FIELD ENTRY INFORMATION TYPE Enter the name of the specific housing benefit HOUSING BENEFIT TEXT or incentive. BENEFIT 1, 2, 3, 4, or 5 Enter the name of the type of the benefit. TEXT Enter the cash dollar value of the benefit, if applicable, for other benefits mark if “YES” BENEFIT AMOUNT they have them, or provide a summary of the TEXT value of the benefit, e.g. reduce rent, housing voucher, etc. Enter the name of the Organization that VERIFIED BY WHOM & verified the benefit type and amount. Enter TEXT how the benefit was verified, e.g. telephone to HOW Metropolitan Housing, etc. OTHER BENEFITS OR CONSIDERATIONS FOR EMPLOYMENT 1 2 3 4 FIELD ENTRY INFORMATION TYPE Planners may use this area to document other OTHER BENEFITS OR benefits that the Individual may receive that CONSIDERATIONS FOR TEXT are not included above and/or financial in EMPLOYMENT nature. MEDICAL INSURANCE OPTIONS FOR INDIVIDUALS WITH DISABILITIES (SHOULD INCLUDE DISCUSSION ON OPTIONS SUCH AS MEDICAID BUY-IN FOR PEOPLE WITH DISABILITIES, MEDICAID/MEDICARE, AND OTHER SPECIAL PROGRAMS SUCH AS SLMB, QMB, 1619, ETC. FIELD ENTRY INFORMATION TYPE Planner should review available medical MEDICAL INSURANCE OPTIONS FOR INDIVIDUALS WITH insurance programs, such as 1619, QMB, DISABILITIES (SHOULD SLMB, and Medicaid Buy In for People With INCLUDE DISCUSSION ON TEXT Disabilities (MBIPWD) so that Individuals OPTIONS SUCH AS MEDICAID understand that they can work and still BUY-IN FOR PEOPLE WITH maintain some medical coverage. DISABILITIES,
FIELD ENTRY TYPE INFORMATION HOUSING BENEFIT TEXT Enter the name of the specific housing benefit or incentive. BENEFIT 1, 2, 3, 4, or 5 TEXT Enter the name of the type of the benefit. BENEFIT AMOUNT TEXT Enter the cash dollar value of the benefit, if applicable, for other benefits mark “YES” if they have them, or provide a summary of the value of the benefit, e.g. reduce rent, housing voucher, etc. VERIFIED BY WHOM & HOW TEXT Enter the name of the Organization that verified the benefit type and amount. Enter how the benefit was verified, e.g. telephone to Metropolitan Housing, etc. OTHER BENEFITS OR CONSIDERATIONS FOR EMPLOYMENT 1 2 3 4 FIELD ENTRY TYPE INFORMATION OTHER BENEFITS OR CONSIDERATIONS FOR EMPLOYMENT TEXT Planners may use this area to document other benefits that the Individual may receive that are not included above and/or financial in nature. MEDICAL INSURANCE OPTIONS FOR INDIVIDUALS WITH DISABILITIES (SHOULD INCLUDE DISCUSSION ON OPTIONS SUCH AS MEDICAID BUY-IN FOR PEOPLE WITH DISABILITIES, MEDICAID/MEDICARE, AND OTHER SPECIAL PROGRAMS SUCH AS SLMB, QMB, 1619, ETC. FIELD ENTRY TYPE INFORMATION MEDICAL INSURANCE OPTIONS FOR INDIVIDUALS WITH DISABILITIES (SHOULD INCLUDE DISCUSSION ON OPTIONS SUCH AS MEDICAID BUY-IN FOR PEOPLE WITH DISABILITIES, TEXT Planner should review available medical insurance programs, such as 1619, QMB, SLMB, and Medicaid Buy In for People With Disabilities (MBIPWD) so that Individuals understand that they can work and still maintain some medical coverage.