"You Will Get A Call!"... Oh, Really?

Aspects of Need addressed: Financial, Occupational

Today at 11:20 was the appointment: my son was going to receive a call from a New Jersey Department of Labor and Workforce Development "Claims Examiner". The LWD's officious appointment letter sent to my son ordered, "You are required to participate in a telephone fact-finding interview to determine your eligibility for benefits."

Quick Recap

On February 11, my son and I went to Mercer County One Stop Career Center to file for his umemployment compensation. We were sent there by The Mercer County Board of Social Services, which needed my son to find out his eligibility for umemployment so to determine whatever amount of adjustment could be made in his Food Stamps. He needed to get his Food Stamps adjusted because he was no longer receiving part-time wages from his cashier job at Walmart. He had to leave that job to attend a partial hospitalization program for continuing treatment of his mental illness. (See the blog entry from February 11. Scroll down to "Filing for Unemployment, Just To Get Denied".)

After filing his claim at the Career Center, a couple of days later my son received a form letter saying that he was not eligible for general unemployment comp. Thus his Food Stamps were adjusted. But on the day he filed, he heard from the LDW Re-employment Call Center's Mr. Levy that his disability might make him eligible for another form of unemployment comp. Today's appointment is therefore important for helping us determine this.

Trying To Comply, But Can't Get Through...

As another requirement for eligibility, every Wednesday (including yesterday) my son is now supposed to call another LWD number which responds with an automated system to verify his availability for work, job search progress, etc. (You know the type..."For the period from Feburary 6 to 13, were you able and available to work? If yes, push 1. If no, press 2...")

My son tried to make the call yesterday as required. Trouble is, the call center numbers provided all responded the same: "Due to the high call volume of calls, we can't take your call right now. Please call back later." So through no fault of his own, he wasn't able to comply with the requirement .

We'll take this up with the examiner when (if?) he calls. We're now 90 minutes into the 120 minute window for the call... I'm having trouble holding my distractable son's attention... He's gone off to exercise on the stationary bike...

Four hours later...

It's now 3:20 pm. No call from the Claims Examiner.

Good News: The System Adjusts His Food Stamps

Aspect of Need addressed: Financial

Following up our previous visit to the Mercer County Board of Social Services ("BOSS") to get my son's Food Stamps adjusted (see that blog entry), there is good news. I called the case worker, Mr. Holloway, who told me that the adjustment has been made.

This adjustment is good for two years, when my son will be "recertified", unless his situation changes. If my son moves or secures another job, he will at that time have to report back to the BOSS.

[Note: "Food Stamps" is the old name for what is now called "SNAP", or the Supplemental Nutrition Assistance Program of the US Department of Agriculture, which is funded by the USDA through the states. In New Jersey's case, SNAP funds pass through the New Jersey Food Stamp Program of the Division of Family Development of the NJ Department of Human Services. The application for and management of SNAP funds to eligible individuals is handled at the county level, which in my son's case is at the Mercer County Board of Social Services. --Ed.]

You'll recall that my son's SSI has been increased. This resulted from the loss of his part-time work (when he had to go for all day medical treatment over a period of time) and the wages that it generated. His overall income, now being only SSD and SSI and no longer including his part-time wages, has dropped to only $695 per month. So he needed to get his Food Stamps increased to more able to pay for food. While he was working, his Food Stamps allocation was $60 per month. The good news from Mr. Holloway is that now this will be increased to $181 per month.

So, effectively his gross disposal income will now be $876 per month.

Subtract from that his rent of $388 (more about his new subsidized apartment in a later blog entry...).

That leaves $488.

From this amount he will have to pay for food (supplemented by the $181 of Food Stamps), gas and electricity, and telephone. Yesterday my son asked about internet and cable. These would cost about $80 per month.

So, for these calculations one can see a withering reality: that a psychiatrically disabled citizen on SSD and SSI lives on the absolute bottom rung of the American economic ladder.

Tangled Up: Verizon's Lifeline A PsychoSystemic Noose?

Aspect of Need addressed: Financial

Thinking about my disabled son's future need to be able to receive financial credit, as necessary to be able to access a credit card or apply for a mortgage, I hatched a plan to help him build his own credit history. The first thing I did was to put my home telephone service under his name. My service provider is Verizon. My telephone service is for one line with DSL service and a particular package, called a Freedom Package, that bundles DSL, long distance, and line service all together.

After I changed the account name early last year, some time later Verizon sent my son a notice. It read:

"We're pleased to let you know that you can receive a special discount on your local Verizon phone service. Based on information from the New Jersey Departments of Human Services or Health and Senior Services, we've been notified that you are eligible for the Lifeline Program."

The "Lifeline Program" is the Verizon Lifeline Communications Program, established in New Jersey during the McGreevey administration. The program provides a monthly discount of up to $13.28 on basic phone service. Verizon will automatically enroll phone customers when they participate in at least one of eight state assistance programs for residents with low incomes. In addition, the company will allow seniors 65 years and older who meet income guidelines to enroll in the program simply by providing proof of income to Verizon.

The notice continued:

"Lifeline provides monthly discounts on basic telephone service. That means you can save up to $13.28 every month on your local phone service. However, before you can take advantage of Lifeline, you must mean certain requirements:

• You can only have one phone line in your house.
• You cannot purchase any Local, Regional, or Freedom Package."

According to a Verizon press release, to be eligible for automatic enrollment, customers must participate in at least one of these eight New Jersey state programs:

• Food Stamps
• General Assistance
• Supplemental Security Income
• Medicaid
• Temporary Assistance to Needy Families/Work First New Jersey
• Lifeline Utility Credit/Tenants' Lifeline Assistance
• Pharmaceutical Assistance to the Aged and Disabled
• Home Energy Assistance Program

Because he is receiving SSI, Food Stamps and Medicaid, my son is eligible three times over for this program. Good news, I thought. Let's get him signed up!

But wait.

Disability Status Can Open Many Doors...

The availability to my disabled son of this kind of disability benefit underscores a very important support consideration for the mentally ill. The psychiatrically disabled should, if possible, get themselves a proper diagnosis of their illness from a doctor. Such a diagnosis is generally necessary for the Social Security Administration to make determination of disabled status. Such a determination leads to an entitlement to receive Supplemental Support Income, or SSI. And the receipt of SSI opens many doors to other financial support.

...If Only You First Can Get Through Some Gates...

The program requires an application, documentation about the disabled person's disability and finances, and an approval. Step One, then, is to get an application.

Not so easy...

The notice concluded:

"According to our records, you currently do not meet these requirements. However, if you'd like to take advantage of this discount, all you need to do is call the Verizon Business Office at 1-800-427-9977 (Mon.-Fri., 8:30 am-5:30 pm) and we'll remove any non-eligible service, so you can receive the Lifeline discount.

Sincerely,

Verizon Customer Service"

Descent Into Recorded Response Hell

All right. My son doesn't yet qualify. Better call Verizon, like the note says. Pick up the phone, punch in the number, 1--8-0-0--4-2-7--9-9-7-7... Ring. Ring. A recording answers.

"Thank you for calling Verizon. You have reached a non-working number at Verizon. Please call 1-800-VERIZON."

Oops.

OK. Call the new number, 1--8-0-0---V-E-R-I-Z-O-N...

A taped voice answers, "Thanks for calling Verizon, also on the web... Do you currently have a Verizon account? Press 1 for yes..."

I press 1.

"We appreciate you business. Please say or enter your phone number..."

I enter my phone number.

"You entered [xxx-xxx-xxxx]. Is that right?"

I say, "Right."

"OK. I've got your records. You can say Billing and Payments, press 1... or press * for help."

I press * for help.

"OK, here's some help..." The voice precedes to repeat the previous set of instructions. "High speed internet, press 1, Technical difficulty, press 2. Neither of these, press 3..."

Now exasperated, I pressed 0, hoping to short circuit the process.

"In order to transfer you to the right agent, I need to know..." .

I press 3 for "something else". Finally I get transferred "to someone who can help you".

"All representatives are currently assisting other customers..."

And now I wait. Think about what is happening here. I'm just trying to do what the note suggested I do, but now I'm stuck in a recorded-response do-loop. What if the caller is a psychiatrically disabled?

Not Here. Go There.

Last May, when I first called Verizon on my son's behalf, Verizon's rep told me that they would send a Lifeline application. None came. I forgot about this until last month, when I resolved to try it all again. On January 20, I got through to another Verizon rep. She told me that my son would have to get an application one of the agencies providing him one of the qualified services. Since he was getting SSI, he could get it from the Social Security Administration. Once in hand, he should complete the application, then send it in.

Ten days later, when my son visited Social Security's Trenton office to straighten out other details, he asked for the Lifeline Application, but SSA didn't have any. He was directed to the Mercer County Board of Social Services, which administers his Food Stamps.

A week later, my son visited the Board of Social Services to sort out his Food Stamps (which, as it turned out, required him first to get more documentation from other place. Read all about that in my previous post...) So he took the opportunity to ask for a Lifeline application. The case manager, Mr. Holloway, citing staffing shortages, said he was very busy and wasn't able to retrieve one for him just then, that he would send one to him in the mail.

Uh-huh... Still no Lifeline application in hand...

When At First You Don't Succeed...

Yikes. Maybe we ought to call Verizon again to ask just one more time for Verizon to send the application to us. Once again, I punched up the numbers: 1--8-0-0--V-E-R-I-Z-O-N... Once again I navigated the recorded response nonsense. I got to a live voice!

The answer was the same: your son will have to go to one of the agencies to get the application. I protested that he had received the original notice from Verizon saying that he is already eligible, but needed only to call Verizon to remove any non-eligible services.

"He received a notice from us?" the rep sheepishly asked. "Well, in that case..."

BINGO! All we needed to do was to arrange for the DSL currently on the line, an "ineligible" service, to be paid by a credit card. This would allow my son to get his discount, albeit on my telephone line.

Done! The rep took my credit card number over the phone, and now the Lifeline is enabled. What had taken six months to determine now took six minutes to conclude.

Still Not Quite Kosher?...

We're not completely disentangled, however. My disabled son, who unofficially resides with us, officially resides in his own rented apartment close by. Soon we are going to have to connect that apartment with a telephone line. This will mean that we must transfer his name from my telephone account to his own. Wishing to ensure correct compliance with the Lifeline Program's requirements, another time I called Verizon to ask how this could be done.

It turns out that such a transfer of his name from my account to his own account will necessitate a 3-5 day disruption in my DSL service! I'm not sure why. It seems to have something to do with a Verizon policy requiring a new credit check when a service is transferred... I'll have to think that one through... Maybe now that my DSL is being charged to my credit card, my son will be able to transfer his name to his new account without disrupting my DSL... But I don't know...

Such are the mental gymnastics required when taking on The System for the mentally ill. What psychiatrically afflicted loved one could do this without help? (Indeed, what highly capable "normal" family member can?...)

Hassling The System to Revise the Food Stamps

Aspect of Need addressed: Financial

My son and I returned to the Mercer County Board of Social Services this afternoon. We went back to return a paper required to establish his unemployment status. His case worker, Mr. Holloway, needed it to complete his documentation for adjusting my son's food stamps.

Because in December he had to stop his part-time job to receive further medical attention, my son hasn't been working. He has been without his part-time pay for nearly eight weeks. During this time his government financial support has been paying him at a lower level, taking into account his part-time income. Since for now he cannot work, he needs to get his his government financial supports adjusted.

The first step to adjustment was at the Social Security Administration. At the SSA's Trenton Office two weeks ago, he applied to have his SSI adjusted back to its maximum permissible amount. With that adjustment, he could proceed to the second step of getting his food stamps adjusted upwards as well. These, too, had been decreased when he was making his part-time wage. But Step Two required the intercession of another agency, the local county board of social services which administers food stamps.

SSDI, SSI and Food Stamps

Because of his psychiatric disability, the Social Security Administration determined nearly three years ago that my son as a disabled American citizen was eligible to receive financial assistance from the Federal government. This assistance comes in cash from two sources: Social Security Disability Income ("SSDI") and Supplemental Support Income ("SSI"). SSDI is a disability insurance system paid from a fund into which we all pay from our paychecks. SSI is an income support system paid from general Federal government funds to empoverished citizens earning below a certain threshold. Many citizens with mental disabilities are deemed disabled by virtue of their illness. Because their illnesses eclipse them from steady work, many also become poor. SSDI and SSI are unfortunately critical supports for the mentally disabled.

This assistance also comes in a kind of restricted cash, i.e., Food Stamps. (Actually, the program is now called Supplemental Nutrition Assistance Program, or SNAP. It is funded not by the Social Security Administration, but by the Department of Agriculture.) Each month my son's Food Stamp account is creditted with a certain amount, which he can access at a supermarket check-out counter by using a kind of restricted debit card, issued in his case by his local county board of social services. Food Stamps is a Federal program that is funded to state governments. In New Jersey, the State reallocates the funds to the county level, where each of New Jersey's 21 counties administer Food Stamp payments to citizens of their particular counties.

Not So Fast...

On our visit to the County Board last week, we expected that the adjustment would be a simple matter of reporting. That was not the case. Instead, Mr. Holloway needed more information about my son's employment status. "But my son hasn't been working for about two months," I pointed out. "He's been in a partial hospitalization program."

"Did he get laid off from his job?" Mr. Holloway asked.

"Well, no," I said. "He has taken time off to tend to a medical matter.

"You mean he quit the job?" Mr. Holloway responded.

"No, he has left it for medical reasons," I explained.

"He'll have to go to the Labor Department first to file for unemployment compensation," Mr. Holloway instructed. "Before we can increase his Food Stamps, we have to know if he has any unemployment compensation coming."

"Oh boy," I sighed. "And what will that entail?"

Filing for Unemployment, Just To Get Denied

Before he could determine what to do about my son's Food Stamps, Mr. Holloway said that he needed to know if my son would not be receiving unemployment compensation. To determine that, he needed what he called a "denial letter" from the Labor Department (meaning the Division of Unemployment Insurance of the New Jersey Department of Labor and Workforce Development). My son could get that by filing for unemployment compensation and being officially being denied it. To make the filing, Mr. Holloway directed us across town at a local career center.

The next day my son and I returned to Trenton to visit the Mercer County One Stop Career Center. We took a ticket and waited our turn. After a while my son was called to the counter. The clerk asked him some questions, determined that he would not qualify, handed him some badly copied instructions, and sent him across the room to a phone bank. The clerk told him to pick up the phone and speak to whomever would answer.

The phone was linked directly to the Division of Unemployment Insurance's regional call center in Freehold, NJ, about 30 miles away. We waited on hold for about 20 minutes until a voice named Mr. Levy answered. When discussion became technical, my son handed me the phone, and Mr. Levy and I spoke for about ten minutes. He described my son's need to participate in two telephone interviews within the next two weeks. The first would be with a "monetary agent" to determine my son's eligibility for compensation. If eligibility was confirmed, the second interview would be with a "claims examiner" to decide upon the amount of compensation. When Mr. Levy then went to schedule the meetings, limited agent availability (partly caused by State government furloughs) necessitated that the meetings be held in reverse order. So he set phone appointments with my son on February 18 (in eight days time) at 11:20 am for the Claims Examiner and on February 25 at 1:40 pm for the Monetary Agent. (Are you getting all this?...)

Mr. Levy then stipulated a third appointment. On February 17, he said mysteriously, "your son must call a number". Mr. Levy described the requirement for confirming a claim by phone. "Your son will claim benefits for the weeks ending February 6 and February 13. The System [Ah ha! --Ed.] will ask him seven questions from a form that he will first get in the mail. After his answers, your son will be creditted [What?]. Another form will be sent to him..." I wasn't comprehending. I was losing his train of thought to the recesses of bureaucratic oblivion. My focus returned in time to hear him tell me how my son should represent the reason for unemployment. "Since he was not laid off, he will have to get a note from his doctor establishing the cause of his leaving work. [Yikes! Yet another hoop to jump through...] He should fax that note to the Claim Examiner..." But Mr. Levy didn't have the Claim Examiner's fax number!

Well, after all that, my son would receive something: either a confirmation of eligibility and entitled amount, or a letter of denial. We left the Career Center contemplating a possible lag of up to two weeks before my son would receive his determination. Only after that would my son presumably be able to return to Mr. Holloway with the denial letter by which to get his Food Stamps adjusted. Or so was the clear impression Mr. Levy left with us.

Funny thing about the Government, however. It doesn't always work as expected. Just two days later, mail from the Labor Department arrived at home for my son. It was one of those apersonal government missives with the perforated edges to tear first and the overly affixed folded statement that haphazardly ripped when forced open. We had received what Mr. Holloway needed: the denial letter!

So now my son's Food Stamps will apparently be adjusted. We don't yet know by how much. That we will find out when he next uses his Food Stamps card when shopping at the grocery store.

The System, Defined

The following content is copyrighted ©T.H.Pyle 2009. All rights reserved.

So, what is "The System"? What is this beast, this behemoth, this bureaucratic mountain that the psychiatrically disabled must battle?

To tackle this institutional challenge, it is helpful to break it down into its various parts and then to show the interrelationships among all its elements. (The following graphics describe The System in the state of New Jersey. Elements and linkages of The System in other states may be different, although the complexity is similar.)

First we will start with the basics. We will add elements as we go. Beware: the result will look complex. Think about how it will look to someone with a mental illness... daunting? This is the reality that the psychiatrically disabled and their advocates are up against. (Could this be why, as some experts attest, half of all schizophrenics are on the street and homeless? How can such poor souls without advocates possibly manage The System?)

Components

The System has four components. The first component is Needs, both immediate needs and ongoing needs. These are
the many needs that all people have. But regularly capable people don't really have to think so much about these in the course of their lives. They just unconsciously act to fulfill them as they go along. When in recovery, the psychiatrically disabled and those who help them must think about these needs specifically. Services of The System tend to be strictly need specific. To find, secure and sustain these services takes specific planning and persistence. The second component is Services, being the actual services of The System that provides to address particular needs. The third component is Providers, those individuals, agencies and institutions that provide the services. The fourth component is Funders, those entities which finance the service providers.

Aspects of Need

Let's look more closely at the first component, Needs. In the graphic below, fifteen needs are arrayed in a circle. Those in blue represent needs of a more immediate nature: Psychiatric, Medical, and Functional. These are the needs arising most frequently and urgently, especially for an afflicted soul who is florid, cycling, or actively psychotic. But another immediate need is Financial. Many mentally ill are deemed disabled. As such they live meagerly on disability and supplemental income from government sources, currently only about $8000 p.a. They must also secure other supplemental financial services like food stamps, utilities subsidies, prescription drug assistance and Medicare and Medicare. (More about all these in later posts...) Financial need is immediate because the various financial supports and supplements derive from different sources, and they never seem to be either enough of timely.

Then there are the regular, recurring needs. These are Legal, Residential, Occupational, Educational, Political, Recreational, Cultural, Mobile, Emotional, Social, and Spiritual. Each of these will be described in more detail as the PsychoSystemics blog evolves.

Addressing the Immediate Needs

With the Aspects of Needs as our framework, let's investigate how The System addresses immediate needs. The bubbles in white indicate specific services which address particular needs. The blue bubbles represent agencies providing the services. The funding sources are designated at the top of the graphic. For the sake of simplicity, this example shows the funding relationship between a local entity of Catholic Charities ("CathCharities"), a service provider being funding by the Division of Mental Health Services (DMHS) within the New Jersey Department of Human Services ("NJDeptHumServ"). Catholic Charities provides its Program of Assertive Community Treatment ("PACT") to address an afflicted individual's Psychiatric need.

Addressing Subsequent Needs

Now let's add elements addressing three more needs, Financial, Legal, and Residential. needs is a critical step for the psychiatrically disabled. Financial support services come in many forms. Securing some, like Supplemental Support Income ("SSI") opens the door to securing others, like Medicaid (and, later, Medicare), utilities supplements, and additional prescription drug support. Note the geometrically increasing complexity of The System when the funding, now from Federal, State, and County sources, is included.


Addressing All Needs (?)

And so it goes, as The System morphs and complexifies into...



...which leads us to ask some important questions: