PBRC Public Benefits Screening Chart8 by trinidadc


									PBRC Public Benefits Screening Chart (Use only for quick reference: Consult Manual for further information)

PROGRAM/PG # Access-A-Ride

BENEFITS Paratransit system for disabled individuals who cannot use regular public transportation.

ELIGIBILITY Must have disability that prevents passenger from using public transport some or all of the time.

ADMINISTRATION NYC Metropolitan Transit Authority (877) 337-2017

Transportation ADAP Plus /APIC

ADAP Plus: Free medical services including prescription drug coverage, primary care and home care for people with HIV/AIDS APIC: Health insurance coverage for individuals with AIDS

* Diagnosis of HIV/AIDS * Uninsured or under insured * Resources under $25,000 * Gross annual income under; 1-$44,000 2-$59,200 3 or more $74,400 * For APIC the applicant must have high insurance costs that poses financial hardship. The client must be “at risk”, that is, in need of protection from actual or threatened harm, neglect, or hazardous conditions caused by the action or inaction of either the client him/herself or other individuals.

NYS ADAP Plus Hotline (800) 542-AIDS (2437)

Medical Coverage

Adult Protective Services

Provides services to adults age 18 or older who, because of mental or physical impairments, can no longer provide for their basic needs for food, clothing, shelter or medical care.

Central Intake Unit (212) 630-1853

Crime Victims SErvices

AIDS Health Insurance Program (AHIP)

Assists low-income individuals with HIV/AIDS maintain their insurance coverage. Pays health insurance premiums on existing insurance; will not subsidize new health insurance.

* Diagnosis of HIV/AIDS


* Unemployed or working part-time and eligible to continue insurance plan from former employer, or self employment
* Gross household income below 185% FPL

Medical Assistance Program
(212) 630-1152

Medical Coverage

Child Care (Publicly Funded)

Free or low cost child care for children 2 months to 12 years old.

* Parents must be in need of day care (working, etc.) * Income limits for free or subsidized day care

Administration for Children Services (877) 543-7692

Child Care/Child Support Child and Dependent Care Tax Credit

Federal tax credit for working families with child and dependent care expenses.

* Caring for a child or dependent adult * Have income from earnings * Only work-related child and/or dependent care expenses will be credited

U.S. IRS Federal: (800) 829-1040 NYS Dept Taxation & Finance State: (800) 225-5829 CHP Hotline at the NYS Department of Health (800) 698-4543 (800) 522-5006 (Growing Up Healthy)

Tax Credits/Exemptions

Child Health Plus B

Free or low cost health coverage through managed care organizations for children from low and moderate-income families. Fees based on family income.

* Children under 19 years * Not eligible for Medicaid and have no similar health coverage * Has income below 250% FPL for subsidized CHP B

Medical Coverage

Children’ Nutrition Programs

Free or reduced price meals for school children, children in publicly funded childcare, and during the summer.

* Low income for school meal * In a participating program for child care food program * No documentation needed for summer program

Office of School Food and Nutrition Services (718) 729-6100, or (800) 342-3009, or inquire at the child's school or childcare center.


Child Support

Child Care/Child Support

Ensures that legally responsible parents provide financial support for their children. Assists in locating absent parents, obtaining or updating support orders and collecting payments.

Any custodial parent may receive assistance.

NYC HRA Office of Child Support Enforcement, Child Support Helpline (212) 226-7125

Child Tax Credit

Tax credit for families with children, up to a maximum of $1000 per dependent child. Now available as a refund.

A qualifying child must be in the household.

U.S. Internal Revenue Service (800) 829-1040

Tax Credits/Exemptions

Civilian Health and Medical Program (CHAMPVA)

CHAMPVA is a fee-for-service health insurance plan for dependents of 100% permanently and totally disabled veterans.

Spouse or child of a veteran who has been rated 100% permanent and total service-connected disability are eligible.

Veterans Administration (800) 733-8387

Veterans Assistance

COBRA Continuation Coverage Program

Assists persons in maintaining health insurance coverage after loss or reduction in employment

* Monthly gross income of no more than 100% of the Federal Poverty Level * Resource limit: 1-$4,000 2 or more $6,000

NYC Human Resources Administration Medical Assistance Program (877) HRA-8411

Medical Coverage

Certain burial funds or prepaid arrangements, depending on category, may be allowed in addition to the resource levels. * Apply within 60 days of end of coverage *Must be legally blind *Immigrants must be legally permitted to work in the United States, and *Must be residents of New York State

Commission for the Blind and Visually Handicapped

Provides vocational rehabilitation to legally blind individuals who are unable to work and who demonstrate the motivation and potential to become gainfully employed.

CBVH (212) 961-4440 (212) 825-5710

Employment and Training Crime Victims Compensation

Partial financial compensation for loss or injury sustained as a result of a crime.

* Victim of a crime who has sustained injury

NYS Crime Victims Board (718) 923-4325

*Victims of domestic violence, drunk drivers, hit & runs and other crimes
Crime Victims Services * Expanded benefits available for elderly (60+) and disabled crime victims

Department for The Aging Senior Employment Programs (New York City)

The Senior Employment Unit employment and training programs to help older adults return to the work force and the Foster Grandparent Program provides opportunities for seniors to provide to work with children with special needs and children in schools and hospitals.

The Senior Employment Unit: *Must be 55 years of age or older *Legal resident *Income up to $11,225 & married couples with income up to $15,150.

Senior Employment Unit (212) 442-1353 Foster Grandparent Program (212) 442-3117

Employment and Training

Foster Grandparent Program:
*60 years of age or older

*Must be in good health
Disability Rent Increase Exemption (DRIE) Provides an exemption from future rent increases for eligible renters with disabilities. *Income up to $1,010 per month & married couples with income up to $1,363 per month * Rent controlled, rent stabilized or Mitchell Lama apartment *Have income at or below $18,060 for an individual, $25,932 for 2 or more household members Housing/Homeless * Receiving a state or federal disability benefit NYC Department of Finance www.nyc.gov/finance

Earned Income Tax Credit (EIC)

Federal tax credit for workers with low incomes.

* Have earnings from employment * under $12,120 for an individual ($14,120, if married)

U.S. Internal Revenue Service (800) 829-1040

Tax Credits/Exemptions

* single parent with one child: $32,001 ($34,001, if married) * single parent with 2 or more children: $36,348 ($38,348, if married) Emergency needs resulting from a catastrophic occurrence that was sudden, unexpected or unforeseen. Income guidelines vary by program. EAF – 200% FPL EAA –SSI recipients or found SSI eligible

Emergency Assistance Grants For Families (EAF), for Adults (EAA), for Safety Net Assistance (ESNA)

Cash grants to meet those needs which if not met would endanger the health, safety or welfare of that family or individual, i.e. food, rent, moving expenses, etc.

NYC Human Resources Administration Infoline (877) HRA-8411

Emergency Assistance Grants Elderly Crime Victim’s Resource Center

ESNA – 125% FPL Emergency financial assistance, supportive services, transportation, home security services, etc. Victims of a crime age 60 and over. NYC Department for the Aging, Elderly Crime Victims Resource Center (212) 442-3103

Crime Victims Services

Elderly Pharmaceutical Insurance Coverage Program (EPIC)

Discount on prescription drugs after paying premium or meeting deductible.

* Age 65 or older * Annual income under $35,000-individual; $50,000-couple

NYS EPIC Program (800) 332-3742

Medical Coverage Emergency Food/Hunger Programs

Free meals or supplies of non-perishable food from food pantries, meal sites and soup kitchens operated by churches, and social service organizations.

Organizations set their own criteria. Most are open to all people in need.

Food and Hunger Hotline (866) 888-8777


Expanded In-Home Services for the Elderly Program (EISEP)

In-home services for functionally impaired elderly; assistance with activities of daily living, housekeeping and case management. Free or sliding scale depending on income.

* 60 years of age or older * Ineligible for similar services under Medicaid, Medicare or PSA. * Income level determines cost of services

NYC Department for the Aging (212) 442-1000

Medical Coverage

Family Health Plus (FHP)

FHP provides comprehensive coverage (though more limited than Medicaid). There are no premiums or co-pays.

*Applicants must be at least 19 but younger than 65 years old. *Same citizenship requirements as Medicaid.

The State Health Department’s Family Health Plus Hotline
(877) 934-7587

Medical Coverage

*Must be ineligible for Medicaid, Medicare, or have limited or no health insurance from any other source. *Income: singles up to 100% FPL and for parents with children up to 150% FPL *Resources: 1 - $12,600, 2 - $16,200, 3 - $19,800, 4 - $19,950

Food and Nutrition Program (FAN)

FAN provides nutritional supplements to women and children.

The applicant must be:
*Not currently in receipt of WIC, and

Queens FAN Program (718) 523-2220 Brooklyn FAN Program (718) 498-9208


*Pregnant or have a child under the age of 6, and *They meet the income guidelines.

Food Stamps


Food Stamp benefits are issued monthly through the electronic benefit transfer system, which can be used like debit card at participating food stores. Value of food stamps depends on household size and income.

* Monthly gross income for household of: 1-$1,062 2-$1,430 3-$1,799 4-$2,167

NYC Human Resources Administration Infoline (877) HRA-8411

Households with an elderly or disabled member are exempt from the gross income test

* $2,000 resource limit; $3,000 if at least one member is elderly (60+) or disabled

Half Fare Program/Reduced Fare for the Disabled and Elderly

Reduced fare on public transportation for the elderly or disabled.

* Age 65 or older or * Disabled

NYC Metropolitan Transit Authority (718) 243-4999 MTA Half Fare


(212) 638-7622

HASA – HIV/AIDS Services Administration (formerly DASIS)

Provides specialized benefits and services to individuals and families living with AIDS or HIV illness including case management, rent enhancement, nutrition and transportation supplement, and home health care.

*Documented diagnosis of clinical symptomatic HIV illness or AIDS

HASA Service Line (212) 971-0626 or 2653

Income: Needs Based

Head Start

A comprehensive childcare program providing education, nutrition, health care and support services to children and their families.

* Children ages 3 to 5 * Annual family gross income for a household of: 2-$13,200 3-$16,600 4-$20,000 5-$23,400 6-$26,800 * Monthly gross income for household of: 1-$1,764 2-$2,307 3-$2,850 4-$3,393 * Higher amounts given to families with small children, elderly or disabled residents

Head Start: (718) 361-6758 ACES Information Line (718) 367-5437

Child Care/Child Support

Home Energy Assistance Program (HEAP)

Grants up to $485 per season to assist in meeting household fuel and utility bills. Emergency benefits also available.

NYC HRA Infoline (877) HRA-8411 NYC Department for the Aging (212) 442-4327 Key Span (718) 643-4050

Utilities Key Span Energy Delivery Residential Reduced Rate Discount on Key Span’s basic service charge for low income residents * Customer of Key Span * Recipient of FA, SNA or SSI



Comprehensive health care coverage for prescription drugs, physician's services, hospital, nursing home and home care.

* Monthly net income for household of: 1-$700 2-$900 3-$1,100 4-$1,109 * Adults with no minor children, under 65 and not disabled must meet P.A standard of need. * Pregnant women and infants under age one: 1-$1,685 2-$2,265 3-$2,845 4-$3,425 * Children 1-5years: 1-$1,121 2-$1,507 3-$1,892 4-$2,278 *Children 6-18 years: 1- $843 2-$1,133 3-$1,423 4-$1,713

NYC Human Resources Administration, Medicaid Eligibility Program (877) HRA-8411

Medical Coverage

* Resources for:
1-$4,200 2-$5,400 3-$6,600 4-$6,650

* No resource test for pregnant women and children through their 18th year under expanded income guidelines
*All legally residing immigrants meet immigration criteria

Medicaid Buy-In

Health insurance coverage for individuals with disabilities who are working and who meet certain income and resource guidelines.

Medical Coverage

*Monthly net income must fall below 250% of the federal poverty level (FPL). If income falls below 150% of the FPL, there is no monthly premium, if income falls between 150% and 250% FPL, recipients are charged a monthly premium. * Resources must be no more than $10,000.

NYC Human Resources Administration , Medicaid Eligibility Program (877) HRA-8411


Part A - Coverage for acute hospital care, limited coverage for skilled nursing facility, home health and hospice care. Part B - Partial coverage for physician services, outpatient services, home health visits and durable medical equipment. Both parts have deductibles and coinsurance.

* Age 65 and older and entitled to a Social Security benefit. * Under 65, if entitled to Social Security Disability for 24 months. * Persons of any age who have end stage renal disease and insured * Those 65 and older can purchase coverage. * Recipient is required to pay monthly premium for Part B * Entitled to Medicare Part A and/or enrolled in Part B

Centers for Medicare and Medicaid Services (800) 633-4227 (800) MEDICARE Social Security Administration (800) 772-1213 Centers for Medicare and Medicaid Services (800) MEDICARE

Medical Coverage

Medicare Part D: Prescription Drug Benefit

A prescription benefit providing insurance coverage for drugs through various private drug plans. Plans will offer a variety of options with different formularies at different cost to the Medicare beneficiary.

Medical Coverage

Medicare Savings Program, (QMB, SLMB, and QI - 1)

QMB: Medicaid pays Medicare Part B premiums, deductibles and co-pays. SLMB: Part B premium only is restored to beneficiary's Social Security benefit.

* QMB-Monthly net income for individual-$843; couple-$1,133 * SLMB-Monthly net income for individual-$1,011; couple-$1,359 * QI-1- Monthly net income for individual-$1,138; couple-$1,529

NYC Human Resources Administration Medicaid Eligibility Program (877) HRA-8411

Medical Coverage

QI-1: Part B premium only is restored to beneficiary's Social Security benefit. (Time limited program)

* Resource for QMB & SLMB: Individual$4,000/burial fund $1,500 Couple-$6,000/burial fund $3,000 No resource criteria for QI-1 *Applicants must be current residents of NYC. *Annual income, after allowable deductions, cannot exceed the greater of, 125% of 7 times annual rental or carrying charges for a family with fewer than 3 dependents, or 8 times for a family of 3 or more dependents, or the median income adjusted for household size for the metropolitan statistical area in which the project is located

Mitchell-Llama Housing


Provides affordable housing to low middleincome families. Eligible families are charged a surcharge up to 50% of the basic rent. The basic rent for the project is approved by the supervising agency, either HPD or DHCR.

NYC HPD (212) 863-5610 Affordable Housing Hotline

NYS DHCR (212) 480-6731

New York State Disability Off-the-Job Disability Insurance

Bi-weekly cash benefits to replace, in part, wages lost because of injury or illness. Payable for 26 weeks of disability.

* Disability did not arise out of and/or in the course of employment * Disability must be medically verifiable and prevents the individual from working

NYS Worker's Compensation Board Disability Benefits Bureau (718) 802-6964

Income: Insurance Based

New York Telephone Discount Program

Discount on residential telephone service and connection charges.

* Recipient of FA, SNA, Food Stamps, Medicaid, HEAP, SSI, Veterans Disability Pension or Veterans Surviving Spouse Pension.

(800) 555-5000


Public Assistance (FA and SNA)

Bi-weekly cash benefits for essential shelter, food, clothing and other needs. Benefit level determined by income and household needs.

Households must past 3 income tests: 185% Standard of Need test, 100% FPL test, Standard of Need test

NYC Human Resources Administration Infoline (877) HRA-8411

*Households with children: Standard of Need test: Income: Needs Based 1-$414.10; 2-501.00; 3-$691; 4-$825.70

*Households without children: Standard of Need test: 1-$352.10; 2-468.50; 3-$577.00 4-$687.70

* Resources up to $2,000, or $3,000, if there is an elderly (60+) household member

Public Housing (New York City)

Apartments in city projects. Partial government subsidy based on tenant’s income.

* Priority system based on income * Immigration status affects benefits

NYC Housing Authority (212) 306-2995


Real Property Tax Credit (IT 214) (New York State)

Tax credit or payment of up to $375 for age 65 and over, up to $75 for those under 65.

* Annual gross income of $18,000 or less * Homeowners - home market value $85,000 or less

NYS Dept. Taxation and Finance (800) 225-5829

* Renters - average monthly rent $450 or less (not counting charges for heat, gas, electricity, furnishings or board)

Internal Revenue Service

(800) 829-1040
Tax Credits/Exemptions Safe Horizon Provides victim assistance, advocacy, and violence prevention organization, to anyone who is a victim of a crime. * Crime victim Safe Horizon (212) 577-7700

Crime Victim Services

School Tax Relief (STAR)

STAR reduces the property taxes for New Yorkers who own and live in residential properties throughout the state. There are two School Tax relief programs: Basic STAR and Enhanced STAR.

For Basic STAR, the taxpayer must:
*Be a New York State resident, *Be the owner of a one, two or three-family home, condominium or cooperative apartment, and *Live in the home they own. For Enhanced STAR *Claimants must meet the same eligibility criteria as with Basic STAR, and: *Be age 65 or over, and *Have a household income $67,850 or less. * For NYCHA Section 8 a family’s gross annual income must be below 50% of the area median income (AMI) for NYC. For HPD Section 8 a family’s gross annual income must not be greater than 80% AMI, although for practical purposes HPD’s priority is for those applicants at or below 30% AMI. * Only limited number of applications accepted * Immigration status affects benefits

STAR Program office (212) 361-7660

Tax Credits/Exemptions

Section 8 Rental Assistance

Provides rent subsidies directly to landlord to make up the difference between the full lease rent and a portion of the tenant’s income.

NYC Housing Authority (212) 306-6601


Senior Citizen Homeowner’s Exemption (SCHE)

Tax exemptions of up to 50% on real property taxes, based on income

* 65 years and older * Annual gross income of $34,400 or less

NYC Dept of Finance Exemption Office (212) 361-7660

* Applicant must be an owner - occupant * Owned property for at least one year Taxpayer Assistance Division (718) 935-9500 NYC Department for the Aging (212) 442-1000

Tax Credits/Exemptions Senior Citizen Rent Increase Exemption (SCRIE)

A certificate to low-income seniors which freezes rent at 1/3 of household income. It does not lower rent, but exempts tenant from future increases.

* Used for residential purposes only * Rent controlled, rent stabilized or Mitchell Lama apartment * Head of household 62 or older * Household income under $26,000

Housing/Homeless Senior Citizen and Disabled Housing Programs

Alternative housing options are available to senior citizens and disabled individuals. They include: Shared Housing, Enriched Housing, Adult Homes, and Supportive Housing.

Eligibility guidelines vary by program type. Call for more information.

New York City Department for the Aging (212) 442-1000, 3086 HRA

Housing/Homeless (212) 971-2787

Senior Citizen Nutrition Programs

Provides low or no cost meals at senior centers or home delivered meals to homebound elderly.

Age 60 and over.

NYC Department for the Aging (212) 442-1000

Food/Nutrition Social Security Disability Insurance (SSDI)

Monthly cash benefits to disabled workers and their families based on prior payroll contribution. Medicare benefits after 24 months of disability.

* Severe mental or physical impairments that prevent the individual from doing any type of substantial gainful work. Disability must be expected to last a year or longer or result in death
* Meet the insured status criteria - prior contribution to Social Security (FICA) payroll taxes and be lawfully present in the U.S.

Social Security Administration (800) 772-1213

Income: Insurance Based

Supplemental Security Income (SSI)

Monthly cash benefits for people 65 and older, blind or disabled. Automatic Medicaid coverage.

* Age 65 and over, legally blind or disabled * Gross income household (if “living alone”) of

Social Security Administration (800) 772-1213

Income: Needs Based

Amount of benefit based on income and living arrangement. Disabled children may also receive benefits.

1-$710, Couple-$1,038 ($20 disregard for unearned income and other disregards for earnings). Different levels for children. * Resource limit: individual-$2,000 couple-$3,000, and burial fund-$1,500 for each spouse

Social Security Retirement and Survivors Insurance (RSI)

RSI is a monthly cash benefit for retired workers, who have worked in covered employment, and their dependents and survivors of covered workers.

* Meet the insured status criteria - prior contribution to Social Security (FICA) Payroll taxes and be lawfully present in the US.

Social Security Administration (800) 772-1213

Income: Insurance Based Transitional Child Care for Family Assistance Recipients

Assists Family Assistance recipients, whose cases are closed for employment reasons, with transitional childcare for up to 12 months after the case’s closing date.

*Case closed for employment related reasons *Income is at or below 200% of the FPL *Was in receipt of benefits for three of the past six months.

HRA Office of Employment Services - Work Related Benefits Program

Child Care/Child Support *Childcare is needed for children under age 13. TRICARE Health Benefits The Department of Defense health care program that serves active duty and retired members of the uniformed services. Eligibility is determined by the various branches of the uniformed services.

(212) 835-7681 TRICARE for Life 1 (888) 363-5433 TRICARE Senior Pharmacy (877) 363-6337 NYS Department of Labor (212) 352-2631

Veterans Assistance

Unemployment Insurance Benefits

Weekly cash benefits paid to workers who have become unemployed through no fault of their own. Payable for 26 weeks in benefit year.

* Have worked in covered employment for a specific period of time * Be ready, willing and able to work

Income: Insurance Based

Veterans Disability Compensation

Provides a monthly cash payment to veterans disabled injured by active service in the line of duty as well as a monthly payment to surviving spouses, dependent children and dependent parents. A Uniform Benefits Package offering comprehensive health care, provided to veterans and their family members in VA hospitals & other Veteran medical facilities.

*Have been discharge under conditions that were other than dishonorable, and
*Must be disabled by injury or disease incurred in or aggravated by active service in the line of duty or was made worse by active military service. Veterans receive inpatient and outpatient services, including preventive and primary care at any VA health care facility in the country and at any of the Veterans Integrated Service Networks.

Veterans Administration Regional Office (212) 807-7229 (800) 827-1000 Veterans Affairs (877) 222-VETS (800) 827-1000

Veterans Assistance Veterans Health Care

Veterans Assistance

Veterans Improved Disability Pension Benefit

Veterans Assistance

This program provides support for veterans and surviving spouses and dependents of veterans with limited income. Payments are made to qualified veterans to bring their total income, including other retirement or Social Security income, to an established support level.

*Had 90 days or more of active military service, *Permanently and totally disabled for reasons not traceable to military service, *Disabled and unable to work full-time, *No assets available to provide adequate support, and

Veterans Administration Regional Office (212) 807-7229
(800) 827-1000

*Income is below $10,929 a month for a single veteran; $14,313 for a married veteran.

Vocational and Educational Services for Individuals with Disabilities (VESID)

Provides education, training, and employment to emotionally, mentally, and physically disabled individuals.

Participants must have a mental, physical, or learning disability that is keeping them from working or is interfering with their present job.

VESID (800) 222-JOBS

Employment and Training Weatherization

WRAP provides low-income elderly free home energy related services that can lower their energy bills and increase the comfort of their home.

*60 years of age or older, or be the head of household on SSDI and meet all of the following criteria: *Income eligible for HEAP *Reside in a dwelling of one to four units, and *Has high heating bills or cold home during winter. *Worker must be covered under Workers’ Compensation Law, and *Have a disability causally related to an accidental injury "arising out of and in the course of the employment" or to occupational disease * Pregnant women, post-partum women, and children under 5 years. * In receipt of Public Assistance, Medicaid, Food Stamps or have income below 185% FPL

Department for the Aging WRAP Hotline (212) 442-3055


Workers Compensation

Provides cash benefits, up to a maximum of $400 per week, and medical care for workers who become disabled because of an injury or illness related to their job.

Workers' Compensation Board
(718) 802-6600 NYS Department of Health WIC Program (212) 268-7593 (800) 522-5006

Income: Insurance Based Women, Infants and Children (WIC) Nutritious food supplements such as formula, cereal, juice, milk, eggs and cheese obtained by food checks redeemed at grocery stores.


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