SSAI Webinar: Waiver Factors Thursday, February 10, 2011.

SSAI Webinar:

Waiver Factors

Thursday, February 10, 2011

Webinar DetailsWebinar DetailsWebinar DetailsWebinar Details

I-Class Webinar

Recorded for later viewing

Mute mode

Write down your questions and when Q/A starts:

Raise your hand if you have a question that can be answered through phone connection

Send a note if you want your question read and answered aloud in webinar

Agenda for Today’s WebinarAgenda for Today’s WebinarAgenda for Today’s WebinarAgenda for Today’s Webinar Background

What’s Happening in March and April and Why?

Review of Waiver Factor Webtool (under development)

Review of Waiver Factor Update Form

Questions/Answers

Overview the 7 Factors that Waive the Four Year/48 month Lifetime Cap on SCSEP

Definitions

How to Assess/Affirm and Document Them

Next Steps for Project Directors and SSAI

Adjourn

BackgroundBackgroundBackgroundBackground

In the 2006 Older Americans Act, Congress added a four year/48 month lifetime cap on SCSEP participation starting July 1, 2007

The first participants to be exited for reaching their four year limit will be July 1, 2011

Congress stipulated that participants who possessed certain characteristics could be “waived” from the four year lifetime limit

These participants get a waiver or extension of time only – they still have to meet all other requirements to participate on SCSEP

SSAI PolicySSAI PolicySSAI PolicySSAI Policy

Notified network during September 8, 2010 “The Facts of the SCSEP Four Year Lifetime Cap” webinar that:

SSAI will seek authorization of a waiver from DOL for any participant who possesses at least one of any of the seven waiver factors

See SSAI Policy and Procedures 203-D and 203-E

Discussed at great length in Buffalo Conference

SSAI Philosophy

Subgrantee Reactions

Can I decide for my program whether my program will grant waivers or not?

No – all subgrantees must adhere to SSAI’s policy.

Can I decide which participants will be granted a waiver/extension of time?

No – per SSAI policy, SSAI will request waiver authorization/extension of time from DOL for any participant who possesses at least one of the seven waiver factors. Congress established the waiver factors in the Older Americans Act.

What’s Happening in

March and April

&

Why

Remember the training from SSAI’s Webinar in

September?

“The Facts of the SCSEP Four Year Lifetime Cap”

There are 13 Most-in-Need Characteristics (7 of There are 13 Most-in-Need Characteristics (7 of which are also Waiver Factors)which are also Waiver Factors)

There are 13 Most-in-Need Characteristics (7 of There are 13 Most-in-Need Characteristics (7 of which are also Waiver Factors)which are also Waiver Factors)

1. Veterans or qualified spouses

2. Have a disability

3. Live in a rural areas

4. Have low employment prospects

5. Have failed to find employment after using services under WIA Title 1

6. Are homeless or at risk of becoming homeless

7. Have limited English proficiency (LEP)*

8. Have low literacy skills*

9. Have a severe disability*

10. Are frail*

11. Are age 75 or older*

12. Are old enough for Social Security retirement but are not eligible to receive it*

13. Have severely limited employment prospects in an area of persistent unemployment*

*Are also Waiver Factors

(See 201-C of Policy and Procedure Manua):

What are the “Waiver Factors?” What are the “Waiver Factors?” What are the “Waiver Factors?” What are the “Waiver Factors?”

The following seven (7) most-in-need (MIN) characteristics qualify participants for potential waivers to the four year SCSEP (48 month) lifetime cap

1. Have limited English proficiency (LEP); or

2. Have low literacy skills; or

3. Have a severe disability; or

4. Be frail; or

5. Be old enough for Social Security retirement but not eligible to receive it; or

6. Have severely limited employment prospects in an area of persistent unemployment; or

7. Be age 75 or older.

These seven are also the only MIN characteristics that can be updated

DOL Has Told GranteesDOL Has Told GranteesDOL Has Told GranteesDOL Has Told Grantees

That in order to get credit for our MIN, we must update those MIN characteristics that can be updated during this program year (i.e. before June 30)

Also, in order to submit waiver requests for approval, the participant’s waiver factor(s) must be updated in the quarter before the request

(because the DOL Database will be closed to updates

from July – September to do year-end closeout)

What’s In It For Me?What’s In It For Me?What’s In It For Me?What’s In It For Me?

GOOD NEWS!

1. You will assess and capture the MIN/Waiver Factors of ALL OF YOUR PARTICIPANTS during recertification

2. Many of you have shared that you are disappointed in your MIN performance; you now have the structured opportunity to accurately capture MIN and improve your score

3. It’s Efficient – you will update your Waiver Factors and your MIN at the same time

During March RecertificationDuring March RecertificationDuring March RecertificationDuring March Recertification

Schedule all of your participants reaching their 4 year/48 month lifetime cap in the first quarter of PY11 (July, August, September) during the first two week of recertification

If you have already made participant appointments, you can decide to re-arrange or not… we don’t intend for you to do extra prep work

Use your “Participant Four Year Cap Report” located in your report tools to:

Schedule appointments with participants who are due to exit in July, August, September 2011 (1st Quarter of PY11)

Instruct the participants with previously identified waiver factors who are due to exit in the 1st Quarter of PY11 what documents to bring to their recertification appointment

During March Recertification (continued)During March Recertification (continued)During March Recertification (continued)During March Recertification (continued)

During your recertification appointments, assess each participant for one of the 7 MIN/waiver factors

If you identify new MIN/Waiver factors, talk with the participant about what documentation they need to provide so that the can go from “pending” to “confirmed” MIN/Waiver Factor Status

Meeting with the participants in March will allow you to confirm their waiver factor status by April

Let’s look at three helpful resources we’ve created for you

HandoutsHandoutsHandoutsHandouts

1. Waiver Factors Update Form Participants sign – serves as formal notice

Participant gets copy Project staff keep copy for participant file

You know who is pending “yes” to a waiver factor(s) and who has no waiver factors

2. Updated Participant Four Year Cap Report”

3. Waiver Factor Webtool Mock-up

For Participants with No Waiver Factors…For Participants with No Waiver Factors…For Participants with No Waiver Factors…For Participants with No Waiver Factors…

Who are reaching their 48 month/4 year lifetime cap and thus exit date in July, August or September…

In March, you need to input the “no waiver” information from the Waiver Factors Update Form in the SSAI Waiver Webtool

Start or update their Transition Assessment and IEP

In April, provide them with their 90 day durational limit letter

In June, provide them with their 30 day exit letter (30 dates before their last date on SCSEP)

Lifetime cap participants are not put on a 30-day approved break without pay

For Participants You Determine Have A For Participants You Determine Have A Waiver Factor(s)….Waiver Factor(s)….For Participants You Determine Have A For Participants You Determine Have A Waiver Factor(s)….Waiver Factor(s)….

Who otherwise would be reaching their 48 month/4 year lifetime cap/exit date in July, August or September 2011

For “Yes’s” of Waiver Factors Only…

In March, you need to input the “pending” information from the Waiver Factors Update Form in the SSAI Waiver Webtool

In April, you need to input “yes validated” information into webtool when participant produces necessary documentation

As soon as you have the waiver factor documentation, you will need to mail copy of waiver update form and all verifying documentation to SSAI

SSAI staff will partner with subgrantees to review and confirm whether participant has waiver factor or not

SSAI will provide written instructions for next steps to participant and project staff if participants DOES NOT have a waiver factor

SSAI will provide more details this entire re-confirmation process soon

Why is SSAI Requiring Why is SSAI Requiring Re-Confirmation/Validation?Re-Confirmation/Validation?

Why is SSAI Requiring Why is SSAI Requiring Re-Confirmation/Validation?Re-Confirmation/Validation?

Because if DOL determines that a participant was improperly identified as having a waiver factor, when the participant DOES NOT, this will be a disallowed cost

We want to avoid any disallowed costs for you and for SSAI

We want to be sure that we are allowing extensions to the four year time limit only to participants who meet the conditions of the waiver factors

SSAI will provide more details this entire re-confirmation process soon

Let’s Take Some QuestionsLet’s Take Some QuestionsLet’s Take Some QuestionsLet’s Take Some Questions

Raise Your Hand to Confer by Phone or Send Me a Note

Scenario QuestionsScenario QuestionsScenario QuestionsScenario Questions

Q. Participant A will turn 75 on June 29, 2011, thus she will be eligible to stay due to age waiver. Participant B will turn 75 on July 4, 2011 and has no other waiver factors. Since he will not be 75 until after July 1, 2011, he will have to be exited, right?

A: The 48 month time limit is inflexible. However, a legitimate approved break in service could mean that Participant B would qualify for the 75 or older waiver factor.

Scenario Questions (continued)Scenario Questions (continued)Scenario Questions (continued)Scenario Questions (continued)

Q: If a participant qualifies for a waiver factor and they exit the program for employment, can they come back on SCSEP ever again? To clarify, the participant has used up their 48 months participation and got the waiver to stay on the program. They exit (after being on the program more than 48 months/4years) into a job or other reason. Can they come back?

A: The 49 month limit is inflexible. In the above example, the participant could only come if he qualified for right of return (see PPM 202-C). Otherwise, no, he can never participate in SCSEP again.

Scenario Questions - ContinuedScenario Questions - ContinuedScenario Questions - ContinuedScenario Questions - Continued

Q: A participant reaches their 48 month/4 year cap with another national or state grantee. The other national or state grantee does not offer waivers but the participant qualifies for a waiver factor. Can I enroll that participant?

A: No. If the participant reaches his/her 48 month/4 year cap with another provider who does not offer waiver factors, he/she cannot pursue a waiver/extension of time with another provider.

Scenario Question - continuedScenario Question - continuedScenario Question - continuedScenario Question - continued

Q: But what if the participant exits another national or state SCSEP provider before he/she reaches their 48 month/4 year limit?

A: Re-enrollment in SCSEP is discretionary (see PPM 202-D) and starting in April you will start balancing how much time a person has already had in SCSEP with all the other factors you consistently juggle with participant enrollment.

During initial assessment, you determine both MIN and waiver factors.

If you feel that you can help a participant (who has no waiver factors) be successful let’s say in 3 months, go ahead and enroll the person and start the Transition Assessment and IEP.

If you enroll a participant who qualifies for a waiver factor(s), then you will follow SSAI’s waiver factor policies.

Let’s Take Some QuestionsLet’s Take Some QuestionsLet’s Take Some QuestionsLet’s Take Some Questions


Assessing/Affirming and Documenting Waiver Factors

What Are the 7 Waiver Factors?What Are the 7 Waiver Factors?What Are the 7 Waiver Factors?What Are the 7 Waiver Factors?

See Policy and Procedure Manual 201-C

1. Age 75 or older before July 1, 2011

2. Limited English proficiency

3. Low Literacy Skills

4. Old enough for but not receiving Social Security Title II

5. Severe disability

6. Frail

7. Severely limited employment prospects in an area of persistent unemployment

Definitions/How to Assess/

How to Document

1. Age 75 or Older1. Age 75 or Older1. Age 75 or Older1. Age 75 or Older

Age 75 or older before participant reaches their four year/48 month limit date

To confirm that there was no math error in the participant’s date of birth, you need to ask participant to bring in age documentation

Examples:

Driver’s License

Government ID

Government or other official document with participants birth date listed (month/day/year)

Birth certificate

Make and retain a copy of document used to verify birth date in participant’s file

2. Limited English Proficiency (LEP)2. Limited English Proficiency (LEP)2. Limited English Proficiency (LEP)2. Limited English Proficiency (LEP)

Definition: individuals who do not speak English as their primary language and who have a limited ability to read, speak, write or understand English

Examples of how to assess/determine include:

Interviewing the participant and during the interview observing the following:

“What is your primary language / first language you learned?”

Did the participant come to the interview with an interpreter or bring a version of the program flyer in another language?

Did the participant bring a card or note translated into English indicating that the participant does not speak English?

Examples of Properly Documenting LEP Examples of Properly Documenting LEP Examples of Properly Documenting LEP Examples of Properly Documenting LEP

SIGNED SELF-ATTEST FORM; OR

SIGNED THIRD PARTY ATTESTATION FORM; OR

DETAILED CASE NOTES AND NOTATIONS ON YOUR INITIAL ASSESSMENT FORM In addition to the standard requirements for all case notes, must also explain:

(1) that the participant has limited English proficiency,

(2) how assessment was made, e.g., participant appeared with an interpreter or directly communicated to case worker that she doesn’t speak English, and

(3) the date that assessment was made.

OR

OFFICIAL RECORDS: that establish limited English proficiency are acceptable, including but not limited to: results of literacy testing, standardized test results.

Make and retain a copy of the document(s) used to verify LEP in participant’s file

The date of the source documentation that verifies this factor should be on or around the date that you enter into the SSAI Webtool. Documentation from a prior program year is not acceptable.

Review LEP Self-Attest Form

What Do We Mean by “Detailed Case What Do We Mean by “Detailed Case Notes?”Notes?”


Detailed Case Notes consist of project staff’s own documentation of his or her activities.

Case notes can be based on information derived in person or by telephone and must contain the following 4 elements:

1. Case notes must include the name of the person who is the source of the information, his or her phone number, and the person’s organization and title or relationship to the participant, whichever is appropriate. Depending on the circumstances, this could be an individual associated with the grantee, the employer, the host agency, or some other party.

2. Case notes must include the name or initials of the staff person making the note.

3. Case notes must contain the date on which the information was obtained, and the date on which it was recorded, if different.

4. The specific facts being documented

Case notes can be stored in any format, including hand-written notes, standardized forms, or electronic records.

The term “detailed” does not correlate to length or amount of information, but instead recognizes that the case notes need to provide sufficient information so that a reasonable person could make a determination as to specific events or decisions.

3. Low Literacy Skills3. Low Literacy Skills3. Low Literacy Skills3. Low Literacy Skills

Definition: the individual computes or solves problems, reads, writes, or speaks at or below the 8th grade level or is unable to compute or solve problems, read, write, or speak at a level necessary to function on the job, in the individual’s family, or in society.


Struggling with spelling when completing required SCSEP forms

Struggling to understand written instructions that you provide

Examples of Properly Documenting Examples of Properly Documenting Low Literacy SkillsLow Literacy Skills

Examples of Properly Documenting Examples of Properly Documenting Low Literacy SkillsLow Literacy Skills


SIGNED THIRD PARTY ATTESTATION FORM; OR


(1) that the participant has low literacy skills;

(2) how assessment was made

(3) the date that assessment was made.

OR

OFFICIAL RECORDS: that establish low literacy skills are acceptable, including but not limited to: results of literacy testing, standardized test results.

Make and retain a copy of the document(s) used to verify Low Literacy Skills in participant’s file


Review Low Literacy Self-Attest Form



Detailed Case Notes consist of project staff’s own documentation of his or her activities.

Case notes can be based on information derived in person or by telephone and must contain the following 4 elements:

1. Case notes must include the name of the person who is the source of the information, his or her phone number, and the person’s organization and title or relationship to the participant, whichever is appropriate. Depending on the circumstances, this could be an individual associated with the grantee, the employer, the host agency, or some other party.

2. Case notes must include the name or initials of the staff person making the note.

3. Case notes must contain the date on which the information was obtained, and the date on which it was recorded, if different.

4. The specific facts being documented

Case notes can be stored in any format, including hand-written notes, standardized forms, or electronic records.

The term “detailed” does not correlate to length or amount of information, but instead recognizes that the case notes need to provide sufficient information so that a reasonable person could make a determination as to specific events or decisions.

4. Old enough for but not receiving Social 4. Old enough for but not receiving Social Security Title IISecurity Title II

4. Old enough for but not receiving Social 4. Old enough for but not receiving Social Security Title IISecurity Title II

Definition: a person may qualify for Social Security retirement benefits at age 62; however if the person is 62 or older and does not have sufficient wage credits to qualify for Social Security Retirement, then the person would qualify for this waiver factor.


Determining participant’s age

Ask whether he/she is receiving Social Security Retirement

If no, ask if he/she expects to receive Social Security

Examples of Properly Documenting Old Examples of Properly Documenting Old enough for but not receivingenough for but not receiving

Social Security Title IISocial Security Title II

Examples of Properly Documenting Old Examples of Properly Documenting Old enough for but not receivingenough for but not receiving

Social Security Title IISocial Security Title II

OFFICIAL DOCUMENTS OR BUSINESS RECORDS:

Official government document that establishes that the participant has not worked in the U.S. for 40 quarters, including but not limited to:

Social Security Administration documents (e.g. Social Security Statement) or immigration records that show the participant has not been in the U.S. for 40 quarters (10 years)

Make and retain a copy of the document(s) used to verify Old Enough for but not Receiving Social Security Title II in the participant’s file


5. Severe Disability5. Severe Disability5. Severe Disability5. Severe Disability

Definition: a severe, chronic disability attributable to mental or physical impairment(s), or a combination of mental and physical impairments, that:

(1) is likely to continue indefinitely; AND

(2) results in substantial functional limitation in three (3) or more of the following areas of major life activity: self-care, receptive and expressive language, learning, mobility, self-direction, capacity for independent living, and/or economic self-sufficiency.

How Do You Assess/Determine “Severe Disability”?

Through securing documentation that supports the regulatory definition in the previous slide (#23) and also in your Policy and Procedure Manual

Properly Documenting Properly Documenting Severe DisabilitySevere Disability

Properly Documenting Properly Documenting Severe DisabilitySevere Disability


When a medical certification or statement is used to support, related documentation should be an official government record or other official record that:

1. Indicates that a medical professional made a determination of disability; and

2. Describes how the disability meets the regulatory definition (as stated on slide 23 and in your Policy and Procedure Manual), including but not limited to:

Social Security Administration records; school records; sheltered workshop certification; social service records or referrals; community-based aging and disability organization records; Independent Living Center records; letter from a group home administrator; referral from Vocational Rehabilitation

Receipt of Social Security Disability Insurance (SSDI) is NOT sufficient to verify “severe disability”

Certifications or statements from medical professionals must not merely conclude that a severe disability exists. They must clearly establish the facts that meet the regulatory definition of “severe disability.”

Make and retain a copy of the document(s) used to verify “Severe Disability”in the participant’s file


6. Frail6. Frail6. Frail6. Frail

Definition: an individual 55 years of age or older determined to be functionally impaired because the person is:

1a. not able to perform at least two (2) activities of daily living without substantial human assistance, including verbal reminding, physical cueing or supervision; or

1b. at the option of the project director, is unable to perform at least three (3) such activities without such assistance;

2. or due to a cognitive or other mental impairment, requires substantial supervision because the individual behaves in a manner that poses a serious health or safety hazard to him or herself or to another individual.

How Do You Assess/Determine “Frail”?

Through securing documentation that supports the regulatory definition in the previous slide (#27) and also found in your Policy and Procedure

Manual

Properly Documenting Properly Documenting FrailFrail

Properly Documenting Properly Documenting FrailFrail


When a medical certification or statement is used to support, related documentation should be an official government record or other official record that:

1. Indicates that a qualified professional made a determination of frailty and

2. Describes how the disability meets the regulatory definition (as stated on slide 27 and in your Policy and Procedure Manual), including but not limited to:

Medical records, certification from a qualified professional; physician’s evaluation; disability records; Veteran’s medical records; vocational statement; psychologist’s diagnosis; rehabilitation letter; worker’s compensation record

When a specific professional certification or statement is NOT used as support, official government or other official records may still be used as long as they establish how the frailty meets the regulatory definition, ,including but not limited to:

Social Security Administration records; school records; sheltered workshop certification; social service records, document from a rehabilitation agency/organization to include a recent evaluation; social service agency record or referral; community-based aging and disability organizations; Independent Living Center statement; letter from a group home administrator

Receipt of Social Security Disability Insurance (SSDI) is NOT sufficient to verify “frail”

Make and retain a copy of the document(s) used to verify “Frail”


7. Severely limited employment prospects 7. Severely limited employment prospects in an area of persistent unemploymentin an area of persistent unemployment

7. Severely limited employment prospects 7. Severely limited employment prospects in an area of persistent unemploymentin an area of persistent unemployment

Severely limited employment prospects in an area of persistent unemployment is a waiver factor that has two (2) separate requirements both of which much be met in order for someone to qualify.

The two requirements of this factor are:

(1) severely limited employment prospects

AND

(1) reside in an area of persistent unemployment.

Part 1: Definition of “Severely limited employment prospect” means the substantial likelihood that an individual will not obtain employment without the assistance of SCSEP or another workforce development program.

Persons with severely limited employment prospects have two or more documented significant barriers to employment; significant barriers to employment may include but are not limited to:

Homeless (must be properly documented)

Limited English Proficiency (must be properly documented)

Low Literacy Skills (must be properly documented)

Disability (must be properly documented

Lacking a substantial employment history

Lacking a high school diploma or the equivalent; and/or

Residing in socially and economically isolated rural or urban areas where employment opportunities are limited.

Part 2: Definition of “Reside in an area of persistent unemployment” means a person who lives in an area where the annual average unemployment rate for a county or city is more than 20% higher than the national average for two out of the last three years.

Counties designated as having “persistent unemployment” are determined by DOL. Check the county look-up table on the SSAI Partners’ Page.

The tables for “persistent unemployment” are updated in April annually. Thus, in each program year, there are two valid tables in existence: one for July 1 – December 31 and one for February 1 – June 30. “Area of persistent unemployment” can be validated if either table verifies the status of the county at any time during the program year.

If I have a participant who lives in an area of persistent unemployment, will they qualify for this waiver factor?

No – to qualify for this waiver factor, the participants must meet and provide the appropriate documentation for BOTH parts, severely limited employment prospects AND reside in an area of persistent unemployment.

How Do You Assess/Determine “Severely limited employment prospects?”

During initial assessment or re-assessment, establish two or more significant barriers to employment.

Significant Barriers include:

1. Homeless

2. Limited English Proficiency

3. Low literacy skills

4. Disabled

5. Lack substantial employment history

6. Lack a high school diploma or equivalent

7. Frail

8. Severely Disabled

Properly Documenting “Severely limited Properly Documenting “Severely limited employment prospects”employment prospects”

Properly Documenting “Severely limited Properly Documenting “Severely limited employment prospects”employment prospects”



(1) Two or more significant barriers to employment

(2) A description of each of the significant barriers claimed; and

(3) How it was determined that those barriers exist.

OR

OFFICIAL RECORDS: that establish that two or more significant barrier to employment exists such as certification from a medical professional, actual medical record (see documentation requirements for Frail, Disabled, and Severely Disabled).

Make and retain a copy of the document(s) used to verify Severely limited employment prospects in participant’s file


Properly Documenting “Area of Persistent Properly Documenting “Area of Persistent Unemployment”Unemployment”

Properly Documenting “Area of Persistent Properly Documenting “Area of Persistent Unemployment”Unemployment”

Check the county look-up table on the Partners’ Page of the SSAI Website

The tables for “persistent unemployment” are updated in April annually. Thus, in each program year, there are two valid tables in existence: one for July 1 – December 31 and one for February 1 – June 30. “Area of persistent unemployment” can be validated if either table verifies the status of the county at any time during the program year.

Let’s Take Any Final QuestionsLet’s Take Any Final QuestionsLet’s Take Any Final QuestionsLet’s Take Any Final Questions


Next StepsNext StepsNext StepsNext Steps “Waiver Factor Information Center” Available on Monday on the Partners’ page

1. Copy of this PowerPoint

2. Copies of Self-attest and third party attest forms

3. Waiver Factor Definitions and Requirement Documentation handout

4. Waiver Factors Update Form

5. Updated Data Validation Checklist (source documents needed to verify all most-in-need and waiver factor information)

6. “Facts of SCSEP Four Year Lifetime Cap on Participation” handout from Buffalo

(coming soon in Spanish and Chinese)

Use your Participant Four Year Cap Report” to schedule your recertification appointments and begin instructing participants what documents to bring with them

Schedule participants during the first two weeks of March (recert) who exit date will be in during the first quarter of PY11 (July, August, September) because they will reach their Four Year Lifetime Cap

SSAI will provide further guidance on what you will need to mail us in order for us to confirm the “Yes” Waiver Factor status of your participants

Thank You for Attending!Thank You for Attending!Thank You for Attending!Thank You for Attending!

We will send a follow-up email with today’s PowerPoint presentation and link to access the recorded webinar

To access the recorded webinar:

www.seniorserviceamerica.org

Log into Partners’ Page

Click on “Webinars” Tab

ADJOURN

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SSAI Webinar: Waiver Factors Thursday, February 10, 2011.

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