This Just the Facts Series addresses pre-release planning for institutionalized individuals, pre-release planning will ensure that both cash and health care coverage will be available at the earliest possible point in time. Easing the financial burden of meeting rent, food and other necessary expenses can only further ease the transition from institutionalization to independence. Counselors, social workers, BPAO and PABSS staff all have a part in this critical transition process

Cebula, Raymond A, III

English

This Just the Facts Series addresses pre-release planning for institutionalized individuals, pre-release planning will ensure that both cash and health care coverage will be available at the earliest possible point in time. Easing the financial burden of meeting rent, food and other necessary expenses can only further ease the transition from institutionalization to independence. Counselors, social workers, BPAO and PABSS staff all have a part in this critical transition process.SSJ8_PDF1.pdf: 674 downloads, before Oct. 1, 2020.0-SSJ8_TXT1.txt: 23 downloads, before Oct. 1, 2020

Cebula, Raymond A. III

eCommons@Cornell

Pre-Release Planning

DigitalCommons@ILR

February 2005
?Title: Pre-Release PlanningBasic Information for BPA&O and PABSS So, what does it mean?How this applies to you.Benefits Eligibility While InstitutionalizedSupplemental Security Income (SSI)
SSI benefits are generally suspended when an individual is institutional-
ized. This is because SSI benefits are paid in order to meet basic needs.  
When those basic needs (food & shelter) are being met by another 
entity, SSI payments will not be made. In many cases, the other entity 
meeting the basic needs of the individual is the state via placement in a 
state institution or by providing Medicaid funding for the placement.
SSI benefits can be suspended for a period of up to 12 months. After 
twelve months the claim is terminated. This is a very important distinc-
tion. A suspended claim can be revived by simple contact to the SSA 
local office and providing information concerning the individual’s dis-
charge. If the claim is terminated, the individual must reapply for SSI, 
creating the need for a new disability and financial determination.
Individuals who are institutionalized (including those in a private 
facility where Medicaid is, or would usually be, paying for more than 
50% of the cost of care) receive a $30 payment (not including any state 
supplement) to assist in meeting incidentals during the month.
Social Security Disability Insurance (SSDI)
SSDI benefits are insurance benefits and, as such, are not restricted in 
the same ways as are SSI payments. An SSDI beneficiary has worked 
and paid social security taxes in order to become “insured” for disability 
purposes. These benefits are paid to the qualified individual regardless 
of financial circumstances or living arrangement.
However, there is one important exception; the prisoner’s suspension. 
This suspension, unlike the SSI suspension mentioned above, will last 
as long as the individual is confined to a penal institution for at least 
30 days, due to the commitment and conviction of a crime.  POMS GN 
02607.025.
ADVANCING  THE  WORLD  OF  WORK 1
Contact Information:
Employment and Disability Institute
Cornell University
ILR School
201 ILR Extension Building
Ithaca, New York 14853
Phone: 607-255-7727
Fax: 607-255-2673
TTY: 607-255-2891
Email: ilr_edi@cornell.edu
www.edi.cornell.edu
Just the Facts
February 2006
Work Incentives Support Center
For institutionalized individuals, pre-
release planning will ensure that both 
cash and health care coverage will be 
available at the earliest possible point 
in time.  Easing the financial burden of 
meeting rent, food and other necessary 
expenses can only further ease the tran-
sition from institutionalization to inde-
pendence.  Counselors, social workers, 
BPAO and PABSS staff all have a part 
in this critical transition process.
Basic Information for BPA&O and PABSS          by Ray Cebula
The suspension may impact individuals residing in 
state facilities, other than prisons and jails, if the 
individual is being held under a “not guilty by reason of 
insanity” finding. As a result, the circumstances of each 
individual’s institutionalization must be examined to 
insure eligibility.
Should SSDI benefits be suspended based upon 
confinement auxiliary benefits (those paid to dependents) 
will continue to be paid as long as basic eligibility 
criteria are met.
As a general rule however, it is not likely that SSDI 
benefits will be suspended when an individual is 
institutionalized. SSDI benefits payments will continue 
to be made.
Discharging Planning Should In-
clude a Pre-Release Benefits Plan-
ning Component
Discharge planning for institutionalized individuals 
necessarily contains a financial component. Individuals 
with no family members to rely on must find there own 
living situation.
Pre-release will take very different routes depending 
upon the type of benefit being paid to the individual.
SSDI beneficiaries are not likely to have payments 
suspended while institutionalized. As a result, the only 
“planning” that needs to be completed is to assure 
that SSA is aware of the discharge and new address of 
the individual so that payments can be appropriately 
directed. Of course, if work is a part of the discharge 
plan, any work activity and earned income must be 
reported to SSA.
For individuals who have no source of income, appear to 
meet the SSA disability criteria and have a work history 
an SSDI application should be considered. In a pre-
release situation these applications can be “expedited” 
in the hopes of having a decision made and benefits 
payable upon discharge. This application should also 
include any dependents that may also benefit from the 
disabled worker’s work history.
SSDI will bring along Medicare benefits after the first 
24 month period of eligibility for cash payments. As a 
result, Medicaid applications, if appropriate, should also 
be considered during the discharge planning process.
There is no formal pre-release program for SSDI 
payments as the program does allow for retroactive 
payments for up to one year and, other than the 
prisoner suspension, does not impose suspensions for 
institutionalization.
An SSI beneficiary’s benefits will be suspended after 
the first full calendar month of institutionalization. 
If benefits are not suspended timely an overpayment 
situation may develop. Should the term of 
institutionalization last less than 12 months the 
suspension can be lifted immediately upon discharge 
in order to begin a flow of cash funding that will 
assist in both discharge planning and meeting basic 
needs upon discharge.
If the term of institutionalization has lasted more than 
12 months SSI benefits will have been terminated. 
Should this be the case a new application will need 
to be filed with SSA. This application can also be 
“expedited” in a pre-release situation.
SSI comes with Medicaid. This will be processed 
automatically once SSI benefits have been approved. 
Should the SSI application be delayed for any reason, 
a separate application for Medicaid can be filed with 
the state’s Medicaid administering agency.
SSI also serves as a “portal” to many other state and 
federal benefits. The disability status associated with 
the SSI program can open the door to Food Stamps, 
Section 8 and other housing assistance programs.
Pre-release procedures were developed by SSA, 
at the insistence of Congress, to assist in this 
very task. The process was designed to promote 
deinstitutionalization by assuring eligible 
individuals timely SSI payments when they reenter 
the community. The distinguishing feature of 
the pre-release program is that it allows for the 
taking and processing of an SSI application for an 
institutionalized individual several months before 
anticipated discharge. It will also allow for a 
determination of a potential payment amount based 
upon the anticipated circumstances of the individual 
upon release. POMS SI 00520.900(A).
The process is intended to serve individuals who, 
because of institutionalization, are currently ineligible 
for SSI cash payments or are subject to the $30 
federal payment amount. POMS SI 00520.900(A).
2 Just the Facts  |  February 2006
Pre-Release Planning
SSA Pre-Release Planning
Congress has emphasized the need for pre-release 
procedures by enacting legislation requiring SSA to 
provide a way for institutionalized individuals to apply 
for benefits before discharge from a public institution. 
This process can also assist those suspended individuals 
facilitate reinstatement of payments upon discharge. 
POMS SI 00520.900(A).
The pre-release procedure can be used for individuals 
who are:
   •  Not receiving SSI, or
 •  Are receiving the $30 payment level.
POMS SI 00520.930.
A Pre-Release Agreement between SSA and the 
institution will allow for applications to be taken 
prior to discharge. POMS SI 00520.930. However, 
pre-release applications should be accepted without 
regard to whether an agreement exists. POMS SI 
00520.900(C)(1).
A Pre-Release Agreement usually includes the following 
procedures:
1.  The facility identifies potential pre-release 
claimants.
2. The local SSA office regularly contacts the 
institution to solicit the list of potential claimants. 
The facility can also contact SSA with this list. The 
lists should include a name, SSN, DOB, and date 
of admission to the institution for each claimant.
3.  The SSA office and facility coordinate 
appointments with potential claimants to complete 
SSI applications and other necessary forms.
4. The facility notifies SSA of the discharge date in 
order to allow expediting of the SSI claim.
POMS SI 00520.930.
Agreements can also delineate responsibilities on 
the part of both SSA and the facility concerning the 
development of medical and financial files allowing for 
an expedited determination. Further, an SSA local office 
liaison can be selected in order to foster and maintain a 
relationship with the facility. POMS SI 00520.930
The institution is in a unique position to provide 
valuable information to SSA in order to allow for the 
expediting of the SSI determination process. Medical 
evidence in the possession of the institution should be 
provided to SSA without delay. Financial information 
as well is a necessary part of the determination process 
and should be provided immediately to assist in the 
facilitation of the application.
Case processing of a pre-release application is 
controlled by POMS SI 00520.920. Upon receipt of a 
referral from an institution, SSA is required to obtain 
all information and forms required for the initial 
claim or reinstatement. Releases from the individual 
allowing the SSA office to speak with the institution 
staff will also be obtained.
A “release statement” must also be obtained. This 
simply requires the institution to provide a written 
indication that the individual is scheduled for 
discharge or is being considered for discharge and the 
approximate date of the discharge.
SSA will make a determination concerning the 
potential payment amount based upon information 
concerning the individual’s anticipated living 
arrangement upon discharge. This information and 
determination must be re-verified after discharge 
actually occurs.
As indicated earlier, medical development is a critical 
part of the application process. SSA will work with 
the institution to ensure that all medical evidence is 
submitted in a timely manner for consideration during 
the determination process. This information will 
include:
   •  Hospital names and addresses and dates of 
     admission;
   •  Findings concerning orientation, coherence, 
     emotional status, etc.;
  •  Diagnosis;
   •  Course of hospitalization;
   •  Recommendations for post-institutionalization 
     needs;
   •  The individual’s ability to manage funds  
     (physician’s statement); and 
3Just the Facts  |  February 2006
Pre-Release Planning
   •  DDS forms for mental impairment development. 
POMS SI 00520.930.
SSA will immediately refer the case to DDS and mark 
the case as a pre-release case ensuring expedited 
processing by the determination services.
Upon determination, SSA will notify the institution of 
the determination as soon as possible. If the institution 
filed on behalf of an individual, SSA will issue both an 
informal and formal notice. If the individual filed, an 
informal notice will be issued to the institution while 
the formal notice is issued to the applying individual. 
The informal notice to the institution will provide 
information as to when payments can be expected 
so that discharge planning can continue. POMS SI 
00520.920(C).
Conclusion
Discharge planning containing a pre-release component 
will ensure that both cash and health care coverage will 
be available at the earliest possible point in time. Easing 
the financial burden of meeting rent, food and other 
necessary expenses can only further ease the transition 
from institutionalization to independence.
Just the Facts  |  February 20064
Employment and Disability Institute
201 ILR Extension Building
Ithaca, New York 14853
Phone: 607-255-7727
Fax: 607-255-2673
TTY: 607-255-2891
Email: ilr_edi@cornell.edu
www.edi.cornell.edu


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Pre-Release Planning

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