At‐A‐Glance: The Final Ticket to Work Regulations

Under the Ticket to Work and Work Incentives Improvement Act of 1999, the Social Security Administration (SSA) was directed to create a new system of employment services for Social Security beneficiaries, The Ticket to Work Program. The ultimate goal of this Program was to double the number of Social Security beneficiaries leaving the benefits rolls due to earnings from 0.5% to 1%. This was to be accomplished through a payment system based on outcomes that ultimately led participants to cease receiving cash benefits. The Ticket Program is not meant to supplant the pre‐existing state VR system but to provide more options for beneficiaries to receive services.

Under the initial Ticket to Work Program regulations, EN participation in the Ticket to Work Program has been minimal and there has been no improvement in the rate of beneficiaries leaving the roles due to employment. Recognizing this, SSA proposed new regulations governing the Ticket to Work Program and the final regulations were published in the Federal Register on May 20, 2008. They become effective July 21, 2008. The full text of the new regulations are available at http://edocket.access.gpo.gov/2008/pdf/E8‐10879.pdf.

This At‐A‐Glance brief summarizes the key changes SSA made through the new regulations. With these changes, SSA has created a payment system based on the attainment of increasing levels of employment over time that is attractive enough to entice Employment Networks to participate. And, SSA has modified the interaction of the VR cost reimbursement system with the Ticket system to encourage collaboration among state VR agencies and private ENs.

Changes to Eligibility of Beneficiaries and ENs

All SSDI and SSI beneficiaries in cash status between the ages of 18 and 64 will now be eligible for a ticket. Tickets will not be mailed to the Medical Improvement Expected category until November 2008.

Beneficiaries may place their ticket in inactive status if they report to the Program Manager that they are unable to make timely progress. The months of inactive status will not count toward the time limitations from making timely progress (see below) but the beneficiary loses the Continuing Disability Review protection during this time.

One‐Stop delivery systems established under the Workforce Investment Act and organizations administering Vocational Rehabilitation Services Projects for American Indians with Disabilities are qualified to be ENs and do not need to respond to the RFP. However, they still must enter into an agreement with SSA to be an EN.

Changes to the Payment System

SSA has changed both the amounts of the payments and the benchmarks that must be achieved in order to receive payments. Under the Outcome Only EN Payment system, the payments have been increased. Under the Outcome‐Milestone EN Payment System, the payments have been converted into three phases:

• During Phase 1, payments are made based on gross income (ignoring deductions for work incentives) and working at the Trial Work Period amount. Phase 1 payments on SSI and SSDI tickets are the same.
• Phase 2 payments are also based on gross income (ignoring deductions for work incentives) and working at the Substantial Gainful Activity.
• Phase 3 payments are based upon countable income and leaving the SSA roles.

Phase 2 and Phase 3 payments differ in amount and number of months available depending on SSDI or SSI ticket status. Significant work activity prior to the ticket assignment will limit the availability of Phase 1 milestone payments, even if the person was not working with the state VR agency. Overall payment under Outcome‐Milestone EN Payment System has been increased from 85% to 90% of the Outcome Only EN Payment System

The new payment system also adds a “milestone reconciliation” payment. This payment includes all milestones available at the time of the first ticket assignment that remain unpaid because a beneficiary met the requirements to begin outcome based payments. Such payment will be made when the 12th outcome payment occurs.

SSA will not seek to recover the overpayment to an EN caused by a retroactive determination that a ticket was not available for assignment because the beneficiary was not entitled to cash benefits.

SSA’s summary table detailing the new payment system is attached as an appendix.

Changes to the State VR Agency Relationship with the Ticket to Work Program

State VR agencies are no longer required to assign Tickets in order to assure cost reimbursement from SSA. State VR agencies have the option to participate in the Ticket to Work Program and assign tickets for reimbursement through the two EN payment systems if they choose to do so.

When beneficiaries works with the state VR agency under the cost reimbursement method, their ticket is not technically assigned to the state VR agency. But, the beneficiary cannot assign the Ticket to another EN while the VR case is open. While the VR case is open, the beneficiary will have the protection from a Continuing Disability Review just as he or she does with an assigned ticket. This status begins on the effective date of the IPE or the first day that a ticket would otherwise have been assignable if services were not being provided by a State VR agency that elected cost reimbursement. The Continuing Disability Review Protection is in place for 90 days after the case is closed by VR. VR agencies will work with SSA to submit information on ticket holders whose cases have been opened under the cost reimbursement method. Once the VR case is closed, the ticket is available for assignment to an EN. If the state VR achieved an employment outcome prior to closure, that EN is still eligible for Phase 2 and Phase 3 payments under the EN Outcome‐Milestone Payment System. This new “EN/VR Partnership” allows a beneficiary to access the services and supports needed to obtain employment from the state VR agency and then receive follow‐along services and supports from a private EN.

Changes to the Timely Progress Requirements

SSA conducts timely progress reviews to assure that beneficiaries are making progress toward greater self‐sufficiency. If it is determined that a beneficiary is not making timely progress, the Continuing Disability Review protection is removed. No loss of benefits or other negative consequence is imposed.

Timely progress requirements can be met in several different ways at different periods: work activity, completion of high school diploma or GED, participation in a degree or certificate program and participation in a technical, trade or vocational program (see table below). It is also possible to meet the timely progress goals through partial completion of the work requirement with partial completion of the post‐secondary education requirement or vocational or technical training requirement. SSA will determine what percentage of the work requirement and education/training requirement have been met. If those percentages are equal to or greater than 100%, timely progress requirements have been met.

Timely Progress Requirements

Source

Added July 21, 2008