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Peer Counseling Perspectives
Coming Someday: A Look at the Ticket to Work Programs (Part II)

By Jeff Smith, M.S.W.

July 2001

This article is the second in a two-part series outlining how the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA) is being instituted. This article will explore the Ticket to Work Program (hereafter referred to as the Ticket Program).

The Ticket Program is designed to expand the universe of service providers available to beneficiaries with disabilities. The Ticket Program is being phased in gradually over a period of three years. Eventually, if all goes as planned, most Social Security beneficiaries with disabilities will receive a ticket. The first thirteen states involved are: Arizona, Colorado, Delaware, Florida, Illinois, Iowa, Massachusetts, New York, Oklahoma, Oregon, South Carolina, Vermont and Wisconsin. The Ticket Program should be available in all states by 2004 and maybe in Georgia by 2003.

Social Security beneficiaries with disabilities who are seeking employment services, vocational rehabilitation services, and other support services to assist them in obtaining, regaining, and maintaining gainful employment can use a ticket to secure work. It increases their choices in obtaining employment support, vocational rehabilitation and other services needed to get and keep a job. This program is voluntary and the services are provided free of charge.

Individuals will not need to undergo the regularly scheduled disability reviews while they are using tickets. Social Security disability beneficiaries who have been receiving benefits for at least 24 months will not be asked to go through a disability review because of the work they are doing. However, regularly scheduled medical reviews could still be performed and their benefits could be stopped if their earnings exceed the substantial gainful activity limits (currently defined as $740 a month).

When a person's Social Security or SSI disability benefits have ended because of earnings from work, and the person has once again become unable to work because of their medical condition, he or she would be able to request reinstatement of benefits without filing a new application. The person must file the request for reinstatement with Social Security within 60 months from the month their benefits are terminated. In addition they may receive temporary benefits as well as Medicare or Medicaid for up to six months while their case is being reviewed.

The Social Security Administration (SSA) is charged with implementing the Ticket Program, and with providing independent evaluations to assess the effectiveness of the program. They will determine the sequence and timing of the implementation of the Ticket Program in each state, determine beneficiary eligibility, schedule the mailing of the Tickets to eligible beneficiaries, and make payments to Employment Networks (ENs) for services provided to Ticket holders.

The day to day administration of the Ticket program is the responsibility of the Program Manager (PM). SSA has contracted with a private company called MAXIMUS to perform this role. The duties of the PM include: recruitment of ENs; assisting in the facilitation of access for beneficiaries to ENs; ensuring adequate employment services are available and ensuring reasonable access to these services for beneficiaries. The PM is also charged with operating a toll-free line to answer questions about the Ticket Program; and overall administration of the Ticket Program operations.

Many SSDI and SSI disability beneficiaries will receive a "Ticket" they can use to obtain services from an approved provider of their choice of ENs. The EN will discuss possible services with the beneficiary. The EN and the beneficiary will then work together to design an Individual Work Plan (IWP) to outline the services to be provided to help the beneficiary reach his or her employment goal. Any agency, public or private, that takes responsibility for the coordination or the actual delivery of services is eligible to be an EN. ENs are either a single entity, a consortium, or an association of organizations collaborating to combine resources to serve ticket holders. Some examples of organizations that participate as ENs include:

One of the underlying objectives of the Ticket Program is for SSA to work cooperatively and proactively with disability advocates and the health care community to assist disabled beneficiaries in their efforts to work. This is where you and I come in, as the disabled, and advocates for the disabled, we can help shape the program. The same states that were successful with the Medicaid Buy-In should be used as models for how to implement the Ticket Program. (See Part I of this article in the June 2001 issue of Survival News.) The same higher spend down levels, incentives for home buying and exclusion programs implemented in the Medicaid Buy-In program will ultimately affect how successful people are on the Ticket Program. By allowing these increased limits and exceptions, the beneficiaries of the Ticket Program will have more incentives to work again by being able to earn more and be penalized less for it.

Another issue to be aware of regarding the Ticket Program involves the way the payment program is set up for ENs. Because the Ticket Program only reimburses vocational rehabilitation providers when benefits stop, this could create an environment where beneficiaries are moved quickly through programs. In such an environment they might receive poor training and be pushed into jobs before they are ready, just so the provider can earn a quick buck. We need to advocate at the state and federal levels for additional protections so that the disabled beneficiaries of this program receive adequate training and job search help.

As TWWIIA comes closer to being implemented in the State of Georgia, we will all have more opportunities to help shape this valuable legislation. Please keep your eyes and ears open for opportunities to help make the Ticket Program in Georgia a success. Continue checking out Survival News and our website (www.aidssurvivalproject.org) or sign up for our list serve for updates on lobbying and advocacy opportunities surrounding this issue. Implementing the Ticket Program the right way the first time will hopefully result in a skilled workforce who may someday truly be able to get off Medicaid and SSI.


Resources

MAXIMUS:
Toll-Free Line: 1-866-YOURTICKET (1-866-968-7842)
Toll-Free TDD Line: 1-866-TDD2WORK (1-866-833-2967)

SSA website: www.ssa.gov/work

SSA Red Book on Work Incentives

SSI Coalition website: www.ssic.org


To read part I of this series, click here.




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