Some Seniors Get Drug Subsidy
Prescription Drug Plan Starts January 2006
Thelma Grady Gets Liberty Bell Award
How to Double Your Savings Account
What the Medicare Part D Will Cost You
Waiver Program Offers More Services
Living Will - Do You Need One?
Unemployment Compensation is for No-Fault Job Loss
Temporary Job When on Unemployment Benefits
Child Care Subsidy Rules Are More Parent Friendly
Utility Shut-Off Warning
New Rules from Child Care Information Services

Some Seniors Get Drug Subsidy

Medicare beneficiaries who have an annual income below $14,355 if single ($19,245 if a married couple living together) may get some extra help or subsidy in paying for their Medicare premiums, deductibles, and co-payments for their prescription drugs, according to the new Prescription Drug Program (PDP) for Medicare recipients. The average subsidy from the plan, called Medicare Part D, is $2,100.

When you receive the letter from the Social Security Administration (SSA), together with the “Application for Help with Medicare Prescription Drug Plan Costs,” fill it out or have someone help you fill it out and return it as soon as possible to SSA in the envelope provided.

However, you need not return the application form if you have both Medicare and Supplemental Security Income (SSI), or both Medicare and Medical Assistance (MA), or the state pays for your Medicare premiums. You will automatically receive the subsidy. Included in this group are low income persons in the Healthy Horizons category, MA consumers in long term care facilities, individuals enrolled in the PDA waiver or another MA waiver, and persons enrolled in the MAWD program.

You are eligible for the extra help if your savings, investments and real estate are not more than $11,500 if single or widowed, or not more than $23,000 if married and living together. Resources not counted are your home, vehicles, burial plots or personal possessions.

For more information, call Social Security at 1-800-772-1213 or visit www.socialsecurity.gov .

Prescription Drug Plan Starts Jan. 2006

The Medicare Prescription Drug Program will start on January 1, 2006.

Anyone with Medicare Part A and/or Part B can enroll in a Medicare prescription drug plan between November 15, 2005 and May 15, 2006. If you join after May 15, 2005, you may have to pay a higher monthly premium.

The monthly premium in 2006 will be about $37, and the yearly deductible, up to $250. You will also pay a part of the cost of the prescriptions, including a copayment or coinsurance.

Since plans will be offered by different companies, costs and coverages will vary. But if you have limited income and resources, and you qualify for extra help, you may not have to pay a premium or deductible.

For more information, go to www.medicare.gov , or call 1-800-MEDICARE (1-800-633-4227).

Thelma Grady Gets Liberty Bell Award

Thelma Grady received the 2005 Liberty Bell Award from the Erie County Bar Association during its Law Day luncheon on April 29 at the Erie Shrine Club.

The Liberty Bell Award is given annually by the Erie County Bar Association to a non-attorney who has “strengthened the American system of freedom under the law.”

The Erie County Bar Association honored her for her many years of community service to the Erie region, specially as a Northwestern Legal Services (NWLS) board member and lay vice president, and for her leadership role in local, state and national legal services, particularly her work with the Clients’ Council of Pennsylvania and the National Legal Aid and Defender Association.

Grady contributed towards the creation of such community programs as Crime Watch, Erie Tenants’ Council, Welfare Rights Organization, and the Clients’ Council of Erie County. She is an active member of the local chapter of NAACP. She was also involved in Project Vote, a grassroots movement distributing voting registration materials at County Assistance Offices.
 

Robert A. Oakley, Esq., executive director of NWLS, introduced Grady during the Law Day luncheon. Keynote speaker at the event was Jack Ford, Court TV news anchor and former legal correspondent for ABC and NBC News.

How to Double Your Savings Account

If you want to earn $1.00 for every dollar you save, join the Family Savings Account (FSA) Program administered by an agency in your county. If you save $1,000 during the first year, the program will give you $1,000. If you save another $1,000 the second year, your savings will be matched again with $1,000.

Part of the Governor’s Project for Community Building through the Department of Community and Economic Development, the program encourages Pennsylvania residents to save with matching grants in order to be able to purchase a home, repair an existing home, further education, start or expand a business, or purchase a car.

To qualify, a single person must have an annual income limited to $19,140; a married couple, $25,660; a family of three, $32,180; a family of four, $38,700; a family of five, $45,220; a family of 6, $51,740; a family of 7, $58,260; a family of 8, $64,780.

The program requires that the participant must save at least $10 a week in an approved FSA account, attend four FSA economic workshops, complete the entire program before being able to access the matching money, and use the money saved and matching money only toward one of the program’s approved asset use.

During the workshops, participants will learn how to budget, manage debt, set long-range financial goals, access government-sponsored home mortgage programs, and plan personal finances. Enrollment period is 12 to 24 months. Participants deposit their savings in local banks partnering with the agency.  To enroll, you meet with the staff of the agency administering the program and establish your savings amounts and savings goals.

The Family Savings Program is administered by various agencies in different counties.

• In Erie and Crawford Counties, call the Workforce Development Program of GECAC at 814-459-4581, Extension 595.
• In Warren and Forest Counties, call the Warren-Forest Counties Economic Opportunities at 814-726-2400.
• In Mercer County, call Community Home Buyers, Inc. at 724-342-6848.
  In Potter, McKean, Elk, and Cameron Counties, call the Potter County Human Services at 814-544-7315.
• In Venango, Clarion and Jefferson Counties, call Choice Enterprises at 814-227-2731.

What the Medicare Part D Will Cost You

Medicare Part D is a voluntary program. But if or when you enroll in Medicare Part D during the enrollment period (Nov. 15, 2005 through May 15, 2006), you will pay a monthly premium of about $37. Enrolling late will cost you a late fee for every month you delay, unless you are covered under an insurance plan that provides “creditable” drug coverage. Creditable insurance plans provide drug benefits determined to be at least equivalent to Part D benefits.

You will be responsible for a deductible of up to $250 in 2006, that is, for the initial purchase of prescription drugs up to $250. After you have spent $250 for prescription drugs, Medicare will cover 75% of your prescription drug purchases up to $2,250. You will be responsible for the other 25% of drug costs.

After paying the total drug costs of $2,250, you will be responsible for the next $2,850 of drug costs. This out-of-pocket amount is referred to as the “donut hole.”

But when your out-of-pocket costs, not including premiums, reach $3,600, which is the “catastrophic limit,” Medicare will start paying approximately 95% of the remaining drug costs. You will only be responsible for either $2 for generic drugs and $5 for brand-name drugs, or 5% of the drug costs, whichever is greater.

Medicare Part D premiums, deductibles, benefit limits and catastrophic limits will increase every year, as estimated by the Congressional Budget Office.

If you have a Medicare Supplement plan that provides drug coverage, you can choose to keep your current plan as is or enroll in Part D. If you enroll in Part D, you can either (1) keep your Medicare Supplement plan and remove the prescription drug benefit, or (2) change to a Medicare Supplement plan A, B, C, or F (including High Deductible F). You can do this on a guaranteed issue basis from the same insurance carrier.

(Sources: Center for Medicare and Medicaid Services, Bankers Life and Casualty Co.)

Waiver Program Offers More Services

The Pennsylvania Department of Aging (PDA) Waiver Program may provide more home and community-based long-term care services than nursing home care. These services are funded through a special waiver of certain Medicaid restrictions, allowing payments for home-care services.

The following services may be available under the PDA Waiver Program: homemaker services, personal care, respite care, home health aide, transportation, adult day care, home delivered meals, companion services, counseling, attendant care, extended state plan physician services, occupational therapy, speech therapy, home support, chore services, emergency response system, home environment modifications, and medical supplies and equipment.

To qualify for the Waiver Program, you must: (1) be 60 years or older; (2) meet Medicaid financial requirements or have a monthly income of $1,737 or less and have no more than $8,000 in assets; (3) require the level of care of a nursing home; (4) choose community-based services rather than a nursing home and can be safely served in the community within budget guidelines. To apply, call your local Area Agency on Aging.

Living Will - Do You Need One?

A few months ago the entire nation was caught up in the fate of Terri Schiavo. We watched her parents and her husband battle over whether Ms. Schiavo would live or die. The Schiavo case has prompted many of us to ask what we would want if we were in Terri Schiavo’s shoes.

One way to make sure that your wishes are honored if you cannot speak for yourself, are terminally ill or in a state of permanent unconsciousness, is to prepare a living will. In Pennsylvania, a living will is called an advance directive for health care. In 2002 the Pennsylvania legislature passed a bill that governs living wills.

How is a living will different from a last will?
A last will contains final instructions to be followed after your death. A living will contains medical treatment instructions for use before your death.

What kinds of medical treatment instructions are covered in a living will?
The Pennsylvania legislature included a living will form in the Advance Directive for Health Care Act. If you use this form, you can indicate whether you want specific treatments such as cardiac resuscitation, mechanical respiration, tube feeding, blood or blood products, surgery, kidney dialysis and antibiotics. You can also state whether you wish to donate any organs after death.

Can I name someone in the living will to make health care decisions for me when I can no longer make them myself?
Yes. You can appoint someone, called a surrogate, to make health care decisions for you when you are no longer able to make them. You should choose someone you trust, someone who knows your wishes and will carry them out. Be sure to ask this person if he/she is willing to be your surrogate.

How do I make a living will?
It is always best to have help from an attorney to make a living will, although it is not required. A living will can be made at the same time you make your last will. You must sign the living will and it must be witnessed and signed by two adults. You should make several original copies.

What do I do with my living will once I make one?
You should give an original copy to your doctor and to your surrogate. Bring an original copy when you are admitted to the hospital. Keep a copy with your important papers.

When does a living will become effective?
A living will becomes effective when:

• it has been signed and witnessed.
• the attending physician has a copy.
• the person who signed the document is diagnosed with a terminal condition and is unable to communicate or is in a permanent unconscious state.

It is never pleasant to think that we may be terminally ill and unable to communicate or in an irreversible coma or unconscious state. As responsible people, however, we need to consider planning for anything the future may bring to make sure our wishes are honored and to spare our loved ones from the guilt or burden of making difficult decisions.

(Contributed by Julia Bandecca, Attorney, Northwestern Legal Services)

Unemployment Comp is For No-Fault Job Loss

Unemployment Compensation (UC) is for people who lose their job through no fault of their own.

If your application for UC benefits is denied by the UC Service Center you have 15 days to appeal. If you are granted benefits the employer may appeal. A Referee’s Hearing will then be scheduled. You will receive a Notice of Hearing telling you the date, time and place of the Hearing, along with the name of the Referee and the issues to be decided.

You should arrive at least 15 minutes before the Hearing to review the Exhibit File to see what was said by the employer and you. The employer may also do this. The Referee will come out and announce it is time for the Hearing and take you and the employer to the Hearing Room. The Referee will explain the procedure and your rights. He will name the documents in the Exhibit File and ask if anyone objects to them. The Referee will get all the facts from you and the employer.
 

The Hearing is tape recorded and anyone testifying is asked to take an oath to tell the truth. You should have your facts organized before you go to the Hearing so you can tell your story to the Referee. Take any documents to support your case and give them to the Referee. You may also take witnesses who were directly involved.
 

The Referee will listen to you and to the employer and any witnesses. Each side may question the other and the Referee may ask anyone questions at any time. The Referee’s Hearing is very important because it is the only time you can tell your side of the story in person.

The Referee will issue a decision in writing. It will list the facts, the law that applies, and whether benefits are granted or disapproved.

Either side can appeal the Referee’s Decision to the Unemployment Compensation Board of Review and if not satisfied with that decision, appeal to the Commonwealth Court. However, no one appears in person and no new issues can be brought up at these levels of appeal.

The tape recording of the Referee’s Hearing and the Exhibit File is sent to the next level of appeal for their review to decide whether the Referee made the correct decision according to the law.

Feel free to contact Northwestern Legal Services if you need help with a UC case.

(Contributed by Mary Jane Weed, Paralegal, Northwestern Legal Services)

Temporary Job When on Unemployment Benefits

A worker who is receiving unemployment benefits must attempt to find other suitable work.

Many employers now fill positions at their companies with employees placed through temporary employment agencies for both short term jobs, and to screen employees for possible permanent positions. Accepting a position through a temporary employment agency during the time someone is eligible for unemployment benefits can complicate things if the temporary job does not last.

When a worker obtains a placement through a temporary employment agency, he becomes an employee of that agency, not of the company where he performs the work. If the temporary job ends or he quits the job, he may still be an employee of the temporary agency, and not necessarily unemployed and eligible to resume receiving benefits. Most temporary agencies provide an employee with a copy of their procedures when the employee is first hired, and these describe the procedures the employee must follow to obtain a placement. This often involves calling the agency daily to determine if there is a position available whenever the worker is not at an assigned job.

Failure to call in as required could result in disqualification for unemployment benefits. Similarly, if a worker accepts a temporary job, and then decides he does not like the work, or there are other problems with the position, he may be disqualified from receiving unemployment benefits, even if he only works one day. Also, if a job is offered and the employee turns it down without a good reason, the offer will be reported to the unemployment office and benefits might be terminated.

Finding work through a temporary agency may lead to a permanent placement at a good job. However a worker needs to be sure to read their handbook or contract with that agency and follow all reporting requirements. He must also be very specific in describing the types of work which are acceptable, and any restrictions such as a minimal rate of pay and the distance he is able to travel.  He can then accept only those referrals which meet those specifications without jeopardizing unemployment benefits he has been receiving.

(Contributed by Judy Wilson, Attorney, Northwestern Legal Services)

Child Care Subsidy Rules Are More Parent Friendly

The Department of Public Welfare (DPW) has recognized that barriers in the current subsidized child care program have been a significant concern to low-income families and allowed many to fall between the cracks.

Key Policy Changes in DPW’s Child Care Subsidy Regulations have made it more parent friendly and a positive program that will make a big difference to parents striving for self-sufficiency.

First major change was restoring the 20 hour per week work requirement as well as allowing those parents who are attending an educational or training program, count 10 hours of the time they spend in class toward the 20 hour per week work requirement.
The second major change is that parents who encouraged to file for voluntary support. Mandatory Support Cooperation has been eliminated.

Child Care Information Services (CCIS) now informs parents about the benefits of pursuing court ordered child support. It encourages and helps them file support actions, but leaves the decision about whether to pursue court ordered support - a decision that can have profound implications for children - to be made by the parent, not the state.
 

Many mothers were forced to leave the subsidized child care program, or elected to abandon their applications for subsidy, rather than pursue court ordered support and risk upsetting carefully negotiated voluntary support agreements that keep fathers financially and emotionally involved in their children's lives. The third significant change was streamlining and simplifying the verification process. There are now three ways to provide the necessary verification to complete an application.

(1) Preferred verification. Preferred verification includes any document from a list of acceptable documents specified for each factor of eligibility.

(2) Collateral contact/agency assistance. If the parent cannot obtain one of the listed documents, the eligibility agency worker will, with the parent’s consent, attempt to contact a third party (e.g., an employer) or agency by phone to verify the information needed.

(3) Self-declaration. If the attempted collateral contact does not succeed, then the parent will be permitted to self-declare the information needed, using a form provided by DPW, which the parent signs under penalty of perjury. Child care will be authorized or reauthorized to an otherwise eligible family based upon the parent’s self-declaration.

(Contributed by Jeannine Lawton-Knepper, Paralegal, Northwestern Legal Services)

Utility Shut-Off Warning

Gov. Ed Rendell signed Chapter 14,which allows electric, gas and water utility companies to terminate service between December 1 and March 31 without approval from the Public Utility Commission. Affected are customers earning more than 2 1/2 times the official poverty level, or $23,275 for an individual.

The utility industry in Pennsylvania lobbied to have this bill signed, arguing that good customers were being forced to make up the losses from deadbeats who don’t pay their utility bills.

Before the law was passed, service terminations in that time period required PUC approval.

Call the utility company if you need help.

New Rules from Child Care Information Services

The Child Care Information Services has new regulations and other helpful policy changes.

Some highlights include:

• Improved process for eligibility redetermination. The new regulations retain a 6-month redetermination, but provide a more streamlined process. Under this process, families must verify their earned income at each 6-month redetermination, but other factors of eligibility will not have to be verified unless there has been a change. A subsequent increase in earned income would not have to be reported until the next redetermination.
• Provisions paralleling the federal Family Violence Option adopted by DPW for the TANF and General Assistance programs providing for waivers of certain subsidized child care program eligibility and verification requirements for victims of domestic violence. These new provisions allow the special circumstances of victims and their families to be accommodated.
• More streamlined and inclusive TANF transfer provisions permitting families exiting TANF a 183-day time period to enroll in subsidized child care with priority status maintained.
• Special provisions to support children from low-income families enrolled in Head Start or a pre-kindergarten program and who need extended hours or days of care for continuous, uninterrupted care helping to ensure that these children remain in programs designed to prepare them for school.
• Expansion of subsidy continuation from 30 days to 60 days due to involuntary loss of work or the parent’s completion of an education or training program.
• Elimination of the requirement to count the income of live-in companions and inclusion of a step-parent deduction in calculating family income and copayments.
• More flexible requirements and an extended 30-day time-frame for face-to-face interviews to better accommodate working parents and care takers.
• Provision of subsidy to two-parent families where one parent works and the other parent has a physical or mental disability or need for treatment that results in an inability to work or care for a child.
• Provision allowing for suspension of subsidy over a parent’s summer break in education so the child can be at home with her parent over the summer, but continue in the subsidy program in the fall.
• Inclusion of travel time in the hours for which child care will be paid.
• Expansion of the hours of uninterrupted sleep time during which a parent or caretaker who works a night shift is eligible for subsidized child care.
• Elimination of the 50-hour-per-week cap on hours of care for which subsidy will be provided.
• An improved definition of disability for children between 13 and 19 who are over the program’s normal age limit and would otherwise not be eligible for subsidy.
  These changes in the regulations should bring substantial improvement to every aspect of the child care subsidy program.

(Contributed by Jeannine Lawton-Knepper, Paralegal, Northwestern Legal Services)

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