicaid 64

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MAGI v. Non-MAGI Medicaid

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*MAGI = Modified Adjusted Gross Income from tax return

• Childless Adults ages 19 through 64 who are not on Medicare

• Parents/Caretaker Relatives (even if on Medicare or 65+)

• Pregnant Women• Children under 19

MAGI*

• 65+ • Certified Disabled or Blind

Non‐MAGI

MAGI Medicaid Income Limits

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Eligibility Category Federal Poverty Level Limit –MAGI income

Parents & Childless Adults 138%

Children under 19 154%

19 and 20-year olds living with parents

155%

Pregnant women, infants 223%

No Resource Limit!!!

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MAGI Medicaid Income Counting• Adjusted Gross Income (AGI) from Tax

Return

• IRS rules

• Do not count child support, workers’ comp, veteran’s benefits

• Must add foreign earned income, tax-free interest, all social security income

• What counts as income may not be what you think!

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Lump sum payments?

Count as income in the month received

Need to know source of lump sum payment to determine if its income

• Gifts or inheritance = not included

• Qualified lottery winnings = included

12-month continuous coverage rule might apply!

Must report receipt of any lump sum 68

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Example: MAGI budget

James earns $400 per month from PT job

James gets $1,000 in SSD per month

He is not yet on Medicare

His MAGI is $1,400 = below 2019 MAGI level for one person ($1,437)

James is eligible for MAGI Medicaid

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Non-MAGI Medicaid Eligibility

Lower income cutoff than MAGI

• But can “spend down” to income limit

Resource limit applies

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Family Size 1 2

Monthly Income $859 $1,267

Resources $15,450 $22,800

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Non-MAGI Income Counting

Includes a number of income disregards• Health insurance premiums

Based on budgeting rules that treat different types of income differently:• Unearned income:

o $20 disregard (applied to earned income if unearned income less than $20)

• Earned income: o Subtract $65 ($85 if only have earned income)

o Subtract impairment related work expenses

o 1/2 remainder71

Example: Non-MAGI Eligibility

James earns $400 per month from PT job

James gets $1,000 in SSD per month

He is now receiving Medicare and pays $135.50 per month for his Part B premium

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Unearned Income Calculation

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Unearned Income $1,000

Income disregard - $20

Medicare Part B premium - $135.50

Net Unearned Income $844.50

Earned Income Calculation

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Earned Income $400

Earned Income disregard - $65

½ remainder ÷ 2

Net Earned Income $167.50

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James’ Non-MAGI Budget

James’ income is above the Non-MAGI Medicaid level

If he were 65+ he would have a $153 per month spenddown (remember ADAPexpenses!)

BUT he is under 65…

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Net Unearned Income $844.50

Net Earned Income $167.50

Net Countable Income $1,012.00

Medicaid standard (single) -$859

Excess Income/Spenddown $153

Medicaid Buy-In for Working People with DisabilitiesMBI-WPD is a special program for

individuals with disabilities under age 65 who have income from work

Allows people with disabilities to:

• Qualify for full Medicaid benefit without a spenddown at higher incomes

• Meet their medical needs

• Work without fear of losing essential medical benefits

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Two Categories of MBI-WPD

MBI-WPD Basic Coverage Group

MBI-WPD Medical Improvement Group

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Family Size 1 2

Monthly Income (250% FPL)

$2,603 $3,523

Resources $20,000 $30,000

MBI-WPD Basic Coverage Group EligibilityAge 16-64

Live in New York

Be a U.S. Citizen, a National, a Native American or an immigrant with satisfactory immigration status

Income & resource under MBI-WPD limits

Disabled (as determined by SSA)

Working for financial compensation

No minimum hours or pay requirements! 78

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MBI-WPD Medical Improvement Group EligibilityPreviously in Basic Coverage Group

No longer disabled

Severe medically determined impairment (by state Disability Review Team)

Work requirement:

• Minimum 40 hours per month

• Earn at least federal minimum wage79

MBI-WPD Income & Resource Counting Income

• Same budgeting rules as Non-MAGI Medicaid

• Cannot spend down to income limit

• Can put income above MBI-WPD into a pooled trust

Resources

• DO NOT count Retirement Accounts

• All other rules same as Non-MAGI Medicaid80

More MBI‐WPD info

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Example: MBI-WPD Eligibility

James earns $400 per month from his PT job

James gets $1,000 in SSDI per month

He is receiving Medicare and pays $135.50 per/month for his Part B premium

His income is determined using the same rules used for his Non-MAGI budget

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James’ MBI-WPD Budget

James’ countable income of $1,012 is well below the MBI-WPD level of $2,603

James is eligible for the MBI-WPD

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Net Unearned Income $844.50

Net Earned Income $167.50

Net Countable Income $1,012

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Example: Morgan

Morgan used to receive SSDI but no longer does due to work

She still meets social security definition of disabled

Morgan earns $5,000 per month (almost $60,000/year) from a fulltime job

She has no other income

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Morgan’s MBI-WPD Budget

Morgan’s countable income of $2,457.50 is below the MBI-WPD level of $2,603

Morgan is eligible for the MBI-WPD

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Earned Income $5,000

Earned Income disregard - $85

½ remainder ÷ 2

Net Countable Income $2,457.50

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MBI-WPD Coverage

Same benefits as other Non-MAGI Medicaid

No premiums for coverage

• MBI-WPD technically requires premiums for those over 150% FPL, but New York has no provision for collecting them

6 month grace period, if stop working

• May have multiple grace periods, but total amount may not exceed 6 months in a 12-month period

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Tips for Accessing MBI-WPD

Local DSS worker may not be familiar with program

Write “MBI-WPD” in HUGE letters on Medicaid application & renewal

Provide documentation about the program with application & renewal

NYSDOH Toolkit

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Section 1619(b) Medicaid

Protection for SSI beneficiaries

Allows people who lose SSI due to work to continue to get Medicaid

Eligibility automatically determined by SSA, but must report wages!

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1619(b) Medicaid Eligibility

Lost SSI due to increased income

Disability must continue

Unearned income & resources below SSI level

Gross earned income under $46,316 per year

Received SSI or 1619(b) benefits in at least 1 month during prior 12-month period

Used Medicaid in last 12 months, expect to use Medicaid in next 12 months, or would be unable to pay unexpected medical bill in next 12 months 88

1619(b) Eligibility info

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Example: 1619(b) Medicaid

Maria is single

She stops receiving SSI when she returns to work and starts making $24,000 per year

Her gross income is less than NY’s 1619(b) income threshold ($46,316)

Maria will get Medicaid under 1619(b) if she continues to meet the other criteria

Remember: If Maria’s income gets too high for 1619(b), she may be eligible for MBI-WPD!

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Medicaid and Immigrants

Some immigrants with incomes below the MAGI Medicaid limit (138% FPL) are eligible for the Essential Plan instead of Medicaid

• There are no premiums

• Cost sharing is the same as Medicaid

• The benefits mirror Medicaid, but are not identical

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Health Coverage Crosswalk: Eligibility by Immigration Status

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OTHER HEALTH INSURANCE

What health insurance can I have while working?

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Subsidized options

Insurance Affordability Programs purchased through the Marketplace:• Essential Plan

o Household income 138-200% FPL

o Zero or low premium & cost sharing

• Qualified Health Plan (QHP) o Lower cost premiums and reduced cost sharing

o Four cost-sharing levels (bronze to platinum)

o Size of premium tax credit based on sliding scale

o May be eligible if income up to 400% FPL

All use MAGI to determine income eligibility92

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Other Health Insurance

Employer or Union Sponsored Insurance

Full-pay Qualified Health Plan (QHP) purchased through Marketplace

Individual health insurance purchased directly from insurance plan

Note: APIC may be able to help with premiums if eligible. This is true even of the Essential Plan and people getting help with QHP premiums.

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Questions?

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How Will Employment Affect HASA Benefits?

Presented by: Sally Friedman, Legal Action Center

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Summary of HASA benefits

Financial benefits

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• $376/month ($188/semi-monthly)Food & Other (F&O)

Enhanced rent subsidy up to $480 for 1st

HASA eligible person, and up to $330 for each additional household member. Plus expenses.

30% rent cap if have outside income (earned and unearned) and are already getting cash assistance from HASA.

Rent Assistance

SNAP & Medicaid

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Summary of HASA benefits

o Housing – Supportive housing – congregate and scatter site as well as emergency housing for singles and families

o Home care and Homemaker services

o Case management 97

Social Services

Peer workers & HASA benefits

Peer workers

• Peer stipends do NOT affect or reduce any HASA benefits (financial and social services)

o HASA “disregards” all peer stipends when budgeting.

o Per OTDA directive, 8/23/94 (see below)

o No time limit

• BUT must submit documentation or HASA will find the income and count it!! Best to do within 30 days.

• Peer Educator Stipend Exemption Form available at https://otda.ny.gov/policy/directives/1994/INF/94_INF-41.pdf 98

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Employment & HASA

Income affects financial benefits:

• F&O

• Rental assistance

but not social services.

• Can still get case management, live in HASA housing, etc.

• Let’s see how earned income affects financial benefits….

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Food & Other (F&O)

Employment & HASA

• Income will reduce F&O dollar for dollar. No income disregard.

Example #1

o Joe is a HASA client. Begins a job paying $500 semi-monthly. Won’t get any F&O. Earns more than full F&O amount of $188 semi-monthly.

Example #2

o Joe’s hours are slashed. Only earns $100 semi-monthly. Instead of full F&O ($188 semi-monthly), Joe will only get $88 semi-monthly:

$188 (full F&O) - $100 (income) = $88.100

Food & Other (F&O)

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Employment & HASA

– Can Joe get 30% cap?

Joe has $1000/month gross salary ($500 semi-monthly).

• Eligible for 30% rent cap if he’s eligible for cash assistance:

o Net countable Income – rent = $376/month or less

• What is net countable income? Income after subtracting any income that HASA ignores –“income disregards.”

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Rent Assistance

Employment & HASA - RENT

Joe might be eligible for income disregards through HASA’s Work Opportunities Program – “disregards” some earned income when calculating budgets of HASA clients who already get cash assistance.

Income disregards - Joe has active cash assistance case, so HASA will use the income disregards when budgeting.

But 1year only, unless Joe’s household includes children under 18 (in which case, no time limit).

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Employment & HASA - RENT

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Which of Joe’s income will HASA disregard?

• HASA disregards first $90/monthly (per OTDA policy)

• Then disregards 53% of the balance of Joe’s income. This amount is called the “earned income disregard,” or EID. Subtract EID from income for monthly budgeted income.

• If – after subtracting disregards and rent – Joe has no more than $376 left, he’ll be eligible for the 30% cap.

Employment & HASA-RENT

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Joe’s earned income/month $1,000

Subtract OTDA earned income disregard

- $90

Multiply remainder of $910 by .53 (HASA rule)

X53%

Earned Income Disregard (EID)

$482

Net Countable Income = Income ($1000) – EID ($482)

$518

Subtract rent of $1200 - $682

No more than $376? YES

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Employment & HASA benefits

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BUT if Joe’s income rises so that after subtracting “disregards” ($90 plus 53% of the balance) and rent, it is more than $376 monthly, Joe will not be eligible for the 30% rent cap.

Will Joe be able to stay in scattered site housing if his income is too high for 30% rent cap?

Yes. But he’ll have to pay a larger share of rent – as he would in private market housing.

Employment & HASA-RENT

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Rent Assistance

What about Mary? She was never on HASA cash assistance. Heard about 30% rent cap. Can she get it?

• Earns $1680/monthly in a job. $1200 rent.

• First question– eligible for income disregard?

• Sorry, Mary! Income disregards only apply to existing HASA cash assistance clients.

• But is she eligible for 30% rent cap even without the earned income disregard? Let’s see…..

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Employment & HASA-RENT

Mary’s countable income of $480 is more than $376!

Mary is not eligible for 30% rent cap.

She can still be a HASA client – eligible for caseworker, home care, other social services. But not financial assistance.

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Mary’s earned income $1,680

HASA earned income disregard does not apply to Mary

0

Subtract rent - $1200

No more than $376? $480

Employment & HASA-RENT

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Mary’s earned income $1,680

HASA earned income disregard 0

Subtract rent - $1304

Less than $376? Yes. $376

But if Mary’s rent were at least $104 higher, she would be eligible.  

Or, would be eligible if her salary were $104 lower. ($1576 ‐ $1200 = $376)

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Employment & HASA benefits When to report income?

• Must report within 30 days (from when began earning income) – or possible recoupment for overpayment. HASA likely will find unreported income.

• HASA says it won’t recoup for first month salary (while also getting cash assistance), provided report it within 30 days. But will recoup if don’t report income after first month.

• Bring all paystubs for that month (weekly, every 2 weeks, semi-monthly). HASA averages the hours, if vary.

• If hours go down in a future month, let HASA know. Can re-calculate budget in your favor.

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Employment & HASA benefits

Can Joe & Mary put any extra earnings into the bank?

• Only up to $2,000, without affecting his HASA eligibility.

• $2,000 “resource” limit for single person.

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Questions?

Email your questions relating to SSI/SSDI, Health Insurance and Public Assistance to:

o Michelle Peterson, Sr. Training Manager, mpeterson@empirejustice.org

Questions relating to HASA only, contact Legal Action Center

o (212) 243-1313, www.lac.org111

HOW DID WE DO?

In just a moment, you will receive the webinar evaluation. Please take a moment to complete. We value your comments and suggestions and thank you for your time.

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Did you register?

If you haven’t officially registered with the NYS Department of Health AIDS Institute, http://www.hivtrainingny.org/ please DO IT NOW!

Get credit for your attendance!

Contact Michelle Peterson, mpeterson@empirejustice.org

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Thank you!

This concludes the webinar.

Thank you.

And thanks to the AIDS Institute, New York State Department of Health.

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