Significant Provisions in the Final Regulations Implementing the

1
Significant Provisions in theFinal
RegulationsImplementing the

• Ticket to Work
• and Self-Sufficiency Program

2
Ticket to Work Program--Purpose

• To expand the universe of service providers
  available to serve individuals entitled to SSI
  and SSDI benefits based on disability in
  obtaining services necessary to find, enter, and
  retain employment

3
Ticket to Work Program--Implementation

• To allow thorough evaluation and ensure full
  implementation of the Ticket program on a timely
  basis, the Program will be implemented in three
  phases.

4
Ticket to Work Program--Implementation--Phase 1

• The Ticket program was launched February 2002 in
  the 13 States
• Arizona, Colorado, Delaware
• Florida, Illinois, Iowa
• Massachusetts, New York, Oklahoma
• Oregon, South Carolina, Vermont
• Wisconsin

5
Ticket to Work Program--Implementation--Phase 2

• The Ticket program was phased into additional
  States and the District of Columbia in November
  2002
• Alaska, Arkansas, Connecticut, District of
  Columbia, Georgia, Indiana, Kansas, Kentucky,
  Louisiana, Michigan, Mississippi, Missouri,
  Montana, Nevada, New Hampshire, New Jersey, New
  Mexico, North Dakota, South Dakota, Tennessee,
  Virginia

6
Ticket to Work Program--Implementation--Phase 3

• The Ticket program will be phased into the
  remaining States and territories in 2003 for
  complete National implementation by 2004
• Alabama, American Samoa, California, Guam,
  Hawaii, Idaho, Maine, Maryland, Minnesota,
  Nebraska, North Carolina, Northern Mariana
  Islands, Ohio, Pennsylvania, Puerto Rico, Rhode
  Island, Texas, Utah, Virgin Islands, Washington,
  West Virginia, Wyoming

7
Eligibility to a Ticket

• All SSI and SSDI disability cash beneficiaries,
  except
• Beneficiaries whose conditions are expected to
  improve, and who have not had at least one
  continuing disability review
• Beneficiaries who have not attained age 18
• Childhood SSI beneficiaries who have attained age
  18, but who have not had a redetermination under
  the adult disability standard.

8
Receipt of a Ticket

• A beneficiary receiving a Ticket
• can choose whether or not to use the Ticket
• can use the Ticket to obtain services from
  employment network of his or her choice, or from
  a State VR agency if he or she qualifies for
  services
• can retrieve the Ticket from the EN or the VR
  Agency and reassign it to another EN or the VR
  Agency

9
Suspension of CDRs--Using a Ticket

• SSA may not initiate a CDR while a beneficiary is
  using a ticket (making timely progress toward
  self-sufficiency)
• A CDR is suspended while the beneficiary is using
  a ticket. The regulatory definition of using a
  ticket provides the beneficiary with a limited
  period to prepare for work, and subsequent
  periods during which the beneficiary must
  demonstrate increasing levels of employment.

10
Use of aProgram Manager

• SSA has contracted with a Program Manager (PM)
• MAXIMUS, Inc., 09/30/00
• PM responsibilities
• Recruit/monitor/recommend ENs
• Facilitate beneficiary access to ENs
• Facilitate payments to ENs
• Resolve EN-State VR agency disputes
• Other administrative duties for SSA

11
Employment Networks

• Employment Network (EN)
• Any qualified State, local, or private entity
• Assumes responsibility for coordination and
  delivery of employment services, vocational
  rehabilitation services, or other support
  services under the Ticket to Work program

12
Employment Networks--Eligibility

• Employment Network
• Can be a single entity or an association of
  entities combining resources
• Can provide services directly or by entering into
  agreements with other organizations or
  individuals to provide the needed services to a
  beneficiary

13
Employment Networks--Qualifications

• All ENs must meet minimum qualifications
• Licensure or accreditation, if applicable or
• Education, or experience
• Non-traditional service providers (such as
  employers, and religious and charitable
  organizations) may be approved as ENs.

14
Employment Networks--Agreements with SSA

• An Open Request for Proposals was published April
  13, 2001
• FedBizOpps http//www.eps.gov
• WorkSite http//www.ssa.gov/work

15
Employment Networks--Must Report

• Information to assist the Program Manager in
  determining whether a beneficiary is making
  timely progress toward self-sufficiency (for CDR
  suspension) and
• Information about a beneficiarys work activity
  and earnings so SSA can determine their effect on
  entitlement to benefits and benefit amounts

16
State VR Agency Participationin the Ticket to
Work Program

• State VR agencies must participate in the Ticket
  program to receive payment for serving a
  beneficiary with a ticket
• A VRA can choose for each beneficiary it serves,
  on a beneficiary-by-beneficiary basis, to be paid
  under the cost reimbursement system or under one
  of the EN payment systems
• A VRA must provide reports on beneficiary
  outcomes when choosing to be paid as an EN.

17
Individual Work Plan

• Required written document
• Developed, signed, and implemented in partnership
  by the EN and the beneficiary
• Outlines specific employment services, VR
  services, or other support services the EN and
  beneficiary have determined are necessary to
  achieve the beneficiarys employment goal

18
Individual Work Plan, continued

• Must include at least statements of
• of the beneficiarys vocational goal
• of services and supports necessary to achieve the
  beneficiarys vocational goal
• of any terms and conditions
• that EN may not request or receive any
  compensation for cost of services and supports

19
Individual Work Plan, continued

• Included statements, continued
• of conditions under which EN can amend the IWP or
  terminate the relationship
• of the beneficiarys rights, including the right
  to retrieve the ticket
• of remedies available to the beneficiary,
  including the availability of advocacy services
  and assistance through PA Services

20
Individual Work Plan, continued

• Included statements, continued
• of the beneficiarys rights to privacy and
  confidentiality
• of the beneficiarys right to seek to amend the
  IWP
• of the beneficiarys right to have a copy of the
  IWP made available to the beneficiary in an
  accessible format

21
EN Payment Systems-- Outcome Payment System

• Outcome payments to an EN(over 60 months)
• at 40 of average monthly SSDI or SSI benefit
• for every month beneficiary does not receive
  benefits due to work/earnings

22
EN Payment Systems--Outcome-Milestone System

• Payment for four milestones--after work starts
• -worked for 1 calendar month at SGA
• -worked for 3 calendar months out of 12 at SGA
• -worked for 7 calendar months out of 12 at SGA
• -worked for 12 calendar months out of 15 at SGA

23
EN Payment Systems-- Outcome-Milestone System

• Outcome-Milestone payments, continued
• Reduced Outcome payments--about 85 of total
  potentially payable under the Outcome payment
  system over 60 months for the same beneficiary

24
EN Payment Systems-- Increased Incentives for
ENs

• Final regulations
• Added 2 new milestones (doubled the number of
  possible milestone payments)
• Moved one new milestone to follow 1st month of
  work
• Doubled the value of milestone payments
• Extended period of recoupment (reduction in
  outcome payments due to milestone payments) from
  12 months to 60 months

25
Dispute Resolution in theTicket to Work
Program--Beneficiary and EN

• The dispute resolution process describes the
  responsibilities of an EN that is not a State VR
  agency to
• have grievance procedures that a beneficiary can
  use to seek resolution of a dispute
• inform each beneficiary of the right to refer a
  dispute first to the PM, and then to SSA for
  resolution
• inform each beneficiary of the availability of
  assistance from the State PA system.

26
Dispute Resolution in theTicket to Work
Program--EN and PM

• The PM is required to have procedures to resolve
  disputes with ENs that do not involve an ENs
  payment request.
• An EN can seek a solution through the PMs
  internal grievance procedures.
• If the PMs internal grievance procedures do not
  result in a mutually agreeable solution, the PM
  must refer the dispute to SSA for a decision.

27
Dispute Resolution in theTicket to Work
Program--Beneficiary and State VR Agency

• The dispute resolution procedures in the
  Rehabilitation Act of 1973, as amended, apply to
  any beneficiary who has assigned his or her
  ticket to a State VR agency.
• The Rehabilitation Act requires the State VR
  agency to provide a description of services
  authorized through the CAP program, and to
  provide an opportunity to resolve disputes using
  formal mediation or an informal hearing process.

28
Resolution of Payment Dispute--EN and SSA

• If an EN other than a State VR agency has a
  payment dispute with SSA, the dispute will be
  resolved under the dispute resolution procedures
  contained in the ENs agreement with SSA.

29
Ticket to Work Programand Alternate Participants

• The AP process will end in each State as the
  Ticket program is phased-in
• APs providing VR services will be asked if they
  choose to become ENs
• If an AP chooses to become an EN, services to
  current clients will continue to be covered under
  the current cost reimbursement system for a
  limited time

30
Ticket to Work Programand Alternate Participants

• If an AP chooses not to become an EN, payment
  will not be made for services to new clients
  after the Ticket program is phased-in the State
• If an AP chooses not to become an EN, payment
  will not be made for any services after January
  1, 2004

31
The Work Site

• SSA Office of Employment Support Programs Web
  Site
• http//www.ssa.gov/work