In this section, we describe the types of supports that are available within each locality, and we briefly compare programs in each category across localities.
Public Income Support. Public income support programs supplement income through direct cash payments. These are primarily federal (and federal/state) programs, including Social Security Disability Income (DI), Supplemental Security Income (SSI), Department of Veterans Affairs (VA) programs, and Workers' Compensation (WC). DI and SSI are designed specifically for people with disabilities. Other programs, such as VA and WC programs are not designed specifically for people with disabilities; however, a large percentage of individuals who receive program benefits have disabilities or have a child with a disability, so we include them here.
All three states provide public income support programs through DI, SSI and Workers' Compensation, and the participation requirements and features of these programs vary somewhat by state. The rate of SSI participation is about twice as high in California (3.2 percent of the population) as in New Jersey or Washington (1.8 and 1.7 percent, respectively) (Committee on Ways and Means, 2000).
Transitional Income Support. Transitional income assistance programs are designed to provide temporary assistance to unemployed or otherwise disadvantaged individuals and families. Typically, these programs have restrictions on the receipt of such benefits, in terms of eligibility criteria and the amount of time an individual can receive payments. The major programs available under this category are Temporary Assistance for Needy Families (TANF), General Assistance (GA) and Unemployment Insurance (UI). The eligibility requirements, benefits and provisions of the programs vary by state.
All states also provide transitional income support services, primarily through the TANF block grant program and through unemployment insurance. The TANF program operated in California is called CalWORKS (California Work Opportunity and Responsibility to Kids). Persons receiving cash aid under the program are also automatically eligible for food stamps, Medi-Cal (the state Medicaid program), child care, and transportation subsidies. In both New Jersey and Washington, the TANF program is referred to as WorkFirst. In New Jersey, individuals eligible to receive cash assistance under WorkFirst are also eligible for child care, transportation services and health care services. Many participants who leave WorkFirst for employment may be eligible to receive extended child care and medical coverage for up to 24 months, as well as other temporary supports, such as transportation, housing assistance and food stamps. In Washington, WorkFirst recipients are eligible for cash assistance, and subsidies for child care and health care. Help with medical costs is available for up to one year after assistance ends due to employment.
Work activity requirements and time limits on benefit receipt vary by state. In California, TANF recipients with disabilities are exempt from work activity requirements. In New Jersey, people with disabilities may be exempt from work activity, depending upon the severity of the disability. In Washington, individuals with disabilities are not exempt from work activities. Case workers assist TANF recipients with disabilities in the development of individualized service plans that emphasize the capacities of the individual, and require participation in work, training or other activities designed to move the individual toward self-sufficiency. In California, TANF recipients with disabilities are exempt from the 60-month limit on lifetime benefits. In New Jersey, people with disabilities are exempt from time limits only if they are exempt from participating. In Washington, TANF recipients with disabilities are subject to time limits. The maximum benefit available to a family of three (with two children) in California is $626 a month. In Washington, the maximum benefit is $546, and it is $424 in New Jersey (Committee on Ways and Means, 2000).
Each state also provides GA, which typically serves as the program of last resort. In California and Washington, the program provides income support to low-income individuals or individuals with disabilities who are not eligible for any other state program. In California, the program is funded and maintained by the counties employing various standards. New Jersey's WorkFirst New Jersey General Assistance (WFNJ/GA) program provides temporary cash assistance and supports to single adults and couples without dependent children under uniform statewide rules similar to WFNJ/TANF. As of March 2001, approximately two-thirds of the 566 municipal welfare departments transferred administrative authority of GA to county welfare agencies. The remaining one-third of the municipal welfare departments continues to administer their GA programs. The Washington GA program employs uniform statewide rules, as well, and, unlike California and New Jersey, has restricted eligibility for people with disabilities (Gallagher, 1999).
Public In-kind Support. In-kind support consists of goods and services that are provided free of charge. The most prominent of these are Medicare, which provides health insurance to people over the age of 65 and people with disabilities who have received DI benefits for at least 24 months, and Medicaid, which provides health insurance for low-income individuals (including most SSI recipients and some others who have disabilities), respectively. Other programs include food stamps, housing and home heating subsidies. There is substantial variation among these programs across states.
The Medicaid program in California is known as Medi-Cal, and the program pays for hospital visits, physician visits and prescription drugs. A number of programs targeted specifically at people with disabilities and funded through Medi-Cal include the Aging with Dignity Initiative, which provides funding to improve the quality of long-term health facilities for elderly people and people with disabilities. The Child Health and Disability Prevention Program provides immunizations, and blood and urine tests to help prevent disabilities.
The New Jersey Care Program for the Aged, Blind and Disabled provides Medicaid coverage to people with disabilities, and includes early and periodic screening services to prevent disabilities. The Medically Needy component allows individuals to "spend down" the program's income limit to help those with high medical costs (and incomes that are too high to be eligible for the regular Medicaid program) to receive assistance. Washington provides a number of programs through Medicaid to assist people with disabilities, including spend down and prevention programs.
Average Medicaid payments for individuals with disabilities vary by state. In 1998, average payments in California were about $7,000 per person, compared with approximately $14,000 per person in New Jersey and $9,000 per person in Washington (Committee on Ways and Means, 2000). In general, California has the highest allowable income for Medicaid eligibility, followed by Washington and New Jersey (National Conference of State Legislatures, 1996).
All states provide food stamps and run a number of supportive housing and independent living programs, as well as a variety of access and assistive technology programs.
Education and Rehabilitation. Education and rehabilitation programs are designed to help individuals invest in developing their abilities and skills, often with the primary goal of helping individuals become employed and self-sufficient. The major programs and policies include the Individuals with Disabilities Education Act (IDEA), which mandates that states provide a free public education, in the least restrictive setting possible, to students with disabilities. The Workforce Investment Act governs federal job training programs, adult education and literacy programs, and VR programs, with the purpose of coordinating service delivery to needy individuals. A variety of state and local programs also provide education and rehabilitation services.
All states provide a variety of education and training programs, including vocational rehabilitation and other training services. In California, individuals can participate in Internet and other job search services, work activity program services (which include supportive habilitation services), and Head Start, which includes Family Resource Centers that link families with disabled children to support networks. In Fiscal Year 1998-1999, approximately 114,000 individuals with disabilities registered with the Department of Rehabilitation, and the state spent $4,019 per case (California Department of Finance, 1999). In addition to the federal/state vocational rehabilitation program, New Jersey residents have access to a technical assistance center funded by NIDDR that provides training, technical assistance and service referrals regarding the ADA to businesses and individuals. In addition to providing services to individuals, Washington emphasizes providing assistance to businesses in training and hiring individuals with disabilities through its Employment Services for Businesses program.
Each state is also developing a One Stop service delivery system, in accordance with the Workforce Investment Act of 1998 (WIA), to deliver integrated employment, rehabilitation, disability benefit and other services. Each state also provides a number of tax incentives to provide income assistance to people with disabilities and to promote the hiring of such individuals. Finally, a variety of non-profit and other private entities offer programs in each state, which we describe in some detail in the appendices.
Community-Based, Private and Non-Profit Programs and Policies. A variety of non-governmental organizations and programs are available to individuals with disabilities within each locality that provide day care services, medical care, housing subsidies, job search services and VR services. A number of national non-profits have a presence in all three localities, such as the ARC, which provides support and services for people with mental retardation and developmental disabilities. The National Federation for the Blind and the Lighthouse for the Blind have a presence in all locations, as well. In the Seattle/Tacoma area, the Tacoma Area Coalition of Individuals with Disabilities is very active, providing a wide array of services, including providing information on housing and employment, job referrals, access to volunteer opportunities, and access to support groups. Within Los Angeles, Tri-City Mental Health Services provides mental health services and independent living training. In Newark, the JESPY house provides independent living skills, vocational training and other services for people with developmental disabilities.
More detailed information regarding local programs in each of the states profiled is available in the sections that follow.