NORTHROP GRUMMAN SYSTEMS CORPORATION
Instructor: Lucy Miller
11-06-13/1:00 p.m. ET
Confirmation # 96050011
Page 1
NORTHROP GRUMMAN SYSTEMS CORPORATION
Supporting Beneficiaries to Progress along the Employment Continuum
Instructor: Lucy Miller
November 6, 2013
1:00 p.m. ET
Operator:
Good afternoon. My name is (Heather), and I will be your conference
operator today. At this time, I would like to welcome everyone to Supporting
Beneficiaries to Progress along the Employment Continuum Conference Call.
All lines have been placed on mute to prevent any background noise. After
the speakers' remarks, there will be a question and answer session. If you
would like to ask a question during this time, simply press star then the
number one on your telephone keypad. If you would like to withdraw your
question, press the pound key. Thank you.
Ms. Miller, you may begin your conference.
Lucy Miller:
Thank you, (Heather). Hello, everybody. I hope that all of you are enjoying
gorgeous fall weather as we are here in Kentucky. A little crowded, a little
cloudy rather but still very, very nice. And I hope you were enjoying it as
well.
OK. Most of you know that rule. We've got a two-hour presentation. We are
going to be covering the topic of supporting beneficiaries to move forward
towards employment. That's really what the subject matter is today.
We will be taking a break half way through and accepting questions then, and
then back in the lecture mode and then taking questions at the end of the
presentation. You should have received two things from the lovely and
talented Julie Schall. You should have gotten a PowerPoint presentation that
NORTHROP GRUMMAN SYSTEMS CORPORATION
Instructor: Lucy Miller
11-06-13/1:00 p.m. ET
Confirmation # 96050011
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would probably – I think not in PDF format. Hopefully, you've printed that
out or you had it opened on a screen in front of you.
I will try to indicate the number of the slide as we move forward so folks
know where we are.
You should also have gotten a little handout. It's like a chart, several pieces of
chart and it shows you the stages of progression towards employment and then
provides some information about the kinds of counseling that you would give
beneficiaries who are at each day. And we'll talk about that.
Now, the content of the material that we're covering today comes out of
module six in your manual. Some of it is presented in the first unit in module
six where we talked about doing initial intakes and prioritizing beneficiaries,
and figuring out what services people need, things like that. But the concept
of progressing towards employment really weaves itself all the way to module
six. So we'll touch on some places in the unit on benefit summary analysis
development, and the development of (width), and also in the area of ongoing
follow up and providing services to people long-term. So it is a continuing
thing.
And that really is my first message to you before we (went) to the slides. The
whole purpose of a (inaudible) is to provide information that help
beneficiaries make decisions about employment. And we definitely are prowork. We want to see people work to the greatest extent that they are possible.
That's possible. And we have to remember that when we're working with
beneficiaries, that is our primary focus.
All right. So, let's get started wit the PowerPoint presentation. And again,
let's just reframe it under the mission of WIPA. And throughout the manual, I
think maybe 1,000 times, we say that the mission of the WIPA initiative is to
promote employment and enhance financial stability of the beneficiaries that
we work with.
So, let's break it down. What does that mean? Our work, when we're talking
about benefits, our focus is on work incentives counseling and issues directly
related to employment. A lot of it is focused on overcoming mythology that
NORTHROP GRUMMAN SYSTEMS CORPORATION
Instructor: Lucy Miller
11-06-13/1:00 p.m. ET
Confirmation # 96050011
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people have about the negative impact of employment on benefits. A lot of it
is showing people how they can use specific work incentives like impairmentrelated work expenses, or pass, or student or an income exclusion, to work and
earn more and to smooth that transition from being completely dependent on
that government track to being more independent and more reliant upon a
paycheck.
So that's the focus of the counseling that we do around the benefit. Now, the
long-term outcome that we hope to achieve is that more beneficiaries will
choose to work at some level. And that's one of the reasons why of course,
you know, now that the WIPA initiative is back and operational, we're going
to be moving back to the ETO tracking system. We really want to track the
extent to which people go back to work after receiving counseling from us.
Third, we are really focused on supporting beneficiaries to maintain
employment. Unfortunately, one of the things that some of the research
Social Security has done, one of the things that pops or that they have shown
is a bad sort of recurring thing is that beneficiaries do get jobs. They just don't
keep jobs. And part of our mission really needs to be focusing on people who
do obtain employment and then providing that long-term service, the follow
up, the continued booster shots of information, the friendly check-ins to make
sure that folks stay employed over time, and hopefully, even moved up in
employment, more hours, better job, better pay, all of those things.
We are there to encourage and to support. So it isn't about bring them in, give
them the BS&A and on to the next person and we never follow up. That is –
that was sort of the old (BPIO) model but that's not what we're doing in WIPA.
We need to focus on those people that are employed and do everything within
our frame of influence or our scope of influence to help people stay employed
and progressively move up.
And finally, we really want to help people improve their financial stability.
So, whether that is getting better skills to get a better job at least to getting off
the benefits or working at a level where there are some benefits to receive,
possibly health insurance and working. It all depends on the individual and
what they're capable of doing. But our mission is to have people be better off
NORTHROP GRUMMAN SYSTEMS CORPORATION
Instructor: Lucy Miller
11-06-13/1:00 p.m. ET
Confirmation # 96050011
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financially by working than by sitting at home watching the old SpongeBob
SquarePants. So it's all about more money, OK, more money in the pocket
and even more money in the bank building resources. And we'll talk about
that a little bit later as well.
All right. So, what is this employment continuum thing? Well, we're on the
next slide, slide three.
It's really – in the (main), I think we describe it kind of as a road. And there's,
you know, a place where the individual puts their toe first on the road of sort
of deciding, "Do I even want to work? Is that something I can do? Is this
something that is in (accord) to me that I'm capable of doing and that I really
want to pursue?" All the way up to, "I really want to be working full-time. I
want to have a great job. I want to get off these benefits and move towards a
more independent lifestyle."
So, along this continuum, there are umpteen billion little stages, but we break
it down into four sort of large categories that people fall in. And the top of the
key for us of course is employment. And within the employment stage, we've
got people who are minimally employed all the way up to people who are
employed at full-time in professional jobs and might be letting go of the cash
payments and health insurance.
So employed folks are – really that's the end. That's where – on the picture on
your slide, that's where that sun is on the horizon. That's the employment.
The next step back is people who are actively looking for work. And this
really means folks that are submitting applications, submitting resumes, going
to interviews, you know, going door to door and talking to employers,
whatever it might be to actively look for a job.
The third stage is preparing for employment. And this is pretty broad. This
can be anything from – I've actually made an appointment to go to V.R. and
see what services they can offer me so that I can get a job to, well, I'm going
to the one-stop career center, I'm taking classes and interviewing to, you know,
I'm going back to school. I'm trying to get a certification or a degree that will
prepare me for a better employment outcome later on.
NORTHROP GRUMMAN SYSTEMS CORPORATION
Instructor: Lucy Miller
11-06-13/1:00 p.m. ET
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And then, the people with their toe, right, stepping onto this road are the
people that we call "in contemplation status." And those are the folks that are
thinking about it, OK. They haven't even made the decision, "Yes, I'm going
to pursue employment and I'm going to do something to get from where I am
today to where I ultimately want to be."
And again, remember it's a continuum. So things aren't always so cut and dry.
These are four broad categories. And a person who is in preparations category,
everybody in that category wouldn't look exactly the same. So think of it as a
broad range of people in each phase.
OK. So slide four. We break this down a little bit just to make sure
everybody's clear.
We really want you to identify what stage people are in when they first call
you. It's really important that whatever information gathering tool you use,
that you literally are starting from jump by sorting people. Where is this
person when they first contact you? Because this can really show you how
much progress you're making with beneficiaries if someone makes that first
contact and they're kind of sort of maybe going to one day think about work
and by the, you know, by six months later they are actively searching for work
or preparing for work. This is progress and we need to be tracking where
people are when they first call us.
So, contemplated. These are the folks that are just beginning to think about
the possibility of going to work. They typically have no clear employment or
earnings goal. A lot of times, they don't even know what they can do,
particularly folks that may have a long career doing something else. They
now become disabled or ill and their former career is not available to them
now. It's not something they can pursue now because of the nature of the
disability.
So, people in contemplated stage often have no idea what they can do. They
don't often understand or even think about, well, how many hours, what can I
sustain, what can I physically manage. And a lot of them are very fearful of
the impact of work on benefits. Remember, a lot of folks that are really
NORTHROP GRUMMAN SYSTEMS CORPORATION
Instructor: Lucy Miller
11-06-13/1:00 p.m. ET
Confirmation # 96050011
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contemplative, you know, scared to pursue employment. It took them a long
time to get on benefits and they have to fight really hard to get on them. And
all that time, they were proving the Social Security, "I can't work. I can't work.
I can't work."
Well, now, they're on and we're saying, "You know, you can work" and
they're like, "What?" So, wee kind of have to undo a lot of what they learned
in that really long and difficult process of applying in and becoming eligible.
All right.
Preparatory stage. These are people who are beyond – they are saying, "You
know, I want a job. I want to be employed." Now, again, they may not have a
super clear earnings goal or employment scale but at least they are saying, "I
want to pursue employment." And we know that they are in preparatory stage
because they've taken some steps towards employment. And that can be a
wide range of things, like calling Voc Rehab to get that initial appointment,
like going to the one-stop career center, like in at least investigating
certification programs or degree programs.
So, this is a person who is demonstrating that they are preparing for
employment by actually doing something. It can be something fairly minimal,
but they've done something to take that step beyond, "You know, I think I
want a job," to moving in that direction.
There is a clear employment and earning. So, well, actually in preparatory
stage there might be, let's say, a murky employment and earnings goal. They
may know broadly, "I want to work in the service industry" or "I know I need
an office job." And, you know, there's going to be some clarity here. It's
going to be beyond, "Do you have no idea what I can do, what I want to do?"
But it may not be crystalized into, "I want exactly this kind of job, exactly this
many hours a week. I know exactly what kind of salary I can expect."
And then, finally, the steps to achieve the goal have at least been identified or
some of them have been identified.
So, that has been given to, "OK, here's where I am today. Here's where I want
to be. And here's the step I kind of need to do between this point and that
NORTHROP GRUMMAN SYSTEMS CORPORATION
Instructor: Lucy Miller
11-06-13/1:00 p.m. ET
Confirmation # 96050011
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point." So those are all indicators that a person would be in the preparatory
stage.
On slide five, job search. All right. When you're looking for a job, people
have a clear employment and earnings goal. I mean they have picked out the
kinds of jobs that they want and those are the ones they are pursuing. They're
applying for them. They're submitting resumes. They're doing something.
They completed some preparatory steps, typically. They got that open case
with V.R. They've gone through the intake appointment in the profiling that a
support and employment agency needs to go look for a job. They have
attained their certification, gotten their GED, you know, finished their college,
and whatever it was that they needed to do to prepare has been completed.
And they are actually out there knocking on doors. They are submitting
application, submitting resumes, interviewing. And those are the kinds of
questions, when you have a beneficiary on the phone, you don't say, "Are you
in the job search stage?", because they don't always know what that means.
Ask specific questions like "Have you submitted any application? Are you –
have you gone on any interview?" You know, things like that.
Finally, it's very obvious, I would think, who's in the employment stage?
Somebody who is already working or self-employed, OK? So, remember that
for a person who's self-employed, it's not just that they are thinking about it
but that they have actually be gone to provide the items or services that their
business is all about. So they're single is up and they're out there conducting
business of some level.
Now, a person who is employed could be recently employed like "Oh, my
gosh, I just got this job yesterday," or it can be somebody who's been working
for a very long time. And you'll get calls from all different kinds of people. It
maybe a person who's experiencing a problem at work or – because of their
benefit that's causing them to consider cutting back or changing job. It may
also be someone who's considering something that we would consider quite
positive a raise, a new promotion, a new job, an additional job, OK? People
do sometimes work more than one job or they have wage employment and
move towards opening their own business at the same time.
NORTHROP GRUMMAN SYSTEMS CORPORATION
Instructor: Lucy Miller
11-06-13/1:00 p.m. ET
Confirmation # 96050011
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So, all kinds of combinations here. But these are the folks that would be
considered in employment stage.
So, all right, these questions that are on this slide and then next slide are
(these) indicators. This should be part of your interviewing process when you
have that initial call from someone. These are the kinds of things we need to
be getting sorted through and figuring out, and you need to be clear what stage
the person is in.
So, let's move on to slide six. So, you figured out where the person is on the
continuum, and the object is to move the person forward. So if you've got
somebody in contemplation, we want to get them to the point where they say,
"Yes, work is good." And they move towards preparation. If you've got
somebody in preparation, you want to get them to the point that they are
looking for that job in job search. And person in job search, we want them to
be successful and actually get that job.
So be specific. Think about your role in that way. What can I do to move this
human being up a step from this stage to this stage? Or maybe skipping some
step. What we don't want to do is move backwards if we can possibly help it.
So, what is our role in promoting that progression along the employment
continuum? Well, first and foremost, when we talk to beneficiary we
encourage employment. We are positive about work. We are pro work.
We're enthusiastic about work. We express that work is good, OK?
Now, I'm not saying that everyone needs to go to work full time tomorrow.
I'm saying we're looking at any level of employment as being positive change
for beneficiaries. That is our philosophy, our value system, OK. Work is
good.
We are there to really be an employment cheerleader that when someone takes
a step forward, we congratulate them. We cheer them on. We provide
support, encouragement, positive reinforcement moving forward. And we –
when a backward step has to be taken and that happens, we work to help the
NORTHROP GRUMMAN SYSTEMS CORPORATION
Instructor: Lucy Miller
11-06-13/1:00 p.m. ET
Confirmation # 96050011
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person remain positive and get back on track and move forward again. We
really are a cheerleader.
Now, that maybe a role that you just sort of never sort of thought of yourself
in, but a good (CWIC), cheers. I mean we encourage, we promote, we
persuade, and we appositive, right.
Now the next bullet is about balancing the emphasis on paid employment with
common sense. So let's think about what that mean.
We are not so pedantic and such zealots that we push people to do something
that isn't good for them, OK? For example, if you have someone on a
Medicaid waiver, they have significant disabilities. They use the waiver for
attending to care services. Those services are critical to the well being of that
person. Those services are not replaceable on the open market. Then maybe,
as part of our counseling, we make sure that the individual is aware of what
the income limits are in the waiver program.
We encourage employment that helps people, that gives them a better life.
We do not push people to do things that cause them harm, certainly, financial
harm. And I'm going to give you some very specific examples of that soon in
just a few minutes. And you're going to say, "Oh, I don't do that. I would
never do that." You'd be amazed. I see BS&As on a weekly basis where the
(CWIC) is unwittingly not pointing out a course of action the beneficiary is
pursuing that actually could lead to a worse financial outcome than what
they're currently experiencing. That is not what we want.
All right. Next, we provide information and advisement that encourages the
beneficiary to take the next step. So, for example, if you have a beneficiary
that is taking you six months to agree to work at all and they have finally got
the little part-time job making $600 a month, and let's say they're Title II
beneficiaries. That's not even going to hit the radar screen for trial work
period month.
And they're really – for most beneficiaries, there's no reason to park at that
level of wages when you could earn more and be better off financially. So
what we're always doing without being annoying about it, I hope, is showing
NORTHROP GRUMMAN SYSTEMS CORPORATION
Instructor: Lucy Miller
11-06-13/1:00 p.m. ET
Confirmation # 96050011
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people the next step what you could be doing. Did you – have you thought
about this. I know you're nervous. I know what makes you feel more
comfortable not to earn enough to use TWP month, but let's again talk about
how that wouldn't be a bad thing. All right?
So, we need to build a little bit more proactive when somebody comes to us
with these teeny-weeny little work goal. And they're choosing these goals
because they're frightened, OK. That we don't just accept that work all and
call it a day. We show the person what that work goal would do to their
benefits, but then we challenge them to think about working more if possible
and show them the financial benefit of doing that. All right?
And then lastly, we are the experts on the little bells and whistle that can be
applied to help people earn more, right, the work incentives that might reduce,
you know, SGA level work to allow that person to retain benefits a little
longer or in the SSI Program. Things like (DWIs) and (ERWIs) or student or
income exclusion, but can put more money in the pocket of that beneficiary.
Allow them to work more, have lots of their SSI reduced, OK? It's about
more. It's about helping people live better economic lives.
All right, on slide seven. All right. Myths, everyday. It's interesting the way
people hear things that are said in the manual. But they get ideas sort of stuck
in their head. And I'm here to try to shake those ideas losing, get rid of them.
The WIPA Initiative does not say, "All disability beneficiaries must go to
work." That is not the way this Social Security Disability Benefit Program
works, OK? There is – this is like welfare reform where (inaudible), if you
know, go to work within five years are getting benefits to benefits and then he
get cut. It's just not like that.
There is recognition at Social Security that maybe of the people in these
programs are very ill and that working at any level at all right now may not be
possible. But there is also a recognition that we know a lot more about
supporting people with disabilities to go to work and that is possible for a lot
of people who may never have believe that in the past.
NORTHROP GRUMMAN SYSTEMS CORPORATION
Instructor: Lucy Miller
11-06-13/1:00 p.m. ET
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So, this is not so strict. Everybody has to go to work, OK? We value work.
We people to work. But again, we're balancing that with common sense. And
we understand that some people are very critically ill or simply unable to at
this time.
The other thing we don't get into is value judgment. It's about beneficiaries
who choose not to pursue employment. They're not bad. They're not wrong.
This is their choice. This is a welfare reform again, OK? This is their choice.
Now, what we want to do is help people make informed choices. I can't stand
it when I know if someone is choosing not work because they are horrified
that a reduction in their SSI does, you know, one little job and the SSI checks
then it to go zero and they're going to leave their Medicaid. Because we know
that's not true. And I know that it's very difficult sometimes to persuade
beneficiaries that you are speaking the truth and that it is OK to work and that,
you know, the house of cards doesn't have to come tumbling down. But that's
what we challenging you to do.
So, people who choose not to. They're not bad and they're wrong. But (Bi
George), I'm going to try to get them to change your mind.
But if an individual has discussed several times with me and the decision is
made not to pursue employment, guess what that means for ongoing with the
services. We're done, OK? We're done. That person needs to make a
determination that to investigate work, to at least contemplate work, hopefully
to decide that work is positive. A person that says, "I am absolutely
uninterested in working. I do not want to go that way." You have to let go off,
OK? At some point, you've got bigger fish to fry. All right?
Also, we do not put a higher value on people who work at higher level. So, if
you're not a person who can work fulltime, that doesn't mean that you're
slacker. That's not the attitude we have. Having said that, I can't stand it
when I've got a person who is holding back on working more. They're doing
that $500 a month thing because they don't even want to use a TWP month out
of (here). It's not a value judgment. I'm not saying you're bad to do that. I'm
saying let me show you what you could do, what would happen so if you got
NORTHROP GRUMMAN SYSTEMS CORPORATION
Instructor: Lucy Miller
11-06-13/1:00 p.m. ET
Confirmation # 96050011
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the job, you know, working 30 hours not 20 hours, this is what would happen.
Let me show you. All right.
So, again, focusing on possibilities, showing people the opportunity. You
know, once you've done that, if the beneficiary says, "That's all very well and
good, Lucy. I really only want to work $500 a month," that's fine. Working
at some level is always better than not working at all. But we don't get real
judgmental. We don't put the hate on people that, you know, choose to work
at a fairly low level.
Finally, this notion that only people who worked their way off at benefits are
worthwhile. Well, you know what? That's awesome when somebody is able
to do that and does it and we want to cheer, cheer, cheer for those people. But
some people can't do that, some people just are horrified. They're so fearful of
letting go of the benefit in case they need them back again. And their health
situation might be so precarious they just don't feel comfortable with that.
That's OK.
We want people to work as much as they are able. And we certainly want to
encourage people to have the capacity to earn a better living by working than
by collecting a check. We want to encourage them to do that. But again, we
don't get into judgments about people who cannot work at that level or for a
variety of reasons or choosing not to.
So, none of the statements are true. None of the statements characterize our
value system. If any of these statements have ever come out of your mouth,
you got to get your act together and stop it, because this just isn't where we're
going.
We encourage. We promote. We assist. We support. We cheer lead. We
want people to move forward. And we try to do that in as positive a way as
we possibly can.
All right. Let's take a look at the next slide.
All right. So, you've got a beneficiary on the phone. It's the first time they've
called you. All right. There are some things related to the employment
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Instructor: Lucy Miller
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continuum that you need to think about. And I would suggest that your
information gathering process, your interviewing process include questions
that helps you dredge up some of this information.
So, in step number one, where is the person on the continuum today? So,
make sure you're figuring that out.
Question number two, what is the next step that this person needs to take?
And what can I do, very specifically, what I can do to help this person take
that step? So what that means is you have to think about or asked what is
keeping this beneficiary for making this – or that next step. What are the
barriers? Why isn't this person at that stage right now? What needs to be
done? You have to think about this.
And then you have to think about what can I do? You're not, you know, all
powerful. You have a limited role. But what can you do to move this person
forward? What information do I need to provide this human being at this
point in time that might facilitate progression along the continuum? So, if a
beneficiary is saying to you, "Well, you know, I'd like to go to work and, you
know, I've been offered – you know, I'm working with the supported
employment provider and they're offering me a little $10 an our job, but I just
don't know, you know. That might cause my SSI to go down."
Yes, it will. But let me show you how much more money you're going to
have by showing the person that they will be better off. This is how you
encourage people to move forward. All right. You're positive. You show the
opportunity.
So, are there any barriers to employment this person faces? You know that
section on the BS&A that asks about employment supports and services? It
(talks) to understand what that's all about. As part of your interviewing
process, you should be asking what is your employment goal? What do you –
what are the barriers? How come you don't have a job already? What is the
hold up? What is – what needs to be overcome? What help do you need?
And beneficiaries will tell you. They also know, OK? But are you asking
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that? And if you are asking that, how can you ever put anything meaningful
in that section of the BS&A or provide that counseling to the beneficiary?
If you don't know what's keeping them from attaining that goal right now,
how will you going to know what information – what resources to provide this
person with so they can move forward? Ask. What do you see as the barrier?
What do we need to take care of to help you get where you want to be? And
then your job – you're not the V.R. counselor, and we know you have a
limited job here, but you're job is to have some knowledge.
You refer to V.R. You refer to the one-stop. You refer to E.N. You would
help people overcome transportation barriers. Do you know what the options
of for transportation in your community? What about transport barriers? You
thought about those? Those are all barriers to employment. You are an
information specialist. You're to be providing information and referral, OK?
What specific services or supports can I provide to help this beneficiary move
forward? All right. So beyond this making referral, OK, what can you do?
Can you help this person to report? Can you help this person develop (in)
early? Do you see the potential for subsidy in a job? But no one else is
noticing it and no one else is making the efforts to speak to the beneficiary
about what subsidy is and to the employer and get that claim. What other
things that you can do to help this person work at all or work more and on
more?
And then finally, we got it all. Stop thinking that we do our job in the closet
by ourselves. You can't do your job in the closet. You have got to reach out
to other people. If you're working with beneficiaries, we have folk rehab
services, are you getting a copy of the plan? Are you asking permission to
send the BS&A to the V.R. counselor? Are you offering to talk to the V.R.
counselor about the beneficiary and explain the work incentive? OK.
There are other members of the team as well that might be a case manager,
might be a therapist, might be supported employment provider, might be a
residential provider, might be (payee). Lot's of people surround individuals
with disabilities. They all participate in this process of moving people or
NORTHROP GRUMMAN SYSTEMS CORPORATION
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impeding people from employment. And we need to do a much better job of
working in collaboration not in isolation.
So, information gathering again, is your interview process asking who else is
involved with you? Do you have a V.R. counselor? Do you have a case
manager? Do you have a therapist? Am I allowed to talk to that person? Can
we work together? Far too much has been done all by ourselves sitting in the
closet.
All right. So, on slide nine, what are some strategies for success? What can
we do to help people move forward? Well, we've got four basic strategies.
We're going to go over each one.
One is the cheerleading message. We're going to talk about what needs to
come out of your mouth on a consistent basis. Are you communicating
consistently the message that belong to the WIPA value system?
Then secondly, there's the anti message. We're going to talk about that too,
which is about discouraging people from doing substantial work. All right.
Then number three, are you giving people too much? Are you literally
disgorging the entire manual on people after their first meeting, which did not
help them, OK? That's overwhelming. And then people are like, "Oh crap,
this is too complicated. I'm just unbalanced. I can't deal with this." OK.
We're overwhelming people sometimes.
And then, are we really thinking, finally, about just in time work instead of
counseling. Are we really looking at – what does this person perceive as the
barrier to working related to their benefits? And am I providing targeted
information to help them understand what (took us) back that will overcome
the fears and concerns this human being have? And sometimes beneficiaries
don't tell us what their actual fears or concerns are. We have to kind of pull it
out of them. Almost have to be sort of a therapist job in this manner.
All right, next slide.
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So what is the message? Here is the message. I want everyone on this call, I
want you to print the slide. I want you to blow it up the sides of a wall. I
want you to put it in your office, above your desk, and I want you to start your
day chanting the message in unison, holding hands. I don't care. We've got to
get better about this message. We are forgetting what it is we need to be
telling people. And we communicate this message every time we talk to them.
And we communicate this message to everyone surrounding the person. And
we offer these points constantly.
Number one, you don't have to choose between your benefits and work unless
you want to. OK. You can control what happens to you. You, as beneficiary,
are in charge. You can choose what happens to your benefits by choosing
what level of work. And no one is saying you have to get off. OK? That's
important.
Number two. It is possible to work even full-time and not let go of your
government-sponsored health insurance. OK.
Now, you need to be careful about this message because what we don't want
to do is encourage people to impoverish themselves, to retain eligibility for
Medicaid when they have other options, particularly in the days of the ACA,
Affordable Care Act, with employers offering more packages, the Federal and
State Health Insurance Exchanges offering affordable options for health
insurance. OK?
But, if you're fearful that getting a job, earning, you know, $100 a week, is
going to cause a lost of your Medicare, we've got to start getting the message
out. That is not true, right?
It is possible to work and to come out ahead financially to have more money,
to live a better life even if your benefits are reduced or stopped entirely.
We've got to stop focusing on maximizing benefits. That's not what we do.
We maximize financial outcome from working, right?
And that's OK if some of the benefits are retained. What we want is the best
financial outcome that we can get for this specific individual.
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And (last), how much are you talking about this? You can let go of these cash
payments. It's possible. You can let them go. You can get them back again.
There are multiple ways to get benefits back again. All right? This idea that I
get this one-time for customer benefit, if I ever let go of it I'm never getting it
back. That is wrong.
And we need to be a lot more proactive in showing people, OK, OK, so you
engage in SGA or you go over the break-even point. Your SSI goes away.
You're still getting Medicaid. So you need to check back again at some point.
Let me show you how to do that. There's option one, there's option two,
there's option three. OK.
We have got to cheerlead again and again and again. You can let go of these.
And it's – as long as medically-remained disabled, they will be available for
you again and again and again. And I'm not saying let's do a good job on that.
So on slide 11, what is the anti message? The anti message is "Don't ever let
go of benefits. You need to always stay on benefits the rest of your life,
engaging in SGA is terrible thing. Letting go of your Medicate is a terrible
thing." I don't know how this started, but we have some (CWICs) out there
who really believe their job is to keep anyone from ever being determined as
engaging in SGA.
But somehow you're on this mission to save people from an SGA
determination. That's not your job. SGA is not a universally bad thing.
Working over that threshold amount and letting go of the SSI-related. It's not
universally a bad thing. (Savoring) your attachment to the disability benefit
system is not universally a bad thing. And if you are setting that expectation
of – if you're describing it that way, you're not doing your job and you need to
stop that. We need to help people see that there are positives about letting go
of that attachment. It is still there again if they need it. Now, again, don't
listen to me and say, "Well, Lucy's saying everybody needs to get off," I am
not. I'm saying, some people may lead to retaining that attachment. Other
people, not so much. It isn't a black or white thing.
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11-06-13/1:00 p.m. ET
Confirmation # 96050011
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And to the extent that we portray SGA as this horrible thing that happens to
people and it's universally terrible, we are working across purposes with the
mission of our program, OK? It's not your job to save people from benefit
termination due to employment at all cost. And I see the – or I see the
confusion people have in their minds when they send me to BS&A. And I can
see people jumping through all kinds of, "Oh, my goodness, this job goal you
have, this is going to result in SGA level work. Oh, the – oh, oh, we need to
find subsidies, we need to find early." It's like, "What?"
If this person is able to earn a lot more money than they get in benefits,
encourage them to let it go, encourage them to try, as long as the financial
outcome is better and that's total financial outcome considering the effect on
the health insurance, OK? As long as the financial outcome is good, it's OK.
We don't want to pull people back. We don't want to present information in a
way that cause beneficiaries to unnecessarily fear working over in a certain
limit. This is the reason why if you sent me a BS&A and you get real hung up
in your BS&A about the break-even point in SSI, I'll highlight that and say,
"Take this out. Take this out."
Break-even point, who cares? So you let go of your cash payment. Who
cares? That doesn't matter. If the person needs to retain Medicaid, that
1619B, and we'll talk about that. But focusing on the dollar figure that the
person needs to stay under to avoid from going over break-even is nonsensical.
It's contrary to our mission. We don't want to do that. We don't want to
encourage beneficiaries to purposely suppress their wages to stay under
arbitrary limits.
Now, we all know beneficiaries do that. I'm not so out of it that I don't get it.
I talk to beneficiaries all the time. Tons of them do that. That is their choice.
I can't make anybody do anything. But (inaudible), I'm going to try to show
that person that they don't need to do that. If they have the capacity to support
themselves and live a better by working, I'm going to try to show them that
that's possible. And that they do not have to – everyone doesn't have to park
under the cliff.
NORTHROP GRUMMAN SYSTEMS CORPORATION
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11-06-13/1:00 p.m. ET
Confirmation # 96050011
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OK, some people are better off because they can't replace their wages with
their work. They're not ready to do that, they're not capable of doing that.
Some people are better off not working at low levels right above SGA, but not
everyone is like that. It's not your duty to find some way anyway to reduce
kind of the (earnings) to avoid benefit cessation and termination. You just
have to embrace this.
All right, next slide.
All right, having said that, let's talk about avoiding financial harm because I
read two BS&As in the last week where the (CWIC) was actually encouraging
a beneficiary to do something that would hurt them financially. Bad idea,
right? Some work incentive, so work situations and actually caused a
beneficiary to be less financially stable. Some examples are here.
Let's say you got a Title II disability beneficiary. This individual gets $1,200
a month and like SSDI, all right? This person has a job offer where gross
monthly wages would be $1,200 a month. Maybe we need to shoot for a
higher earnings goal. Remember that the SSDI cash payment alone is not
going to be tactful, not at that level anyway. And the wages of $1,200 are
going to have all kinds of tax taken out. Working at that level would be
enough to cause eventually cessation of cash payments and the take home pay
would be less than the benefit, all right?
So, you tell us, "Oh, don't take the job." No. You say, "Let me show you
what this level of earning will do to your status, your financial status. Now let
me show what taking a job earning $2,000 a month or $3,000 a month would
do." All right.
So maybe the idea here is go big. All right. Don't go smaller, go bigger. Can
we figure out a way for you to get a better job, and then maybe a level of
(way) that this job is offering would not be beneficial. What about a Title II
beneficiary to get QMB, you know, the Medicare Savings Program that is
paying for the Medicare Part B premiums, and all of the other out-of-pocket
cost, and this person is not getting from Medicaid in anyway, it's just, you
know, like low level Title II beneficiary. You'll see a lot of people that's
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getting $800 of CDB or SSDI. They've got QMB. They're getting the low
income subsidy to help with Part D. And then they take a little job making
$500 a month.
That is just – and that's not going to cause termination. That is not SGA, all
right, you get that. But it's just enough if you look at all the Medicare Savings
Program calculation sheets, the low income subsidy calculation sheets, (going
to) be enough the cause that person to lose a $104.90 minimum (inaudible)
with Part B premium and possibly lose all or some of the help with Part D.
While other taxes are taking now that $500, you can take home $500. So,
well, is this a really good financial outcome? Well, I don't know. Maybe the
beneficiary is OK with it, but it's your job to point this out. Let me show you
your total financial outcome if you accept this job.
And so – and maybe it's not positive. So you don't say, "Well, don't take a
job," you say, "Let's look – let's go bigger. Let's look at more income and
how that might give you a better financial outcome. We're not doing this,
OK?"
The BS&As never approach this and I'm reading that cost-benefit. We've got
to do a better job of this. This is how we incentivize work.
What about a Title II beneficiary who works a level that causes the lost of
Medicaid waiver? That's not good, if the person needs the Medicaid waiver
services and there's no way to replace those services in an affordable manner
on the open market.
And for a lot of waiver participants, there are no replacement like that isn't
replaceable, there's nothing out there like the waiver service, OK? And again,
we don't want to – help you, "Well, don't take that job, don't take that job."
We say, "If you take this job, this is what will happen. Let's look at this
outcome here and this is what will happen. The decision is yours, but (Bi
George), you're going to make an informed choice."
When we don't provide this information to people, they might accept the job.
They will work for a while. When it becomes clear to them that this job has
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Confirmation # 96050011
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harmed them financially, what do they do? They quit. All right. So what did
you accomplish? Nothing. OK. You need to be pointing this out. We all
need to do a better job of helping people make better decision, financial
decision.
What is your role? We're on slide 13 here in avoiding financial harm. Well,
if a work goal would potentially resolve in a diminished financial outcome,
you have a duty to point this out. And that (inaudible), so I don't think I was
allowed to do that. What? No one wants a beneficiary to be hurt, Social
Security doesn't want people worse off. They don't want you telling people
not to go to work at all, OK, get that. But, you know, it's OK for you to point
out, "Well, you know, maybe this job isn't quite perfect. Let me show you
why. Why you didn't consider doing this." All right. You never tell a person
not to work, not to accept the job, or suggest that beneficiaries quit their job.
We layout the information, we show them, here's the cost, here's the benefit.
If you do this, here's the cost, here's the benefit. Now look at this, which one
is better? You choose. All right. You've got to be more focused, all of us
have to be more focused on explaining the cost benefit of a variety of options
and helping the beneficiary compare the financial outcome of various options
or courses of action.
Any of you on this call, if any of you have a financial adviser yourself,
someone who helps you with retirement decisions, investment decisions, isn't
that what those people do?
So, if you invest primarily in stocks, here's the cost and here's the benefit, here
are the risks, and here are the rewards. If you choose to go more with bond or
I don't know, buying gold, whatever it is. Here's the cost, here's the benefits,
here's the risk, here's the reward. This is what you do. You're working with a
different population. (Inaudible) a financial adviser.
And so, advice, I mean show the person what they need to know in order to
make decision. It's up to the beneficiary to make the choice, not you, but you
have to provide information, enough information, and as accurate and specific
information that the person can make (and have) been choice.
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11-06-13/1:00 p.m. ET
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So, in slide 13, let's talk a little bit about TMI syndrome. And I see this in
(CWICs) who are fairly new and, particularly, we see it when you're
submitting your BS&A for assessment. You're afraid to leave anything off for
fear of losing points. And I understand that, but there is a point that we just
provided too much information. And trying to figure out the balance of how
much is enough and when it's – when (am I) not being provided, and that's
(inaudible) provided too much. It's a challenge. OK. I struggle with it. We
all do.
And every beneficiary is different. Some people want you to tell them
everything right now. Other people, you need to tell him enough to get him
moving and you don't need to burden them with like, "Let me project out 20
years and tell you what's going to happen," all right. You don't need to tell the
beneficiary everything that's in the manual right away, OK? And that's not to
say we would hold information, but we're going to tell people enough so that
they can have a basic understanding, and then we expand in detail over time
as people have adjusted the information we've provided at first and are ready
to hear the information, OK?
Think about what it was like when you went to initial training, I mean that's
painful. Where we literally (disclose) the entire manual on you and (its base)
on five days. That's five days, and it was too much.
If you try to do that in an hour and a half interview, the person is never going
to call you back again, right? Don't worry about calling – covering all of the
potential basis, OK. Try to avoid giving super, super detail at every possible
provision of work incentive or every warning, or every possible bad thing that
could happened. Focus initially on the basics, and what is the basics? The
message, remember that's why, that I said blow up and it needs to be huge like
wall size in your office. Go back to the message and focus your discussion of
the work incentive on the message.
For example, it is possible for you to keep your cash payment, some are all,
and still work. So, if your Title II beneficiary, I'm going to explain certain
things about the trial work period, right? The EPE, the work incentive that
allow people to earn more than SGA and not lose their check right away, OK?
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11-06-13/1:00 p.m. ET
Confirmation # 96050011
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Focus on those – the message and count your work incentive detail around
those messages.
Beneficiaries can really become overwhelmed. It's very easy for them to
become overwhelmed and intimidated. If you dump too much information on
people too quickly, they will shut down, and people who shut down don't go
to work, OK.
So, work from generality to specifics, all right. Start general, start by being
the talking red book, then get into more detail with subsequent conversations,
and finally that BS&A would be capturing some details, but even to BS&A
can be TMI syndrome.
If you're sending people 20-page documents, they're not going to read them. I
don't know, maybe the parent is an attorney would read them. But beneficiary
is not going to read that much information.
So, being overwhelmed equals increase fear of benefit loss, the end-result is a
decision not to work or I'm so confused about SGA and this break-even point,
and say that "I'm just – OK, I'm just going to earn the $400 a month and call it
a day." We don't want that, right, we want people to work more, not less.
And finally on slide 15, just in time work incentives counseling means that
you are providing the information this human being in front of you (need) to
move forward, not too early or not too late. And that is going to be a different
kind of information for each post (time).
So, what do these persons fear? What are their worst nightmares? We need to
address those. People cannot learn things when they aren't ready to hear what
you have to say, right. You have to start from the general and move to the
specific. Start with the positive and then move to the devil being in the detail
as you move forward, right?
Just in time benefits counseling, the whole process is providing the right type
of information and support needed to help that human being move forward,
not backward, towards that employment goal. Some people don't even have
an employment goal.
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11-06-13/1:00 p.m. ET
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So the moving forward is to gain employment goals, to actually say, "You
know, I'm going to try this employment thing." Small doses of relevant
information at the right time will help beneficiaries realize their employment
goal far more than dumping the manual on people, OK. Having said that,
remember everyone is different. Some people can tolerate a lot more specific
information earlier on than others.
And it all depends on the person, it all depends on what they need to know
and we don't want to be dismissive of people or paternalistic when individuals
ask us specific questions, even if you think it might be TMI. A human being
who asks very specific questions deserves your respect and the dignitary of
you answering it, OK, at least in general term, OK.
What you don't want to do is go overboard with too much scary detail. You
don't want to get into, "Oh, well, this is could happen and this bad thing can
happen, and then this bad thing can happen, and then this bad thing can
happen." You might want to get to that in time, OK.
But do answer questions that people very specifically ask you, and some
beneficiaries will have lots of very specific questions. And guess what, just in
time counseling, it only works if you have an ongoing relationship with
somebody, OK. If you think you can do this job by meeting with the person
one time, writing a BS&A and sending it to the person and never seeing them
again, then that's not just in time counseling. I totally get that, and when we
weren't – and with the mode for a lot of it, that's where we were stuck with,
because that's the only way we got paid to do this service.
We got money to generate the BS&A and that was it. So you did the best you
could and we understood that you were going to further down the road in
providing information at these folks because you may not get a crack at them
again. But that isn't WIPA, OK? WIPA is taking those high priority clients
and working with them over time so that you have opportunities to deepen the
level of understanding this person has over time. You have an opportunity to
revise the BS&A and to add the WIP and to change the steps that you're
moving forward there. It's an on going relationship. All right.
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So, if you're doing the purge and run, if you're dumping the manual on people
and never seeing them again, in the WIPA world that is not what we will
consider good service, right? I am showing – it is 2:00 and (Heather) who is
probably falling asleep listening to this, if you could open the line for
questions, that would be great.
Operator:
At this time, if you would like to ask a question, please press star then the
number one on your telephone keypad. Again, it's star one to ask a question.
Your first question comes from Anthony Bibbo.
Lucy Miller:
Hi, Anthony.
Anthony Bibbo:
Hi, Lucy. I have a question about the (CWIC) role in avoiding financial harm.
Lucy Miller:
OK.
Anthony Bibbo:
Meeting with people recently who are ticket to work people. How do you
explain to them the best option when there E.N. is trying to promote, going
over SGA no matter what for them to get their payment?
Lucy Miller:
I hear you. It's very challenging and you have to really focus on who is your
customer. Your customer is the beneficiary. Your job is to provide
counseling that helps them make informed choices.
The E.N. and, you know, what their advising (capability), that's their own look
up, that's their own problem. So, I would never say for – promote people, I
would not say, well, maybe engage and that is a bad thing for you but
engaging an SGA at this level is probably not financially positive.
Let's go bigger. Can we go bigger? And you are challenging the beneficiary
to go back to the E.N. and to say, "Huh. This person showed me this. This
job that you're pushing me to take would not lead to a positive financial
outcome for me. I really need a better job that will replace my benefits and
give me a better life."
And I understand that E.N.s might not like that.
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Anthony Bibbo:
Because they're referring them to you.
Lucy Miller:
Yes. But you're customer is the beneficiary not the E.N.
Anthony Bibbo:
OK.
Lucy Miller:
And I know, you just – you have to – and if you get any (fall out) form that,
you know, let your technical assistance liaison know. But I can guarantee you,
Social Security will support to in your efforts to you help people live better
lives and have a job that creates a better financial outcome rather than
financial damage.
Anthony Bibbo:
Sounds good.
Lucy Miller:
OK.
Anthony Bibbo:
Thanks.
Lucy Miller:
Next question.
Operator:
(Wisely Lynn), your line is open.
(Wisely Lynn):
Hi.
Lucy Miller:
Hi.
(Wisely Lynn):
Hi. So I'm a community partner and I contract V.R. And so usually, the
BS&A is a one-time event, like it's a service person and then I never see him
again and I was wondering about how to develop in more longer term service
program with them or how do I not give them too much information in there
BS&A?
Lucy Miller:
Well, so you're stuck because the way the funding mechanism works and it's a
one-time our customer (saying), and it's certainly isn't ideal. I can tell you
what I have to seen others do. For example, in the State of Kentucky, we do
have a vendor option, still available through V.R. even WIPA is back, and
some V.R. counselors do or refer to vendors that are non-WIPA providers.
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11-06-13/1:00 p.m. ET
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The fee that Kentucky V.R. offers for BS&A development is – well, I would
consider this significant.
So, some of the people out there providing the service had been willing to
provide follow up at no addition cost because the fee that they're being paid to
develop the BS&A is lucrative.
So, you know, they're throwing it in as part of their service. Now I'm sure that
there has to be a limit on that. You know, you can't provide everything sort of,
well, for free. So you need to, you know, really think about the value of your
time and who you can and cannot do that for.
But it – that's depends on the fee, the value of the fee that your V.R. agency is
providing. And, you know, I think that what we have to do is educate the
funder to show them that this one-time per customer is not a good idea, that
may be you could pay a fee for the BS&A development, but then offer some
additional money, and Kentucky does this as well, at an agreed upon rate and
a $50 an hour that V.R. counselor can authorize even additional hours up to, I
don't know, 10 hours, 20 hours, whatever of additional follow up services as
authorized by the V.R. counselor when needed.
And the problem with that is you're relying on the V.R. counselor to know
when additional benefit counseling services might be needed, and typically,
when do they know that, well, when there's crisis. When the client calls the
counselor and, "Go back. You know, I've got this terrible letter from a Social
Security and I don't know what to do."
So, I don't have a silver bullet for you on this one other than to educate those
funding sources to show them that the service, good quality service, for people
who are really high priority clients, this one-time per customer approach is not
very effective, and that perhaps they could build other mechanism. The other
thing you could do is refer the person to the WIPA provider for the long-term
component. But you would need to collaborative arrangement with them to
make sure that works.
(Wisely Lynn):
OK.
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Lucy Miller:
Sorry. I mean I don't have any real set answers, good answer there.
(Wisely Lynn):
OK.
Lucy Miller:
Next call.
Operator:
Once again, to ask a question, please press star one. There are no further
questions at this time.
Lucy Miller:
OK. OK. Well, let's move ahead. All right. We're moving in the slide 16.
Now, we're going to talk about documentation and, you know, the record
keeping and BS&A development, stuff like that, and how does that concept of
the employment continuum affect your documentation.
Well, when you're working with a beneficiary who is obviously going to go
beyond the basic information and referral, this is a person that is definitely a
WIPA-eligible client, and for some of you it's like, "Oh my goodness, deja vu
all over again. I sort of having thought about things like that since WIPA
shutdown over a year ago."
But is this person going to be WIPA-eligible? And then you need to consider
again, what stage is the person currently in. What is the most affective way to
provide follow up information to the beneficiary to help them move forward?
And is a benefit summary and analysis necessary at this point?
Now, you know, this has been interesting since WIPA came back and was
refunded, because during the WIPA pause, a lot of V.R. agencies were
purchasing BS&A development, and they were paying, so they were the
masters, and they would refer anyone they felt like to you and you would
accept or rejected the referral and then would do BS&A development, because
that's what you were being paid to do.
Well, under the WIPA paradigm, not every beneficiary needs a BS&A and
that's, you know, if you read the manual carefully, we go on and on about the
types of people who require a written summary of their benefits and their
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work incentives and those individuals who don't need one right away,
certainly.
And other – we even give an information about other ways to impart
information in writing beyond a BS&A, people who wouldn't require one.
And what's been interesting is that this has sort of rankled some of our V.R.
friends who got used to being the master of who got a BS&A and how didn't
and unless they're paying now, and lot of agencies decided they didn't want to
pay once (when they) came back, they still want to refer every time they can
hear you and they think you are beholding to them to develop a BS&A., (well),
you won't. OK.
If you forgot, in the WIPA, who is really a BS&A candidate and who isn't,
and we encourage you to go back to module six and read in the BS&A chapter
the current module please about who is and is not a good candidate for BS&A
development. And quite frankly, people who are at the one end of the
continuum who really are not even ready to commit to employment. They're
not even ready to say, "You know, I think this is a good idea for me." We
really don't need to be writing BS&A for people like that. They haven't made
a determination. They don't have a clear employment goal. You can't be
specific with them. You can be a sort of a talking red book, but is that a really
a BS&A? I will tell you no.
So, you know, you have to stand firm with this and this is the challenge that
when we were providing this training, you know, two years ago hasn't yet
occurred to us.
So, first, the decision is a BS&A really necessary at this point. And if the
BS&A is appropriate, what depth of information is needed so that just in time
learning can occur. What is this person need to be told to make a decision
about work? And then what is the best format for the beneficiary to
understand the information being presented.
We do offer a variety of BS&A examples in the current manual. We have
question and answer format. We've got the standard format that most of you
probably are very familiar with. This says, here's what's going to happen to
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your check. Here's what's going to happen to your medical benefit. Things
like that.
But I've seen some very creative approaches as well that are even beyond
those. So you have to think about this. This cookie cutter, all I do everything
the same way for everybody, not a good idea, right?
Now, with the materials you got for today's training, you got a handout about
the stages of employment progression and then the kinds of questions that
people ask at the various stages and the kinds of services you might provide to
support them. And then starting with slide 17, we're going to talk about this.
You may want that handout in front of you.
So let's just kind of start. So, let's look at people in the contemplative stage.
These are folks that really don't need a benefit summary analysis, at least the
way we define that type approach. And your manual is very prescriptive
about what has to be in a BS&A for it to be called a BS&A, for it to count.
And since we typically have benchmarks and one other things have been
measured on the past on – in the past is BS&A development. We have to
have a definition of what counts and what doesn't.
For most people who are kind and (sort of) may begin on one day think about
work, a full blown BS&A is not necessary. And what you may want to do,
you want to talk to these folks, I mean definitely want to talk to them. Then
you want to follow and you want to encourage work, and you want to
communicate the message, all right, and stay clear of the anti message.
Then you probably should follow up with something in writing but I could be
a general letter, it could be something like just about the mission of WIPA, a
review of specific questions asks, you could develop – this is my preference, I
would do a cute little customized packet where I would have a packet folder
and I would pull fact sheets that I had individualize for that person. That
might be publications that Social Security has developed. That might be fact
sheet that I have had approved on my project officers, things that I've gotten
out of the manual, the WIPA manual, and I'm going to put together a little
customized packet, put my card in there, a very nice letter of thank you for
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calling and mail it out to the individual and then more or less leave follow up
contact to that person.
So, a person who is calling you who really doesn't have any idea what they
can do, what they want to do where they're headed, if they even think work is
appropriate, possible, you need to provide referral sources for that person to
go get clarification. And maybe they need to go to V.R. Maybe they need to
get some career counseling.
But until that person is ready to commit and to say, "You know, I'm going to
pursue employment." We're all about work people. All right. You can't be
everything to everybody. So, somebody like this, you don't need to do that
level of individualized documentation.
So let's look at slide 18. Work incentive summary versus benefit summary
and analysis. Now in your manual, we talked about two different kinds of
written reports that you could send people. I worked incentive summary is
very generic. It's like a quick sort of customized red book. It would explain
the basic rules that apply to people who get the type of benefit this person gets,
what happens to their (inaudible) at their work. But it's not individualized, it
doesn't require a BPQI, an in depth analysis. And, you know, you don't need
to do BS&A for someone who just has no individualization necessary.
Now, a person who needs a BS&A would benefit from one would be someone
who has – A, I've decided work is what I want to do eventually at least, I need
to have some type of monthly earnings goal or some idea about what I want a
be. And I need individualized (advisement) that is specifically customized to
my earning or employment goal. All right.
So, not everyone is going to meet this criterion. You don't have time to write
BS&As for everybody who calls you. You just can't.
All right. Slide 19. Beneficiaries who have not identified any type of goal,
earnings, employment, to analyze – how do you get individualized about that?
People like that really just need generic work incentive information. And you
can use a work incentive summary, you can do a customized packet, you can
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do whatever you want to. You don't need to use this BS&A format to do that.
All right.
The summary would include a list of the individuals, benefits that you knew
were being received, the summary of relevant work incentive, just generic
information. You might want to offer some recommendations for getting help
to determine an employment or earnings goal. And, some basic
recommendations for addressing benefit issues if any but it's going to be
shorter than a BS&A, it's going to be far less individualized, and it doesn't
even have to be a report that you developed. It can even be just a customized
packet of, of handouts with a brief letter.
So how do I know, slide 20, so, how do I know when a beneficiary has an
earnings goal because that sounds like really specific?
Well, the, the current manual, we clarified this several years ago because
people were really unclear about what this meant. So, if you don't have a
current manual, you need to get one, remember they're online at our Web site.
You need to go to module six and re-read this chapter. An employment goal
is identified as well as a specific monthly earnings target based on this goal.
So that would be one thing, that's the most specific.
The person also would be considered to have an earnings goal when an
employment goal is identified and it's possible for you to estimate some
monthly earnings.
Now, some people don't have a clear employment goal defined but at least
they can indicate to you the amount of earnings that they need to meet their
financial obligations and their goals or for how much they would need to
replace their benefits. Now there is a contact. All right. Look at how much
they're getting, think about how much they would need to earn to fully replace
that benefit and use that as your analysis target point.
Now, sometimes people, they don't quite know exactly what they want to be
when they grow up, but they're able to indicate maybe how many hours
physically they think they could tolerate work. Or they might even have a
general idea of how much they will need to earn or would like to earn an hour.
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So, you can see we are trying to be quite reasonable when we define what we
mean by the beneficiary having an earnings goal.
On slide 21, there is some additional option. So, let's say the individual
doesn't quite know how many hours or what level of wages, but they have a
range of hours or wages that they would consider. Then that is real nice to use
in BS&A because it gives you a couple of target points to compare and
contrast. And I love reading BS&As, and I read one yesterday as a matter of
fact that that took a person with very a low earnings goal and did a nice
explanation of that and then said, "But, you know, you told there wasn't –
there was a range, and I want to show you what things would look like at the
top level of your range as well, and here's what would be likely to happen."
And then at the end, the person, the (CWIC) compared the financial outcome
of both side. And as it turned out, working more offered a better financial
outcome than working less, even though working more did was an SGA level
outcome.
Now, what about an individual understanding – understand the impact that
working at varying earnings level. A lot of people are like that. That's fine
too. You just have to have something specific in the BS&A to plan against.
And in that section in the BS&A that talks about what you told me your
earnings goal were – was, which employment statuses and where you want to
be, that section needs to be written clearly and concisely so that everyone
knows where the – what is the target or targets that you're planning against
that you're going to analyze the benefits around. But, you know, not targeting
anything there makes it almost impossible for you to write a BS&A.
OK. On slide 22. Remember that people in the preparatory stage, I would
move to benefit summary and analysis for them. And remember for it to
count as a BS&A, it must include certain things. Now, you can put it in a
different order, you can use a little bit different verbiage, you don't have to
copy word for word what's in the manual. But if you don't include all of the
required sections, then if you submit it for assessment you're going to get
things on point, and if you count that as one of your BS&As scores with a
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benchmark, which will be back eventually, you may get dinged on a (site)
visit because someone might review that file and say, "What are you doing
calling this a BS&A? Did you count this? Because this is like a red book.
This isn't individualized or whatever." You've got to include these sections.
Clarification of benefits, earnings goal, identification of any problems or
issues that needs to be resolved, current standings in relation to work incentive
already used, referral to employment, support providers, identification of
potential steps to be taken to reach the goal, and of course identification of
work incentives that can help the individual to achieve the employment and
earnings goal.
Think about a person who is preparing for employment, what is it that they
need to know right now, particularly, someone who would be a (Path)
candidate? These are the folks who are in the preparatory stage. Those are
the ones you want to (speak) for that real detailed discussion if they're a (good
PATH) candidate about that very powerful work incentive.
Well, on page 23. What if the person is in a job search stagef, now what do
you need to do? Again, a BS&A would be indicated, OK. Clarification of
benefits, statement of the earnings goal, resolution of any issues that were
identified during the preparatory stage or if any, OK, current standings in
relation to work incentive already used, follow up on job search activity
assistance previously provided, identification of work incentives for that –
based on that person's unique constellation of benefits. You want to show
examples of calculation sheets or TWP-EPE tracking chart to demonstrate the
impact of earnings on benefits and more than one if the person has a variety of
different wage levels in mind or potential and then offer option. Show cost
benefit. All right.
Now, if you already did a BS&A for the same person who was previously in
preparatory stage, then maybe you don't need to start over, maybe you just
need to do some additions, maybe you need to do a revision, or maybe the
person contacts you for the very first time just – as they are starting to
interview and you would develop a BS&A for this person.
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Now, how about the next slide, slide 24, employment stage. If you don't do
BS&A or anybody else, people who are employed – I mean this is a nobrainer. These guys need something at writing. They already have job, all
right. If it's a Title II beneficiary, they might have – and jobs that came before
this job, there might be information you absolutely have to provide this person
about TWP usage, EPE usage, was there any past work that was SGA. These
are the people you really want to dig in on and provide them with very
detailed information about how the job they have now is going to affect their
benefits all of their benefits. And if they have additional goals related to wage
increases, hours, increase of hours, a job change, you want a probe for that
and you want to include that as well.
Remember, what's the point? The point is to move the person forward on the
employment continuum. For a person who's already employed, that could
mean more hours, arrays, an additional job, long term stability in employment.
Remember, there's idea that people get a job and hang in there for nine months
and then get the letter saying, "Gee, we think you might be engaging in SGA,"
and they quit. That is not a good outcome. All right. It's preparing the
individual to maintain employment over time.
So keep the eyes on the prize. What is our goal? The goal is steps forward on
the employment progression and what can you – the (CWIC) do to provide
just in time information and counseling to answer that person's question, to
ease their fears and to encourage them to move forward.
And on slide 25, let's talk about following up, because WIPA is back. And
remember we don't just do the BS&A and call it a day. We've got to get back
to the notion of prioritizing beneficiaries, not every beneficiary you work with
needs proactive contact from you.
And what do we mean by that? Proactive means you initiate contact with the
beneficiary, that you're not reactive sitting and waiting for people to just call
you when an emergency arises. So again, get back into your manual, refresh
your memory on these procedures.
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Who is it that we want to provide follow up for and when are we going to
follow up with specific people because it's not one-size-fits-all. Some people
might need an every quarter contact. Some people might not need another
contact for you until the end of the TWP is near. Everyone is different and
you need to be thinking about, "OK, for this human being, what makes sense
in terms of a proactive follow up contact schedule?" And some people don't
need proactive contact from you, all right. Somebody who is in the
preparatory stage who doesn't have any critical transition point, you don't
want to call them up every month and say, "Are you ready yet? Are you ready
yet? Are you ready yet?" I mean that's stalking, OK.
So be (planful). Think about it. People are different. What does this person
need from me? When are the points in time that makes sense for me to initiate
contact? And then how are you going to initiate contact? Are you going to
use a phone? Are you going to use e-mail? Are you going to text? Are you
going to send letters? What are you going to do? What makes sense to this
person? Did you ask them? You know, if I need to contact you, what do you
prefer? How do you like to be contacted? And, you know, what you – you
need to think about what's most effective. And certainly leaving the door
open for beneficiaries to contact you at anytime when they have question that
is critically important.
All right. Let's go to slide 26. I have no problem with using standard 30, 60,
90-day schedules to contact people if you're program is not pedantic about it.
All right. This idea that every single person you've enrolled in WIPA services,
remember that enrolled in WIPA services to (ETO) with the baseline
assessment, deja vu all over again. Every single person enrolled in WIPA
services doesn't need to be called every month. That's annoying. You don't
have time for that anyway. Why would a person need to be contacted every
month? All right.
Hardly anyone needs to be contacted every month. I'll tell you who I would
suggest for a while, a newly employed person. You might want to call them
once a month for the first three months to make sure they're OK. A person
who has an approved (Path), you might want to call those people once a
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month to make sure that they haven't cashed in their (Path) account and gone
to Aruba. All right.
Are you OK? Do you need help? Those are the kinds of people who might
need you to make a proactive call every 30 days. All right. Sixty days, 90
days, unless you have a reason to contact people, there is no point in just
adding work to your day that gives you no result. No one expects you to
contact every beneficiary every month.
Do what is necessary to help the person move forward toward employment or
to retain employment.
So newly employed people and (Path) people, those are the ones that you
might want to do 30, 60 days. And remember that excessive proactive
contacts can be viewed as excessive and annoying. I mean just be respectful
of that.
Put on your schedule, think about what makes sense for the person. And for
most people, critical transition points aren't going to be every month. You
have to think about what are those critical transition points.
And by the way, you should not be the person always initiating contact. I'm a
huge proponent of giving the beneficiary a list of the critical transition points
when they need to contact you. Give them a list. Don't assume they know.
OK, they don't. They don't know when to call you. You have to give them
that information and where would you do that? You do that either in the
BS&A, OK, at the very end section, and or in the WIP. Remember the last
section of the WIP talks about follow up contact schedule.
In that section, you're going to layout, "OK, I'm going to call you here and
here and here. You, Mr. Beneficiary, need to call me here, here, here and
here." OK. Be explicit. Be overt. Don't assume they know what to do. They
don't.
All right, 27. Periodic follow up. Again, most follow up is going to be
triggered by critical transition points. So you need to know what points apply
to each beneficiary and it depends on the type of benefits they get. And then
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you should plan for these contacts – for making contact when the points occur,
all right.
In some cases, you have to wait for the beneficiary to contact you, make sure
you let them know what's going on. And if you don't hear from someone who
is in the employment preparatory stage or the job search stage by the time you
have expected a transition point to occur, call them. OK.
Here's a tip. Literally sort your clients. Sort your clients by the phase of
employment progression they are in. I would sort their file. In your (locking
file) I would have four sections. You're going to have the kind of sort of
maybe going to someday think about work. Those are contemplative guys.
You can have your preparatory guys. You're going to have your job search
guys. And you're going to have your employee guys. And top priority goes to
employed people, OK. And those are the ones – but that'll be your smallest
group, I'm sorry to say, probably. Those are the ones you're going to have the
most contact with and then moving backwards towards contemplated.
And when someone gets a job, you move him from one section to the other. If
you sort your file, it keeps it in your head. It keeps it in your head. Who are
my top priority clients? Who do I really need to focus on? OK. And I know
that sounds rather kindergarten-ish but it's effective, try it.
On slide 28. Relying on this employment support team. Again, you can't sit
in the closet and do this work. You've got to work with everybody else that's
out there. I just don't see us being very good about staying in touch with the
V.R. counselor or the supported employment professional, the, you know,
case manager, all that sort of thing. So, like if you're trying to make contact
with the beneficiary and you're not getting a hold of them, you know, try to
contact a member of the employment support team to find out what's going on.
You need to make sure you've asked who else is involved with you, make sure
that you have signed releases allowing you to talk to these people.
And the people (who are) interested in are V.R counselors, supported
employment professionals, case manager, residential service providers,
disability program navigator, a (Q1) sub-career center. Anybody that's in that
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circle of support around the beneficiary you need to know about and you need
working relationships with these people because we're all working together,
hopefully, to promote employment and help people live with greater financial
stability.
All right, slide 29. We're coming down to the end wire here. Just some basic
reminders. Be prepared to identify where the beneficiary is in a continuum
and this should occur at the first interview. Look back at your information
gathering form. If all you're doing is filling out (ETO) forms when you're first
talked to somebody, you're not gathering all the information you need. And I
know you don't want to hear that because that's a lot of stupid forms to fill out,
I get it. But you need the information required to do responsible benefits
counseling. And not every – those (ETO) forms were not designed to gather
what you need to do counseling. Those forms were designed to gather data
elements required in a research, OK? Not the same thing. All right.
So, are you asking, "Are you writing down? Are you thinking about where is
this person the continuum?" And, you know, remind yourself, and remember
that people with disabilities, you know, we don't get found eligible for these
benefits by the walking, wounded. I mean this is a pretty significant criterion
for eligibility. People getting these benefits are pretty impacted by their
disability. And things happen, people go into remission but then people get
sick, people go through personal life crises like we all do, death and divorce,
all right, having children.
We don't always march forward one step after the other in a really structured
manner. Some people live pretty sort of (secured) (inaudible) to employment.
Three steps back, one step forward, three steps forward, two steps back, you
know, that's normal. Our job is to continue to be that cheerleader and to stay
focused with the eyes on the prize. And the eyes on the prize means moving
forward down that continuum trying to achieve some level of employment.
Some beneficiaries are going to live all over the continuum and others are
going to take a very (inaudible) route. Some people will tag along, other
people are like the (jack rabbits) and they're going to zoom forward. Some
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people need a lot of help, some people don't need any help at all. Everybody's
different but it's all about employment.
And remember, you know, sometimes, backward progress has to be made
before forward progress can continue. Some of us and I count myself in this
number, some of us learn things the hard way, OK. We make mistakes. We
take jobs that are probably ill advised and no one could tell us that. We kind
of have to experience it and it doesn't work out. And then we have to kind of
lick our wounds and jump back in and say, "You know, that probably wasn't a
good idea, let's revise our employment goals." That's life, you know, things
aren't perfect and beneficiaries have lots of various employment.
And the main thing to keep in mind, everybody that comes to you is different,
and anyone who's done this job totally gets it. If I could come out of training
and people then start knocking on your doors and you realize, "Oh my
goodness. This is so complicated and people are so different, and every Title
II beneficiary has this different circumstance and every SSI person have some
different (met) with (inaudible) and deeming and resources and children and,
you know, it's just complex and we have to really work with individuals as
individuals. And just stay focused on progress down that employment
continuum and moving people back and forth down that continuum with
sorting of files. (Inaudible) might give you a sense of accomplishment.
It's like "OK, I've moved some people out of contemplative into preparatory.
Yes. At least they're doing something to prepare." And if you don't do that,
you know, sometime you can feel very negative that you're not having an
impact and you are, it's just sometimes that impact is not as apparent as you
might like.
So, hopefully this discussion has gotten people kind of renewed and refreshed
and refocused on the goals of WIPA. And so (Heather), I'll take questions
again.
Operator:
At this time, if you would like to ask a question, please press star then the
number one. Again at star one to ask a question.
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Again, to ask a question, please press star one. There are no questions at this
time.
Lucy Miller:
Well, I think, this is the quietest group of people I've trained before. So either
that means I was super awesome and answered all your questions or you're
just scratching your head and saying, "Oh my goodness. I forgot about all this
stuff. I need to go back and read and ponder."
Don't forget that your tech assistance liaison from VCU is there to help you.
Questions that you have about how to help people towards employment, we
are delighted to help you with that.
Most of your VCU team comes from an employment services background.
That's what we did, help people with disabilities get job. We know how to
help people. So, if you're stymied with a case, you're stymied you need help,
reach out and we're here to help you.
So, thank you so much for joining us on the call today. Good luck and let us
know what help you need. Take care. Bye-bye.
Operator:
Thank you again for joining us today. This does conclude our conference.
You may now disconnect.
END