The new Medicaid work and volunteer requirements are very confusing. Healthcare is critical to people living with HIV and 46% of us rely on Medicaid. So we worked with our peers on making them easier to understand. Follow along and learn everything you need to help you maintain Medicaid coverage. That includes whether you are exempt or need to make adjustments to your specific situation. Our toolkit also explain what counts as volunteer hours, who can provide them, and how to track your hours.
What Are the Medicaid Work Reporting Requirements?
Due to new requirements created by the current administration, many states must verify that folks on Medicaid are fulfilling a minimum of 80 hours a month of “Community Engagement.” This means working, looking for work, studying in school performing community services OR earning at least $580 a month.
If you have a verifiable qualifying health condition AND are unable to work, you are exempt from these reporting requirements.
Do This BEFORE Anything Changes With Your Medicaid Access!
This Fall, your state should let you know if you need to take action to keep your Medicaid coverage.
In the meantime make sure of the following:
1. If you’re not sure if you’re on Medicaid, find out ASAP. Remember: States might call Medicaid different things. In Pennsylvania, Medicaid is called “Medical Assistance.” In California, it’s “Medi-Cal.” You can look it the name of your state’s program HERE
2. Your state Medicaid agency has your current information: Make sure that your mailing address, phone number, and email address are up to date so you don’t miss important notices about your coverage.
3. Open and read Medicaid notices from your state: When you receive a letter, text, email, or call from your state Medicaid or your health plan, DO NOT IGNORE IT. It may contain important information about your coverage or renewal.
4. Complete your renewal if you are asked to: If your state sends you a renewal form or asks for additional information, respond as soon as possible and provide any documents requested. We do not want any gaps in coverage!
5. Contact your state Medicaid agency if you have questions: Each state has its own Medicaid program and enrollment process. Your state Medicaid agency can tell you what you need to know about the process.
How to Track Volunteer Hours or Work Reporting Requirements
Volunteering is a great way for people to meet the new work requirement, if they are not working 80 hours a month or making $580 a month or are not exempt from it.
This resource describes how organizations can help people find and document volunteer experiences.
Exemption to Work Reporting Requirements
Some people will be exempt from the Work Reporting Requirement, these exemptions can vary by state and can include the
- Being in a household where someone is already meeting the SNAP or TANF work requirement
- Being enrolled in or eligible for “traditional Medicaid”, Medicare or receiving SSI
- Participating in a substance use disorder treatment program
- Being a totally disabled veteran
- Being a parent or guardian caregiver for a child under age 14 or a disabled family member of any age
- Being pregnant or within 1 year postpartum
- Have been incarcerated at any point in the prior three months
- Being an American Indian, Alaskan Native, or Native Hawaiian
- Being under age 26 and having aged out of foster care while on Medicaid
- Being “medically frail” or having “special medical needs” that interfere with the ability to meet the work requirement:
- Have a “serious or complex medical condition”
- Have a substance use disorder
- Have a disabling mental health condition
- Have a physical, intellectual or developmental disability that significantly impairs the ability to perform 1 or more activities of daily living
- Be certified blind or disabled according to federal law
From The AIDS Institute Fact Sheet on Medicaid Work Requirements
- Alabama
- Florida
- Kansas
- Mississippi
- South Carolina
- Tennessee
- Texas
- Wyoming
Check out PWN’s Summary sheet of Medicaid names, ACA Expansion and 1115 waivers by state, and links to state’s Work Reporting Requirements and Volunteer Hours Reporting
Getting Support From Public or Non-Profit Organizations
Public and Non-profit organizations can help Medicaid recipients document volunteer and community-service hours for Medicaid work reporting requirements.
How? By asking staff or volunteers to maintain accurate records of a member’s volunteer activities. Verified information should include the date, type of service provided, hours completed, and confirmation from the authorized staff. This creates a practical way for organizations to recognize and document the unpaid labor and service of their community.
Please note that states may have different rules about which nonprofit organizations can participate in this process as well as what activities may count towards the 80-hour requirement. Please know that volunteer hours can be combined with work and school hours to add up to the 80-hour minimum.
It is important that you ask organizations you volunteer for how they plan on documenting and reporting your time.
Examples of Organizations that Can Document Volunteer Hours:
Reminder, these can vary by state
A. 501(c)(3) nonprofits: Community organizations, advocacy organizations, service providers, educational organizations, etc. (Like PWN-USA).
B. 501(c)(4) nonprofits: Potentially relevant for organizing, civic engagement, and advocacy activities, depending on the applicable Medicaid rules.
C. Community-based organizations and grassroots nonprofits like AIDS Service Organizations
D. Faith-based nonprofits and charitable organizations.
E. Structured Public Organizations like Health Departments and their planning councils
F. Nonprofit coalitions or networks, when they have an established volunteer program and can verify service.
G. Nonprofit chapters or affiliates operating under a larger nonprofit organization.
H. Organizations that partner with nonprofits, if there is a clear arrangement establishing who is responsible for supervising and verifying the volunteer’s service.
What Can Be Considered Volunteer Work?
*Note, this may vary by state, so be sure to check with your state Medicaid agency to ensure that your volunteer activities count.
Community Outreach & Engagement
- Community outreach and canvassing
- Recruiting and welcoming community members
- Staffing community events
- Tabling, distributing educational or resource materials
- Conducting community education
- Participating in outreach campaigns
- Making outreach calls or sending outreach messages
- Connecting people with community resources
- Travel for community outreach and events
Peer support & education
- Peer education
- Peer support and mentoring
- Facilitating support groups
- Sharing personal experiences in educational settings
- Presenting at community trainings
- Developing educational materials
- Serving on peer advisory groups
- Travel for peer support and education
Advocacy & Civic Engagement
- Travel time to a meeting
- Attending advocacy meetings
- Meeting with elected officials or policymakers
- Participating in public hearings
- Community education about legislation or policy
- Voter education and nonpartisan voter engagement (must be unpaid)
- Participating in advocacy days
- Writing or submitting public comments
- Participating in campaigns or organizing activities
- Speaking at community forums
- Travel for advocacy and community engagement
Organizational Leadership
- Serving on a board or committee
- Chapter leadership
- Participating in advisory groups (unpaid, no honoraria awarded)
- Planning nonprofit programs or events
- Facilitating meetings
- Recruiting and supporting volunteers
- Helping with organizational communications
- Developing newsletters, social media, or educational content
- Participating in strategic planning
- Travel to participate in leadership events
Events & Operations
- Event setup and breakdown
- Travel to an event
- Registration and check-in
- Hospitality
- Transportation coordination
- Food distribution
- Donation collection or distribution
- Administrative assistance
- Data entry or filing
- Translation or interpretation
- Technology or virtual meeting support
- Travel for volunteer work at events
Community service
- Food pantry or food distribution
- Shelter support
- Community clean-up
- Clothing or household-goods distribution
- Community garden activities
- Supporting community resource fairs
- Disaster or emergency-response volunteering
- Travel for community service
PWN-USA Volunteer Work
Leadership and advocacy activities performed on behalf of PWN-USA or a PWN-USA chapter, including organizing, peer education, community outreach, policy advocacy, chapter leadership, advisory participation, voter engagement, public education, and representing the experiences and priorities of people living with HIV.
This includes:
PWN chapter meeting participation
PWN committee/workgroup participation
PWN Cares activities
Membership engagement
Phone zaps
Advocacy days
Legislative meetings
Public comments
Community education
Member outreach
Peer support
Training participation or facilitation
Event planning and support
Conference participation
Preparing presentations or educational materials
Strategic-planning participation
Digital advocacy
Travel to and from PWN events
Volunteer Hours Form
Click HERE to review our sample form.
Volunteer hour tracking forms can be used to track a single event and. gathered in a monthly spreadsheet to generate letters. They should include:
1. Date of event or volunteer hours
2. Volunteer Name, email, phone number
3. Event name
4. Brief Description of the activity
5. Hours tracking travel separately
6. Verification from authorized staff or leader
7. A sign off from the authorized staff or leader
How a Verification Letter Can Look
*Reminder: Please verify if your state requires you utilize their form or if you can submit a letterCheck out PWN’s Summary sheet with links to state Work Reporting Requirements and Volunteer Hours Reporting
This is a SAMPLE of our verification letter.
For Medicaid Community Engagement / Work Reporting
Date
To Whom It May Concern:
This letter verifies that [Member Full Name] performed unpaid volunteer and community-service activities with Positive Women’s Network–USA (PWN-USA) during the period of [Start Date] through [End Date].
During this reporting period, [Name] completed [XX] verified hours of volunteer and community-service activities with PWN-USA.
The documented activities included:
- [Activity]
- [Activity]
- [Activity]
- [Activity]
These activities supported PWN-USA’s mission and included volunteer service such as community outreach, peer education and support, advocacy, organizing, leadership development, public education, chapter activities, community engagement, event support, and representation of people living with HIV.
PWN-USA maintains records documenting the dates, activities, and hours associated with this volunteer service. The hours reported in this letter have been reviewed and verified by an authorized representative of PWN-USA based on organizational records.
This verification is provided to support [Name]’s documentation of volunteer and community-service activities for purposes of Medicaid work/community-engagement reporting requirements. PWN-USA verifies the volunteer service and hours performed.
Please contact [Staff Name and Title] at [email] / [phone] if additional verification of these volunteer hours is required.
Sincerely,
[Name]
[Title]
Positive Women’s Network–USA
[Email]
[Phone]
PWN-USA’s Verification Process for our Members
1. Member completes Volunteer Hour Tracking Form after each event
2. Authorized PWN staff reviews and approves weekly
3. Hours are sorted monthly
4. Letters generated and emailed to member monthly
*Thanks to The US PLHIV Caucus and The AIDS Institute for their shared content, review and dedication to the lives and dignity of people living with HIV.
If you have questions, please contact Barb Cardell: barb at pwn-usa.org