Research on Employment Supports for People with Disabilities: Summary of the Focus Group Findings. Public In-Kind Support


In-kind support consists of goods and services that are provided free of charge. Examples of public in-kind support include food stamps, housing subsidies, and health insurance.

Medi-Cal. The California Department of Health Services administers the Medicaid program in California, known as Medi-Cal. Medicaid pays for hospital, doctor, prescription drugs, nursing home and other health services for low-income children and pregnant women and people who are blind, elderly and disabled. In fiscal year 2000-2001, California intends to spend $23 billion on its Medi-Cal program. The following programs are included under Medi-Cal in Los Angeles County:

  • Public-Private Partnership. Through this program, which runs under a Section 1115 Medicaid waiver, Los Angeles County contracts with private community-based clinics to provide primary care.16

  • Aging With Dignity Initiative. The California Department of Health Services runs this program. The Aging With Dignity Initiative extends no-cost Medi-Cal to elderly and needy beneficiaries as well as beneficiaries with disabilities. It also works to improve the quality of long-term health care facilities. It is available to elderly, needy, and disabled beneficiaries of Medi-Cal who earn up to 100 percent of the federal poverty level. The budget for fiscal year 2000-2001 is $91.8 million.17

  • Comprehensive Perinatal Services Program. This is a Medi-Cal fee-for-services program for low-income pregnant women. It aims to lower health care costs by preventing catastrophic and chronic illness in infants and children. It is available to all pregnant women enrolled in Medi-Cal Managed Care in LA County. Services include client orientation, an initial assessment, an individualized care plan, reassessment and postpartum assessment and care plan. Other program goals are a decrease in the incidence of low birth weight in infants and improvement in pregnancy outcomes.18

Medicare. Medicare is a Health Insurance Program for individuals 65 years old and older; some people with disabilities, under 65 years of age; and people with End-Stage Renal Disease (permanent kidney failure requiring dialysis or a transplant). The Health Care Financing Administration (HCFA) administers Medicare, covering 39 million Americans. Medicare has two parts:

  • Part A subsidizes care in hospitals, skilled nursing facilities, hospice, and some home health care. Beneficiaries with a sufficient earnings history do not pay a premium for Part A.

  • Part B helps pay for doctors, outpatient hospital care, and some other medical services not covered under Part A, including services of physical and occupational therapists, and some health services. Part B helps pay for covered medically necessary doctor services. Consumers are responsible for the monthly Medicare premium of $45.50. The cost of Part B may increase 10 percent for each 12-month period that an individual has Part B but did not take it. Enrollment in Part B is optional; the premium is usually deducted from Social Security, Railroad Retirement, or Civil Service Retirement payment.

The original Medicare plan is available everywhere in the United States. It is the most common plan for receiving Medicare Part A and Part B benefits. An individual may go to any doctor, specialist, or hospital that accepts Medicare. Some people also have access to Medicare Managed Care Plans. Under the Managed Care Plan, an individual is restricted to doctors, specialists and hospitals that are part of the plan. Plans must cover all Medicare Part A and B benefits. Some plans cover extras, like prescription drugs. Private Fee-for-Service Plans is a new health care choice in some regions of the country. An individual may still see any doctor, specialist, or hospital. Plans must cover all Medicare Part A and B benefits. Some plans include extras, such as extra days in the hospital. The plan, not Medicare, determines the cost to the consumer.

Healthy Family Program. The California Department of Health Services runs the Healthy Family Program. It is a low-cost insurance plan providing health, dental and vision coverage for children who do not qualify for no-cost Medi-Cal. Families with incomes at or below 250 percent of the Federal Income guidelines, children who are 18 years of age or younger, and children without employer-sponsored health insurance in the last three months are also eligible for the Healthy Family Program. The budget for this program for fiscal year 2000-2001 is $336 million.19

Access for Infants and Mothers (AIM). AIM is administered by the California Department of Health Services. It provides health insurance for women during pregnancy, and for 60 days postpartum. It also provides health insurance to the child for up to two years of age. It is available to pregnant women without insurance as well as pregnant women with insurance, but who have maternity deductibles or co-payments greater than $500. The Fiscal Year 2000-2001 State budget allocated $44.9 million for this program.20

Child Health and Disability Prevention Program (CHDP). This program is administered federally by the Department of Health and Human Services, and locally by the Los Angeles County Department of Health Services. CHDP provides low and moderate-income families complete access to preventive exams, including immunization, and blood and urine tests. The program is available to low/moderate income families with Medi-Cal. The annual budget for this plan is $85 million.21

Acquired Traumatic Brain Injury Project. The California Department of Mental Health administers this program. Services are targeted at persons 18 years of age or older who have sustained (after birth) an injury resulting from an external force to the brain or any of its parts, resulting in psychological, neurological, or anatomical changes in brain functions. The Acquired Traumatic Brain Injury Project provides individual case coordination, supported employment, intensive day treatment, and structured living arrangements. The budget for this program is $500,000 annually.22

Caregiver Resource Centers. This program, run by the California Department of Mental Health Services, provides multiple services to the families and caretakers of persons with adult-onset brain disorders. Services offered include legal advice, information, long-term planning and consultation, support groups, education, and respite care services. The annual budget is $9,247,000.23

Children's System of Care. The California Department of Mental Health administers the Children's System of Care. This system provides treatment to children with severe mental disabilities. The program integrates the various child-serving agencies and systems to collaboratively provide special education, child welfare, health, and increasingly, juvenile justice services. It redirects monies and resources from institutional care puts these funds into local levels of care, as well as improving service planning, delivery and evaluation across departments. The goal of these changes is an improvement of overall care to clients that have serious emotional disturbances by providing treatment in the child's home or community.24

Early and Periodic Screening, Diagnosis and Treatment (EPSDT). Sponsored by the California Department of Mental Health, EPSDT is a comprehensive health program available to Medicaid-eligible beneficiaries under 21 years of age. It provides periodic health check-ups, developmental and nutritional appraisal, vision and hearing screening, health immunizations, and health education.25

California Major Risk Medical Insurance Program. The California Major Risk Medical Insurance Program is overseen by the California Department of Health Services and administered by the Managed Risk Medical Insurance Board. This program provides health insurance to California residents who are ineligible for Medicare and can not get insurance on the open market. The budget for the Major Risk Medical Insurance Program is $40 million.26

In-Home Supportive Services (IHSS). The California Department of Social Services manages IHSS. IHSS offers a wide range of services including housekeeping, shopping, cooking, laundry, and personal care. The services are available to persons with disabilities, persons aged 65 or older, or persons who are blind and unable to live safely at home without help. They are also available to persons who are financially unable to purchase these services. IHSS is available to legal residents of California only. The program is maintained with funds from the State General Fund, the County Services Block Grant, Federal Title XIX, and County matching funds.

Adult Protective Services (APS). APS is overseen by the California Department of Social Services and administered at the county level by county APS service. APS provides counseling, financial advice and advocacy for its clients. The program also works to spread information on adult abuse reporting laws. The service is available to any individual, regardless of income.27

Integrated Care Management Project. The Integrated Care Management Project is a demonstration whose main goal is the ability to provide long-term services that allow a case manager to link a recipient with a wide range of services, while utilizing all informal supports and funding sources. In Los Angeles County, this project is administered by the Community and Senior Services Agency on Aging of Los Angeles County in partnership with the Adult Protective Services program, the Los Angeles County Department of Public Social Services, and the California Department of Social Services. The Integrated Care Management Project is available to individuals 18 years of age or older with one of the following: Impairment in one or more activities of daily living (e.g. eating, bathing, dressing); impairment in two or more instrumental activities of daily living (e.g. shopping, cleaning, meal preparation); or inability to manage daily affairs due to emotional or cognitive impairment. The budget for this program is approximately $5.5 million annually.28

AIDS Drug Assistance Program (ADAP). This program provides drugs to HIV patients who could not otherwise afford them. It is run by the Professional Management Development Corporation (PMDC) under contract to the California Department of Health Services. ADAP is provided for residents of California aged 18 or older who are diagnosed with HIV, ineligible for Medi-Cal or other third-party payer, and who have a Federal Adjusted Gross Income of less than $50,000.29

Comprehensive AIDS Resources Emergency Act 1990/ Health Insurance Premium Payment (CARE/HIPP). CARE/HIPP pays the health insurance premiums of individuals who are disabled and unable to work because of HIV/AIDS. The program is administered by the California Department of Health Services.30

California Children Services. The Los Angeles County Department of Health Services directs this program in Los Angeles County. CCS provides medical therapy units (MTUs) to children with disabilities. Children ages birth to 21 years with neurological, neuromuscular and complex orthopedic conditions are eligible for this program.31

California Partnership for Long-Term Care. The California Partnership for Long-Term Care provides long-term care insurance protection in cooperation with private health insurance companies. The program is statewide, and targets elderly citizens.32

Federal Food Stamp Program. California administers the federal Food Stamp program, through the Department of Social Services. The program is statewide, and is available to eligible participants in the CalWORKS (California's welfare-to-work project) program. This program provides cash benefits to aid in paying for food. The amount of food stamps a low-income person or family can receive is based on the United States Department of Agriculture's Thrifty Food Plan. The Plan estimates how much it costs to provide a household with nutritious low-cost meals. Estimates are revised yearly to keep pace with changing food prices. The United States Department of Agriculture funds 100 percent of the cash benefits, and administrative costs are broken down as follows: Federal--50 percent; State--35 percent; County--15 percent.33

California Food Assistance Program (CFAP). CFAP stems from an agreement between the State of California and the United States Department of Agriculture that includes a coupon purchase plan for the purchase of federal Food Stamps. CFAP is a state-funded program providing federal food stamps for legal non-citizens legally present in the United States prior to August 22, 1996 and determined ineligible for federal food stamp benefits solely due to their immigration status.34

Assistance Dog Special Allowance. This program provides a monthly allowance for the feeding, care, and maintenance of guide, signal or service dogs. This program is available to persons who are deaf or have hearing impairments, persons who are blind, and persons with disabilities. In order to be eligible, the candidate must be a recipient of SSI/SSP or In-Home Supportive Services. The California Department of Social Services administers this program.35

Low-Income Home Energy Assistance Program. The Low Income Home Energy Assistance Program (LIHEAP) is a statewide program, funded by the federal Low-Income Home Energy Assistance Program Block Grant. The California Department of Community Services and Development administers the program. LIHEAP provides subsidies (average $300) to help low-income families pay the cost of home heating bills. The gross monthly income of a family determines the family's eligibility for this program.36

Department of Energy Weatherization Assistance Program (DOE WAP). The California Department of Community Services and Development runs DOE WAP. This program reduces heating and cooling bills by improving the energy efficiency of homes. It is available statewide to low-income households, with a special focus on the elderly, persons with disabilities, and families with children.

Community Service Block Grants (CSBG). CSBG's provide low-income households with food, shelter and healthcare needs. The goal of the program is to provide assistance in attaining self-sufficiency. The program was created by the federal Omnibus Budget Reconciliation Acts of 1981 and administered by the California Department of Community Services and Development.37

Homeowner and Renter's Assistance. This program offers payments based on the percentage of property taxes assessed and paid on the home, or taxes paid indirectly through rent. It is available to those who are blind, have disabilities, and/or are 62 years of age and older. The California Franchise Tax Board oversees this program.38

Supportive Housing for Persons with Disabilities. This program provides interest-free capital advances to nonprofit organizations that build, rehabilitate, or purchase rental housing to be used as supportive housing. The Department of Housing and Urban Development administers this program.39

Community Care Facilities. The California Department of Developmental Services oversees this program. These facilities provide 24-hour non-medical residential care to children and adults.40

Family Home Agency. This program is maintained by a non-profit organization under contract to the California Department of Developmental Services. The agency approves homes offering space for up to two developmentally disabled adults to live in a family environment. This program is distributed throughout the state, and administered through 21 regional centers.41

Foster Family Agency. Foster families are residential options for children with developmental disabilities. Foster Family Agencies are responsible for the recruitment, training, and certification of foster homes. They must also provide continued support to certified parents and the children living with them. The California Department of Developmental Services administers this program statewide, but the actual services are provided through regional centers.42

Independent Living Program. The California Department of Developmental Services oversees this program. The Independent Living Program provides and/or coordinates support services for individuals in independent living settings. The program's services focus on functional skills training for adults who have acquired basic self-help skills.43

Supported Living Services. The California Department of Developmental Services oversees this program. These services offer support to adults with developmental disabilities that choose to live in homes they own or lease.44

Cal-Mortgage Program. The Cal-Mortgage Program allows non-profit health facilities to borrow funds from long-term lenders for facility construction, improvement, and expansion. The 2000-2001 fiscal year budget allocated $1.8 million for this program, which is administered by the California Office of Statewide Health Planning and Development.45