 Good evening everybody can see I see that we have at least 16 participants. I'm just going to take a look here see if I can see. Yes, I see I see folks have signed in so good evening everybody and welcome to this evening's presentation of the people's law school. Tonight's topic is understanding benefits and eligibility for three squares Vermont general assistance, Medicaid, and healthcare subsidies. I just want to remind everybody that this evening's presentation is being recorded. The presentation today's presentation is made possible through a partnership with the Vermont Attorney General's Office, the Association of Africans living in Vermont. The Vermont Racial Justice Alliance, the Vermont Institute for Community and International involvement and the Caroline fund with additional support from the ACLU of Vermont. My name is Bessie Weiss, and I am an assistant attorney general for the Agency of Human Services. I'm joined tonight by Jessica Duranlow. Ms Duranlow works at the Economic Services Division of the Department for Children and Families. She is a food and nutrition assistant administrator, and has held this position for the past six months. She has worked for the department, providing direct services to Vermonters for the past nine years. Presenting with Jessica is Fay Longo. Fay has more than 10 years of professional experience in the nonprofit local government sectors. She is currently the associate manager of three squares Vermont community engagement with the Vermont food bank. Where she works to assure all Vermonters have access to three squares Vermont and the many other services and supports that three squares can open the door to. She also provides outreach and education, working to dispel myths and counteract stigma. She is a first generation college student who graduated in Bangladesh from Southern New Hampshire University and will this year begin her MSW program in the fall. She would like you to know that she is a proud lived expert having firsthand experiences with generational poverty, hunger, trauma and addiction. And Mark Eli is interim general assistance program director for the general assistance program. He's worked for the Economic Services Division of the Department for Children and Families for 11 years, and has recently completed a master's degree in public administration at Norwich, and is currently enrolled in the Vermont Leadership Institute. Mark would like you to know that he is a native Erlingtonian. Danny Fuoco is a health care policy analyst with the Department of Vermont Health Access. She has worked in the medicaid policy unit at the Department of Vermont Health Access for over five years. John Sheehan is a senior policy and implementation analyst at the Department of Vermont Health Access. He's held that position for the past two months, but Sean is a diva retread, who did similar work at diva from 2012 through 2017 before hopping over to the legislative joint fiscal office for a couple of years and then hopping back. So tonight, we will be taking your questions via chat. You can see a Q&A icon at the bottom of your screen. If you have a question, just click there and ask your question. I will be able to see when that question is pending, and I will provide your questions to the panelists. We also try to give you a little time at the end of each presentation to ask your questions, and at that time if you want to use the raise your hand function, I can allow you to talk and ask your question. So let me see. I'm just making sure that I've gone through the preliminaries. And this evening we will be starting presentations with Faye Longo and Jessica Duranla, who will be presenting on three squares. So take it away. Thanks, Bessie. Thank you. Can you fill up our presentation, Bessie? And now that's what I will see if I can do. I think, I think I can in just a moment. Do folks see that? Excellent. As Bessie already said, my name is Faye Longo. I'm the Associate Manager for Three Squares Vermont Community Engagement for the Vermont Food Bank, and I've been in that role for about four years now. I've worked in the nonprofit sector across the state of Vermont ever since I was old enough to work. And I am also a lived expert. This is mine and Jessica's contact information so folks can reach out to us directly. So I'm really, really excited to talk to you all about Three Squares Vermont. Three Squares Vermont is our state's version of what is federally known as SNAP or the Supplemental Nutrition Assistance Program. It's intended to provide as a supplement to an already existing food budget, but service providers like us know that for most people Three Squares Vermont is their only food budget. Three Squares Vermont benefits are usually received on an EBT card, which is also known as an electronic benefits transfer card. It's just like a debit card and you'll sometimes hear Three Squares Vermont called EBT because that's what it comes on. Three Squares Vermont benefits can also be received as cash for folks over the age of 65, and for folks who are deemed disabled by Social Security who are receiving SSI only, regardless of how old they are. Many folks are Three Squares Vermont eligible and don't know it. You can be Three Squares Vermont eligible even if you're working, or if you're a local business owner. If you're single or have a family, whether you're younger, older or in between, if you're homeless, many, many folks are eligible for Three Squares Vermont. Three Squares Vermont is our first and best defense against food insecurity. For every one meal that the Vermont Food Bank provides, Three Squares Vermont provides nine. And those are meals that the people receiving them can actually eat, and it's their preferred foods. It's the foods that meet their nutritional needs that they bought from their local preferred grocery store co-op or farmer market. And Three Squares Vermont lifts folks out of poverty and is only rivaled in its ability to do so by the earned income tax credit. It allows, like I said, it allows people to access the foods they need when they need them from where they prefer to get them. And it provides people the power of choice. So not not only of the foods they get, but also of where they're getting them from and that's the definition of food serenity. So finally, when eligible Vermonters sign up and receive their Three Squares Vermont benefit and not only benefits them, it benefits our whole community. It brings money into our local food economy. It helps our schools offer universal meals. It supports our farmers and small local grocers. It's just an all around win. Next slide please. So for what in where, where can you use the Three Squares Vermont benefit? So you can use Three Squares Vermont benefits at all, at most convenient stores, at farmers markets, and grocers stores and food co-ops participating farmers markets, any place that SNAP, EBT is accepted. And you can use Three Squares benefits to purchase non-taxable food items. This includes things like fruits, veggies, drinks, meats, dairies, shelf stable food products, breads and more. I always tell people that you can buy a sand, you can't buy a sandwich from the deli, but you can buy all of the fixings and make one yourself. So anything that is non-taxable for food items is eligible for purchase with the Three Squares Vermont benefit. And then next slide please. Yep, there you go. So what's new with Three Squares Vermont? Please just remember that some of these changes are temporary and they might change due to COVID times. So right now there's an increase in monthly benefit. Everyone receiving Three Squares Vermont is receiving an increase in the total benefit that they are receiving. There is a state of emergency which allows a maximum allotment to households. But the same number of folks that could be receiving different amounts. So everyone is receiving at least an additional $95 a month in Three Squares benefit. Expanded eligibility for college students, most restricted groups for college students, they now have temporary changes. So we are allowing students who are income eligible and receive a zero BFC, which is your estimated family contribution, or if they are eligible for work study with no work requirement at this time, they can be eligible for Three Squares Vermont. At the moment, the federal pandemic unemployment compensation is not being counted, and some payments are not being counted at this time. In the past, we had counted some of this income, and it was putting folks over income but now the FPUC is not counted as income. And then we also have introduced this year, Three Squares in a SNAP program, which is a simplified application process for all household members who are age 60 or are receiving disability benefits. They're not earning income from a job or self employment. And the review period is for 36 months. And with this comes no interviews are required for reviews. Next slide, please. And where can you go to access help with Three Squares Vermont. So economic services has 12 district offices that maintain and they maintain a benefit service center. ESD works with 12 Three Squares outreach partners located throughout the state of Vermont. At these locations, you can ask questions, you can receive help completing and submitting applications, both new and review applications are available at the locations. Our state employees and our state partner sites are available to help explain notices and request for verification that you may have received. And then different types of things that are our state partners do our areas on aging or accounts on aging they specialize in supporting Vermonters age 60 and older. They have geographic location boundaries and you'll see that the links for the different areas on aging is on this slide, which is going to be posted in the group chat. And then our capstone community action agencies work with Vermonters to meet the needs such of Vermonters for food, fuel utility assistance housing headstart, and they also have geographic boundaries. So the, the link to where you can find your local capstone or community action agency will also be put into the group chat. And then the Vermont food bank as you will hear from Fay in a few minutes works with all Vermonters throughout the states, they have no geographical boundaries. And just a reminder, all of the agencies here are here to help answer any questions you have, or may have about three squares, three squares in a snap. Thanks Jessica. It can be a bit confusing for folks, but the state partners with community organizations like Vermont food bank and the area agencies on aging and capstone agencies, so that we can provide that that direct one on one support and service to people who who might have questions about three squares Vermont or maybe their situations a little wonky and they want to talk it out with somebody. And we value that relationship we have with the state so very much. And now I'm going to talk a little specifically about the Vermont food bank because that's why I work for. Um, so Vermont food bank if you didn't know already has a team of dedicated three squares Vermont subject matter experts who can provide we provide three squares from outreach like this. We do eligibility screening we do application assistance, we do referrals and we follow up with folks we can be available to answer your questions. We can act as a liaison contacting the economic services division on your behalf if that's a need or a want of yours. A big part of what we do though I did mention referrals but we also work to assure that the people that we're signing up for three squares Vermont are also aware of and have access to all the other programs that it opens the door to which I'll talk more about in a little bit. It's our team's goal and it's our passion to assure that every eligible for monitor is not only signed up for three squares Vermont, but that they are also receiving the most benefit they're entitled to that they're aware of and utilizing all those other services and supports, and we stay in continuous relationship with folks and the communities that we're supporting and serving. And part of our goal today is of course to share information with you all about three squares Vermont answer your questions. And if there's just a few things that you would take out of this the two things that I would hope that you would remember is that you can always reach out to the Vermont food bank and you can reach out to the state directly to any time or any other of the other community partners if you have questions or you want support. Next slide please. This is my favorite one. I guess so excited about this one. So three squares Vermont ties to a lot of other programs I like to refer to it as a gateway benefit, because once you get three squares Vermont it opens the door to so many other services and supports. And we all know that food insecurity is a symptom of a larger problem. Three squares Vermont opens the door to so many other services and supports like fuel assistance, which is an annual benefit folks receive to pay for fuel to their homes, WIC, which stands for women infant and children which provides nutritional supports to pregnant women and breastfeeding women and children up to age five. Child care subsidy helps parents cover the cost of early ed and care for their kiddos so they can go to work or school. Three squares Vermont household to have school age children automatically qualified for free school meals and assistance with things like SAT testing and college application fees. Q link, which is amazing. Q link provides a free smartphone, along with free texting unlimited data and 250 free minutes per month and lifeline which is a $14 credit on landline phones. Folks who are three squares Vermont eligible are also likely eligible for another Vermont food bank program called commodity supplemental food program, which provides a box of shelf stable foods to folks over the age of 60. If you are three squares Vermont eligible you also are likely eligible for supports like the SNP, which helps people get their animals spader neutered. And you and Jessica told me about this the other day I didn't even know this, you also get a discounted Amazon Prime membership. So it's like half your Amazon Prime membership we have the cost and you can order it food and use your ebt card through Amazon. And also many cable companies offer discounted internet packages for folks that are receiving free school meals or SSI or three squares Vermont spectrum internet is assist is one of them. Comcast offers internet essentials. Please reach out to your local cable companies and ask what programs they're offering or contact the three squares Vermont team at the food bank or the state we'd be happy to assist you and finding more information about that. And I promise I'm almost done there's just so much which is so exciting. Folks can also access crop cash crop cash is so cool. With your three squares Vermont benefit you can access. So you can use up to $10 of your three squares Vermont benefit at participating farmers markets and crop cash doubles that $10 turning it into $20. And three squares Vermont folks can sometimes get discounted CSA memberships, and I can never remember what CSA stands for, but they're those community garden plots that sometimes you have to pay for, or garden share. And you can use three squares Vermont benefits to purchase seeds and starters, which this time of year is just so important and amazing you can even just grow things in a little, you know, in a little box in your window if you wanted to. So these are just, you know, a dozen or so other reasons why three squares Vermont is such a strong and amazing program. Next slide please. A thing and Jessica one second we do have a question. And the question is, how do you determine eligibility. We're about to go into that how timely. Yes, perfect. Do you want me to go through this question and then if you have additional ask at the end of this slide. All right. So, in order to be eligible for three squares there is an application process. And you would need to do this for either three squares or three squares in a snap. First you must fill out an application, you can have an application mail to you, or you can complete one online, or you can stop in any district office or partner location and pick one up. For the application you'll need to complete an interview. This can be completed over the over the phone through our interview unit. Once COVID restrictions are lifted. Then you can complete an interview in person at one of the 12 ESD offices, or you can go to a community partner agency and they can help you complete the interview over the phone. Once you complete your interview you may be asked to provide additional information such as pay stubs income tax forms, sometimes childcare information, medical expense information shelter expenses. This information can be submitted online with the state uploader. You can take a photo with a cell phone, or you can choose a document from your computer and you can upload it right through the uploader website. You can send it off to documents at a local office or you can mail them in to the application document processing center. All of our requests for verification come with prepaid envelopes so you can send that back in to us. If you're having problems collecting the verification that's requested you can reach out to one of our partner agencies, and they may be able to help you gather that information and submit it to us. So the application process is income eligibility listed on this slide you'll see the income eligibility guidelines, your income will be reviewed, and in some cases you can use medical expenses and date and childcare expenses to reduce the amount of income that you've earned. So, this is just a guideline that that we use. Through your proof for benefits, you'll receive an interim report halfway through your certification period, and then that is a three page questionnaire. Most of them are yes or no questions and that you'll have to send back into us. And then, at the end of your certification period you'll receive a review application that will need to be completed prior to the end of your certification period and as far as you'd have to complete an interview for the new three snap program, you do not need to complete the interview. And if you need help with any of this along the way. You can reach out to one of our community partners, or you can call our call center or you can stop in an ASD office. We do have a raised hand. I think Ellen Wicklum would like to ask a question. Ellen, I think I have unmuted you. Maybe not. Let me see, I'm trying to unmute. The joys of our new virtual world. Yeah, I'm sorry, I guess it might have to go in the chat because, or can you try Ellen, I see a mic. And I've hit allowed to talk. So you, but you can't hear me. Now we can hear you. I'm sorry, my phone's in my pocket and I don't have a question. I must have done that accidentally. Okay, thank you. Sorry for the interruption in the drama. Go ahead, Jessica. All right, so if we have no questions, it's on to the next slide please. Sorry. Please see is that right. That's right. Because Vermont food bank provides direct service to people oftentimes the individuals that we assist will share some of their perspective with us which is an honor and invaluable for us as well as our, our partners at economic services division. Um, so these are some direct quotes from folks that our team has assisted over the past year talking about about their three squares benefit, you know, and what it feels like to use it or how it's affected them. And I'm, I'm actually not going to spend a lot of time on the side because I know that we are over time so if you just want to go on to the next one. So there are two slides in here that have very important information the one that lists community partners that Jessica shared and this one. And I really want folks to know. This is the, so there's Jessica's email my email, and then you can visit any of these websites the first one will bring you directly to the state website where you can apply through their online application which is amazing and super helpful. Vermont food help also has a lot of food access resources that people can access and it also has outreach materials for those folks on here who might be interested in spreading the word about the amazing and wonderful three squares Vermont program. And then of course there's the Vermont food bank website where people can go to contact our team directly that's what the link will bring you to, but you can also look for our network partner agencies and other food access supports via our website. Does anyone have any questions. Because if not I might throw some at Jessica just for the fun of it. Or I could wait till the end. I cannot see any questions in the chat with that I feel like we could move on to the next presenter since we did go a little over time and then if there's time at the end I can, we can throw some questions out, because I recognize two people might not know what to ask right now we just share a ton of information. That was a great presentation thank you Faye and Jessica. At this point, I will ask, I will stop sharing my screen and ask that Mark Eli, talk to folks about what he does and general assistance emergency housing. Hello. How are you doing me okay. So Betsy, I know we talked earlier the jets did. I'm live in Manuski, and I'm in the flight path to the F 35. They, I don't know whether they were coming or going so if they were on the way out they may come back to land. So I am currently the director of the general assistance program I know Betsy you mentioned housing. I do. I was going to talk a little bit about about GA and we, as I, as I was going to say we are the island of misfit toys. Faye mentioned B snip. And that is that is actually a GA benefit. So we do a whole whole bunch of stuff. In a general sense, general assistance is a state funded crisis abatement program designed to meet the need the emergency needs for monitors. Like I said, the island of misfit toys, there are a lot of emergency needs we do a lot of benefits. We do everything from providing vouchers for space spaying and neutering companion animals, which is the decent program to housing for monitors experiencing almost like I see mentioned. In addition, we provide assistance to adults with children or adults who are unable to work. We provide vouchers for dental and medical procedures. We provide rental assistance vouchers we have a whole sort of transit transitional rental assistance program that are for it's for people awaiting more long term generally had funded vouchers. We provide transient we've provided assistance to transients. We provide transportation assistance so will the way it's written in the rules will will give you a tank of gas or a bus ticket to the border. And we, we fund burials for people who meet eligibility requirements for that program. So we're primarily state funded program I mean I know that's at the moment that's sort of half true, but in historically we are a state funded program. So we provide assistance for monitors. There are sort of versions of this and other states but they're all, you know, somewhere by county, I think, during the pandemic in California Los Angeles has been doing one housing program but you might find something totally different, you know, in another county. The various GA benefits have their own eligibility criteria I know the last presenters were asked about eligibility. I can give you I'm going to try to give you a general overview but there are more specific rules for more for each of the various benefits, but they're broken so eligibility is broken down into two main categories. There are non catastrophic benefits and their catastrophic benefits. Non catastrophic benefits are typically the rental assistance we provide monthly rent, we provide room rent to relatives and non relatives we pay utilities, we give people a small cash stipend $2 a day for a single person. So those are what we call non catastrophic benefits. It's either based on the presence of children in the household, or on the applicants ability to work generally. There are also other eligibility criteria like work barriers, age. It's not quite this simple but I'm trying to give you the sort of the 10,000 foot view. Income limits they're pretty strict income limits they're, they're a lot lower than with the three squares Vermont program. That operates at about I think it's 185% of the federal poverty level. ours are are much much lower than that for non catastrophic assistance. We generally follow the reach up rules. The income rules in this category. In the beginning that children is the presence of children is one of the eligibility criteria. And this category really what this benefit is is a bridge to social security for adults who are disabled and awaiting a decision. So we, most of the households who apply for and receive this benefit are single adults. We pay in room rent to a relative or non relative. We're giving them $56 every 28 days and cash. If they're renting an apartment we might be paying utilities, but this is kept at a around $400 a month. It's more complicated that we take into account shelter costs and any income, any resources they have, but it's roughly four bucks a month so that's doesn't go very far when you're paying rent utilities and cash. Historically the catastrophic eligibility criteria did apply to temporary housing since the COVID-19 pandemic began. And the GA program began sheltering for monitors that were living in congregate housing settings like almost shelters. That aspect of the criteria has been waived the whole really the whole temporary housing rules have been thrown out and revamped. Historically applicants must have experienced a catastrophic event to be eligible under catastrophic criteria. That was stuff like a flood of fire and sort of natural disaster folks fleeing domestic violence. Sometimes whose apartment was uninhabitable for some reason, you know, black mold or the inspector came in and and said shut this place down, or whose landlord denied them access to the unit. So, you know, sometimes landlords don't want to go through the eviction process and let's just change the locks. In those situations, those people were eligible under catastrophic criteria. They still apply part of this rule to dental and medical vouchers so people have to have a medical emergency. They have to have exhausted all of their available income and resources. Really what we're doing in practice is we're pulling a lot of teeth. We give people eyeglasses occasionally, or a last resort program. We make them jump through a few hoops before they get the eyeglasses we usually people end up getting glasses from the Lions Club. But we do, we do a fair amount of dental vouchers. As I mentioned earlier, since the beginning of the coven 19 pandemic DCF has had the ability to have the authority to wave and vary our rules under legislation passed by the Vermont. Legislature in 2020. The authority to waiver very, very rules is in act 140 section 13. I know I'm speaking to a law school students. Which amends act 91 section for this was signed on July 6 2020. We've used this authority to significantly expand the number of monitors eligible for temporary housing during the 19 public health crisis. I'm sure you've seen. We've been covering this pretty well. The whole the idea behind this was to allow for monitors experiencing homelessness to comply with kill Scott stay home stay safe directive back in March 2020. The programs of GA is a program that's mostly administered by the Economic Services Division of DCF just to ran low as my colleague I've known for a while. We are half of the department for children families. The projects of the program are administered by subcontractors. We do RFP process the V SNP program a lot of that is subcontracted out. We, we contract with the Vermont State Housing Authority to provide inspections for the Vermont rental subject program. But for the most part, we're doing we're administering the general services program. We've been mainly funded through the state general fund. We historically get an annual budget alignment for things like temporary housing, since there was sorry historically there's also been some a small amount of TANF funding available for emergency assistance benefits. It's had sort of a separate eligibility criteria. It's very similar to general assistance but in different and some key ways, the main one, being that children need to be in the household. It is a TANF benefit and TANF is temporary families, especially the reach out program. Normally this is a program that's funded through the state general fund, you know where it's in the low millions for temporary housing. Now, we have been funded. Since the COVID started we are being funded by FEMA reimbursement. That's going to change this summer but for right now we are everything we spend on COVID housing is funded with FEMA reimbursements and you know we are. Our old budget is just, it's laughable compared to what we're spending now. The last part I was going to say is general assistance so GA has been around for a while. We're sort of newly famous, but it's been a, it's been a thing for a long time. The rules, I think date back to the late 1960s while they've been revamped I shouldn't cast this in such a bad light. The rules have been rewritten many times with the original rules date back to the late 1960s. Before that it was a town level county level program that was administered by what's called overseers of the poor. But if the state took over sometime in the late 60s, I think it's 1968. I can share my screen and show you. Oh boy. Our new digital world. Oh, there it is sorry the green button. I'm so used to teams at this day we do everything on teams, and I haven't shared a screen on zoom. I don't think I've done this whole time but it is the big green button bottom. I can share my screen and show you what an application looks like. And what our worksheet looks like. If anyone's interested, do that real quick. Also, Mark, we do have one question. And that question is, how does somebody access section eight. That is a good question. We so yes he does not administer section eight vouchers. I think the best way to get that rolling is to talk to your local housing authority or the state housing authority. You can probably reach out to community organizations like cuts or any of the rock or the local community organizations like CBO, you know, could probably be helpful as well. I thought I heard a Jeff for a second but it is just a regular client coming in for learning. So, okay. I think if I share the application, it will sort of, I want to. So, folks, what what the program used to look like. So, there we go. So, I think this is working please tell me if it's not. This is the old. Well, it's not we still use it's the general assistance application. The benefits here would also include housing this is actually kind of a draft copy. So, normally housing would be right here. We're at you see the section here for household information. We're looking for the name of the first the applicant anybody who's applying with them. This is where in this section the employment information section sort of sort of gets into the eligibility program. So where we're looking for the person's usual application or occupation. Have they been working so we're asking really is this person able to work. Have they been working recently. Have they been offered a job in the past 30 days. There are some employment requirements so there are requirements to accept suitable employment if it's offered for some GA benefits. And then this last question here, do you have a medical condition that prevents working or looking for work. This is the eligibility criteria that probably. I don't have a number but a very high percentage of our non catastrophic eligibility is based on this question here. The section here is for resources so it is an empty pockets program, as we say, any resources that an applicant has are counted against the amount of benefits they can receive. And then here we're looking for the applicants income information. We evaluate the last 30 days of income, according to a pretty strict, pretty low payment standard. We're looking for the landlords information in case we have to pay rent. This is our worksheet. So this is sort of what we use to determine the eligibility. And this is where we get into the eligibility. We use the basic needs standard to reach a basic needs standard for a household of their household size. I know off the top of my head I'm pretty sure for a household of one that's $585. We have the shelter standard so in Chittenden County that's $450 the rest of the state it's $400 that total is multiplied by 49.6% it's called a rateable reduction. What's left is the amount of benefits. Off that comes any resources that are available, any income in the last 30 days. This is pretty boring. This is just their income and expenditures this is internal benefits we granted, or if we denied the reason. This is our old. I keep saying old I'm sorry I'm so wrapped up in the housing world these rules are still fully functional operational they are, I guess in some respect old, but they are current rules. They have been waived under our act 140 authority for temporary housing, but the rest of them are very much in effect. I'm not going to go through the rules, obviously, but it's nice to say we have a pretty long rule book it's 111 pages. This covers all of it. And it is posted online. These are by comparison, these are our current temporary housing rules also posted online. As you can see these rules and June 30 2021 2021, but there are 12 of them. You got to be a homeless Vermont or you got to live in Vermont. We apply the definitions of from our old rules. You got to be a US citizen or legal alien, you got to be living in Vermont temper voluntarily enough for temporary purpose so you can't, you know, we're not housing people who are here on vacation. We're a shelter first program like I said it's sort of the empty pockets emergency aspect of the general assistance program so if there's shelter space available. You got to take the shelter space. We barely left the place he stayed, we do have income limits and now for temporary housing we are using 185% of touch poverty level which is the three squares, while one of the three squares income limits. We have a resource limit of $2,250 for the household. Sorry, can I ask a quick question. They go ahead. Due to the pandemic, the income guideline for access to GA is currently increased but normally you mentioned it was lower but I don't I if you said it I'm sorry I didn't catch it. Normally normal. It's there's it's you can't really. It's one number that you can pin down it's that equation where we take the reach up basic needs standard plus the shelter standard, and then we multiply that by the rate of a reduction. That was never used for temporary housing medicine non catastrophic general assistance benefits. temporary housing under the 2600 rules was catastrophic benefit so applicants had to expend all available resources, but there was not an income limit per se. Mark, I am going to need to ask if you can try to wrap up in the next few minutes. We're done actually. So, like I said, we went from 111 pages here to two pages of rules 12 of them in total. Number eight the resources. We're asking that people work with case management there's a lot of federal money for rental assistance we want to connect people with that. We're asking the house applicants together if they ask, and there is a period of eligibility for certain behavioral issues. And with that, I'm done. All yours bestie. Thanks very much Mark. I'll just know does not look like we have any more questions right now. So with that, I will turn it over to Danny Foucault. I'll mute myself here. And Bessie, are you able to pull up those slides, or would you like me to do that. If you could do that that would be great. Sure. Share this can you see this. Not yet. Okay. Figure out what just happened here. Are you able to see it now. I've been going through my own screens here. How am I doing now. I think you're doing well now. All right, thank you. Also not used to not used to zoom. So, please let me know if the slides are working and if they're not just feel free to interrupt me. So, my name is Danny Foucault. I am a policy analyst in the department of remote health access. I work in healthcare policy. I have a master's in public administration from the University of Vermont plug that since I forgot it in the bio. I'm going to talk about Medicaid today. So, just really going over the basics. What is Medicaid, Medicaid is a public health insurance program for people with low income, the people with disabilities. Every state operates its own Medicaid program within broad federal rules and guidelines. Some folks sometimes mistake it with Medicare. Medicaid and Medicare are both programs that were created by federal law. Medicare is specifically for folks who are 65 and older, or who have been determined disabled by Social Security Administration. Medicaid is more of a federal state partnership public health insurance program that is designed to provide health care coverage for individuals and families who are generally low income. And there's a lot of terms that get tossed around in Vermont, Medicaid sometimes called by other names. One is Green Mountain Care, which is like the umbrella name of all the state-sponsored health care programs in Vermont. And if you have Medicaid, it's going to be the name on the card you get. It says Green Mountain Care card. But it could be different programs that might be full Medicaid, or it could mean that you have a pharmacy assistance program coverage depending on who you are, what you applied for, and what you were granted. Another name that you might hear is Dr. Dinosaur. Dr. Dinosaur refers to Medicaid for children under age 19 and pregnant people. And who can get Medicaid? Like I said, it's folks with low income. An example of this would be if you are. Excuse me, I'm sorry, but the slides that we're seeing are, we're just seeing the Medicaid in Vermont and it has your name. Okay, so it's not moving for you. Interesting. If you hit F5, I think it should switch into presentation mode. Sorry, Sean. I'm not sure. I have a split screen situation going on, so I'm not sure my screens look different. I'm so sorry about that. And I apologize too. I'm struggling a little bit in the Zoom environment. I can try to pull it up, Danny, and I guess I would encourage you. Oh, it's working now. Okay. Yeah, I'm not in the slide setting. Is that okay, folks? The slides show the setting needs to work better. Thank you for the interruption. So let me see. So folks with low income specific categories of eligibility is what Medicaid looks at when they get your application. Perhaps you are a parent or a caretaker relative of a minor child. A child, a pregnant person, a person with a disability. Are you 65 and older? Or are you a general adult between the ages of 1964? For example, the income threshold right now for mental who's a household one would be about $1,481 and 70 cents a month. That would be the income standard or limit for that general adult household one. That's not gross income. That's something called modified adjusted gross income. And there's a whole methodology for how your income can be determined. So if you are 65 and older or you have a disability or maybe some other special category of eligibility, there may be a different way in which your income is calculated. So the rules can get pretty complex. And I've left them here as kind of a general overview. And one thing I wanted to mention too is if you receive SSI. Supplemental security income, I believe, from the Social Security Administration, you are deemed eligible for Medicaid. No matter what state you go to, you get SSI, you get Medicaid. They go hand in hand. So that is something that's helpful to know if you ever leave the state of Vermont. Because another thing is that you have to be a Vermont resident to get Medicaid in Vermont. And if you move to another state, you would have to apply in that state and qualify under their eligibility standards. And another important thing to know is to get Medicaid that you have to be a US citizen or national or have something called qualified immigration status. And there are federal rules about immigration status for Medicaid. If you're a green card holder, you may be eligible. Qualified non-citizens are eligible and this might be someone who's a refugee or has been granted asylum in Vermont. Vermont has chosen to provide Medicaid to pregnant people and people under age 21 who are lawfully present. An example of an immigration status that might be considered lawfully present is someone who has applied for asylum but not yet being granted asylum and has had their application pending for at least 180 days or has been granted a work authorization. There's a five year waiting period for some qualified non-citizens. So if you're a green card holder and you just became a green card holder, you may need to wait five years in order to be eligible for Medicaid. But you could be eligible for other financial assistance and getting health insurance through Vermont Health Connect, which I think is something Sean's going to talk about in a minute. But you would have a five year waiting period for Medicaid. But there are categories of folks who are exempt from waiting five years if you are a lawfully present child under the age of 21, if you become pregnant, or if you have a certain humanitarian status such as refugees, asylees, or victims of trafficking, those folks are exempt from what we call the five year bar. Let me make sure I'm moving the slides right here. So how much does Medicaid cost? Well, right now it doesn't cost anything because we're in a public health emergency and all cost sharing is suspended. But if COVID wasn't happening or when the public health emergency ends, normally there are premiums for children who are above 195% of the federal poverty level. And I have them broken out here. They go by family per month. So if you have one child, you are at 200% of the poverty level, you would pay $15 a month. If you have three children and you're at 200% of the poverty level, you'd pay $15 a month. VFARM is a state pharmacy assistance program that's specifically for people with Medicare drug plans. It provides wraparound pharmacy coverage for those folks. These premiums are charged per person per month. And there's different levels of assistance with VFARM. So those are the two programs that have premiums. If you are an adult, 21 and older, and you're not pregnant, you might be charged co-pays when we're not in a public health emergency or prescription drugs, dental, or an outpatient hospital visit. And none of those co-pays are more than $3. So for the most part, Medicaid is no cost. And then what kind of benefits does Medicaid offer? It's comprehensive healthcare coverage. You've got hospital, medical doctor, laboratory imaging. There's dental coverage, which is more limited if you're an adult over the age of 21, covers prescription drugs. If you don't have a car or you don't have access to transportation, you can book a ride and Medicaid will pay for that ride. And an important thing to know is if you have Medicaid and other health insurance, such as Medicare, or maybe you have a Blue Cross plan, Medicaid is the pair of last resort, and that means that your healthcare provider will bill your other insurance first, and Medicaid will pay second. Tani, is it possible for people to be receiving Medicare and Medicaid? Sure is. So you might be eligible for Medicare. You might also be very low income, and you can get both Medicare and Medicaid. And that would essentially take care of your Medicare premiums and all of your Medicare cost sharing. And then what you would have left is the prescription drug co-pays that would be charged under the low income subsidy program, which is a Social Security program. But that would be your only out of pocket cost if you are what we call dual eligible, which is on Medicare and Medicaid. And I just have one more question too. I'm sorry because I'm a facilitator. It won't let me enter my questions in the Q&A. My other question is, is it true that, for instance, if there's a family of two, there's a mom and a child, the child could be Dr. Dinosaur eligible even if the parent is working and not Medicaid eligible, right? Yes, because there are many different income limits depending on who you are. And it's possible that depending on who the child's, if the child has a parent that's not living in the household, their household for Medicaid eligibility could be different from the mother's household. So it gets pretty complicated. The income limit for eligibility for children is much higher than adults. So sometimes we see that, you know, well, the children are just on Dr. Dinosaur, particularly if they fall into one of the higher incomes that has a premium, that would have a premium absent the public health emergency. And feel free to keep interacting with great questions. So these are some Medicaid services by federal category just to give you a sense of what is required on a federal level. These are the mandatory categories or what is required to be covered by Medicaid in every state. There's a lot of acronyms here. The one I just want to call out quickly is something called EPSDT. This is early and periodic screening diagnostic and treatment. This is a standard that basically says that it's important to provide health care to children. And I'm not particularly, I'm not the most foremost expert of EPSDT in the state, but it's saying that if, you know, if kids need this treatment to correct or ameliorate a condition, then Medicaid needs to cover it. And this is just really important in terms of making sure that children, which is defined as people under the age of 21, are getting all the services that they need that are really medically necessary. Even if the state doesn't choose to provide that category of service. And so you'll see that these optional categories of service, some of them seem like nice additions. Some of them sound like something that's surprising to find in an optional category of service, such as description drugs. But these are all optional categories of service that's provided. There's limits on eyeglasses and bento for adults. And but for the most part, these are all, you know, comprehensive services that are offered and there's more that could then could fit on this slide. But how do you apply. There's lots of ways to apply. You can apply online, you can apply by phone, you can fill out a paper application and mail it in. You can also get help from a certified as sister. And there is a link, I think on my next slide, that shows you how to find an assistant by county. And they are very trained and very, very helpful if you have a complicated health care situation with some questions. So we've got a lot of additional resources here. And I'm not sure best see if we're able to. I know this is getting posted I suppose I don't know if you have a way to put links. We're definitely going to post the presentations will be able to make them available at the AGO. And I'll, I'll share I think I'll be able to share a web a email at the end, or I'll make sure my email I'll give people my email and make sure that they can access them through me. We do have one question. Sure. So two questions. What does lawfully present mean is asylum. What if I think is this asylum request has been filed but not determined. What about if it's not, not yet filed. So if you haven't filed your request for asylum, you wouldn't meet the criteria for lawfully present that's in the Medicaid rules. The Medicaid rules say that if you have an application pending for asylum, and you have been granted a work authorization. And I'm not sure if it's the Department of Homeland Security or who would be granting the work authorization but the federal agency that would do so. It would become eligible for Medicaid. So, you're, if you have an application pending for asylum, and you've been granted your work authorization, you become lawfully present for Medicaid purposes. If you have an application pending, and you are age 14 and under, or under the age of 14, the application has to be pending for at least 180 days under the rule, which is about six months. So there's definitely, these are like very much federal rules. The states don't have a lot of options in terms of the rules around immigration status. And there's a lot of specific categories that we have available in our rules that talk about who meets a lawfully present status. So it's kind of tricky that you have an application pending for other humanitarian statuses. And it also just gets very, very, very specific in immigration law. So it's kind of tricky, because I'm not an immigration expert to go over that. But part of very thing, and I realized, I'm sorry, this is in the way. The Office of the Healthcare Advocate, I wanted to put a plug in here. This is, they are not affiliated with the state. They're a free program, confidential service provided by Vermont Legal Aid. If you, if you are an immigrant, and you have questions about your specific status and your specific eligibility for Medicaid or other healthcare programs in the state. I encourage you to call their office because they're able to give you one-on-one advice about how your immigration status might intersect with the eligibility rules for state healthcare programs in general. Medicaid and qualified health plans. Additionally, you know, when you call Vermont Health Connect or you call Green Mountain Care Member Services, they can give you the information about what the rules say about immigration status, but it's, they aren't able to provide advice for you. So if you're comfortable, I would encourage you to call the Office of the Healthcare Advocate for specific immigration status questions. And, Danny, yes, one more question. The other question is, are abortions paid for by any programs? Medicaid covers abortions. Yes. Thank you. Thanks, Danny. And, Sean, can you take it away? I can. I will get my screen going there. Hit the share screen button. Okay. Great. Well, hopefully everyone can see that. Thanks for joining. And with that, Danny and I went back to back. The nice thing in Vermont, we could both work for Department of Vermont Health Access, which is the state's Medicaid agency, as Danny was talking about. It also oversees the state's health insurance marketplace. Every state has a health insurance marketplace, their own, or use the federal marketplace for the qualified health plans that Danny was talking about. In a lot of states, you have to apply separately. They're not integrated. But because Department of Vermont Health Access oversees both, and it's the one enrollment system through our marketplace. From on Health Connect, that same number that Danny was showing, you can apply. You don't have to do a whole lot of homework before to see if you're going to likely qualify for Medicaid versus subsidized qualified health plans. Well, we can figure when you call that they'll figure it out for you. The big thing I wanted to talk about here and I regret kind of the with the time I gave a one hour long webinar yesterday and then try to keep this one to 10 minutes but that means is yesterday went into a lot of health insurance literacy terms health insurance is complex. I'm not going to do that today. I want to want to focus on the financial help that's that's available but I will point towards resources. If I'm using terms, health insurance terms that you're not not familiar with I'm guessing there's a breadth of people in this session who have used the marketplace before or familiar with health insurance terms and those who aren't. The American rescue plan, like those passed in March had three main provisions for that impact our health insurance marketplace. Number one, people who qualified for tax credits in the past, which you know to make their health qualified health plans cheaper will get even more money than they did that in the past. Number one, for both this year and next year. Number two, there used to be an issue of a big benefit cliff. And I should flag to a lot of the programs that we've heard about tonight are have a much lower income threshold of no 185% been thrown around a population for Medicaid for children and adults it's 138% higher for Dr dinosaurs Danny talked about but for for the qualified health plans that used to be 400% of the federal poverty level, which would be an individual up to about $51,000, or family for about $100,000, but now with the American rescue plan that cap goes goes away it used to be that if you were at $50,000 you'd be getting thousands and thousands of dollars and help per year, and if you were at $52,000 you'd get nothing was a big, big cliff that was gone away replaced by a phase out. That's the second second provision for people with much higher incomes, qualify for help. The third piece is that if you had, if you qualify for unemployment compensation for one week during 2021. You'll get much more generous subsidies. That really would make sense to do apply. And those three provisions are pieces that require system updates one thing for them to be passed in March, another for us to make all the technical system implementations that are needed so when you apply you get that benefit. And that's going to happen in June. So, if you applied today, you'd get a little bit different of a, you'd be determined on the old, the old system, you'll then automatic. Next month, after the system updates telling you about your, your additional benefits. I won't talk as much about the tax credit reconciliation just hopefully everyone filed their taxes by. Was that Monday. But basically usually if people think if they end up reporting a lower income having a higher income, you have to pay back some of your tax credits. The federal government granted a holiday for the 2020 filing year because of the pandemic. The other provision that doesn't directly relate to the Department of Vermont health access but does relate to Vermonters is that Cobra continuing coverage, which is health insurance you get through a job when you leave your job if you're laid off or leave your job you can, you can get your employer, you can, you can pay to keep your health plan but it's quite expensive is you're picking up the full tab for six months from April through the end of September on the federal governments picking up that full tab if people were, were laid off. So that's, that's available as well. One piece I wanted to talk about I'm guessing there's some people who may be on that already have marketplace plans and want to know about the extra benefits they'll be getting had choose plans. But there may also be people on here or you may know people who are, who are uninsured. And maybe they've looked in the past, and, and saw what subsidies they were eligible for and said you know it still would be too costly. One of the messages I want you to take away with and help spread the word is, don't assume that it's the same same landscape. As I mentioned, those are big, big changes for the American rescue plan and they really want to take another, take another look. Because a reference is no longer that benefit cliff phase out meaning individuals people in single plans up to nearly $95,000 can qualify for financial help, and people and family plans with with incomes up over a quarter million can also qualify for tax credits. So, so people who are, are out meet meet the eligibility guidelines and have the incomes, obviously we all know we live in Vermont, I don't, I don't know too many people in the state making, making families making which over over that Silicon Valley. The other piece I think for people who you know to will get to choosing a plan in a minute. But if you're at the point of thinking do I go on insured or do I, do I get a plan. It's important to realize that there there are zero premium plans that now with the American rescue plan, you can qualify for if you're an individual and have an income up to $38,000 per year, or a couple with an income and nearly $60,000 per year, you can, you can get a health plan that you don't have to pay any, any premium at all. It's important to underscore you can only get the financial help if you apply through the marketplace for Mount Health Connect. Some people apply through directly through their enroll directly through blue blue cross the shield or MVP health care, typically if they don't if they didn't qualify for subsidies in the past, they might enroll directly with with those health insurance companies. It's important that they transfer over, and they can transfer over their plan. Everybody should have gotten a letter, the 7500 people in the state who who are enrolled directly through their insurance carrier would have gotten a letter sometime last month with the instructions for transferring their plan over to the marketplace, letting them know that if they paid any money towards their deductible that would transfer as well so there's really was no downside and in transferring their, their plan. We have more work to do getting getting the word out to people there a lot of, a lot of people don't open their mail from their, their insurance companies. Not usually a fun thing to open but in this case, potentially worth a whole lot more money than those $1400 checks that made such a big deal about in, in, in March as far as the American rescue plan, people who buy insurance on their own. So it'll dwarf those, those payments. And one thing I think to flag here if you do anything out here that like a person tool we have available at brahmonhealthconnect.gov, you'll see the shopping cart icon you can, you can click on it. There's no bronze plans before we certainly don't give recommendations of what plans to be in and, and one thing to have a warning about bronze plans as they can have high out of pocket costs but that's why I prefaced it on this page as far as if your decision or somebody wants to know is having that decision between, do I not get insured at all, or do I, you know, by, do I buy a plan with those incomes $60,000 for a couple of you could, you could get a plan that should have some out of pocket costs but a lot lower out of pocket costs than if you don't have insurance at all and if you have an accident potentially on the hook for, you know, six, six figures or whatever the case, case may be. So it's really a good opportunity for people to get, to get insured. If you click on that plan comparison tool icon you'll be asked a few questions it's anonymous you don't have to go through the full application, just to get this this estimate. You answer the ages of people in your, in your household. And how many people in your household whether they can get employer coverage if, if, if there's affordable employer coverage offered to people in your household they, they don't qualify for subsidies, just like if you qualify for Medicaid. You can't turn it down and take qualified health plan subsidies and instead, or if you qualify for Medicare for that, that matter. So you can put in whether you have any unemployment benefits as we mentioned that will give a big bonus for this year. And then you're expected household income. Once you put that in. It'll tell you what you qualify for so for example, an individual making $25,000 per year would qualify for $662 per month in, in financial help. That's about $100 more than they would have qualified for before the American rescue plan. You'll be hearing $662 that's, that's great that's $8,000 I get but what is it, what does it mean what do I know what do I pay, and we get there next once you see that subsidy qualify for you click to compare plans, and it'll allow you to go up here to sort by by premium if if you like, and you sort by by premium. It'll it'll show you the plans that here have, you know, no, no premium, as we mentioned, sometimes I've been making $25,000 that's less than $38,000 they can get free premium plans, but in a bad year if they have all that out of pocket they could be on the hook for for $8400. So go back up to the top and sort by cost in an average year, and that's going to take somebody in your, your age group of your family if you put in what your health status was, it'll do an estimate based on people of your age and health status, you can leave off health status if you want it'll go to the average of people of your, your age, the actual premium and cost of the plan is the same, regardless of of what your age is Vermont's one of only two states that has full community rating doesn't. Sean, I've just lost your audio. Still gone. I hear you now. Okay, great. So, but really the, the differences that just that if you're older you're more likely to need more more health care and you'd have more out of pocket costs for that reason. So, in this case, somebody sort by cost in an average year, you could still get a very low premium in this case less than $4 a month, but instead of having that potential high out of pocket costs. You're looking at a much, you know, much lower, less than half of what it was before, and if you're healthy you'd still pay less than 50 bucks for that for the year, preventive care is always free so your annual doctor visits and any preventive care comes with all your plans there's no co pays for those. So, somebody who's really interested in risk or what your worst case scenario could be, you could go up to the top and sort by cost in a bad year, and that will give you the plans that have the lowest bad year costs so the, the out of pocket costs will be a little bit lower, lowest here. So you see that that good year if you don't use coverage going to be a little bit higher, still under $100 you're paying $7 a month for that premium, the average year is a little bit higher. But you know, you have that protection and if, if you really get hit by a bus get cancer get something really bad that would cost you hundreds of thousands of dollars in care the most you have been in that case. So if you want to do more research you can click on these blue plan names. When you do that you'll come to a screen that has a lot more details that you can read about. If you have a doctor you regularly see or for other provider you want to make sure that they're in network. So if you're going to click here it'll take you over to Blue Cross for MPP sites you see what doctors are in the health plan. If there's a certain prescription, you take you can can click on the plans drug list, it'll show you what the what the co pays what the covered drugs are for for generic specialized drugs and so forth. There's a lot more options there. I think just to end on you'll notice as I referenced at the beginning the website and phone number is the same as the one standing gave the Vermont health connect dot gov for 8558999600. They can help either answer questions, or you can process your application over over the phone, you can also apply by online. As Danny mentioned there are a sisters so on the website of remind health connect dot gov there's a fine local help button that has a link right to that. The assistant directory that the Danny links links to, and there's also a bunch of links there for health insurance 101 to explain all the terms that I kind of flew through like premium and out of pocket costs and co pay and, and all kinds of things we could talk about all night but we'll keep you any any longer you can, you can find them there, or, or call for more, more information. Happy to take any questions. Thanks Sean I don't see any questions and since we are going a little over time. I, I think that if you could stop sharing your screen. I will quickly share mine. And talk quickly about appeal rights. Our folks able to see that. Nope. No. Let's see. How about now. Good. Okay. So for most of the benefits tonight. You do have a right to appeal if your benefit if your application for the benefit is denied, or if the benefit is reduced or ended. So that would be that would be true of Medicaid, that would be true of any benefits that you might apply for through the division of economic, the Department of Economic Services or the Economic Services division of the Department of Children and Families. And many other benefits of the state just does not apply to plans that you help plans you get through Vermont help connect you would go through the particular insurers appeal process. So, if your benefit application is denied, or a benefits reduced or terminated, you can ask for a fair hearing. A hearing officer from something called the human services board would hear your appeal. The hearing officer and the board are independent from the state of Vermont. You can also have any trusted you can ask any trusted person to help you with your appeal. You could qualify for free legal help. How do you get it asked for fair hearing well you can request one by calling the department that denied or reduced or terminated your benefit, and you simply call them and ask for a fair hearing. They will make sure that that request goes to the human services board. You could also call the board directly, and I provide their contact information here. Before you're hearing the department would give you and your representative a copy of any of the evidence that they would be presenting. And, and you certainly can bring in your own evidence and witnesses. It's pretty scary but this is the process is actually quite informal. So, you know this is not in a courtroom. This is generally by the hearing is generally by by phone. And if you would like to seek legal assistance, you should contact Vermont legal aid law line. You may, they may be able to represent you or they may be able to if they can't represent you in the hearing they may be able to help talk you through the process and and help you prepare. And I provide that their information here. So, with that, I am going to be. I don't see any questions right now I want to thank our presenters. Thank you so much. I think this was really great and very helpful. And just a couple little housekeeping, where I want to remind everybody that this presentation will be available on the Attorney General's offices YouTube and Facebook page. I will also give you, you have my name, my name is Bessie the SS IE. Weiss WSS. You can email me that would be bestie dot Weiss at Vermont dot gov. If you have, if you think of any questions later or if you have trouble finding the PowerPoint at the AGO. Thank you so much everybody and have a very nice evening.