Transcript Disability Program Navigator Initiative

TICKET 101 OVERVIEW
Hosted/Facilitated by: Miranda Kennedy
Presented by Kevin Nickerson,
NDI Technical Assistance Team Members
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November, 2010
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DEI Projects at the state level and/or local level participating
LWIBs are required to become Employment Networks under
Social Security Administration’s Ticket to Work Program.
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Training and Technical Assistance to DEI Projects in attaining
Employment Network status and implementing effective EN
operations is provided under U.S. DOLETA contract with NDI
Consulting, Inc. and the National Disability Institute (NDI).
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Evaluation of the impact of the DEI Projects implementation
and outcomes as Employment Network will be provided under
U.S. DOL ODEP contract with Social Dynamics.
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What is the Ticket to Work Program
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Ticket to Work Basics
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Review of 2008 Changes to the Ticket to Work Program rules
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EN models and partnerships
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What’s my next step? How do we apply?
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The Challenge EN Experience
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Consistent with Challenge Mission
Established as an EN in 2001
First Ticket assigned in NYS to private EN
Knowledge of SSA benefits increased Ticket
holder confidence in services and assisted with
referrals to program
Increasing Ticket assignments now due to
changes in regulations which occurred in 2008
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2nd EN in Nation to achieve 60th Outcome payment
(achieved March, 2007)
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Our second 60th Outcome measure occurred in
May, 2009
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Our third 60th Outcome measure occurred in July,
2010
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A Social Security Administration Program
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Established through the signing of legislation in
December 1999, The Ticket to Work and Work
Incentives Improvement Act
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Provides payments to participating Employment
Networks for assisting Social Security
beneficiary’s in becoming more self-sufficient
through employment
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A program designed to assist Social Security
beneficiaries in the return to work through the provision
of employment services from public and private
providers
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Allows Social Security beneficiary’s to receive a Ticket to
Work which may be assigned to a participating
Employment Network for assistance in achieving their
desired vocational goal
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Expands the universe of choices people with disabilities
have in getting assistance in the return to work through
participating Employment Networks
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The goal:
Self-sufficiency.
Decrease the Ticket Holder’s dependence on their
cash benefits by increasing their work effort to
substantial gainful activity level and beyond.
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A Shift:
Customer Service.
A shift in how Rehabilitation services are offered,
increasing beneficiary choice and customer service
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EN’s offer another level of choice to Social Security beneficiaries
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Increased need for exemplary Customer Service in providing
rehabilitation services is important, especially as more EN
providers become available
EN
WIPA
State
VR
ITA’s
MBI
SBA
PASS
One
Stop
In 2008, SSA made several improvements to the Ticket to
Work employment program to increase participation.
Today you will learn about these improvements and…….
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Ticket to Work program basics
New payment structure
How Partnership Plus works
Next Steps to becoming an Employment Network
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The Ticket to Work and Work Incentives Improvement Act was passed in
1999 and provided benefits to SSA Disability beneficiaries & EN’s
including:
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Yearly cost of living increases for Ticket Payments to EN’s
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Two new work incentives
◦ Extended Medicare benefits
◦ Expedited Reinstatement of Benefits
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Medicaid Buy-In Programs
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Work Incentive Planning and Assistance projects
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Ticket to Work and Self-Sufficiency employment program
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Creates an opportunity for any entity (other than a Federal Department)
to become a Ticket to Work ‘Employment Network’ and begin receiving
payments for supporting ‘Ticket Holders’ as they work at increasing their
earning capacity.
◦ Ticket Holders are qualified Social Security Disability Beneficiaries
ages 18 to 64, receiving Title XVI and/or Title II benefits (SSI or
SSDI)
◦ Now both Medical Improvement Expected (MIE) and Medical
Improvement Not Expected (MINE) groups are eligible due to
changes in TtW regulations from 2008
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Offers long-term funding to ensure Ticket Holders receive ongoing
return to work support.
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Increases choice for Ticket Holders and Employment Networks allowing
both to choose who they work with under the program.
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Ticket to Work – Provider basics
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This is a voluntary program (you do not have to participate,
although DEI projects have committed to becoming EN’s as
a part of this grant)
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Provides additional monetary support to approved providers
(Employment Networks) who assist Social Security
beneficiaries with disabilities in obtaining and maintaining
employment
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Ticket to Work – Ticket Holder basics
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This is a voluntary program - as a Ticket Holder, I do not have to
participate.
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Provides Ticket Holders with CHOICE – as a Ticket Holder, I decide
who I assign my Ticket to based upon who I feel can best provide the
services I need.
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Ensures continued employment support – as a Ticket Holder, I know
you will continue to provide me support beyond the time that State VR
or Medicaid funding permits in some cases.
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Actively participating in the Ticket to Work program suspends a Ticket
Holder’s medical Continuing Disability Review – as a Ticket Holder, I
can return to work without fear that I will medically improve before I am
gainfully employed.
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EN & Ticket Holder Connect
EN & Ticket Holder discuss
needs/services & Ticket Holder gets
benefits planning.
EN & Ticket Holder Negotiate the
Individual Work Plan (IWP)
IWP is sent to Maximus – once
approved, Ticket is assigned to EN
(7 days +/-)
EN provides
agreed upon
services and
supports
Ticket Holder Goes
to Work
& EN Collects
Evidence of Earnings
EN submits
Payment Request
to Maximus &
receives Ticket
Payment
(30 days +/-)
EN continues to
provides services &
supports in
accordance with
Ticket Holder’s IWP
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Training and Employment Notice No. 20-07 clarifies that Ticket
funding is an additional revenue source for One-Stop delivery
systems and is not considered program income and WILL NOT
replace existing funding sources (i.e. funding is in addition to current
funding sources, to be used how you see fit)
Braiding Medicaid funded services and Ticket to Work funds is not
“double dipping”
The Centers for Medicare & Medicaid Services (CMS) clarified this
recently in a State Medicaid Director Letter (SMD #10-002), See:
www.cessi.net/ttw/docs/CMS_Letter.pdf
Choose Work Quarterly Newsletter of the Ticket to Work Program,
Summer 2010 issue also reviews this concept:
http://www.cessi.net/ttw/docs/CW_newsletter_Summer2010_r1.pdf
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2008 Improvements of Importance
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Ticket payments have increased and allow for payments before
the Ticket Holder works at SGA level
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Ticket payment structure encourages the use of available work
incentives with new Phase 2 payment structure
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Tickets are now available to all beneficiaries with disabilities, ages
18 through 64 (with a few exceptions)
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Timely progress reviews are now one time per year
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Partnership with State Vocational Rehabilitation agencies are
more clearly defined, and now called Partnership Plus
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Outcome Payment System
Type
Outcome
Ticket Holder
Earnings
EN Payment for
SSDI
EN Payment
for SSI
Earnings sufficient
for “zero” cash
benefits status
$711/mo. for up
to 36 months
$409/mo.
for up to 60
months
$25,596
$24,540
Total Possible Outcome
Payments
2010 Rates
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Milestone-Outcome Payment System: Phase 1 Milestones
Type
Ticket Holder Earnings
EN Payment
for SSDI
EN Payment
for SSI
Phase 1
Milestone 1
$720/mo for 1 month (or $360
within a two week period)*
$1,275
$1,275
Milestone 2
$720/mo for 3 months within 6
months (cumulative)
$1,275
$1,275
Milestone 3
$720/mo for 6 months within
12 months (cumulative)
$1,275
$1,275
Milestone 4
$720/mo for 9 months within
18 months (cumulative)
$1,275
$1,275
$5,100
$5,100
Total Potential Phase I Milestone Payments
2010 Rates
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Understanding Phase 1 Payments
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There are reasons some, or all of, Phase 1 payments
may not be available to an EN:
◦ Recent Work Activity
◦ State VR history with Ticket Holder
Recent Work Rule
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Work at or above applicable Trial Work level earnings
($720 in 2010) within 18 months “prior to Ticket
assignment” can impact EN access to Phase 1 Milestone
payments
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Does not apply to Tickets assigned prior to July 21, 2008
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MAXIMUS has created a tool to explore a beneficiary
recent work history
> Check out the 18-Month Prior Earnings Tool at
www.yourtickettowork.com.
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Partnership Plus
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VR Cost Reimbursement payments and EN Phase 2
Milestone and Outcome payments both possible for same
beneficiary
◦ SSA will pay for sequential, but not concurrent,
services
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When VR chooses to serve a beneficiary under Cost
Reimbursement, beneficiary’s Ticket is
-- Not assigned to VR, and
-- Cannot be assigned to another EN while VR case is
open
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New “in-use SVR” status extends Continuing Disability
Review (CDR) protection to beneficiary while receiving VR
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services under Cost Reimbursement
Partnership Plus: VR Case Closure
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Beneficiary can assign Ticket to an EN after VR case
closure
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Phase 1 Milestones not available to EN if VR closed
case with beneficiary employed
-- VR provided services leading to initial
efforts at self-supporting employment
-- SSA can pay EN for Phase 2 Milestones &
Outcomes achieved after Ticket assignment
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Milestone-Outcome Payment System: Phase 2 Payments
EN Payment
for SSDI
EN Payment
for SSI
$382/mo. (up to
$220/mo.
11 mos.)
(up to 18 mos.)
Total Phase 2
Payments
$4,202
$3,960
Total Potential Ticket
Payments
Phases 1 and 2
$9,302
$9,060
Type
Phase 2
Ticket Holder
Earnings
Gross > SGA
($1000/non-blind;
$1,640 for blind)
2010 Rates
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Milestone-Outcome Payment System: Outcome Payments
Type
Outcome Phase
Ticket Holder
Earnings
Net > SGA
EN Payment for EN Payment for
SSDI
SSI
$382/mo. for up
to 36 months
$220/mo.
for up to 60
months
Total Outcome Phase
Payments
$13,752
$13,200
Total Potential Ticket
Payments
$23,054
$22,260
($1000/non-blind;
$1,640 /blind) AND 0
cash benefit
2010 Rates
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Will becoming an EN help me with individuals that
can only work part-time?
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The overall goal of the Ticket program continues to be selfsufficiency
Part-time work can increase an individuals self-sufficiency,
and in some cases, reduce benefits reliance
Example: Joe works 20 hours/week and makes $8.50/hour,
monthly average wage=$736
This example would qualify your EN for Milestone payments
NOTE: Your IWP needs to be developed showing the Ticket
Holder will achieve at least TWL earnings in order to be
assigned by Maximus, however, the overall goal is to assist
the individual in achieving greater levels of self-sufficiency,
and strive for SGA level earnings
Milestone Reconciliation Payment
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Occurs when Beneficiary moves quickly into the
Outcome Payment Period
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Includes all Milestones “available” at time of first Ticket
assignment that remain “unpaid” due to the start of the
Outcome payment period
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Reconciliation payment made when 12th Outcome
payment is achieved
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Requesting Ticket Payments
Three options for requesting payment:
1. Evidentiary Payment Request (EPR)
-- Requires primary evidence of earnings
2. Certification Payment Request (CPR)
-- Uses secondary evidence of earnings
3. Auto Pay
-- SSA gathers evidence of earnings starting at
Outcome payment #13 (less work for EN, takes
longer to get paid)
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Benefits of becoming an EN include:
1.
2.
3.
Increase your bottom line - Get paid for the work you are
already doing
Ticket payments are your own to use as you wish
Generous funding stream – $23, 054 (SSDI) and $22,260
(SSI) per successful beneficiary who achieves all payments
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Q&A
To ask a question/make a comment
please click on the “raised hand
icon” OR submit it via the Q&A
panel, both are located on the right
hand toolbar
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Funds through the Ticket program are flexible to
use as you wish, however, so is the Business
Model you choose to develop for your
Employment Network
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The following are examples of strategies found in
various locations across the U.S.
Local Level Strategy
Each EN completes a
separate application to
operate as an
independent EN
One-Stop / EN
One-Stop / EN
Ideally, State
Vocational
Rehabilitation
provides information
about all EN options
when closing a case
One-Stop / EN
STATE VR
Partnership
Plus
One-Stop / EN
One-Stop / EN
One-Stop / EN
This example shows a
collaborative web
allowing for referral and
mentoring efforts
amongst separate EN’s
Collaborative Agreement Strategy
State Vocational
Rehabilitation
Agency
Partnership Plus
Advantages: Sharing of
information &
resources, staffing and
community outreach
EN of record –
Has submitted RFP,
In this example a 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 in place
to serve mutual Ticket holders
Consortium Strategy
Partnership Plus
STATE VR
Private
non-profit
Administrative
Agency
Providers of
Employment
Services
One-Stop / EN
One-Stop / EN
One-Stop / EN
20% of payments for
administrative functions
(i.e. billing / marketing)
EN of Record
80% of payments go
to providers under
local agreement
One-Stop / EN
One-Stop / EN
One-Stop / EN
State
Vocational
Rehabilitation
Agency
Partnership Plus
Possible contractor for
Ticket Administration
One-Stop / EN
One-Stop / EN
State Office
(i.e. Labor,
Mental Health)
Private / Gov.
organization
One-Stop / EN
Policy / Outreach / Reporting
EN of Record – State level –
operating under one EIN
Provide direct service to Ticket
holders / Follow-up supports /
data collection
One-Stop / EN
One-Stop / EN
One-Stop / EN
Becoming an Employment Network
Get the EN RFP at http://www.ssa.gov/work/enrfp.html
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Download and complete on your computer
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Cover letter provides information on how to contact SSA
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Advised not to mail your RFP, send by:
 Email: [email protected] or
 Fax number: 1-410-597-0429
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RFP Basic Components
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Must have an Employer Identification Number (EIN), also known as the Tax
ID #
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Must have general business or professional liability insurance in effect
(minimum of $500,000 per occurrence)
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Must have a DUNS number (contact Dun & Bradstreet at 1-866-705-5711
or apply online at www.dnb.com)
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Must register your DUNS number through the Central Contractor
Registration (CCR) process (www.ccr.gov)
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Must complete forms for simple security clearance for all staff working with
beneficiaries or handling personally identifying information of beneficiaries
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CESSI, the Program Manager for Recruitment and Outreach, will
assist you in completing the RFP….
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Contact Emily Malsch, National EN Specialist: One-Stops, CESSI,
the Program Manager for Recruitment and Outreach, at
[email protected], or (703) 448-6155 x203
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REGISTER for the EN Application Walk-through Teleconference for DEI
Grantees on November 17th from 3pm to 4:30pm EST:
https://ndi.webex.com/ndi/onstage/g.php?t=a&d=965395414 )
 documentation requirements
 review forms
 Q&A
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Additional help is available through SSA’s Employment Network Contracts
Team
 E-Mail: [email protected]
 Call: 1-866-584-5180
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Once you become an Employment Network, MAXIMUS, the Operations
Support Manager for the Ticket to Work program will:
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Handle the process for assigning & un-assigning Tickets
Maintain the list of approved ENs
Process Ticket payments
Conduct timely progress reviews
Staff an EN Help Desk
Provide training & technical assistance to ENs
Visit the MAXIMUS website at www.yourtickettowork.com
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Ticket to Work Program Resources:
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)
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Kevin Nickerson
Program Associate
NDI Technical Assistance Team
[email protected]
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