Transcript Work Incentives Planning and Assistance (WIPA)

The NEW Ticket To Work
New Program, New Opportunities
Tom Gloss
Ticket to Work Specialist
Jul-15
CESSI, A Division of Axiom Resource Management
Program Manager for Recruitment & Outreach
Briefing for National Alliance for Mental Illness
July 8, 2009
Thomas Hale, Project Officer
Soosan Shahrokh, Alternate Project Officer
Why Mental Illness?
• Largest group of disabled participants in the
Social Security programs
– 27% of SSDI beneficiaries (~2.1 ml)*
– 39% of SSI recipients (~2 ml) **
• Most forms of mental illness are treatable;
many promising treatments integrate work as
therapy.
* All beneficiaries in pay December 2007, from the Annual Statistical Report on the SSDI Program 2008
** Recipients under age 65 in December 2006, from the SSI Annual Statistical Supplement Report 2006
3
Research & Policy Questions
• To what extent does access to high quality mental health
treatment and employment supports lead to better employment
outcomes and other benefits?
• What are the characteristics of beneficiaries who elect to enroll
in the study (insurance, demographics)?
• What are the characteristics of beneficiaries who choose not to
enroll?
• What are the costs of the services provided?
• What programmatic disincentives exist that create barriers to
return-to-work?
• What specific programmatic changes can be made to support
efforts to sustain competitive employment?
4
Design Overview
• Enroll 2,200 SSDI workers with Schizophrenia
or Affective Disorder
• Randomly assign 1,100 to the treatment group
and 1,100 to the control group
• Recruit over a 21 month period
• Treat/Monitor each recruit for 24 months post
enrollment
• Each recruit participates at one of 23 sites
across the country
5
Data Elements
• Treatment and control group each have 9 interviews
over a two year period
• Demographics and Work History
• Psychiatric Diagnosis
• Health Assessment
• Health Status, Symptoms and Functioning
• Health Care Coverage and Utilization
• Attitudes toward Treatment and Work
• Others (e.g., costs, outcomes, quality of life)
6
Management
• Contract to Westat in October 2005
• Principal Investigators
– William Frey, Ph.D., Westat
– Robert Drake, MD, Ph.D., Dartmouth
7
Treatment Group Interventions
• Baseline clinical diagnosis via SCID
• General physical examination (if none in past
6 months)
• Health insurance coverage
• Behavioral health services
• Supported employment services
• CDR waiver for 3 years
8
Control Group Interventions
• $100 in incentives distributed over the 9 interviews
• Community resource manual provided upon
randomization into control group
9
Heath Care Financing
Study provides:
• Insurance for participants with no insurance and
supplemental insurance for underinsured beneficiaries
• Out-of-pocket costs for all behavioral health services
• Supported employment costs not reimbursed by insurance
• Costs up to an average of $10,000 per person per year
Study does not provide:
• Co-payments for general health care
10
Interventions
Employment Supports: Based on Individual
Placement and Support (IPS) Model
Placement at time participant expresses readiness
Competitive employment
Employment integrated with treatment
Follow-along supports are continuous
Systematic Medication Management
Evidence-based use of individual medications
11
22 Study Sites
Vancouver WA
Portland OR
Spring Lake Park MN
Grants Pass OR
M
Denver CO
Chicago IL
Mentor OH
Peoria IL
Indianapolis IN
Manchester NH
Framingham MA
Norwich CT
Bridgeport CT
New York NY
Bethesda MD
Washington DC
Kansas City KS
Aiken SC
Smyrna GA
San Antonio TX
St. Petersburg FL
Ft. Lauderdale FL
12
MHTS Site Staff
• Research Assistant
– Recruit and enroll beneficiaries
• Nurse Care Coordinator
– Facilitate and monitor treatment
• Case manager
– Provide other non medical non employment
supports (e.g., talk to families, recommend
clothing, transportation to appointments)
13
Timeline
• Start-up activities: Oct ‘05 to Sep ‘06
• Recruitment, enrollment and randomization: Oct ‘06
to Aug ‘08
• 24-month intervention: Oct ‘06 to Aug ‘10
• Analysis: Aug ‘10 through Jan ‘11
• Final Report: Jan ’11
http://www.socialsecurity.gov/disabilityresearch/mentalhealth.htm
14
Preliminary Finding
Percent of Beneficiaries Employed
50
Percentage
40
30
Treatment
20
Control
10
0
Q1
Q2
Q3
Q4
Q5
Q6
Q7
Interview Type
15
THE TICKET TO WORK AND
WORK INCENTIVES IMPROVEMENT ACT
What Is the Ticket to Work Program?
• A free and voluntary employment program
run by the Social Security Administration
(SSA) to assist SSA beneficiaries with
disabilities who want to work.
• Beneficiaries include individuals with
disabilities ages 18 through 64 who are
receiving Social Security Disability Insurance
(SSDI) and Supplemental Security Income
(SSI) benefits.
Ticket to Work Program
• Increased choices for getting the services &
supports you need to engage in work and reach
your employment goals.
• Approved providers of services are called
“Employment Networks” or “ENs.”
• Examples of services and supports offered by ENs
include:
–
–
–
–
Help finding a job
Education and training
Vocational rehabilitation services
Ongoing services and supports
How Does the Program Work?
• A paper Ticket is mailed to you when you are determined to
be eligible for SSDI or SSI benefits.
– If you already receive disability benefits, your Ticket may have already
been mailed to you.
– You do not need the paper Ticket
to participate.
• You decide:
– Whether to use your Ticket
– Where to assign your Ticket
– When to assign your Ticket
• MAXIMUS can help you through the process. Call them
toll-free at 1-866-968-7842 (v) or 1-800-833-2967 (tty).
• Remember, participation is free and voluntary – There are
no penalties if you choose not to participate.
What Does the Program Do?
• Connects you with the resources, personnel
and programs to make full use of existing
Federal, state and local programs.
• Offers protection from medical Continuing
Disability Reviews (CDRs).
• The goal is to assist you to:
– Go to work.
– Make more money.
– Reduce your need for cash benefits.
– Increase your independence and self-sufficiency.
What Are Employment Networks?
Employment Networks (ENs) are public and private agencies,
schools, colleges, training programs, community-based service
providers, employers and others that have agreed to provide
services under the Ticket to Work Program to help you achieve
your work goals.
State Vocational Rehabilitation agencies (VR) are automatic
ENs that provide a wide variety of services to help people with
disabilities enter or re-enter the workforce.
ENs and VR agencies receive payments when they help you
get and keep a job.
What Types of Services and
Supports can ENs Provide?
• Counseling and guidance
• Education and training:
– Vocational
– Technical
– Postsecondary
• Job search services
– resume writing
– interview skills
• Job placement services
• Job coaching and ongoing support services
• Work adjustment counseling
• Job retention services
• Other supports and services
Not all ENs offer the same services. Talk to the EN about
services you need before assigning your Ticket.
Individualized Work Plan
When you decide to work with an EN, you and someone
from the EN will develop an Individualized Work Plan (IWP)
An IWP:
• Is developed and agreed to by you and the EN.
• Identifies your chosen employment goal.
• Lists the services and supports that the EN agrees to provide
you in achieving that goal.
• Signing the IWP = assigning your Ticket to that EN.
• While working with the EN and progressing towards your
employment goal, you will not have a medical (CDR).
• Your IWP can be changed if your situation changes.
Your Ticket is the Key
• ENs get paid a bonus
from the Ticket
program, but only if
you work!
• Your Ticket works as
an incentive for the
EN to provide you
services and help you
keep working.
Partnership Plus – A New Option
under the Ticket to Work Program
If you are receiving services from your State VR
agency, you can choose to assign your Ticket to
the EN of your choice after VR closes your case.
The EN can:
•
•
•
•
Provide additional job training
Provide ongoing supports
Help you keep your job
Help you advance in your job
Work Incentives
What Are Work
Incentives
• Work Incentives are SSA rules
that help you keep your
benefits as you explore work.
• By using Work Incentives you
can make more money, gain
new skills, and achieve greater
independence through work.
Examples of Work Incentives
• Trial Work Period (TWP) (SSDI only)
– The TWP allows you to test your ability to work for at least
9 months.
• Extended Period of Eligibility (SSDI only)
– For 36 months after the TWP SSA may restart your SSDI
benefits without:
• a new application,
• disability determination,
• or waiting period.
• Earned Income Exclusion (SSI only)
– Less than half of earned income is counted by SSA as
earnings in determining the amount of your benefit check.
Work Incentives (continued)
• Expedited Reinstatement (EXR)
If:
– your cash disability benefits ended because of
your work and earnings,
– and you stop work within 5 years of your benefits
ending
Then:
– SSA may be able to quickly get you on benefits.
• Up to 6 months of “temporary cash benefits”
• Continued Medicare and/or Medicaid coverage
Work Incentives (continued)
Medicare
• You can keep your Medicare
coverage for at least 8 ½ years after
you return to work.
Medicaid
• If you have earnings too high for a
SSI cash payment, you may still be
eligible for Medicaid through
1619(b).
• If your state has a Medicaid Buy-In
program it may provide Medicaid
benefits while you work.
Other SSA Work Incentives
• Social Security offers many Work
Incentives that are designed to meet
your needs.
• Talk to your benefits planner to make
sure that you take full advantage of
other Work Incentives SSA offers.
Who Can Help Me
Understand All of This?
• Work Incentives Planning and Assistance
(WIPA) Projects
• Protection and Advocacy for Beneficiaries of
Social Security (PABSS)
• SSA Benefits Specialists
–Area Work Incentives Coordinator (AWIC)
–Work Incentives Liaison (WIL)
Work Incentives Planning and
Assistance Projects
WIPAs are 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 your
Federal, state and local benefits.
– Can help you find the resources or services to achieve
your individual employment goals.
– Host Work Incentives Seminar Events (WISE).
Work Incentive Seminars (WISE)
At a WISE Event you can expect to:
• Learn about the Ticket to Work program and other
SSA Work Incentives.
• Meet with:
–
–
–
–
–
–
ENs
The State Vocational Rehabilitation agency
WIPA Project staff
SSA staff
Other beneficiaries who want to go to work
Additional state agencies and community partners
To find out if a WISE event is happening
near you, visit www.cessi.net/WISE/
Protection & Advocacy (P&A)
Services
The Protection & Advocacy for
Beneficiaries of Social Security
(PABSS) Program
• Provides advocacy and legal
assistance for disability-related
employment issues
• Is the nation’s largest provider of
legal advocacy services for
individuals with disabilities
• Services are free
Locating Your WIPA or P&A
To find the WIPA Project nearest you or to
locate your State Protection and Advocacy
agency, visit:
www.ssa.gov/work/providers
SSA Benefits Specialists
Social Security has a team of Work Incentives
Specialists to ensure that you receive:
• Accurate information about how work will
affect your benefits
• Assistance in reporting your work activity
They are:
• Area Work Incentives Specialists (AWICs)
• Work Incentives Liaisons (WILs)
What Are Area Work Incentives
Coordinators (AWICs)?
AWICs are experts on SSA’s Work Incentives and
employment support programs.
They:
• Manage and coordinate Work Incentives Training
• Provide public support services to beneficiaries with
disabilities who want to start or keep working.
• Conduct public outreach to other members of the
community.
Visit http://www.ssa.gov/work/awiccontacts.html
to find your local AWIC.
What Are Work Incentive
Liaisons (WILs)?
Every local SSA office has a WIL who provides
advice and information about:
• SSA's Work Incentive provisions
• Employment support programs.
Contact your local SSA office for the name and
telephone number of the WIL in your area.
Visit www.ssa.gov or call 1-800-772-1213.
What Is MAXIMUS?
MAXIMUS, the SSA contractor that assists in
the administration of the Ticket to Work
program:
• Helps you assign, un-assign and re-assign
your Ticket
• Provides you with a replacement Ticket
• Helps you locate ENs
Contact MAXIMUS at 1-866-968-7842 (v),
1-866-833-2967 (tdd) or
www.yourtickettowork.com
For More Information
For more information on Ticket to Work:
Visit SSA’s Ticket to Work Site at
www.ssa.gov/work
Contact MAXIMUS at 1-866-968-7842 (v),
1-866-833-2967 (tdd) or
www.yourtickettowork.com
So, How Is it Going So Far?
• As of May 2009, over 269,000 Tickets assigned
(VR & EN); about 22,000 of those assigned to
about 820 ENs
• March & April 2009—first consecutive months
with over 1,000 new Tickets assigned to ENs!
• Total Ticket payments to EN’s hit all-time highs
after the new regulations went into effect
• There has been a steady increase in the number
of Tickets assigned and Ticket payments
requested under the new rules, telling us that
the new payment structure is working
Ticket Payments
Ticket Payments
$1,400,000
$1,200,000
$1,000,000
2007
$800,000
2008
$600,000
2009
$400,000
$200,000
$0
Jan
Feb
Mar
Apr
May
Jun
Jul
Aug
Sep
Oct
Nov
Dec
Ticket Payments
SSA Hiring Initiative
• The Commissioner of Social Security has
implemented a national recruitment and hiring
initiative for people with disabilities.
• This is a historic opportunity because SSA’s
budget for 2009 has been increased enough to
hire thousands of new staff, nationwide.
• SSA wants to maintain it’s leadership in federal
government in hiring people with disabilities and
reach out to Ticket Holders, veterans with
disabilities, and students with disabilities.
SSA Hiring Initiative
• There will be a variety of entry level positions as well as
some higher level positions:
– Claims Representative and Service Representative
positions. These are direct public service positions
located in our 1300 field offices across the nation.
– Teleservice Representatives, 37 teleservice centers
nationwide, to assist the public calling SSA’ 800 number.
– Claims Authorizers and Benefit Authorizers to process
post entitlement claims related issues - 6 program
service centers nationwide and Headquarters location in
Baltimore.
– Support positions nationwide related to the hearings and
appeals process including Legal Assistants, Paralegal
Specialists, and Attorney Advisors.
SSA Hiring Initiative
• For more information visit:
www.cessi.net/ttw/SSAHires/index.html
• Send resumes and Schedule A forms for SSA’s
review to:
[email protected].
Should Have Used My Ticket!
David Jones
CESSI Account Manager
SSDI Beneficiary Story
• I became a beneficiary at age 19
– Because of work during High School I qualified for
SSDI and also received some SSI.
– While learning to cope with Bipolar disorder I received
services from Department of Rehab in CA; a great
counselor helped me set career goals and I decided
on Social Work.
– To make sure college was the right place I started at
community college then transferred to a university.
– I used a PASS Plan, one of the SSA Work Incentives,
to pay for my BSW.
Volunteer Work
• While obtaining my Social Work degree I
volunteered my time with NAMI and
helped with Family-to-Family Groups
• I shared my story of success in college
• This built my confidence to transition to a
professional job after college
Received Ticket
• I received a Ticket in the mail; wish I would have used it!
• At the time I had no idea what it was and did not ask:
– How would my benefits be affected?
– Was this a program I would have to commit to?
– Who would I be working with if I used the Ticket?
• Some of the benefits of the Ticket I did not use:
– After college I was on my own to find a job.
– I did not receive help creating my resume.
– After the second month of work I received a
Continuing Disability Review notice; it was difficult to
deal with on my own.
– Not having the guidance of an EN, I was overpaid by
SSA and had to pay them back!
• I should have called MAXIMUS at 1-866-968-7842
Gamble with Benefits by not
Using a Ticket
• Other benefits of using the Ticket include:
– Postponing medical continuing disability review
– Long term supports and services to help maintain
employment
– Expedited reinstatement of benefits if work ends
within 5 years of when benefits stopped; up to 6
months of SSDI or SSI benefits paid while
reinstatement application is pending
How to Become an
Employment Network
David Jones
CESSI Account Manager
Who Can Become an EN?
•
•
•
•
•
Any private (for profit & non-profit) organization, government
agency, postsecondary institution, employer or service providers
that is qualified and agrees to provide employment services,
vocational rehabilitation services and other types of supports to
assist Ticket Holders to enter and maintain employment
Must have an Employer Identification Number (EIN), also known as
the Tax ID #
Must have general business or professional liability insurance in
effect (minimum of $500,000 per occurrence)
Must have a DUNS number (contact Dun & Bradstreet at 1-866705-5711 or apply online at www.dnb.com)
Must register your DUNS number through the Central Contractor
Registration (CCR) process (www.ccr.gov)
Must complete forms for simple security clearance for all staff
working with beneficiaries or handling personally identifying
information of beneficiaries
Why Become an EN?
• Increase your bottom line - Get paid for the work
you are already doing
• Ticket payments are yours to use as you wish
• Generous funding stream – between $20,990
(SSI) and $21,905 (SSDI) per successful
beneficiary
Employment Network
Request for Proposal (RFP)
Get the EN RFP at:
http://www.ssa.gov/work/enrfp.html
EN RFP Contents
• There are 5 main parts of the RFP
• Cover letter provides information on how to
contact SSA
• Advised not to mail your RFP, send by:
Email: [email protected]
Fax number: 1-410-597-0429
Part IV--EN Proposal
Documentation Requirements
Part IV has 5 Sections- all must be completed
and submitted to SSA
Section 1: Form 1449
Section 2: EN Information Sheet
 Describes who you are, name of EN, services provided
- determines how your agency will be listed in the online EN directory
 Need organization’s EIN, DUNS, and CCR registration
RFP: Part IV (Continued)
Section 3: EN Information Sheet Addendum
Only required if you have more than one
location to list in EN Directory
Section 4: ACH Vendor Enrollment Form
This is how you get paid from SSA—direct
deposit
Bank Official must sign!
Section 5: Representations and Certifications
Comply with EEOC, you are a service
provider, defines what type of organization
RFP: Part IV (Continued)
Section 6 : EN Offeror Checklist
This is a fantastic way to make sure your
EN proposal is complete
CESSI offers Application Walk-through
teleconferences twice a month.
Recommend to send your RFP to Account
Manager to review that your RFP is error
free
Security & Suitability
Determination
• All employee’s working with Beneficiaries
need to fill out Optional Form 306Declaration of Federal Employment.
http://www.opm.gov/forms/pdf_fill/of0306.pdf
• These will need to be turned in with the
RFP.
Beneficiary Referral CD
• Approved ENs can get a CD listing all
beneficiaries with Tickets available for
assignment in the EN’s service delivery area
• To receive the Beneficiary CD, in addition to
Optional form 306, an organization must
complete:
– Form FD-258 Application Fingerprint Chart
– Fair Credit Reporting Act (FCRA) Authorization form
– Standard Form (SF) 85 Questions for Non-Sensitive
Positions
• Beneficiaries’ contact information is to be used
only for the Ticket to Work program (e.g., for
outreach purposes)
Need Help Completing the RFP?
• Contact David Jones, Account Manager at CESSI, the
Program Manager for Recruitment and Outreach, toll-free
at (877) 743-8237 or (703) 448-6155 x 201
• Participate in an EN Application Walk-through
Teleconference (E-Mail [email protected])
 documentation requirements
 review forms
Q & A
• Additional help is available through SSA’s Employment
Network Contracts Team
 E-Mail: [email protected]
 Call: 1-866-584-5180
Help Continues After
Being Approved As an EN
•
•
•
•
•
•
•
MAXIMUS, the Operations Support Manager for the
Ticket to Work program:
Maintains the list of beneficiaries with Tickets available
for assignment
Handles process for assigning & un-assigning Tickets
Maintains the list of approved ENs
Processes Ticket payments
Conducts timely progress reviews
EN Help Desk
Provides training & technical assistance to ENs
Call (866) 949-ENVR (3687) or visit the MAXIMUS
website at www.yourtickettowork.com
For More Information
• To become an EN, contact David Jones, Ticket to Work
Account Manager at CESSI, at 1 (703) 488-6155 x201
• For more information on the Ticket to Work Program:
> Visit SSA’s Work Site at:
www.socialsecurity.gov/work
> Visit CESSI’s web site at: www.cessi.net/ttw
> Visit the Maximus web site at:
www.yourtickettowork.com
or call: 1-866-949-ENVR (3687)
• Any questions on the Ticket to Work Program should be
e-mailed to: [email protected]
Ticket to Work –
Stepping Stones to Employment