Reporting Types of BPA&O Contact to the Database Have you ever driven in one of those fancy neighborhoods where the street signs are so hidden that you have to know where you are in order to know where you are going? Do you have similar concerns about the BPA&O data entry system? This handout is designed to provide you with information to guide you on your data entry "journey"! Levels of Service There are five levels of service that can be provided to consumers when assisting them in achieving their work goals. To assist you in differentiating between these different services, try imagining yourself as a travel agent. You want to give everyone as much information as necessary, but there is a long waiting line of people who need assistance. Your goal is to make sure that no one gets lost, hits a dead end, or faces barriers that would prevent them from getting to their destinations. You must quickly assess where they want to go, provide accurate directions, and move on to the next customer. In addition, the boss wants to know what services are used most frequently. You must submit reports based on the type of travel services provided to each customer. The following information is designed to help you understand the categories of service for assisting your customers on their "travels" toward their work goals. Level of Service Examples of Assistance Provided Information and Referral * Answer general questions about benefit topics. * Direct consumers to other agencies that can better serve them. Problem Solving and Advocacy * Answer questions specific to the consumer but relevant to only a small piece of the consumer's situation. * Verify facts specific to the problem, writing a letter outlining what you have done, but not writing a complete analysis. Benefits Analysis and Advisement * Research and provide verification of complete benefits picture. * Inform consumer of possible changes or incentives, but do not plan for a specific goal. * Give consumer a formal, written analysis. Benefits Support Planning * Verify and analyze consumer's complete benefit's picture verbally, and in writing. * Create a plan with consumer to assist him or her meet a specific goal. * Include in the plan dates and types of reporting responsibilities, cliffs to avoid until the consumer is ready, and sect. Benefits Management * Verify and provide an analysis of complete benefits picture in writing and verbally. * Write a plan with the consumer and then assist him or her in carrying out that plan. * Help the consumer find informal supports to assist him or her in managing benefits in the future. Specific Descriptions for Each Level of Service Information and Referral Information: At times, consumers know "where they are going", but they need a little assistance. Here are two examples. * An individual knows what SGA is but needs to know the current limit. * A consumer wants to understand work incentives in general but doesn't want to discuss his or her situation. For these consumers, you provide general information that may or may not relate to the individuals. You answer general questions but don't explore the situation in any depth. Referral: Sometimes consumers come to you with questions that you aren't qualified to answer. Because of your training, you know that the best person or agency to serve the individual is someone else. When this happens, your job is to assist the consumer in finding the correct place to get what s/he needs. The following list provides several examples. * Can you help me get those stamps that people use at the grocery store? * I got this letter from the Social Security Administration saying that my SSI is going down because of my income. Can you tell me how that works? * I heard that I could get Medicaid. Can you tell me where to get it? * My ex-husband is getting Social Security because of his back, but I just saw him pick up the neighbor lady and swing her around. Can you tell me where to report this? * My landlord is raising my rent. Can you tell me where to get subsidized housing? =============================================================== Problem Solving and Advocacy In this level of service, you answer a consumer's question. You find out specific information about the consumer and help him or her with a particular problem. Although you verify the information for the situation at hand, you don't analyze the full benefits picture. Instead you examine one piece of the consumer's benefits, help him or her take action to solve the specific problem, and keep case notes on the contact. If the situation is complex, you may write a letter to the consumer explaining what you did. For instance, a consumer comes to you with one of the following specific questions. * I get SSI and am getting married. Can you tell me what will happen? * I got a letter saying that my Medicaid is going to stop. I need the Medicaid for my attendants. Can you help me get it back? * You did my benefits analysis last year. I have been telling the SSA about my work, but they haven't stopped my, should I be worried? =============================================================== Benefits Analysis and Advisement When providing this level of service, you will verify all benefits received and fully analyze how work would affect these benefits. You will write an analysis of the consumer's benefits including work incentives that he may use in the future. It is important to note that you and your consumers are not writing plans to reach specific goals. Rather, you are giving them information on where they are now in order to see what possible "roads" that they might take when they are ready. Examples of Benefits Analysis and Advisement Example #1: Jill receives SSI. She is 20, and has never worked. She and her family want to understand how work will affect her benefits. She doesn't plan to work until she graduates from high school next year. Jill lives with her parents and does not contribute to the household. Service: You verify Jill's situation. Jill plans to move into her own apartment upon graduation. You explain the SSI work incentives. You explain the difference between her current "B" living arrangement where the SSA reduces her benefits by the Value of the Third Reduction (VTR) and an "A" living arrangement. You document everything you told Jill and her family in a written analysis. Example #2: Sally receives SSI and SSDI benefits. She wants to understand how work might affect those benefits, but doesn't have a job goal in mind. Service: You verify Sally's benefits picture and meet with her to explain everything. You write an analysis of all of the work incentives that Sally may access. You include an explanation of how the SSI and SSDI programs work together. Since Sally also receives food stamps and subsidized housing, you explain these programs to her. You also explain in the meeting and the written analysis how work income will affect her benefits. =============================================================== Benefits Support Planning With Benefits Support Planning, you not only analyze the consumer's current situation, but you set out specific landmarks to follow. You outline when and to whom the individual gives receipts, when benefits are likely to stop due to current work effort (if above SGA), and what cliffs to avoid. The consumer has a goal, and you and the consumer "map out" how to get there. Before writing the plan, you verify all benefits and analyze the consumer's current location so that the advice given is correct. Examples of Benefits Support Planning Example #1: You did a benefits analysis for Sally six months ago. She is now ready to work. Service: You verify her current situation, and help Sally plan for her new job. You and Sally write a short PASS to pay for interviewing clothes and resume preparation. You explain the work incentives to Sally again and help her map the points at which she needs to let the SSA know about changes, when things will end or begin, and how to keep track of the PASS receipts and details. You write out the steps for Sally, and help her create calendars and other tools so she can keep track of things herself. Example #2: Fred gets SSDI benefits and doesn't remember working since he became eligible. He has just been offered a job making $25,000.00 a year. He wants to understand how this would affect his benefits. Fred wants to get off of cash benefits but is afraid of losing his Medicare. Service: You verify Fred's situation, and find out that he did work after receiving benefits, but he still has six months of his Trial Work Period to use. You explain all of the SSDI work incentives to Fred. You write an analysis of these benefits. You and Fred together develop a plan for reporting everything to the SSA and mark on a calendar when events should happen. Fred seems very capable of handling all this himself. =============================================================== Benefits Management With this level of service, you verify the consumer's benefits; write an analysis and a plan for the future. Sometimes consumers are confused enough, or their "trip" is perilous enough that you want to "travel" with them for a while. You want to do this sparingly, because monitoring the steps of the back to work process may take a lot of time. Whenever possible, you want to pull in natural supports to help the consumer. The sooner the individual is independent, or is successful with the help of friends or family who will be there for the long-term, the better you have done your job. Examples of Benefits Management Example: Susie has just been offered a job through a special mental health program making $12,000.00 per year. She receives SSDI of $942.00 per month, and pays $435.00 per month for her medications out-of-pocket. Susie has a severe mental illness. Service: You verify Susie's benefits, and realize that she will be eligible for the state's Medicaid buy-in program as soon as she begins to work. Susie has a case-manager that she likes, but the case manager doesn't understand Social Security benefits or Medicaid. You work with Susie and the case manager to develop a plan, but they need help to prevent Susie from getting scared of what will happen to her benefits. You write a detailed analysis. You explain that the special program may represent a subsidy and that either the cost of the prescriptions, or prescription co-payments if Susie applies for Medicaid, may be used as an IRWE. Each month you check in with Susie and her case manager to see how things are going. The SSA determines that Susie has a 40% Subsidy. Susie applies for Medicaid, and now pays only $30.00 per month in co-payments. Through this process, you discover that Susie has a sister who is very interested in helping. With Susie's permission, you bring the sister onto the team, and assist the sister; the case manager, and Susie to understand what happens next. You provide support to Susie and her team on how to keep receipts and how to continue reporting to the SSA. As soon as Susie and her team can take over, you back out, letting them know that they can call if something unexpected happens. =============================================================== Additional Examples of Level of Service Each individual case may require different levels of service at any given point in time. For instance, you may provide minimal support by answering general questions to a person in the form of information and referral. Then, the individual's circumstances change, and s/he requires more intensive support. The following case studies provide examples on how a person on your caseload may require different levels of service at different points in time. Penny's Case Study Example Information and Referral: Penny calls you and asks about a Trial Work Period. What is it? How is it used? She doesn't want to discuss her own situation. Penny just wants general information. You answer her questions and count this as an Information and Referral contact. Benefits Analysis and Advisement: Several weeks later, Penny calls back. She really enjoyed talking to you before and wants a full benefits analysis. She doesn't have a specific goal yet but wants to know all of her options before deciding to look for a job. You meet with her, verify her benefits, and write a complete analysis of her benefits picture. Penny has used her Trial Work Period, so you instruct her to contact the SSA as soon as she begins to work. You count this contact as Benefits Analysis and Advisement. Benefits Support Planning: Six months letter, Penny calls and reports that she has gotten a job. She lost the report and doesn't remember what to tell the SSA. You pull out the report to become familiar with her situation again and answer her questions about who to contact. There have been some changes in her situation, so you suggest that you meet again. At the meeting, you update Penny's analysis, and together you write a plan for her work incentives future. In the plan, you outline when she needs to report what, when she will lose Medicare and cash payments, and so forth. This contact provides Benefits Support Planning. Penny likes you so well, that she has her brother George call you. He doesn't receive benefits, and wants to apply. Since he doesn't receive benefits, he is not appropriate for you to serve. Still, you want him to go away with some good information, so you give him the SSA 800 number and suggest that he make an appointment. Rosa's Case Study Example The local DVR Office refers Rosa to you. She has been working for several months but has not reported her earnings to the SSA. She receives SSI, and her earnings vary from month to month. Rosa has a mild cognitive impairment. Her mother who had been handling her records for the SSA died a few months ago. Rosa wants you to help her manage her benefits. Benefits Support Planning: You meet with Rosa and get releases and an understanding of what benefits she receives. You verify these benefits, and write an analysis of her benefits picture. Together, you and Rosa write a plan that outlines when she must report, how overpayments will be handled, etc. You mark the meeting and analysis as Benefits Support Planning Benefits Management: Rosa does not have a good natural support system but wants to handle her benefits on her own. For the first few months, you help Rosa manage her reporting responsibilities with the SSA. Together, you discuss options for a natural support system to assist Rosa in managing her benefits. You and Rosa create a calendar and envelopes so she can remember where and when to report. Each month, you assist her report. You record this as Benefits Management. Problem Solving and Advocacy: After two or three months, Rosa has developed enough comfort with her reporting responsibilities that you remove her from your active caseload. Six months later, Rosa calls you to say that the SSA has asked her to come in for a redetermination. You work with her to make sure she has the documents that the SSA requested and reassure her that this is an annual process for the SSA. You credit this contact as Problem Solving and Advocacy. Mustapha's Case Study Example Information and Referral: Mustapha has a back injury. He is planning to go back to work next week. He is living with his parents and wants to find an inexpensive place to live, since his SSDI is low, and he will not have high earnings. You refer Mustapha to the local housing office to be placed on their waiting list. You mark this as I & R. Benefits Support Planning: You meet with Mustapha, conduct a complete analysis and help him plan for his return to work. This process takes two months. You credit your agency each month with Benefits Support Planning. Benefits Management: Mustapha starts his new job. He is unsure about how to report, so for the first few months, you help him make copies and send in his earnings. Each month that you do this, you credit your agency with Benefits Management. After a few months, Mustapha is independent, and you take him off of your active caseload.