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The Disabled Poor: Shut In, Out of Pocket

by Linda Ostreicher, Aug 20, 2004
 

Many low-income people with disabilities never have a chance to apply for Medicaid, food stamps, or income assistance because they literally cannot go to all the offices required.

The Human Resources Administration has a policy to remedy this situation: Caseworkers can visit applicants and clients at home.

However, when investigators from the Welfare Law Center visited welfare offices, its report (In PDF Format) reveals, the staff at only about half of the offices suggested home visits for a hypothetical applicant with a disability.

The center's researchers went to Job Centers in all five boroughs, asking the person at the information desk in the waiting room for information for a friend who had no food or money, and needed to apply for benefits but was unable to come in person because of severe depression.

Workers at four of the 30 Job Centers flatly denied that home visits were available, and those at ten other Job Centers required persistent prompting before they said home visits were possible. At two of those ten centers, workers could not give any information about how to get a home visit -- not even a phone number to call for more information.

These findings are especially disappointing because in March 2003, the Human Resources Administration introduced a new policy meant to meet its legal obligation to accommodate people with disabilities. It suggests changes in the way appointments are made, such as scheduling them to avoid conflicts with medical and mental health appointments, and rescheduling when there are disability-related reasons.

However, the policy does not require agency staff to let the public know that home visits are available, and to offer visits to people who do not explicitly ask for them, no matter how visible and severe their disability. Nor does the policy stop agency staff from continuing to send notices ordering clients to come in person to a Job Center, even after they have proved that they cannot.

"Many people are sanctioned for not showing up for one appointment," Cary LaCheen explains. When someone misses an appointment, the agency notifies them that they have 10 days to come into the welfare office and explain why they missed the appointment. This doesn't help people who can't come to the office at all, LaCheen points out.

The investigators reported that most people who succeed in getting home visits already have an advocate who knows they are available. Most who were found to need home visits still were summoned to appointments at the Job Centers, and if they missed one, were told that their case would be closed. Phoning a Job Center to change an appointment or request a home visit is not always an option: at six of 24 centers called by the researchers, the line went unanswered or was busy. At another six centers, callers reached a voicemail message, and either the mailbox was full, or their message was never answered.

Even when researchers were told that home visits are available, agency workers asked for medical proof of need before or during the first home visit. The Human Resources Administration has no uniform standards about what documentation is needed, and when. Some people with disabilities are never able to get benefits because they can't get a doctor to provide proof of their disability until they have Medicaid, or because they are unable to travel to a doctor's office.

People with mental illness face an additional obstacle. At four of the centers visited, researchers were told that although their "friend" was too depressed to come to the Job Center, he or she couldn't get a home visit, implying that depression was not a real disability. This contradicted the new agency policy, which specifically changed the term "disabled" to the more inclusive "physically or mentally disabled."

"Some states and counties have great policies and practices and have shown results," says Cary LaCheen. In Pennsylvania, for example, "they have to contract with community organizations to do outreach, go to people's homes and find out what's needed to bring them into compliance." By contrast, LaCheen says, New York City's practices are still "pushing people with disabilities out of the system."

CUTS FOR 27,000 FAMILIES

New York State quietly began taking a chunk out of welfare benefits to households in which a member receives Supplemental Security Income, a federal program for the elderly and people with disabilities. Even though laws governing benefits for such families have not changed in the past seven years, this year the governor employed mathematical sleight-of-hand to change the way the state calculates the size of benefit checks. [see No Breaks For Low Income New Yorkers]

As a result, the state will keep $9 million that would otherwise go to these low-income families. This works out to some of the poorest people in the state losing up to 17 percent of their already skimpy monthly income so that the State of New York can save less than one ten-thousandth of its annual budget.

- Advocates were hoping that the State Legislature would act to change existing law in time to ward off actual cuts to welfare checks. Like other crucial issues, this one was a bargaining chip in the negotiations that usually take place between the governor and the leaders of the State Senate and Assembly before a budget is passed.

Unfortunately, New York State outdid itself this year, and passed its latest budget ever, after extending last year's budget twelve times. Nearly two-thirds of state funds were spent before the actual budget went up for a vote. In the race to reach a deal on the budget plus all other legislation during one week in August, the little $9 million cut to welfare was left intact, affecting the pockets of 27,000 families.

There is disagreement as to whether state law permits the governor's changed method of calculating benefits. "Our organization and other organizations are definitely exploring potential litigation," said Kristin Brown of the Greater Upstate Law Project. "We're looking for possible plaintiffs." Linda Ostreicher, a former budget analyst for the New York City Council, is a freelance writer and consultant to nonprofits. 

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