Apr 5, 2019

Allison Neswood previously served as CCLP's Deputy Director of Strategic Priorities. She is an expert in public health insurance plans (Medicaid and CHP+), Aid to the Needy Disabled, immigrant access to services and health equity.

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Bill would help people with disabilities get help

by | Apr 5, 2019

No person should have to live on the streets, go hungry, or end up in jail because they have a disability that prevents them from earning an income that supports their basic needs. Conditioning access to basic needs on earning an income is one way our society deprives people with disabilities of the opportunity to live their healthiest, most fulfilling lives possible; and this is made worse by the fact that we make programs designed to mitigate that injustice inaccessible to the people that need them most.

Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI) are federal programs that help people with disabilities meet their needs by providing them with monthly income support. The current SSI benefit amount is $771 per month. The SSDI benefit varies based on the recipient’s work history but the average benefit for an individual is $1,197 per month. (An individual who is eligible for a smaller benefit under SSDI can use SSI to bring their benefit up to $771 a month). SSI and SSDI help people with disabilities obtain housing, get enough food to eat, and maintain the stable circumstances they need to experience recovery.

Unfortunately, for many severely disabled individuals, the federal relief is either long-delayed or simply unobtainable. The problem is the complex application process, which requires detailed documentation of deeply personal mental and physical health issues on up to 14 different forms that require specialized knowledge to complete adequately. The cumbersome process also requires applicants to record up to 15 years of work history and at least two years of medical treatment history. Furthermore, applicants are required to stay in contact with the Social Security Administration (SSA) — which is difficult for clients that don’t have a phone or a home. Failure to communicate, attend an appointment, or provide sufficient information will often result in a denial of benefits regardless of the individual’s actual level of impairment.

The process is challenging for anyone who is not trained to complete it successfully; for those with serious mental illness and people who are homeless, it is hard to even know where to begin. It is no wonder that less than 30 percent of initial SSI/SSDI applications submitted without navigation assistance are successful. And for homeless applicants that number is only 10-15 percent. While about half of the cases that are denied at the initial level are approved on appeal, many applicants simply give up. If they choose to proceed, the appeal process can take more than a year to resolve. In fiscal year 2016, 8,699 Americans died waiting for their disability case to be resolved. In fiscal year 2017, that number rose to 10,002.

Support HB 1223
House Bill 1223
invests in an obvious and proven solution to this problem: SSI and SSDI application assistance. As a result of the bill, client advocates that know and understand SSA’s criteria for disability will be available to help SSI and SSDI applicants navigate the application process and develop strong SSI/SSDI applications. The client advocates will help applicant’s understand the process, gather the necessary documentation, and keep track of necessary appointments. They will also be able to serve as client representatives, providing a consistent point of contact for the SSA when that is needed.

The bill targets those with the greatest need by providing application assistance to recipients of Aid to the Needy Disabled (AND). AND uses state and some county funds to provide just $217 a month to people with severe physical or mental disabilities that prevent them from working. With only $217 per month in income many AND clients are homeless, many do not have access to reliable transportation, and most do not have the stable circumstances they need to attend to their significant health challenges. These individuals are in no position to complete the cumbersome SSI and SSDI application process; though they often need the support the most.

HB 1223 would increase access to application assistance in Colorado and thereby increase the income support for Coloradans with severe disabilities by over three times from $217 per month from state and local revenue to at least $771 per month from federal dollars. People need these resources to help them pay for basic needs like housing, food, and transportation, and with the resources, many are able to experience significant health improvement. A handful of nonprofits, such as Easter Seals and Bayaud Enterprises, provide similar assistance but their reach and resources are limited.

In a small pilot program authorized in Colorado in 2014, 54 percent of cases were approved and clients were connected to benefits in an average of six months from the initiation of the application process – a dramatic improvement from those applying outside of the pilot without assistance. Similar programs in other states have seen even better results.

In addition, the program will generate a large return on investment by increasing the approval rate for SSI and SSDI. When an AND clients is approved for SSI, the SSA reimburses the state for AND payments made to that individual. HB 1223 will increase the number of clients for whom the state receives reimbursement. HB 1223 will also reduce the number of AND payments the state has to make in the first place by reducing the amount of time people spend on the AND program. In addition, SSI and SSDI recipients use their federal support to pay rent to local landlords, buy food and other necessities at local stores, and transportation on local transit or gas at local stations. As a result, all of those federal dollars will be cycled through our Colorado economy.

As a result of the reimbursements and savings connected to AND and the increased income for Coloradans with disabilities, CCLP estimates that Colorado could realize a $6.2 million return from a $3.6 million investment in application assistance. The program will also reduce local spending on homeless services, emergency-room care, and public safety by supporting stability for many of Colorado’s most vulnerable residents.

The things we pay for with taxes reflect the values we hold as a society. We should support access to basic needs for our neighbors with severe disabilities because it is the just thing to do. But, as is often the case, investing in the well-being of our neighbors also happens to be the most financially responsible thing to do too.

-By Allison Neswood

Recent articles

Recap: Special Legislative Session 2023

In the aftermath of the 2023 November election and the failure of Proposition HH, Colorado Governor Jared Polis called a special session of the Colorado General Assembly, held from November 17 to November 20.  Over the course of a fast-paced and grueling weekend of...

Systemic failure in Colorado’s PHE Unwind

During this post-COVID year of Medicaid renewals, known as the Public Health Emergency (PHE) Unwind, Colorado is terminating members at rates that are among the highest in the country, many for procedural reasons.

HEALTH:
HEALTH FIRST COLORADO (MEDICAID)

To maintain health and well-being, people of all ages need access to quality health care that improves outcomes and reduces costs for the community. Health First Colorado, the state's Medicaid program, is public health insurance for low-income Coloradans who qualify. The program is funded jointly by a federal-state partnership and is administered by the Colorado Department of Health Care Policy & Financing.

Benefits of the program include behavioral health, dental services, emergency care, family planning services, hospitalization, laboratory services, maternity care, newborn care, outpatient care, prescription drugs, preventive and wellness services, primary care and rehabilitative services.

In tandem with the Affordable Care Act, Colorado expanded Medicaid eligibility in 2013 - providing hundreds of thousands of adults with incomes less than 133% FPL with health insurance for the first time increasing the health and economic well-being of these Coloradans. Most of the money for newly eligible Medicaid clients has been covered by the federal government, which will gradually decrease its contribution to 90% by 2020.

Other populations eligible for Medicaid include children, who qualify with income up to 142% FPL, pregnant women with household income under 195% FPL, and adults with dependent children with household income under 68% FPL.

Some analyses indicate that Colorado's investment in Medicaid will pay off in the long run by reducing spending on programs for the uninsured.

FOOD SECURITY:
SUPPLEMENTAL NUTRITION ASSISTANCE PROGRAM (SNAP)

Hunger, though often invisible, affects everyone. It impacts people's physical, mental and emotional health and can be a culprit of obesity, depression, acute and chronic illnesses and other preventable medical conditions. Hunger also hinders education and productivity, not only stunting a child's overall well-being and academic achievement, but consuming an adult's ability to be a focused, industrious member of society. Even those who have never worried about having enough food experience the ripple effects of hunger, which seeps into our communities and erodes our state's economy.

Community resources like the Supplemental Nutrition Assistance Program (SNAP), formerly known as Food Stamps, exist to ensure that families and individuals can purchase groceries, with the average benefit being about $1.40 per meal, per person.

Funding for SNAP comes from the USDA, but the administrative costs are split between local, state, and federal governments. Yet, the lack of investment in a strong, effective SNAP program impedes Colorado's progress in becoming the healthiest state in the nation and providing a better, brighter future for all. Indeed, Colorado ranks 44th in the nation for access to SNAP and lost out on more than $261 million in grocery sales due to a large access gap in SNAP enrollment.

See the Food Assistance (SNAP) Benefit Calculator to get an estimate of your eligibility for food benefits.

FOOD SECURITY:
SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC)

Every child deserves the nutritional resources needed to get a healthy start on life both inside and outside the mother's womb. In particular, good nutrition and health care is critical for establishing a strong foundation that could affect a child's future physical and mental health, academic achievement and economic productivity. Likewise, the inability to access good nutrition and health care endangers the very integrity of that foundation.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides federal grants to states for supplemental foods, health care referrals, and nutrition information for low-income pregnant, breastfeeding and non-breastfeeding postpartum women and to infants and children up to age five who are found to be at nutritional risk.

Research has shown that WIC has played an important role in improving birth outcomes and containing health care costs, resulting in longer pregnancies, fewer infant deaths, a greater likelihood of receiving prenatal care, improved infant-feeding practices, and immunization rates

Financial Security:
Colorado Works

In building a foundation for self-sufficiency, some Colorado families need some extra tools to ensure they can weather challenging financial circumstances and obtain basic resources to help them and their communities reach their potential.

Colorado Works is Colorado's Temporary Assistance for Needy Families (TANF) program and provides public assistance to families in need. The Colorado Works program is designed to assist participants in becoming self-sufficient by strengthening the economic and social stability of families. The program provides monthly cash assistance and support services to eligible Colorado families.

The program is primarily funded by a federal block grant to the state. Counties also contribute about 20% of the cost.

EARLY LEARNING:
COLORADO CHILD CARE ASSISTANCE PROGRAM (CCCAP)

Child care is a must for working families. Along with ensuring that parents can work or obtain job skills training to improve their families' economic security, studies show that quality child care improves children's academic performance, career development and health outcomes.

Yet despite these proven benefits, low-income families often struggle with the cost of child care. Colorado ranks among the top 10 most expensive states in the country for center-based child care. For families with an infant, full-time enrollment at a child care center cost an average of $15,140 a year-or about three-quarters of the total income of a family of three living at the Federal Poverty Level (FPL).

The Colorado Child Care Assistance Program (CCCAP) provides child care assistance to parents who are working, searching for employment or participating in training, and parents who are enrolled in the Colorado Works Program and need child care services to support their efforts toward self-sufficiency. Most of the money for CCCAP comes from the federal Child Care and Development Fund. Each county can set their own income eligibility limit as long as it is at or above 165% of the federal poverty level and does not exceed 85% of area median income.

Unfortunately, while the need is growing, only an estimated one-quarter of all eligible children in the state are served by CCCAP. Low reimbursement rates have also resulted in fewer providers willing to accept CCCAP subsidies.