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CCDC Comments on Human Services Rule about Aid to Needy Disabled

This testimony was sent to beth.kline@state.co.us in support of a rule change that will be heard by the Board on August 3rd in Durango.  For information about the board meeting see https://www.colorado.gov/pacific/cdhs-boards-committees-collaboration/state-board-human-services

 

To Human Services Board:

From:  Julie Reiskin, Executive Director, CCDC

RE:  Support for Aid to Needy Disabled Rule Package

Dear Members of the Human Services Board:

I am writing as the director of the largest statewide, disability-run, disability rights organization in Colorado in full support of the AND rule package…and to encourage you to continue with reforms to better support clients that need this program.   Our friends from the Southwest Independent Living Center, the Colorado Center for Law and Policy and the Colorado Coalition for the Homeless will also be testifying and this letter is a supplement to their direct testimony.

Aid to the Needy Disabled (AND) is the program for the poorest of the poor, the most severely disabled with the fewest resources.   People on AND are living so far below the poverty level they are not even on the radar. AND was meant to be a bridge between the time one becomes disabled and the time one can get on some sort of permanent disability benefits.   It is also meant for those with disabilities that last between 6 and 12 months—making the person unable to work for a long time but not eligible for Social Security. Sadly, for some who are unable to navigate the complicated Social Security process, AND ends up as their only means of support for too long.    The disability community, provider organizations, and some state agencies have tried to create programs to help this group of citizens whose disabilities are of a nature that make complying with rules, deadlines and procedures as impossible for them as walking up a flight of stairs is for someone whose legs are paralyzed.   Despite our best efforts, we have not been able to fund a support program that serves all in need.

Even when it is a temporary solution, the system still needs to work with an understanding that one is always in a desperate situation to even apply for AND.  To be considered one must have NO income, no savings, and no support. It is such as a small amount of money that if people have other options they will take those other options.  When someone is waiting for SSI or SSDI and they accept AND the funds have to be paid back when the client receives his or her backpayment. Given that these individuals are already saddled with debt, both formal and informal, people do not sign up for this program when there are other options.   Moreover, applying for ANY disability benefit is a humiliating and demoralizing experience, even when everyone involved is kind (which sadly is not always the case). One must tell strangers about extremely personal details, over and over again. One must confront the fact that one cannot do easy tasks that are considered natural for all adults in our society.  One has to admit that one cannot support oneself or loved ones (if there are any left). Applying for benefits is one more loss, often part of a cascade of defeat. It is imperative that the Board understand the backdrop against which our fellow citizens are applying. Sensitivity training should include trauma informed care as well as an understanding about grief and loss and the disability process.    While disability is NOT a tragedy, the systems that we encounter early in our disability journey do create trauma and find people at their lowest point, when they are still believing that disability is a tragedy.

CCDC strongly supports the following proposed changes for the following reasons:

  1.       Extend the time an AND applicant has to return a completed Med-9 from 10 days to 30 days:  This is important because ten days is not adequate to find a doctor and get the form filled out.  Often the application for AND is done with the application for Medicaid. If one does not have an existing relationship with a doctor, one cannot just find one quickly.   Even if one does have a relationship, not all doctors will do these so sometimes people have to find a different provider to do this form. Along these lines, we supported the law to allow psychologists to fill the form out and support CDHS making rules to allow other licensed professionals such as Social Workers to complete forms, particularly when the disability is mental health.  It is in professional purview of any LCSW to diagnose and assess the severity of any mental disability. Ten days is not adequate and the short time limit created many re-applications which takes time from everyone.

  2.      Extend the time an AND applicant has to verify that they’ve applied for SSI/SSDI from 10 days to 60 days on the initial application and 30 days on subsequent applications:   The SSI process is incredibly complicated and doing a rushed application will result in a denial no matter how eligible the client is—because something will be missed. It is best if the client has an advocate to assist with the process and it is unlikely that any advocate could do an application with a client in ten days.   An advocate needs to meet the client, get releases signed, review the medical records, draft materials, and often do research. Once there is a denial an appeal is necessary and while the client can get AND benefits for the duration of the appeal, this adds to the already problematic backlog of disability determination cases in the Social Security appeals system.  Waiting up to two years for a hearing is now common. This is part of how the AND program has moved from a temporary stopgap to a way of life. During the long wait, clients often lose their place to live, and then miss notices and then lose their appeal for failure to follow up. They then have to start the process again.
  3.      Provide provisional AND benefits to applicants that have met all eligibility requirements (except the SSI verification) while they work on their SSI/SSDI application:  If the client has no benefits while they work on the application the chances of this ever getting done are decreased dramatically. Benefits help pay for things like bus passes to go see their advocate, copayments for medications and treatment (SSA will deny if an applicant is not receiving treatment) as well as basic such as personal hygiene items.  
  4.      Eliminate the social factors matrix assessment:    This matrix has been a burden on worker and client alike and is neither necessary nor appropriate.   We support the elimination of this matrix. As noted above, people applying for AND are already suffering from significant lack of resources and lack of social support.   Another complicated process to make the clients go over and over this, using scarce county worker time does not benefit anyone.

People have been working on this for a long time, and there has been a lot of engagement in this process.  Please pass these rules and continue to work on ways to make the AND benefit easier for those in such desperate need to receive.  As a state we are compassionate people and need not make it harder for people at what is often the lowest point of one’s life.

I am willing to answer any questions but my colleagues who will be at the meeting will be in the best position to answer direct questions at the meeting.

 

Sincerely

 

Julie Reiskin, LCSW

Executive Director

CCDC


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