1. James R. Sheldon, Jr., Esq. National AT Advocacy Project Neighborhood Legal Services, Inc. Buffalo, New York 14203 FUNDING HOME MODIFICATIONS FOR INDIVIDUALS WITH DISABILITIES: An Emphasis on Funding Home Modifications to Support Employment Goals NATTAP Conference April 22, 2009

2. 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. 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. 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. 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. 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. 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. 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. 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. 10 SSI’s Plan for Achieving Self Support (PASS) - Steve Steve’s SSI calculation with PASS exclusion: Unearned Income (SSDI)$720.00 Unearned Income Exclusion- 20.00 $700.00 Exclusion for PASS Expenses-700.00 Countable Income$.00 SSI Base Rate$674.00 Countable Income-.00 New SSI Check Amount$674.00 Good News – Steve gets Medicaid too in most states; can save needed $17,500 in 25 months

11. 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. 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 2009. 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.