Disability Employment Initiative (DEI) Hosted/Facilitated by: Laura Gleneck, NDI Technical Assistance Team Presented by: Sallie Rhodes, Ticket to Work Specialist/Partnership Plus Team Lead Operations Support Manager Team (MAXIMUS 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. 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). 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. 2 Upon completion of this training webinar, DEI grantees and participants and partners from the public workforce system will have the following: Knowledge of the Public Vocational Rehabilitation (VR) program, the Ticket to Work program and the VR Cost Reimbursement program Information on how Partnership Plus can be used as an opportunity to address beneficiary needs for ongoing supports after job placement Information on how State VR agencies and Workforce entities can collaborate to expand the scope of services available to beneficiaries and improve services coordination Brief Introduction to Public Vocational Rehabilitation (VR) program, the Ticket to Work program and the VR Cost Reimbursement program Similarities Differences Points of Tension Introduce Partnership Plus as an opportunity to address beneficiary needs for ongoing supports after job placement Explore opportunities for State VR agencies and Workforce entities to collaborate to expand the scope of services available to beneficiaries and improve services coordination Stress fact that partnership opportunities are not one-size-fits-all Different approaches can work! Administered by the Rehabilitation Services Administration (RSA) in the US Department of Education A federal/state program: RSA distributes federal funding to the States based on a prescribed formula and the availability of the state match 79% federal funding/21% state match 24 states split the funding between a general VR agency and VR agencies that specialize in services to individuals who are blind or visually impaired In recent years, a significant number of States have been unable to secure the full state match, meaning they are unable to draw down their full federal allotment Authorized under the Rehabilitation Act of 1973, as amended Rehab Act is prescriptive while allowing for a lot of state flexibility Each state develops a plan describing how it will provide services to individuals with disabilities Result is variations in service delivery networks from state to state State VR agencies serve approximately 1 million consumers a year, placing close to 200,000 in employment each year Emphasis on employment outcomes and serving individuals with significant /most significant disabilities Employment Outcomes: Entering or retaining full-time or, if appropriate, part-time “competitive” employment in the “integrated” labor market Presumptive Eligibility: Individuals receiving SSI/SSDI benefits are presumed to be eligible for VR services as long as they are seeking to enter employment Order of Selection (OOS): If available resources are deemed inadequate, State VR agency must prioritize services for those with the most significant disabilities first Most significant is defined by the state Individuals, including Social Security beneficiaries, who do not meet priority categories may be wait-listed Every year, approximately 40 State VR agencies operate under an OOS Two programs authorized under the Social Security Act provide compensation to service providers for successfully assisting beneficiaries with disabilities enter, maintain and advance in employment Cost Reimbursement program Compensation is based on the cost of services provided Available only to State VR agencies Ticket program New approach to service delivery = Compensation to service providers is based on beneficiaries achieving employment-related milestones and outcomes as they move towards self-supporting employment Available to approved Employment Networks (ENs) and State VR agencies Major OSM initiative in 2011 & 2012 to get workforce entities to become ENs Supported by DEI grants from DOL State VR agency submits for a lump sum payment when a beneficiary achieves 9 continuous months (within a 12-month period) of earnings above Substantial Gainful Activity (i.e., after deductions for Impairment Related Work Expenses and Subsidies) Rather than do individual calculations for applicable deductions, SSA uses tolerance levels (2012 rates) $1010 + $200 = $1210 for disabilities other than blindness $1690 + $100 = $1790 for individuals who are blind or visually impaired Claim must be submitted within 12 months of the 9th month of earnings above SGA Payment includes reimbursement for the cost of approved services provided plus an administrative fee for each month of service provision Eligibility: Individuals with disabilities, ages 18 through 64, receiving cash disability benefits (SSDI and/or SSI) Referred to as Ticket Holders Purpose: Expand options available to beneficiaries seeking services and supports to enter, maintain, and advance in employment Compensation: EN/One-Stop Center or State VR agency functioning as an EN requests payment when a Ticket Holder achieves designated levels of work and earnings as they progress towards self-supporting employment Payments made based on milestones Ticket Holders achieve after assigning the Ticket to the EN/One-Stop Center or VR agency functioning as an EN, and after job placement Not reimbursement for the cost of services provided Each EN/One-Stop Center must choose between two payment options available under the Ticket program Outcome Payment System: EN receives payments when beneficiary attains self-supporting employment (i.e., no longer receiving cash disability benefits) Outcome/Milestone Payment System: EN receives payments when beneficiary achieves prescribed milestones and outcomes related to work and earnings Two sets of milestone payments based on gross earnings allow Ticket Holders to continue receiving cash disability benefits while exploring work Phase 1 milestones based on work at/above Trial Work level: $720/month in 2012) Phase 2 milestones based on gross earnings at/above Substantial Gainful Activity (SGA) level: $1010/$1690/month in 2012 Ticket program is voluntary and free Beneficiary chooses whether/when to participate EN cannot charge for services provided under Ticket program Medicare & Medicaid can continue www.socialsecurity.gov/redbook/ Beneficiary Safety Net: If disability benefits cease due to work and earnings and beneficiary stops working within 5 years of entering zero cash benefit status, there is an expedited reinstatement of benefits Up to six months of provisional benefits while SSA conducts a disability review If determined no longer eligible, beneficiary does not have to pay back provisional benefits • A paper Ticket is NOT needed to participate SSA stopped mailing paper Tickets in June 2011 • Beneficiary can confirm eligibility to participate in Ticket program by • A beneficiary can learn about ENs by visiting http://chooseworkttw.net/ or www.yourtickettowork.com or by calling the number above • A beneficiary can discuss his/her employment goal and the services/supports needed to achieve that goal with multiple ENs and with the State VR agency before deciding where to seek assistance calling 1-866-968-7842 (v) or 1-866-833-2967 (tty) Many beneficiaries are not aware that they have Tickets Many are already working with service providers that are approved ENs When a beneficiary signs an Individualized Plan for Employment with VR or an Individual Work Plan with an EN/One-Stop Center, he/she has elected to use the Ticket with that service provider Medical Continuing Disability Reviews (CDRs) are postponed if a beneficiary is “Using” his/her Ticket, i.e., either the Ticket is assigned to an approved EN/One-Stop Center or the beneficiary is receiving assistance from a State VR agency under cost reimbursement or based on the Ticket being assigned to VR, and Progressing towards his/her employment goal (referred to as making “timely progress”) Medical CDRs are periodic reviews SSA conducts to determine continued eligibility for disability benefits based on a beneficiary’s medical or disabling condition Conducted every 1, 3, 5 or 7 years, depending on the expectation of medical recovery A CDR may result in the loss of benefits if substantial evidence shows medical recovery The Operations Support Manager (MAXIMUS) conducts “timely progress reviews” (TPRs) to determine if beneficiaries are advancing towards their employment goals TPRs are conducted once every 12 months on beneficiaries who are using their Tickets Specified levels of work and earnings and/or educational achievement (GED, postsecondary education, and vocational/technical education/training) demonstrate timely progress towards attainment of employment goals The TPR process involves sending a letter to the beneficiary, contacting the EN/One-Stop Center or State VR agency if the beneficiary does not respond, and contacting the beneficiary one more time if the EN/One-Stop Center or VR agency does not respond Failure to demonstrate timely progress does not end Ticket use, just the beneficiary’s protection against a medical CDR Both are outcome-based programs Goal is to reduce or eliminate reliance on Social Security disability benefits (SSDI/SSI) Both have the same underlying principles Individual Choice Choice of employment goal Choice of services to reach that goal Choice of service providers Individualized services State VR agencies = Individualized Plan for Employment (IPE) ENs = Individual Work Plan or equivalent plan VR Success is based on placing individuals with disabilities in competitive employment in integrated settings Individual must be employed for a minimum of 90 days for RSA to consider it a successful closure No federal requirement regarding number of hours a person must work to be closed successful No reference to earnings at the Substantial Gainful Activity (SGA) level An SSA concept, not a Rehab Act concept CR State VR agency submits for payment when a beneficiary achieves 9 months of earnings above SGA after applicable deductions (i.e., within a 12-month period) Payment is based on cost of services provided Ticket to Work Payments made based on milestones Ticket Holders achieve after assigning Ticket to the EN/State VR agency, and after job placement 1981: Cost Reimbursement program created as a new program in the Social Security Act 1998: Passage of Workforce Investment Act, incorporated and amended the Rehabilitation Act (Part IV of WIA) State VR agency is a mandatory partner in each state’s workforce system 1999: Ticket to Work and Work Incentives Improvement Act authorized as a new program in the Social Security Act 2000: Last regulations for Public VR program issued 2001: First Ticket regulations published 2002: Ticket program implemented, phased over 3 years 2008: Ticket regulations revised VR program & Ticket program operate in parallel universes Nothing in VR’s legislative or regulatory requirements addresses Ticket program Since the Ticket program was not created for VR, it becomes a melding of opportunities for VR agencies 1999 Ticket legislation recognized VR’s long history of serving Social Security beneficiaries with disabilities State VR agencies were made automatic ENs Must submit SSA 1365 form (signed by beneficiary) to secure Ticket assignment Must function as any other EN in terms of submitting for payments, providing Certification of Services, etc. VR given choice, on a case by case basis, between serving a beneficiary under the CR program or functioning as an EN under the Ticket program New status created for Ticket Holders being served under CR: In-use SVR Under revised Ticket regulations, this choice has important implications A service delivery option under which SSA will compensate both a State VR agency and an EN, including a workforce EN, for successfully serving the same beneficiary under the same Ticket in certain circumstances Option established in July 2008 revisions to Ticket regulations Only applies to situations where VR chooses to serve a beneficiary under the CR program Bottom line: When VR serves a Ticket Holder under CR, the Ticket still has value after VR closes the case Revised Ticket regulations included certain limitations related to Partnership Plus Payments based on provision of sequential, not concurrent, services VR provides up-front services leading to job placement Ticket can only be with one service provider at a time VR agencies are not designed to provide long-term employment supports – Many, if not most, VR cases are closed after 90 days of successful employment Beneficiary has option of assigning Ticket to an EN/One-Stop Center EN after VR closes the case and receiving job retention services and ongoing employment supports to maintain/advance in employment Let you State VR agency know if you One-Stop Center offers long-term job retention services – Access to these services may assist beneficiaries to achieve 9 months of SGA level earnings and increase the revenue VR receives under cost reimbursement Phase 1 milestones not available to EN/One-Stop Center if VR closed the case with the beneficiary in employment (successful closure) Now making payments under both cost reimbursement and Ticket program – Phase 1 milestone exclusion ensures some savings to SSA VR provided services leading to job placement and Phase 1 milestones are viewed as compensation for getting beneficiaries into the workforce EN/One-Stop Center is getting Ticket assignment for a beneficiary who is working or has had at least 90 days of work experience VR is not getting/keeping the Phase 1 milestones Phase 1 milestones are available on beneficiaries whose VR cases are closed unsuccessful EN/One-Stop Center can submit for Phase 2 milestones when beneficiary has gross earnings above SGA Some VR cases are closed with beneficiary earning above SGA ENs are required to provide ongoing supports after job placement, either directly (e.g., career counseling) or though an arrangement with another service provider Workforce entities and other ENs can offer a variety of ongoing support services to assist beneficiaries to maintain and advance in employment after VR places a beneficiary in employment and closes the case Job retention services Benefits planning Skill building (e.g., computer skills training, certification/licensure, etc.) Additional Education/Training Job Accommodation information and assistance Asset Development strategies to assist beneficiaries to move towards greater self-sufficiency Jane, a women with bi-polar disorder, is being served by the State VR agency under the Cost Reimbursement (CR) program VR pays for bookkeeping training and places Jane with a health food store working part-time as a bookkeeper Jane works 25 hours a week, earning $8.25 an hour (approximately $825 a month) VR closes Jane’s case after she is employed for 3 months Jane assigns her Ticket to Careers, Inc., the local One-Stop Center Careers, Inc. arranges for Jane to begin night courses to become an accountant The health food store increases Jane’s salary to $9.00 an hour and her hours to 30 a week Jane is now earning over $1080 a month Careers, Inc. begins submitting for Phase 2 Milestone payments as Jane continues earning above SGA ($1010 in 2012) Careers, Inc. continues working with Jane as she continues studying to be an accountant Upon completion of her course work, the health food store move Jane to a full time position with a salary of $11.50 an hour (earnings > $1840 a month) Careers, Inc. starts receiving outcome payments when Jane’s cash benefits cease VR submits for reimbursement when Jane has worked 9 continuous months with earnings above SGA Everybody Wins! If a beneficiary assigns his/her Ticket within 90 days of the date of VR case closure, the protection against a medical Continuing Disability Review (CDR) will continue uninterrupted Beneficiary can assign Ticket after 90 days, but CDR protection ends at 90 days If SSA initiates a medical CDR prior to Ticket being assigned to an EN/One-Stop Center (i.e., after 90 day grace period), SSA will complete the CDR If the CDR protection ends, the beneficiary will go back in the queue for the next regularly scheduled medical CDR A variety of Partnership Plus models are emerging VR agencies use different approaches/procedures to assist beneficiaries in exercising informed choice in selecting an EN after case closure Remember: Partnership Plus is a service delivery option, not a program VR does not elect to participate State VR agencies participate by virtue of electing to serve beneficiaries under the CR program Many Partnership Plus handoffs occur behind the scenes A beneficiary may Go to www.yourtickettowork.com to get a list of approved ENs (self-referral) Go to an EN/One-Stop Center based on advice from a WIPA or information received through the call center or during a beneficiary outreach event • In many states, VR informs beneficiaries about the option to use the Ticket after case closure by Including information in the case closure letter Providing a list of approved ENs serving the state Providing a list of ENs offering the specific services identified during a postcase closure discussion Referring beneficiaries directly to an EN/One-Stop Center at case closure Some State VR agencies use written agreements or referral forms to transition a beneficiary from VR services to ongoing employment supports provided by an EN – Includes information on how to locate other ENs if beneficiary is interested in looking at other options VR VR EN VR Vendor/EN Employer/EN VR EN EN VR EN There is only one instance in which a written agreement is “required” • Ticket regulations (both prior and current) and the EN Request for Quotation (RFQ) state that an EN can refer a beneficiary being served under the Ticket program to a State VR agency for services only when the State VR agency and the EN have a written agreement that specifies the conditions under which services will be provided by the State VR agency (20 CFR 411.400) Applies only when the EN/One-Stop Center keeps Ticket assignment VR agencies will not be able to get cost reimbursement for these beneficiaries These “referral agreements” must be in writing, signed by both VR and the EN, and sent to MAXIMUS to keep on file EN keeps Ticket assignment VR Although a written agreement is not always needed, a written agreement can be important when Trying to create a coordinated system of services that includes structured referrals between VR and ENs • Sharing information on beneficiary service needs, work history, earnings, etc. Sharing personal information requires a signed “Release of Information” The VR regulations allow VR agencies to treat the Ticket as a comparable benefit (i.e., an alternative source of funding for VR services) • Revenue obtained through EN payments will be shared While most State VR agencies are serving all beneficiaries under the CR program, a few are doing mostly Ticket assignments and some are choosing between CR and Ticket assignment on a case-by-case basis Decision between CR and Ticket assignment is initially made at time beneficiary signs plan with VR If VR chooses Ticket assignment, the beneficiary or the VR agency has the option of un-assigning the Ticket after VR services are completed Must submit a written request to MAXIMUS to un-assign Ticket If the beneficiary assigns his/her Ticket to an EN/One-Stop Center after receiving VR services, the VR agency and the EN/One-Stop Center will likely be looking at a shared Ticket payment situation (similar to two ENs working with the same beneficiary and splitting Ticket payments) The VR agency will not have the option of seeking reimbursement under the CR program Ticket payments may be shared based on a written agreement, for example 50/50 split of Ticket payments VR keeps all Phase 1 payments and lets EN have Phase 2 and outcome payments Other arrangements exist If there is no written agreement, VR and the EN/One-Stop Center may seek guidance from MAXIMUS regarding how to split payments Decision will be based on the services each provided and how those services contributed to the beneficiary’s achievement of the required levels of work and earnings Several factors are critical to the success of Partnership Plus A pool of qualified and active ENs must be available to serve beneficiaries residing in the state One-Stop Center ENs have significantly expanded the pool of qualified ENs Some VR agencies have expressed concerns about qualifications of ENs New EN RFQ requires a minimum of 2 years experience in providing employment services to individuals with disabilities Some VR agencies have expressed concerns about ENs not providing “valueadded” services for beneficiaries after VR case closure New EN RFQ requires ENs to provide a minimum level of services including Career counseling Job placement (including job search, job development and job placement assistance) Ongoing employment supports after job placement – Can be met by contacting beneficiary on a quarterly basis to see if he/she needs additional assistance to maintain/advance in employment State VR agency must be timely and accurate in electronically reporting their cost reimbursement cases to the Operations Support Manager (OSM/MAXIMUS) In 2008, SSA established an electronic process for reporting CR cases to MAXIMUS Electronically reporting date Individualized Plan for Employment was signed Triggers the medical CDR protection for beneficiaries served under CR Prevents another EN from getting the Ticket assignment while the VR case is open Electronically reporting case closings Triggers the 90-day extension of the medical CDR protection Releases the Ticket for assignment to an EN/One-Stop Center Necessary for a smooth Partnership Plus hand-off from VR assistance to ongoing supports provided by an EN/One-Stop Center Note: A VR case may be open several days to up to two months or more before a plan has been developed and signed (i.e., time to conduct assessments of functional limitations, identify appropriate employment goal, identify services to meet that goal, and decide on providers of those services) Beneficiaries need to understand the option to assign the Ticket after VR case closure Many VR counselors discuss option to assign the Ticket during the case closure discussion Currently, VR has no legislative or regulatory mandate regarding the Ticket program or Partnership Plus Offering different options for access ongoing supports after VR case closure should be viewed as an aspect of informed choice Requires good basic understanding of Ticket program and Partnership Plus – Many competing training priorities and initiatives Thousands of VR counselors across the country with large caseloads and competing priorities/requirements Training on the Ticket and Partnership Plus is an ongoing need because of retirements, staff turnover, changes in leadership, etc. VR agencies are encouraged to Include information on the Ticket program in case closure letters Distribute fact sheets/brochures on the Ticket program/Partnership Plus Discuss the Ticket program during orientation programs, at plan development, etc. Ticket also provides an option for beneficiaries being wait-listed under an order of selection to seek services from an EN rather than waiting for VR services A few VR agencies include information on the Ticket program in the letter they send to wait-listed beneficiaries A couple of VR agencies provide a fact sheet on the Ticket program to waitlisted beneficiaries One VR agency is working on a written agreement that addresses referral to an EN when a beneficiary is being wait-listed, releasing the Ticket back to VR when the beneficiary moves back into services status, and referring back to the EN after the VR case is closed ENs/One-Stop Centers need to be proactive in reaching out to VR agencies to work in partnership to meet the employment support needs of beneficiaries Make sure your State VR agency’s administrative offices are aware that your One-Stop Center is an approved EN that can provide job placement assistance to beneficiaries who are being wait-listed and ongoing supports to beneficiaries whose VR cases have been closed Every VR agency has a designated point of contact for cost reimbursement and Ticket issues – Start the conversation with this person Formal agreements, where present, are established at the State level and may be implemented at the state or local level Establishing contacts in local VR offices is also important VR counselors have daily contact with beneficiaries VR counselors do not have time to explore who is an approved EN The most important factor is to focus on the needs of the beneficiary, not on who gets what money If a beneficiary comes to the One-Stop Center first, do an assessment of that person’s employment goal, and the services and supports needed to reach that goal Determine if the One-Stop Center is able to provide the services and supports the person needs to be successful in entering and maintaining employment Don’t seek the Ticket assignment on beneficiaries whose needs are better met by VR Integrated Resources Teams (IRTs): Focus is on assessing the needs of consumers with disabilities and identifying the service provider best equipped to meet those needs Programmatic differences between CR and Ticket program create some points of tension Access to Services Beneficiaries are presumptively eligible for VR services Other ENs can choose whether or not to take a Ticket assignment Choice: VR agencies are required to facilitate informed choice A beneficiary must choose between seeking assistance from a State VR agency or an approved EN Ticket regulations only allow beneficiary to “use” a Ticket with one service provider at a time VR counselors are required to facilitate informed choice In considering a person’s need for post-employment services Partnership Plus offers a new option for beneficiaries to access support services after VR case closure Some VR counselors are uncomfortable making direct referrals to specific ENs Some ENs make referrals to VR agencies and keep the Ticket assignment without having signed referral agreements Prevents VR from getting cost reimbursement on that case Partnership Plus: A Win-Win-Win for All Involved • Benefits to Beneficiaries • Benefits to ENs/One-Stop Centers • VR Increases choices for beneficiaries to access services and supports to enter, maintain and advance in employment Ensures access to ongoing supports to advance to long-term employment with earnings above SGA VR provides the more intensive, up-front services leading to employment and the EN/One-Stop Center provides ongoing supports to help beneficiaries maintain and advance in employment In a Partnership Plus handoff of a successful beneficiary, EN/OneStop Center will be working with someone who has been successfully employed for a minimum of 90 days Offers another option for beneficiaries who are being wait-listed under an Order of Selection Offers another option to address post-employment service needs Offers opportunity to coordinate pre- and post-employment services Partnership Plus: Benefits to All • Emphasizes collaborative relationships by encouraging partnering between VR agencies and ENs/One-Stop Centers, rather than competition • Has the potential to strengthen all partners in the service delivery system by combining potential funding from both CR and the Ticket program (i.e., Phase 1 milestone and outcome payments) CR revenue can increase as beneficiaries work with ENs/One-Stop Centers after VR case closure and achieve sustained SGA level earnings CR is based on 9 months of earnings above SGA during a 12 month period Phase 2 payments are based on gross earnings at the SGA level ENs/One-Stop Centers have access to a new source of revenue to fund employment supports Total potential Phase 2 milestone and outcome payments is $16,000 to $17,000 (depending on SSI/SSDI) per beneficiary Both the VR agency and the EN are focused on getting and keeping beneficiaries at SGA level earnings Sinclair Hubard Lead Disability Resource Coordinator (DRC) Disability Employment Initiative (DEI) Project Lead David Leon Ticket to Work Coordinator, Grants & Special Programs Virginia Department of Rehabilitative Services SSA contracts with two organizations to support administration of the Ticket to Work program and Partnership Plus Operations Support Manager: OSM/MAXIMUS Available to assist ENs and State VR agencies Call 1-866-949-3687 or visit www.yourtickettowork.com Beneficiary Access and Support Services Manager: BASS/Booze Allen Hamilton Available to assist beneficiaries Call 1-866-968-7842 or visit http://www.chooseworkttw.net/ SSA funds local projects to assist beneficiaries Work Incentives Planning and Assistance (WIPA) Projects Protection & Advocacy for Beneficiaries of Social Security You will hear more about the resources on a future webinar To learn more about how to become an EN, call (866) 949-3687 For more information on the Ticket to Work Program Visit SSA’s Work Site at: www.socialsecurity.gov/work Visit the Ticket to Work web site at: www.yourtickettowork.com Visit the Choose Work web site at: www.chooseworkttw.net/ Your EN Business Model & Partnerships for Success will cover the following: Key partnerships to build for both EN and Ticket holder success. Community Partnerships for Long-Term Ticket holder success (NEW MATERIAL: long-term supports, linkages to partners like WIPA, PABSS, Mental Health, etc… Establishing an EN Business Model (Maximus staff to support the tie to the RFQ, NDI to provide overview of EN Business Model concepts). Registration Tuesday, Wednesday 17th (3:00pm – 4:30pm EST) Registration: In order to register go to: https://ndi.webex.com/ndi/onstage/g.php?t=a&d=967496862 Sallie Rhodes Ticket Specialist/Partnership Plus Lead Operations Support Manager for the Ticket to Work Program Office: 410.965.1309 Sallie.Rhodes@ssa.gov 48