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4 disabled individuals receiving federal TANF assistance, State-funded individuals receiving TAONF, GA, and AABD programs, with the Social Security Administration process for 100% federally funded financial benefits. It is more beneficial for individuals to be determined eligible to receive SSI or SSDI federal benefits, as the federal benefits are higher than our state- funded financial benefits, and the federal benefits are not time-limited. Once an individual is eligible for SSI and/or SSDI benefits, they would be deemed ineligible for state-funded financial assistance, which results in a reduced caseload count and may make state-funds available for other needy families and individuals.

Significantly, when an individual becomes eligible for SSI or SSDI benefits, the Social Security Administration (SSA) reimburses the State the amount of state-funded financial assistance the individual received while the application for SSI or SSDI was pending. This is called the interim assistance reimbursement (IAR) program.

In SFY 2012, 391 individuals receiving state-funded financial assistance were approved for federal SSI/SSDI benefits. In SFY 2013, 342 individuals were approved for federal SSI/SSDI benefits and in SFY 2014, 319 individuals were approved for federal SSI/SSDI benefits. In SFY 2015, 252 individuals were approved for SSI totaling $1,037,330.38 IAR from the SSA to the State. In SFY 2016, 606 individuals were approved for SSI resulting in $1,807,586.99 IAR to the State.

In December 2012, the Hawaii Automated Welfare Information (HAWI) payment system was modified to automate the IAR notification to the Social Security Administration (SSA). Prior to this modification, a manual hard copy IAR agreement was sent by FAX or U.S. mail to the SSA. There were multiple problems with the manual process, such as non-receipt, misfiling and transmittal to the incorrect SSA field office. The modification has made the program more efficient and helps ensure that the State timely receives the reimbursements.

These procedures have been instrumental in transferring persons with long-term disabilities to the federally-funded Social Security programs.

II. MEDICAL PAYMENTS

Medicaid is counter-cyclical, meaning that as the economy worsens the number of beneficiaries increases. Medicaid is an entitlement program where any individual who is determined eligible for coverage must be provided services. The Med-QUEST Division (MQD) provides health coverage through several Medicaid programs under Title XIX of the Social Security Act. The health insurance coverage includes the Hawaii QUEST Integration and the Medicaid Fee-For- Service (FFS) programs. Other smaller health insurance programs include the State Children’s Health Insurance program (S-CHIP), Federal and State-funded Coverage of Individuals with Breast and Cervical Cancer, and Special Programs for Medicare Beneficiaries.

With the implementation of the Patient Protection and Affordable Care Act (2010) (PPACA), Hawaii provides medical assistance to low income adults, parent/caretaker relatives, pregnant