THE TICKET TO WORK AND WORK INCENTIVES IMPROVEMENT ACT

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THE TICKET TO WORK AND WORK INCENTIVES
IMPROVEMENT ACT
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What is the Ticket to Work Program?

• An employment program administered by SSA
• 18 through 64
• SSDI and SSI
• Every MH Consumer who gets a disability check of
  any amount from SSA has a Ticket voucher worth
  over 20,000
• Increases choices in obtaining services
  supports to obtain and maintain employment
  leading to self-sufficiency

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Why do Beneficiaries want to use their Tickets?

• Voluntary and free to the beneficiary
• Can postpone regularly scheduled medical
  Continuing Disability Reviews (CDRs)
• Medicare Medicaid can continue
• If the beneficiary stops working, there is an
  expedited reinstatement to benefits
• www.socialsecurity.gov/redbook/

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How Do Beneficiaries Participate?

• A paper Ticket is mailed when SSDI or SSI
  benefits are approved
• If already on disability benefits, the Ticket may
  have been mailed some time ago
• Paper Ticket is not needed to participate
• Beneficiary decides whether to use the Ticket and
  when and where to assign it.

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About Employment Networks (ENs)

• ENs are approved by SSA to provide services and
  supports to Ticket Holders
• Ticket is performance based payment - SSA pays
  the EN based upon the beneficiary attaining
  specific Milestones and Outcomes related to work
  and earnings
• (not fee-for-service)
• ENs can be private (for profit non-profit)
  organizations, government agencies, employers and
  other service providers that offer education, job
  training and employment services

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How Do Beneficiaries Get Services?

• Once a beneficiary chooses an EN
• EN and the beneficiary negotiate an
  Individualized Work Plan (IWP) which can be
  integrated into treatment planning process
• EN submits the plan to MAXIMUS -- Triggers Ticket
  assignment
• EN provides the services and supports outlined in
  the negotiated plan
• When the beneficiary goes to work, the EN submits
  a payment request form and evidence of earnings
  to MAXIMUS payments received within 30 to 45
  days

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Myth 1

• Nobody wants to work!
• Estimate about 2 Million interested in work
• Nearly 1 Million are MH consumers
• Aug 2008 210,000 Tickets assigned
• Oct 2009 270,000 Tickets assigned!
• About 1,000/mo being assigned now
• 85 unemployment rate among people with a serious
  mental illness most want to work.

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Myth 2

• You cant make any money with Ticket!
• New rules mean money is available sooner
• Theres more of it
• Some payments based on Ticket Holder earnings
  consistent with part-time work
• You may need to change your model to 25 hrs/wk
• Payments for SSI-only now closer to those for
  SSDI beneficiaries
• Ticket payments are part of a braided funding
  package, fills gaps in VR and Medicaid funding

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Phase 1 Milestones
Milestone 2 1,211
Milestone 1 1,211
4,844
Milestone 3 1,211
Milestone 4 1,211
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Phase 1Milestone Payments2009 Rates
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Phase 2 Milestone Payments2009 Rates
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Outcome Payments Under Outcome-Milestone Payment
System
2009 Rates
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Availability of Phase 1 Milestone Payments

• Phase 1 Milestones are not available to an EN in
  some circumstances
• When beneficiary assigns Ticket to an EN after VR
  case closure in employment
• When beneficiary had trial work level earnings in
  18 months before Ticket assignment

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See for Yourself!

• Look at the people you served last year and use
  SSAs EN Revenue Estimator to determine potential
  revenue from the Ticket to Work Program.
• http//www.cessi.net/en_estimator/
• (Actual EN payments depend on a number of
  variables and may be different for each
  beneficiary.)

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www.cessi.net/en_estimator
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www.cessi.net/en_estimator
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And the Results.
Nov-09
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Work Opportunity Tax Credit

• Employers who hire qualified people with
  disabilities can get up to 2,400 in federal tax
  credit in first year (4,800 for veterans)
• Some states offer similar tax credit programs
• If EN is also the employer, can receive both WOTC
  and Ticket payments
• www.doleta.gov/business/incentives/opptax

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Myth 3

• I wont be able to find any Ticket Holders!
• Look at those you are already serving many are
  not working and most want to work.
• Receive beneficiary CD from MAXIMUS
• Requires security clearance
• Develop relationships with SSA Area Work
  Incentive Coordinators (AWIC) and Work Incentive
  Planning and Assistance (WIPA) projects

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Work Incentives Planning and Assistance (WIPA)

• SSA-approved organizations that assist
  beneficiaries in making informed choices about
  work. WIPA services are free.
• WIPA staff
• Are trained to provide information about work and
  Work Incentives.
• Can answer questions about how work will affect
  Federal, state and local benefits.
• Can help beneficiaries find the resources or
  services to achieve individual employment goals.
• Host Work Incentives Seminar Events (WISE).
• www.socialsecurity.gov/work Click on Service
  Provider Directory

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Work Incentive Seminars (WISE)

• At a WISE event Ticket Holders learn about the
  Ticket program and other SSA Work Incentives.
• ENs and community resources are invited to meet
  Ticket Holders and explain the kinds of supports
  and services they can provide
• About 300 events in 2009 with 3700 Ticket
  Holders!
• More than 1,000 Ticket Holders attended WISE in
  October! (20 events scheduled this month)
• To find out if a WISE event is happening near
  you, visit www.cessi.net/WISE

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Myth 4

• The Ticket program doesnt work!
• Ticket is working better than ever
• Beneficiaries are assigning their Tickets and ENs
  are getting paid
• As of October, more than 260 ENs had between 10
  and 100 Tickets assigned, an almost 50
  improvement over last year

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Tickets Assigned
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Ticket Payments
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Myth 5

• Were too small to make it work for us.
• Some providers may have smaller numbers of
  beneficiaries ready to go to work at Trial Work
  and/or SGA levels
• Those providers may question becoming an EN. By
  joining together
• Only 1 RFP needs to be submitted
• Administrative duties handled by central point
  services provided locally
• Agreement needed to share Ticket payments

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Examples of Coalitions

• When similar organizations want to band together
  to minimize the burden of paperwork, etc. (e.g.,
  a group of county mental health offices in a
  state)
• When different organizations that each serve the
  same client want to partner to ensure seamless
  access to services (e.g., a homeless shelter, a
  private rehabilitation counselor and a Goodwill
  training facility that are all in the same
  general location).
• The partnering organizations may form a new
  business entity to become the EN or, more likely,
  one of the partners will be the EN of record and
  the others will be listed as "satellite location
  sites."

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Myth 6

• A consumer cant be served under VR and Ticket
• VR funding and the Ticket can pay for sequential
  but not concurrent services Partnership Plus
• VR can pay you for SE and then you can receive
  Ticket payments for ongoing supports after VR
  case closure
• If VR is not taking new cases you can be paid
  under the Ticket for job placement and later
  refer to VR for educational or career advancement
  assistance.

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Ticket to Work Stepping Stones to Employment