The Ticket to Work and Self-Sufficiency Program Training for Employment Networks and State Vocational Rehabilitation Agencies January 2007 Module 1 Overview of the Ticket to Work Program Learning Objectives Describe the events leading to the Ticket to Work and Work Incentives Improvement Act legislation List the four purposes of the Ticket to Work and Work Incentives Improvement Act Cite the state goal of the Ticket to Work and Self-Sufficiency Program Learning Objectives Describe the purpose of the Ticket to Work and Self-Sufficiency Program Describe the objectives of the Ticket to Work and Self -Sufficiency Program Describe the mission of MAXIMUS as the Operation Support Manager, and Describe the basic components of the Ticket to Work and Self-Sufficiency Program Background to the Ticket to Work and Work Incentives Improvement Act of 1999 National Organization on Disability/Harris Survey Findings 29% of individuals with disabilities were working full or part time From 1986-1989, the number of people receiving disability benefits rose 80% Reasons for Increase Expanded eligibility Social Security Administration outreach efforts Economic condition during the late 1980s and early 1990s Lack of affordable health care insurance Demographic changing workforce U.S. General Accounting Office Findings Less than 1% of SSDI and SSI beneficiaries attain paid employment enabling them to be self-sufficient One-third of the people who leave the rolls return in 3 years In one half of one percent of those individuals were to attain self-supporting employment, savings would total $3.5 billion Explanation for the Increase in Individuals With Disabilities Continuing As Beneficiaries Lack of affordable health care insurance and often are uninsurable by private plans Unable to obtain health care coverage that provides services supporting independency Fear of losing health care coverage thus unable to maximize earnings potential Fear the risk of losing medical coverage that is linked to cash benefits Purpose of the Ticket to Work and Work Incentives Improvement Act Purpose of the Legislation Provide health care and employment services to individuals with disabilities Encourage state to enable beneficiaries to purchase Medicaid coverage Provide Medicare to beneficiaries while working Establish the Ticket to Work and Self-Sufficiency program (TTWP) that allows beneficiaries to seek employment and reduce cash benefits Purpose and Goal of the Ticket to Work and Self-Sufficiency Program Overall Purpose of the Ticket to Work Program To expand the universe of service providers available to beneficiaries covered under Social Security Disability Insurance and Supplemental Security Income based on disability or blindness in obtaining the services necessary to find, enter, and retain employment. Overall Goal of The Ticket to Work Program Accomplishing the overall purpose of the TTWP will achieve the goal of: Increasing the number of beneficiaries entering the work force, and Reducing dependency on cash benefits Overview of the Ticket to Work and Self-Sufficiency Program The Ticket to Work Program Address barriers that beneficiaries encounter when returning to work, Expand availability of health care services and medical coverage, Eliminate work disincentives, and Provide enhanced benefits planning and assistance from service providers Major Components of the Ticket to Work Program Social Security Administration MAXIMUS Tickets Beneficiaries Employment Networks Individual Work Plans EN Payment Systems Social Security Administration Designated by Congress to oversee the implementation of the Ticket to Work Program Responsible for writing the Regulations for the TTWP Will monitor the success/short-comings of the TTWP Will determine which beneficiaries will receive tickets Will have the final say on all decisions MAXIMUS Selected by Social Security Administration to serve as the Operations Support Manager for the TTWP Responsible for overseeing the administration/day-to-day functions of the TTWP The MAXIMUS Mission Assist SSA in accomplishing the Ticket to Work Program's objectives, Provide beneficiaries with a network of Employment Networks (ENs), Provide an effective process by which beneficiaries can secure program information and make EN selections, and Provide follow up and quality monitoring of the services beneficiaries receive. Specific Responsibilities of MAXIMUS Monitor EN payments Ensure beneficiaries ability to change ENs Reassign Tickets Maintain list of available ENs Ensure all information is in accessible format to beneficiaries Resolve payment issues Train Employment Networks and State VR agencies Tickets Document providing evidence that the Commissioner of the Social Security Administration has agreed to pay an EN or State Vocational Rehabilitation (VR) Agency for providing support services to the beneficiary Available for SSDI/SSI beneficiaries who meet the established eligibility criteria Ticket Ticket Distribution Distributed in graduated phases Rolled out in 13 states initially (Phase 1) beginning in February 2002 Next 20 states & D.C. rolled out in November 2002 Final roll out (remaining 17 states and U.S. Territories) in November 2003 Beneficiaries Eligible beneficiaries will: Be 18-64 years old In an active pay status; and Must not be medically expected to improve, or if they are medically expected to improve, they must have had a Continuing Disability Review within the last 12 months Beneficiary Participation Ticket Program is VOLUNTARY Beneficiaries will not be penalized for choosing not to use their ticket In choosing to participate, beneficiaries may assign their ticket to the EN of their choice Employment Networks Organizations or groups of organizations that have come together to provide necessary services to a beneficiary in support of an employment goal Two payment options available to ENs State Vocational Rehabilitation Agencies (VR) Located in each state, 81 nationwide Title I of the Rehabilitation Act of 1973 Must participate in the TTWP, but does not have to function as an EN Three payment options available Individual Work Plan (IWP): Definition An agreement between the beneficiary and the EN Contains a statement of the beneficiary's vocational goal and outlines services necessary to achieve the goal Represents mutual agreement between the 2 parties to work together toward the goal of gainful employment Individualized Plan for Employment Document used by State VR Agencies Similar to an IWP Employment Network Payment Systems ENs are compensated for services provided to beneficiaries with Tickets when those beneficiaries achieve certain milestones or outcomes ENs can select from 2 payment systems: Outcome Payment Method Outcome-Milestone Payment Method Outcome Payment Method ENs can receive up to 60 payments Payments are received for months when the beneficiary has earnings from employment sufficient to preclude payment of cash benefits or to reduce cash benefits to zero Outcome-Milestone Payment Method ENs can receive up to 4 payments for Milestones that the beneficiary reaches, in addition to the 60 Outcome payments Milestones are achieved after the beneficiary starts working and are based on earnings The beneficiary may still receive his/her cash benefit in the month that the milestone is paid to the EN Cost Reimbursement Payment Method ONLY available to State VR Agencies Payment method available to State VRs under Title I of the Rehabilitation Act of 1973, as amended State VRs may choose to receive payment through this method or one of the EN payment methods The Ticket to Work Self-Sufficiency Program Training for Employment Networks and State Vocational Rehabilitation Agencies January 2007