James R. Sheldon, Jr., Esq. National AT Advocacy Project Neighborhood Legal Services, Inc. Buffalo, New York FUNDING HOME MODIFICATIONS FOR INDIVIDUALS WITH DISABILITIES: An Emphasis on Funding Home Modifications to Support Employment Goals NATTAP Conference April 22, 2009

2 The Case of Steve – Age 42 Spinal Cord Injured, Gets the Following Benefits: Social Security Disability Insurance - $720 Medicare Parts A and B No SSI (state rate is $674) No Medicaid  state has Medicaid buy-in for working people with disabilities

3 Steve’s Work History Worked 15 Years for Insurance Company, Selling a Number of Products: Auto insurance Life insurance Homeowner’s insurance Disability insurance Cannot do this work any more.

4 Company Offers Steve Job – Home-Based Insurance Adjuster Job Will Involve: Settling vehicle, homeowner’s claims Collaboration with field adjuster Company will pay for 8-week, online training

5 Needed to Set Up Home Office Home Addition, Cost = $24,500 Use existing first floor bedroom Accessible entrance, widened doorways State VR agency will cover $10,000 Steve will still need $14,500

6 Office Furnishings, Computer Equipment Employer will cover $3,250 for: Adapted desk, storage units Office phone system, four-in-one printer Chairs for occasional meetings Adapted computer/keyboard/mouse Voice dictation software

7 Employer Will Not Pay For: Central air for office ($1,800) Environmental control unit ($1,200)  Operate door to outside  Turn on/off air conditioning  Answer phone

8 Funding Needed Items Not Covered by VR Agency or Employer $14,500 of home addition $1,800 for central air $1,200 for environmental control unit $17,500 total needed!! What are possible funding sources?

9 Potential Funding Sources Alternative financing project Telework loan SSI’s PASS plan Help available through Work Incentive Planning & Assistance (WIPA) Project Medicaid/Medicaid waiver Other funding sources?

10 SSI’s Plan for Achieving Self Support (PASS) - Steve Steve’s SSI calculation with PASS exclusion: Unearned Income (SSDI)$ Unearned Income Exclusion $ Exclusion for PASS Expenses Countable Income$.00 SSI Base Rate$ Countable Income-.00 New SSI Check Amount$ Good News – Steve gets Medicaid too in most states; can save needed $17,500 in 25 months

11 The Bad News – Steve Cannot Wait 25 Months to Start Work Collaboration with AFP Loan Program: Steve’s benefits adviser at the WIPA project calls the state AFP to facilitate referral. AFP takes application and approves loan for $17,500 at very competitive interest rate. With loan proceeds released right away: Home addition done while Steve completes online training. Central air installed at same time. Environmental control unit also purchased. Steve starts job on employer’s time table.

12 The Medicaid Buy-In Steve’s state has implemented a buy-in program for individuals with disabilities who work. Eligibility based on 250 percent of the federal poverty level. His countable monthly income, after all SSI-related exclusions, must be below $2,257 in Her state’s buy-in program allows her to have non- exempt resources of up to $13,800. If approved for the buy-in, his state will require that he pay a modest monthly premium. Medicaid will be future funding source for AT.