Sunday, December 05, 1999

Measure should help disabled

Medicare, Medicaid eligibility lengthened

The Cincinnati Enquirer

        A piece of legislation passed by Congress last week could have as much impact on the employment rate of people in the Tristate with disabilities as the 1990 Americans with Disabilities Act has had on access to public facilities and an awareness of civil rights.

        The Work Incentives Improvement Act, passed Nov. 18, was proposed by President Clinton in his 1999 State of the Union address, and referenced by him in several other public speeches, has promised real opportunity on the employment front in a way that has disability rights activists excited.

        The cost of wheelchairs, medications, medical supplies, and other disability-related expenses is high, and for many, the only conceivable way of covering those costs has been through Medicaid and Medicare. Most Americans depending upon those benefits know all too well the dilemma posed by the long-standing system. If you work, your Social Security Disability benefits disappear — and along with them, your Medicaid or Medicare benefits as well. Thus, many disabled Americans who want to work have been caught in the inescapable circle of choosing between health care and employment.

        The Work Incentives Improvement Act brings a number of changes to the existing system. First, Medicaid and Medicare coverage will con tinue, despite earnings limits, up to three years beyond the time that Social Security benefits are replaced by earnings from employment. Secondly, participants will have the option of buying in to those services for an additional 4.5 years, extending total Medicaid or Medicare coverage to a total of 7.5 years beyond the time of gainful employment.

        Another change is the way in which employment can be obtained by people with disabilities. Traditionally, the vocational rehabilitation system, set up somewhat differently in each state, has provided training necessary for employment to people with disabilities. For each person who replaces Social Security benefits with a successful job placement, the vocational rehabilitation agency that provided the training is reimbursed by Social Security for the cost of that training.

        Under the Work Incentives Improvement Act, private sector facilities can become “vendors” in the job training and placement business. Where waiting lists are long and training requirements relatively simply, this might broaden options.

        Perhaps as never before, people with disabilities need to be aware of choices. Eric Parks, former chair and current commissioner for the Ohio Rehabilitation Services Commission points out, for example, that, in many instances, private agencies simply won't have the cash for extensive training to make an individual employment ready.

        “We, in Ohio,” Mr. Parks says of the state vocational rehabilitation agency, “are second only to the state of California in the number of reimbursement dollars received from Social Security for successful placements.”

        A “successful” employment is a job placement which, after completing all necessary training, has a nine-month track record for providing a person with a disability with the “substantial gainful employment” rate as determined by the Social Security Administration. After that nine months is completed, the state agency is reimbursed for the cost of the training by Social Security, the recipient's SSI or SSDI cash benefits cease but, with the new law, Medicaid or Medicare continues.

        To read the Work Incentives Improvement Act Bill and related reports on the Web, visit

        Cincinnati writer Deborah Kendrick is a nationally recognized advocate for people with disabilities. Write her at Cincinnati Enquirer, Tempo, 312 Elm St., Cincinnati 45202. E-mail:


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