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  Medicaid & Section 301
 
 

Federal Link: policy.ssa.gov/poms.nsf/lnx/0413515001

What is it : Section 301 is a Social Security provision that allows for the continuation of Supplemental Security Income (SSI) and Social Security Disability Insurance (SSDI), beneficiaries cash benefits while they complete an approved Vocational Rehabilitation Program even though Social Security has determined that they have "medically recovered" or no longer meet the medical qualifications through a Continuing Disability Review – “redetermination.” CONTINUED PAYMENT UNDER A VOCATIONAL REHABILITATION PROGRAM (Section 5113 of the Omnibus Budget Act of 1990 extended eligibility for Section 301 of the SSDI Amendments of 1980)

Who qualifies: Youth, SECTION 301 allows :

  • Former SSI recipient who has been enrolled in an approved vocational rehabilitation program prior to their 18 th birthday may keep SSI and SSDI cash benefits while they work on their vocational goals.
  • Keep Medicaid benefits while they are a VR client (in non 209b states)

Who makes the decision: The Social Security Administration, with documentation from the State vocational rehabilitation that proves the person’s participation in the vocational rehabilitation program will increase the likelihood of permanent independence and self-sufficiency.

What it covers: Access to Medicaid benefits, which vary from state to state.

  • Payments to the beneficiary/recipient and any auxiliaries, including hospital insurance benefits, State services, Medicaid, and State Supplementation, where applicable, will continue until training is completed, participation in the VR program ceases, or Social Security determines that continued participation will not increase the likelihood that the person will be permanently removed from the disability rolls.

TERMINATION: Benefits will be terminated with the month after the month of cessation of participation or the month after the month that it is determined that continued participation will not increase the likelihood of permanent removal from the disability rolls. Once the VR program participation stops for more than 30 days, benefits will be ceased and cannot be resumed.

What it costs: Often the services are free or have small co-pays. Each state plan and services are different.

Impact to YOUTH: The potential loss of SSI as a result of the age 18 redetermination and often associated Medicaid benefits has significant implications – both financially and medically - for youth and young adults.

The Social Security Administration will re-determine SSI eligibility for children between 18-21 when they finish school. Many may be found "medically recovered" and lose their SSI benefits. While primarily this is due to not meeting the SSA Adult Standards for Disability but it may also be attributed to the lack of medical and other evidence that not provided during the application process.

LAW: The Employment for Disabled Americans Act of 1986 (Public Law 99-643) requires states to continue Medicaid coverage when an individual who became disabled before age 22 and received SSI becomes eligible for SSDI or has an increase in SSDI benefits. Such disabled adult children continue to be considered SSI recipients for Medicaid purposes . Disabled adult children c. 175 § 108 2(a)(3) c. 176A §8(d); c. 176B § 6(c)

Recommendations:

  • Increase understanding of families, providers and interested others of the SSA redetermination process. (1) Documentation they will need to prepare and provide; (2) the high rate of SSI denials at age 18; and (3) need to prepare ahead to assure needed cash benefits (SSI) and medical services (Medicaid) are not lost.
  • Encourage educators to become more familiar with providing education evidence in the SSA/SSI application process and to initiative referral to state Vocational Rehabilitation Office. www.jan.wvu.edu/SBSES/VOCREHAB.HTM
  • Engage State Vocational Rehabilitation to initiate services to youth prior to their 18 th birthday to assure qualifying for Section 301 continuation of benefits.
  • During middle and high school obtain job training, self-care and independence skills, and connections to resources to ensure that young adults use their cognitive and physical abilities to work and live in the community with the supports they need and thrive without SSI which is a life in poverty.

How to Apply: Contact VR Office prior to age 18. Since this law is not well known (not too many people apply for this), it might be helpful to make a copy and bring with you to your VR appointment.

VCU-List of Vocational Rehabilitation Agencies
www.workworld.org/wwwebhelp/state_vocational_rehabilitation_vr_agencies.htm

Guides:

VOCATIONAL REHABILITATION “301” PROGRAM DEVELOPMENT
Social Security Administration - Form Approved - OMB No. 0960-0
www.rcep7.org/ssawork/glossary/OMB0960-0form.doc
Form that verifies person is enrolled in an approved VR program.

Resources:

WORKWORLD-VIRGINIA COMMONWEALTH UNIVERSITY (VCU)
VCU-Continued Payment Under a VR Program (Section 301 Benefits)

www.workworld.org/wwwebhelp/continued_payment_under_a_vr_program_
section_301_benefits_.htm

Overview of Section 301 includes several helpful links to terms and related agencies.

VCU-List of Vocational Rehabilitation Agencies www.workworld.org/wwwebhelp/state_vocational_rehabilitation_vr_agencies.htm

VCU- Legal Citation and explanation of SECTION 301
policy.ss a.gov/poms.nsf/lnx/0413515001
The 1980 disability amendments (P.L. 96-265, section 301) provides for continuation of SSDI and/or SSI payments after the physical or mental impairment ceases to be disabling under four provisions, one is: “The beneficiary/recipient is participating in a vocational rehabilitation plan approved under the Rehabilitation Act of 1973, as amended.”

The Precarious Safety Net: Supplemental Security Income and Age 18 Redeterminations
www.work support.com/Archives/proed5.asp
The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 substantially changed the Supplemental Security Income (SSI) program, and the implementation of these changes has important implications for children and youth with disabilities. SSI is a federal program administered by the Social Security Administration that provides cash assistance and increased access to Medicaid health insurance and vocational rehabilitation for low-income persons with disabilities. PRWORA required redeterminations for all youth receiving SSI benefits within 1 year after reaching age 18 using stricter adult disability criteria. As a result, the majority of age 18 SSI participants were recommended for cessation nationally. These changes have critical implications for transition planning, employment, and quality of life for young SSI participants and those removed from the program. This article examines the background of the SSI program, age 18 redetermination procedures, current implementation data, and issues focusing on the involvement of teachers and rehabilitation professionals involved in the transition planning process. Recommendations for practice and future research are also discussed.

 

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The HRTW Center is headquartered at the Maine State Title V CSHN Program. Activities are coordinated through the Maine Support Network's Center for Self-Determination, Health and Policy. The Center is funded through a cooperative agreement (U39MC06899-01-00) from the Integrated Services Branch, Division of Services for Children with Special Health Care Needs (DSCSHN) in the Federal Maternal and Child Health Bureau (MCHB), Health Resources and Service Administration (HRSA), Department of Health and Human Services (DHHS).
Lynda Honberg, HRSA/MCHB Project Officer.