Transcript Slide 1

29th Annual NYAPRS Conference:
Making the Ticket Work for You
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Presenters
Joshua Carpenter, M.S.Ed., C.R.C., Clubhouse of Suffolk,
Ronkonkoma NY
Jason Vandewater, LMSW, Federation of Organizations, West
Babylon NY
Kelly Stengel, MPH, NYAPRS, Albany NY
Oscar Jiménez, MPH, NYAPRS, Albany NY
TRACK: PROS
WORKSHOP: 135
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Our Program for Today
• Ticket-to-Work Program At A Glance:
– What is the Ticket –to-Work
– Purpose of the Ticket-to-Work Program
• Provider’s Perspective:
– Clubhouse of Suffolk
– Federation of Organizations
• Resources for Employment Networks
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What is the Ticket to Work?
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Ticket-to-Work Program: 101
• What is the goal of the program?
– Help people with disabilities get jobs and become more
self-sufficient
• What is it the Ticket?
– Similar to a voucher that allows people with disabilities
to purchase employment services and supports
• Who can a Ticket Holder purchase services from?
– An Employment Network (EN): Agency or program preapproved by Social Security to take Tickets
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Ticket-to-Work Program: 101 cont’d
• How much money is each Ticket worth?
– Up to $23,000 (up to $5,100 the first 9 months)
• Who does the Ticket belong to?
– The Ticket belongs to the person with a disability
(“Ticket Holder”), not the provider nor the government
– The Ticket Holder can choose the Employment
Network she/he likes best, and switch at any point in
time
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2011 Payments At A Glance
2011 MILESTONE-OUTCOME PAYMENT METHOD
Payment Type
Beneficiary Earnings Required After Ticket Assignment
Phase 1
Milestone 1
Milestone 2
Milestone 3
Milestone 4
$360/ month x 1 month
$720/ month x 3 months within 6 months
$720/ month x 6 months within 12 months
$720/ month x 9 months within 18 months
Total for Phase 1
SSDI TicketHolder
SSI Ticket-Holder
$1279
$1279
$1279
$1279
$1279
$1279
$1279
$1279
$5,116
$5,116
Phase 2
Milestones
Outcome
Phase
Gross earnings at or over $1,000(nonblind)/month (SGA)
Gross earnings at or over $1,640 (blind)/month
(SGA)
Up to 11
payments of
$382/ month
Up to 18 payments of
$221/ month
Total for Phase 2
$4,224
$3,978
Total Phase 1 + 2 Milestones Payments
$9,340
$9,094
Earnings sufficient for “zero cash
benefit” status
Up to 36 payments of
$384/ month
Up to 60 payments of
$221/ month
Total of Outcome Payments Available
$13,824
$13,260
Total of Milestones + Outcome Payments
$23,164
$22,354
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Milestone-Outcome Payment System: Phase 1 Milestones
Type
Ticket Holder Earnings
EN Payment EN Payment
for SSDI
for SSI
Phase 1
Milestone 1
$360/ two weeks within 1
month
$1,279
$1,279
Milestone 2
$720/mo for 3 months
within 6 months (cumulative)
$1,279
$1,279
Milestone 3
$720/mo for 6 months
within 12 months (cumulative)
$1,279
$1,279
Milestone 4
$720/mo for 9 months
within 18 months (cumulative)
$1,279
$1,279
Total Potential Phase I Milestone Payments
$5,116
$5,116
2011 Rates
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Milestone-Outcome Payment System: Phase 2 Payments
Type
Phase 2
Ticket Holder
Earnings
Gross > SGA
EN Payment EN Payment
for SSDI
for SSI
$384/mo. (up
$221/mo.
to 11 mos.)
(up to 18 mos.)
Total Phase 2
Payments
$4,224
$3,978
Total Potential Ticket
Payments
Phases 1 and 2
$9,340
$9,094
($1000/non-blind;
$1,640 for blind)
2011 Rates
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Milestone-Outcome Payment System: Outcome Payments
Ticket Holder
Earnings
EN Payment
for SSDI
EN Payment
for SSI
Net > SGA
$384/mo. for up
to 36 months
$221/mo.
for up to 60
months
Total Outcome Phase
Payments
$13,824
$13,260
Total Potential Ticket
Payments
$23,164
$22,254
Type
Outcome Phase
($1000/non-blind;
$1,640 /blind) AND
0 cash benefit
2011 Rates
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2011 Payments At A Glance
2011 MILESTONE-OUTCOME PAYMENT METHOD
Payment Type
Beneficiary Earnings Required After Ticket Assignment
Phase 1
Milestone 1
Milestone 2
Milestone 3
Milestone 4
$360/ month x 1 month
$720/ month x 3 months within 6 months
$720/ month x 6 months within 12 months
$720/ month x 9 months within 18 months
Total for Phase 1
SSDI TicketHolder
SSI Ticket-Holder
$1279
$1279
$1279
$1279
$1279
$1279
$1279
$1279
$5,116
$5,116
Phase 2
Milestones
Outcome
Phase
Gross earnings at or over $1,000(nonblind)/month (SGA)
Gross earnings at or over $1,640 (blind)/month
(SGA)
Up to 11
payments of
$382/ month
Up to 18 payments of
$221/ month
Total for Phase 2
$4,224
$3,978
Total Phase 1 + 2 Milestones Payments
$9,340
$9,094
Earnings sufficient for “zero cash
benefit” status
Up to 36 payments of
$384/ month
Up to 60 payments of
$221/ month
Total of Outcome Payments Available
$13,824
$13,260
Total of Milestones + Outcome Payments
$23,164
$22,354
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Partnership Plus at a Glance
1. When an individual has an ACCES-VR case OPEN, the
Ticket is considered “in use” and it cannot be assigned to
an EN
2. After VR case is formally closed, then the beneficiary can
assign Ticket to an EN
3. If the VR case is closed successfully, then Phase One
payments are NOT available
4. If the VR case is NOT closed successfully, then ALL Ticket
payments may still be available
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Types of EN business models
– Independent
– Collaborative
– Single administrator
– State level strategies
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Independent ENs
Each EN completes a
separate application to
operate as an
independent EN
Community
Rehab
Provider A
Community
Rehab
Provider E
ACCES-VR
Partnership
Plus
ACCES-VR provides
information about all
EN options when
closing a case
Community
Rehab
Provider
D
Community
Rehab
Provider
B
Community
Rehab
Provider C
This example shows a
collaborative web
allowing for referral and
mentoring efforts
amongst separate EN’s
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Collaborative Agreement Strategy
ACCES-VR
ACESSVR
Partnership Plus
Advantages: Sharing of
information & resources,
staffing and community
outreach
EN of record –
Has submitted RFP,
In this case, local
CRP
Ticket Holder
may discover
EN through
One Stop, or
through local
CRP which
is EN of record
Specific Advantage of
collaboration with OneStop: Access to database of
potential Ticket holders
who wish to return to work
One Stop
Career Center –
Local
agreement
arranged
to serve mutual
Ticket holders
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Single Administrator EN Strategy
Partnership Plus
ACCES-VR
Administrator
EN
Community
Rehab program
A
Community
Rehab Program
B
Community
Rehab Program
C
Contracted for Ticket
Administration/ Outreach
/ Reporting
Community
Rehab Program
D
Community
Rehab Program
E
Provide direct service to Ticket
holders / Follow-up supports /
data collection
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State Level Strategy
Partnership Plus
ACCES-VR
EXAMPLE:
NYS Office
of
Mental Health
Policy / Outreach /
Reporting/Administration
Contracted for Ticket
Administration
Program
A
Program
B
Program
C
Program
D
Program
E
Provide direct service to Ticket
holders / Follow-up supports /
data collection
Program
F
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Provider’s Perspectives: Lessons and
Challenges in Utilizing the Ticket- toWork Program
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Clubhouse of Suffolk - EN
• Current status of Tickets assigned
– 28 total assignments
• 9 currently employed (4 @ TWL, i.e. triggering Phase 1 Milestones)
• 12 in job placement phase, 7 in job readiness development
• 5 payment requests thus far, with several expected in coming months
• Potential revenue look-back
– 3 years since TTW regulations changed (July 2008)
– Had tickets started being assigned then, potential revenue to date:
• $214,200 (approximately), based on past employment data at our 2
sites - Ronkonkoma & Riverhead (Synergy Center)
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Clubhouse of Suffolk – EN (cont’d)
• Strategy for targeting Ticket holders
– Target current and incoming PROS members first: 48 seeking
employment at this time who are also eligible Ticket holders.
– 4-6 calls per month from community ticket holders (about half
do not have a psychiatric disability, provide referral)
– Market Clubhouse Ticket to Work Services at Behavioral Health
Trade Show (Mental Illness Awareness Day, October 2011)
– Referral CD / Collaboration w/ Community ENs
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Clubhouse of Suffolk – EN (cont’d)
• Lessons learned
– Be selective in WHO you choose to assign and WHEN
– ALWAYS check Ticket status with MAXIMUS (1st
meeting/contact, before IWP)
• Challenges and opportunities
–
–
–
–
Staffing / Expertise (Benefits counseling/planning paramount)
Everything must be submitted in paper format at this time
Integration into existing Electronic Health Record (EHR)
Expand into Clubhouse Case Management? (Future)
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Clubhouse of Suffolk : New EN Requirements
• Impact on service delivery
– More documentation (but not much) & better organization
– Better, more comprehensive services, more qualified employees providing
services
– Complements and is in accordance w/ COS’s mission
• Affect on organizational structure
– Differentiation and designation of staff w/ specific TTW related duties
(counseling, billing, intakes, recordkeeping, etc.) and who has access to
TTW-specific information.
• What have the changes meant for the Clubhouse of Suffolk:
Not that much!
– More structure, clarity of EN expectations, more solid service delivery.
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Resources and Tools for Employment
Networks and Ticket Holders
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Resources and Tools for ENs and
Ticket Holders
• Decision Tree Tool for Assigning Tickets
• YourTickettoWork.com
• SSA’s Technical Assistance and Support Center
(TASC)
• Chooseworkttw.net
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YourTickettoWork.com
• Social Security Administration’s (SSA) website
to provide information to ENs, VR agencies,
and potential ENs
• For ENs
– Has forms related to contract maintenance, Ticket
assignments, and payments
• For potential ENs
– Has information about program requirements and
applying to become and EN
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YourTickettoWork.com
Resources for ENs
•
•
•
•
•
Individualized Work Plan (IWP)
18 Month Prior Earning Look-Back Worksheet
Payment Request Form
Certification of Services Statement
2011 Payment at a Glance
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YourTickettoWork.com
Resources for Potential ENs
• Information on Ticket to Work Basics
• Information and Tutorials Related to:
– Outreach
– Ticket Assignment
– Requesting a Beneficiary CD
– The Partnership Plus Program
– Timely Progress Review
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Technical Assistance and Support
Center (TASC)
• Established to address technical assistance
needs of Employment Networks
• Goal is to improve trainings and internal
processes, increase Ticket assignments and
payments, and increase access to sustained
employment for Ticket Holders.
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Technical Assistance and Support
Center (TASC) (Cont.)
• Each Social Security region has a TASC Team
lead by a Senior Account Manager
• TASC can support organizations by:
– Answer questions regarding the EN application,
completing IWPs, and submitting payment requests
– Helping to incorporating TtW into their current
business models
– Facilitating the development of effective making
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strategies
Contacting Technical Assistance and
Support Center (TASC)
• Current ENs:
Michael Yozzi
Senior Account Manager, Region 2
703.336.8008; Toll Free: 866.949.3687 ext. 8008
Fax: 703.893.4149
[email protected]
• Prospective ENs:
Joel Middleton
Account Manager, Region 2
703.336.8108; Toll Free: 866.949.3687 ext. 8108
Fax: 703.893.4149
[email protected]
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Chooseworkttw.net
Resources for Ticket Holders
• A website created for Social Security
beneficiaries with disabilities who want to work
Chooseworkttw.net
• This site has:
– Videos of success stories
– Information about the Ticket to Work Program
– Work Incentive Seminar Event (WISE) information
– Ticket to Work program documents
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Questions about future trainings and
technical assistance?
Kelly Stengel, MPH
NYAPRS Assistant Director of Community and Economic Development
8-436-0008, ext. 33
[email protected]
Oscar Jimenez, MPH
NYAPRS Director of Community and Economic Development
518-436-0008, ext. 21
[email protected]
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New York Makes Work Pay
Partnering Organizations
New York Makes Work Pay is a Comprehensive Employment System Medicaid Infrastructure Grant
(Contract No. #1QACMS030318) from the U.S. Department of Health and Human Services, Center
for Medicare and Medicaid Services to the Office of Mental Health on behalf of New York
State. It is a joint effort of the Burton Blatt Institute at Syracuse University and the Employment and
Disability Institute at Cornell University with the collaborative support of the Employment Committee
of the New York State Most Integrated Setting Coordinating Council to develop pathways and
remove obstacles to employment for New Yorkers with disabilities.
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