Social Security: TWWIIA%20Final%20Summary

8/14/2019 Social Security: TWWIIA%20Final%20Summary

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Significant Provisions in theFinal RegulationsImplementing the

Ticket to Work

and Self-Sufficiency

Program



Program

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 inobtaining services necessary to find, enter,

and retain employment



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 or have attained age 65 (SSI) or Full Retirement Age(SSDI)

• Childhood SSI beneficiaries who have attained

age 18, but who have not had a redeterminationunder the adult disability standard.



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 fromemployment 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



Suspension of CDRs--

“Using a Ticket”• SSA may not initiate a Medical CDR while a

beneficiary is “using a ticket” (making “timely progress toward self-sufficiency”)

• A CDR is suspended while the beneficiary is usinga ticket. The regulatory definition of “using aticket” provides the beneficiary with a limited

period to prepare for work, and subsequent periodsduring which the beneficiary must demonstrateincreasing levels of employment.



Use of a

Program Manager • SSA has contracted with a Program

Manager (PM): MAXIMUS, Inc.,

– 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



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



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 servicesto a beneficiary




Qualifications• All ENs must meet minimum qualifications

– Licensed or accreditation, if applicable; or

– Education that provides expertise, or experience invocational rehabilitation

• Non-traditional service providers (such as

employers, and religious and charitable

organizations) may be approved as ENs.




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 beneficiary’s work activity

and earnings so SSA can determine their effect on

entitlement to benefits and benefit amounts



State VR Agency Participation

in the Ticket to Work Program• State VR agencies (VRA) 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 paidunder the cost reimbursement system or under oneof the EN payment systems

• A VRA must provide reports on beneficiaryoutcomes when choosing to be paid as an EN.



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 arenecessary to achieve the beneficiary’s

employment goal



Individual Work Plan,

continued• Must include at least statements of:

– of the beneficiary’s vocational goal

– of services and supports necessary to

achieve the beneficiary’s vocational goal

– of any terms and conditions

– that EN may not request or receive any

compensation for cost of services and

supports from the beneficiary




continued• Included statements, continued

– of conditions under which EN can amend

the IWP or terminate the relationship – of the beneficiary’s rights, including the

right to retrieve the ticket

– of remedies available to the beneficiary,including the availability of advocacy

services and assistance through P&A

Services




continued• Included statements, continued:

– of the beneficiary’s rights to privacy and

confidentiality

– of the beneficiary’s right to seek to amend

the IWP

– of the beneficiary’s right to have a copy of

the IWP made available to the beneficiary

in an accessible format



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




Outcome-Milestone System Payment for four milestones--after work

starts:

1 -worked for 1 calendar month at SGA

2 -worked for 3 calendar months out of 12 at

SGA

3 -worked for 7 calendar months out of 12 atSGA

4 -worked for 12 calendar months out of 15 at

SGA




Outcome-Milestone System

Outcome-Milestone payments, continued:

– Reduced Outcome payments--a bout 85%

of total potentially payable under the

Outcome payment system over 60 months

for the same beneficiary




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



Dispute Resolution in the

Ticket 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 P&A system.




Ticket to Work Program--EN and PM

• The PM is required to have procedures to

resolve disputes with ENs that do not

involve an EN’s payment request.

• An EN can seek a solution through the

PM’s internal grievance procedures.

• If the PM’s internal grievance procedures

do not result in a mutually agreeable

solution, the PM must refer the dispute to

SSA for a decision.




Ticket 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 servicesauthorized through the Client Assistance Program,

and to provide an opportunity to resolve disputes

using formal mediation or an informal hearing

process.



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 EN’s agreement

with SSA.



Ticket to Work Program

and Alternate Participants• The Alternate Participant (AP) process will

end in each State

• 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 becovered under the current cost

reimbursement system for a limited time



Ticket to Work Program

and 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 servicesafter January 1, 2004



The Work Site

• SSA Office of Employment Support

Programs’ Web Site:

• http://www.ssa.gov/work

Date post:	31-May-2018
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