Sunday, June 17, 2001

Alive and well

Get a job and keep Medicaid coverage

        Imagine that you are a person with a severe disability whose complicated medical needs are inexorably linked to Medicaid coverage. Then imagine that you finally have the opportunity to go to work. You've been surviving on $500 a month as an SSI recipient, and you can now make three times that much as a contributing taxpayer. The job is one you'll enjoy and you're tired of explaining to people that you're unemployed. But the medical benefits would never begin to continue the needs now covered by Medicaid.

        Peter Elliott, a disability benefits counselor for Cincinnati's Center for Independent Living Options, says that the above scenario is one heard every week by case workers and service providers throughout the Tristate. All too often, Mr. Elliott says, the choice seems to be a simple one of choose to work or choose to keep your Medicaid. The fact is, however, that many work incentives exist making that choice an unnecessary one, and service providers are simply too bogged down in assisting people with other needs to keep current with the myriad options.

        At a June 21 workshop at Thomas More College, Mr. Elliott plans to cut through some of the jargon and illustrate solutions to apparently inescapable conflicts. “At the very least,” he says, “we hope to familiarize service providers enough with the various work incentives that they can make appropriate referrals and will know when to query a benefits counselor like me.”

        Take, for example, the basic rules of receiving SSI and Medicaid coverage.

        At a glance, the rule seems to be that a recipient can have no more than $2,000 in personal resources, cannot earn more than about $21,000 annually and still receive SSI or Medicaid. The reality, Mr. Elliott points out, is that you can own a house — if it is your personal place of residence; you can own a car — if it is required for transporting you to medical appointments; and, best of all, you can earn a good living and still have your medical needs covered by Medicaid.

        “1619B is the magic word here,” Mr. Elliott says. “If you see that you are going to surpass whatever the current annual earnings limit is, but will not be able to cover medical expenses, tell your Social Security representative that you want to be placed on 1619B.”

        What this accomplishes is to hold SSI eligibility open in definitely, allowing the individual with a disability to continue earning wages while also receiving Medicaid. One consumer, Mr. Elliott cites as example, requires daily oxygen. Although she now earns roughly $50,000 a year, her 1619B status has allowed her to keep Medicaid benefits for her oxygen needs. Obviously, everybody wins.

        Several other incentives exist that can be used to assist consumers with disabilities in seeking and keeping gainful employment. Ohio has led the way, Mr. Elliott says, in enabling individuals to establish special needs trusts to shelter inheritances or other capital gains without losing Medicaid benefits.

        Another often overlooked incentive is PASS (Plan for Achieving Self Support) which is the Social Security Administration's solution for the SSI recipient who needs to set money aside for an employment-related goal. If you need a computer, for example, you make an agreement with SSA to designate a bank account as your PASS account. Money placed in the account will not be taxed or counted against your $2,000 personal resource limit. It cannot be withdrawn for any but the designated purpose. When the goal has been reached, you then withdraw the money to purchase your computer and are one step closer to holding a job.

        Peter Elliott cut his disability benefits teeth at the first independent living center in America. As a Social Security benefits expert at the Center for Independent Living in Berkeley, Calif., the groundwork for his role for the past three years in Cincinnati was laid. “We think of California as being much more progressive in many disability areas,” Mr. Elliott says, “but Ohio can be very proud of the lead it has taken on a number of fronts.”

        Now, the key is getting the rules and information regarding those advances into hands and minds of more people who can use them.

        The Work Incentives Workshop for Service Providers, sponsored by Independent Living Options will be 10 a.m. to 4 p.m. June 21, room 3307 of the science wing at Thomas More. Cost is $35 and includes lunch.

        Continuing education units are available. To register, call 241-2600.

        Contact Deborah Kendrick by phone: 673-4474; fax: 321-6430; e-mail:


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