Data from the U.S. Census is used to assign congressional seats to states, and it directly affects how more than $400 billion per year in federal funding is distributed to state, local and tribal governments. Accurate counts impact several important programs and services that are critical to the disabled community.

Here is what the census means for people with a disability:

* Helps state and county agencies plan for eligible recipients under the Medicare, Medicaid,and Supplemental Security Income (SSI) programs.

* Distributes funds and develops programs for people with disabilities and the elderly under the Rehabilitation Act.

* Distributes funds for housing for people with disabilities under the Housing and Urban Development Act.

* Allocates funds for mass transit systems to provide facilities for people with disabilities under the Federal Transit Act.

* Awards federal grants, under the Older Americans Act, based on the number of elderly people with physical and mental disabilities.

* Allocates funds to states and local areas for employment and job training programs for veterans and disabled veterans under the Job Training Partnership Act, Disabled Veterans Outreach Program.

* Ensures that comparable public transportation services are available for all segments of the population under the Americans with Disabilities Act.

Supplemental Security Income (SSI) is a federal program that helps people with disabilities and very low incomes pay for food, clothing and shelter. SSI is often confused with Social Security Disability Insurance (SSDI). One of the main differences between the two programs is that SSDI is available to people with disabilities no matter how much money they earn or have, while SSI places very strict limits on a recipient’s income and assets. However, in most states, an SSI beneficiary who receives even $1 from the program also qualifies for Medicaid health coverage, which can be far more valuable than SSI’s benefit itself.

How to Qualify for SSI:

This first requirement is often the hardest for SSI applicants to meet, in large part because the federal government’s definition of “disabled” is so narrow. In essence, adult SSI applicants who are seeking benefits based on a disability must show that they are almost completely unable to work at any job whatsoever. The applicant must have a physical or mental impairment that makes it impossible for him to engage in any “substantial gainful activity,” and this impairment must be expected to last for longer than one year or to result in death. If an applicant is able to engage in substantial gainful activity, then he will typically not be eligible for SSI. A child applicant must have a physical or mental impairment that results in marked and severe functional limitations and can be expected to last for longer than one year or result in death.

An SSI Beneficiary Must Have Very Limited Resources:

Once an SSI applicant has shown that she is disabled, she must also prove that she has less than $2,000 to her name. If the applicant can use or liquidate an asset to pay for food or shelter, the asset will probably count as a “resource” against this limit. A resource would include any funds held in the applicant’s bank accounts, retirement accounts, or in cash. If the applicant has set up a trust that does not meet specific requirements, the trust funds are also counted against the $2,000 limit. The applicant’s own home will not be considered an available resource, and her car is also exempt. The $2,000 resource limit does not disappear once a person qualifies for SSI. If an SSI beneficiary ends a month with more than $2,000 in her name, she will lose her benefits in the following month.

Income Is Key:

SSI recipients get only a modest monthly benefit, and this sum is reduced by any income they may have. In 2009, the maximum federal SSI benefit was $674 a month, although many states add a small supplement to this. In addition, SSI benefits are reduced by $1 for each dollar of unearned income a beneficiary receives (such as interest or dividends), and by $0.50 for each dollar of earned income (such as wages). SSI benefits are also reduced if an adult beneficiary lives in someone else’s home without paying rent, or if he receives free meals. Finally, the income of the people living with the beneficiary can count against the beneficiary. If the beneficiary’s combined income reduces his SSI benefit to zero, he loses SSI, along with any Medicaid benefits that may come with it.

Supplemental Needs Trusts Can Help:

Although SSI’s income and asset rules are highly restrictive, several types of trusts, called “Special Needs” or “Supplemental Needs” trusts, can protect an SSI beneficiary’s assets while allowing her to maintain SSI eligibility. Relatives and friends of the SSI recipient can also set up a trust for the recipient and fund it with their own money. If properly structured, these trusts also will allow an SSI recipient to continue receiving benefits. Unfortunately, a poorly drafted special needs trust can destroy any hopes an applicant has of ever qualifying for SSI.

Quality Advice Is Necessary:

SSI is a very complicated program with rules that most attorneys who do not focus on this practice area have trouble understanding. Therefore, it is essential to seek out a qualified special needs planner, such as the Attorneys at the Law Firm of Needham Mitnick & Pollack, who can guide you or your family through the complicated process of obtaining and maintaining SSI benefits.

It is my pleasure to announce that starting this January 2010 I will be joining the law firm of Needham Mitnick & Pollack, as “Of Counsel.”

After being a solo practitioner for the last 15 years I did not enter into this position lightly. However, I feel that this relationship with the wonderful people of this firm will be a benefit to both myself and my clients.

At Needham Mitnick & Pollack I will continue practicing Social Security Disability Law and Special Needs Planning as well as some additional areas in the future.

I will be available to see clients at Needham Mitnick & Pollack’s offices in Falls Church as well as my present office in Fairfax.

Needham Mitnick & Pollack is a well established Elder Law, Estate, Disability & Special Needs Planning law firm that can assist clients with Wills, Trusts, Probate, Trust Administration, Powers of Attorney, Advance Medical Directives, Guardianships, Long Term Care Planning, Disability Planning, Medicaid Eligibility, Veterans Benefits and Special Needs Trusts.

For more information on the law firm of Needham Mitnick & Pollack, please click here.

During its 2009 session, the Virginia General Assembly expressed its intent to eliminate the waiting lists for the Medicaid Intellectual Disabilities (formerly “Mental Retardation”) Waiver and the Individual and Family Developmental Disabilities Supports Waiver.

In doing so, it required the Department of Medical Assistance Services (DMAS) to collaborate with the Department of Planning and Budget to increase the number of funded waiver slots at a minimum of 67 slots for the Individual and Family Developmental Disabilities Supports waiver and 400 slots for the Intellectual Disabilities waiver per year, until the waiting lists are eliminated and directed the Governor to develop a plan to eliminate the waiting lists for these waivers by the 2018-2020 Biennium.

The full report can be accessed here.

Unfortunately, a diagnosis of a terminal illness often comes with many expenses. If you need money to pay for your medical care or comfort, you may be able to use your life insurance policy to get some immediate cash. “Viatical settlements” allow terminally ill individuals to sell their life insurance policies. Alternatively, some insurance companies allow you to receive an accelerated death benefit.

A viatical settlement is similar to a life settlement, but it is designed for individuals that are terminally ill. You sell your policy to a company, which then collects the death benefit when you die. Most companies require that you have owned your policy for at least two years, your beneficiaries sign a release or waiver, you have a life expectancy of anywhere from two to four years (depending on the company), and you allow the company access to your medical records.

A company will usually pay more than the cash surrender value, but less than the death benefit, although the exact price depends on a number of factors. In determining price, companies look at your life expectancy, how long you have had the policy, and the face value of the policy, among other things.

Rather than selling your policy, some insurance companies allow you to collect a portion of your death benefit before you die. This is called an accelerated death benefit. This option may be included as part of your policy or you may have to pay extra for it.

Accelerated death benefits are paid under certain circumstances, usually the onset of a terminal illness, the need for long-term care, or the diagnosis of a specified medical condition. The amount you can receive may be capped and you may be able to receive either a lump sum or monthly payments. Any remaining amount will go to your beneficiaries when you die.

Both viatical settlements and accelerated death benefits could have tax consequences and affect Medicaid planning. Before taking either option, you should consult with attorney Sheri Abrams.

Because of its size and cost, Medicaid has been called the “workhorse” of the U.S. health system. Now it’s front and center in the debate on overhauling the U.S health system and expanding coverage to the uninsured.

With 60 million enrollees, Medicaid dwarfs other insurance programs, including its cousin, Medicare, which covers 44 million elderly and disabled people.Medicaid is a joint federal-state program, with the federal government picking up about 57 percent of the overall Medicaid tab. But the federal contribution varies by state, ranging from 50 percent to 73 percent, with poorer states getting a bigger matching rate.

Medicaid isn’t a one-size-fits-all program; after meeting certain federal requirements, each state has the flexibility to shape coverage and benefits. As a result, the Medicaid program in Pennsylvania bears little resemblance to the one in Louisiana. For example, non-working parents in Pennsylvania qualify for Medicaid if their incomes are below twice the federal poverty level ($44,100 for a family of four). But in Louisiana, non-working parents qualify only if their incomes are below 11percent of the poverty level ($2,426 for a family of four). States frequently experiment with new concepts in benefit design, eligibility and delivery systems.

In general, Medicaid covers about 45 percent of poor Americans, defined as those with incomes below the federal poverty level (about $22,000 for a family of four). To be eligible for coverage, individuals must fall below certain income thresholds, which vary by state, and belong to certain categories, such as having dependent children, or being pregnant or disabled. In 20 states, a parent in a family of four who gets paid the federal minimum wage makes too much to qualify. Only 18 states cover adults without dependent children.

Medicaid benefits include mental health services, transportation-to-health services, and comprehensive screenings and treatment for children. In addition, Medicaid enrollees have much lower out-of-pocket costs than people with private coverage. There are typically no monthly premiums and no, or very low, co-payments

However, in many states, specialists and dentists don’t see Medicaid patients. Providers typically blame low reimbursement rates as the main reason for not accepting Medicaid patients. In Kentucky, Medicaid pays doctors $210for a colonoscopy; Medicare pays $333. Private insurers usually pay more. In Pennsylvania, Medicaid pays doctors $300 for an appendectomy, while Medicare pays $575.

About 76 percent of all enrollees are children and their parents. And 65 percent of people on Medicaid come from working families. About three quarters of Medicaid spending is for the elderly and disabled, even though the two groups make up only about one quarter of the program’s enrollees. Medicare provides little coverage for long-term care, so many elderly, after depleting their savings, rely on Medicaid to pay their costly nursing home bills.

Administrative costs of Medicaid are less than 7 percent, or half the rate that’s typically seen in the private sector. Medicaid holds down costs in part by paying providers lower fees and doing little marketing.

The Senate Finance Committee is working on ideas to change the way people become eligible for and utilize the Medicaid Home and Community Based Services Waiver Program.The Medicaid Home and Community Based Services Waiver is a federal program administered by the states, which provides funding for people with disabilities to live in the community and obtain support services. There are currently long waiting lists for this waiver program in many states.

The Senate Finance Committee is creating policy options as part of President Barack Obama’s efforts to reform the American health care system.

The options pertaining to the waiver program include:

• Requiring states to lift their caps on the number of waiver recipients to include more people. Or, prohibiting states from using waiting lists to prevent eligible individuals from accessing services.

• Eliminating a current requirement that in order to obtain funding from the waiver individuals must need an institutional level of care.

• Giving states more latitude to determine income requirements for waiver eligibility.

• Allowing individuals to enroll in multiple Medicaid waivers at one time.

Access to affordable health care through the Medicaid program is one of the great benefits afforded to most recipients of Supplemental Security Income (SSI). In many states, full Medicaid coverage is often equal to, or even better than, many private health insurance plans, allowing SSI beneficiaries and other Medicaid recipients to effectively manage their illness or disability.

However, many Medicaid recipients don’t realize that their health insurance coverage may not provide a full set of benefits should they require care while out of state. For example in some states Medicaid only covers out-of -state emergency room visits to stabilize emergency conditions. Should a beneficiary need to be admitted to a hospital in another state or if he must receive essential, regular psychiatric care or medications from an out-of-state provider, some states will not pay for the services through Medicaid. In these situations, a caregiver or other family member is often required to sign an agreement to pay for the services before the person with special needs can receive care.

Since Medicaid is administered as a joint program between the state and federal governments, each individual state has its own rules regarding out-of-state Medicaid coverage. If a loved one with special needs is planning to take an out-of-state trip, or if you live near your state border and travel between states for work or recreation, it makes sense to find out your states out-of-state Medicaid rules. By investing the time now you could save thousands of dollars in medical bills down the road.