The Ticket to Work and SelfSufficiency Program

1
The Ticket to Work and Self-Sufficiency Program

• MAXIMUS Staff Training

2
Module 7

• Management of the Ticket Process

3
Learning Objectives

• At the end of this module you will be able to
• Define a Ticket under the Ticket to Work Program
• Define Ticket eligibility
• Describe what constitutes an assigned Ticket
• Describe how a Ticket is unassigned
• Describe voluntary termination of a Ticket
• Describe what constitutes a Ticket being in use
  (continued on next slide)

4
Learning Objectives

• Define Continuing Disability Review and its
  implications for a Ticket holder
• Define an Individual Work Plan (IWP)
• List the elements necessary in an IWP
• Define Timely Progress toward Self-Supporting
  Employment

5
The Ticket in the Ticket to Work and
Self-Sufficiency Program
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Definition of the Ticket

• A Ticket under the Ticket to Work and
  Self-Sufficiency Program is a document that
  provides evidence of SSAs agreement to pay the
  ENs or State Vocational Rehabilitation (VR)
  Agencies that have provided employment services,
  VR services, and other support services to a
  beneficiary who has assigned them his Ticket

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Ticket
8
Eligibility Guidelines

• Individuals meeting the following guidelines are
  eligible to participate in the Ticket to Work
  Program
• Age 18 to 64
• Title II in current pay status based on
  disability
• Title XVI in current pay status and
• Have a disability that is not designated as a
  medical improvement expected diary review case
  or,
• Have disability is designated as a medical
  improvement expected diary review case, and
• One continuing disability review has been
  completed indicating that disability continues.

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Steps for Assigning the Ticket

• Participation in the program is completely
  voluntary
• Beneficiary discusses employment plans with
  prospective providers
• Beneficiary selects an Employment Network (EN)
• EN provides beneficiary with comprehensive
  explanation of services
• Beneficiary and EN develop and sign an
  IWP (continued on next slide)

10
Steps for Assigning the Ticket (continued)

• EN calls MAXIMUS to verify that beneficiary has
  an unassigned Ticket
• EN forwards IWP to MAXIMUS within 2 weeks of
  signing the IWP
• MAXIMUS makes assignment official on date of IWP
  signature

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Taking the Ticket Out of Assignment

• Beneficiary is dissatisfied with services from an
  EN or State VR Agency
• EN wishes to terminate services with beneficiary
• EN goes out of business

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Taking the Ticket Out of Assignment

• Ticket will not longer be assigned effective the
  first day of the following month in which an EN
  goes out of business or is no longer approved to
  be an EN
• MAXIMUS will send a notice to beneficiaries who
  are affected by this

13
Conditions for Reassigning a Ticket

• Beneficiaries can re-assign their Tickets if
• Meet eligibility requirements of the Ticket to
  Work Program,
• Agree to and sign a new IWP, and
• Notify MAXIMUS of wish to re-assign Ticket

14
Steps for Voluntary Termination of Ticket
Assignment

• Beneficiary informs the EN and MAXIMUS
• MAXIMUS updates the SSA database
• SSA informs beneficiary of rights and
  responsibilities
• MAXIMUS notifies EN of terminated relationship
  with beneficiary

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Definition of Using a Ticket

• Beneficiaries who are considered to be using a
  Ticket will not be subject to medical Continuing
  Disability Reviews.
• Beneficiary must be making timely progress under
  the IWP/IPE during the first 24 months after the
  Ticket is assigned
• After the first 24 months, beneficiary must meet
  work guidelines and earnings at the SGA level as
  specified under each year of the Ticket to Work
  Program.

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Beginning Ticket Use

• Ticket use begins on date that Ticket is assigned
  to the EN/State VR Agency
• Ticket is assigned to an EN/State VR Agency on
  the date that the IWP/IPE is signed

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Ending Ticket Use

• End of the 60th month for which outcome payment
  is made to the EN, or
• Day before effective date of the decision that
  the beneficiary is no longer making timely
  progress toward self-supporting employment, or
• The close of the 3-month period which begins with
  the first month in which the Ticket is no longer
  assigned to an EN, or
• The month when benefits end, or
• Day on which the Ticket terminates.

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Placing Tickets in Inactive Status

• Occurs when beneficiary is unable to participate
  in the IWP during the first 24 month period
• Beneficiary may not place Ticket in inactive
  status after the initial 24 month period
• Months in which Ticket is in inactive status do
  not count toward time limits for making timely
  progress towards self-supporting employment
• Ticket is not in use during periods in which it
  is inactive

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Steps for Placing Ticket in Inactive Status

• To place Ticket in inactive status, beneficiary
  must submit written request to MAXIMUS
• Request must include a statement from the EN that
  beneficiary will not be participating in the plan
  or receiving services
• To reactivate a Ticket, beneficiary must submit a
  written request to MAXIMUS
• Ticket is reactivated in first month following
  the month in which the request was received

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Continuing Disability Reviews
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Continuing Disability Review (CDR)

• Reviews conducted by SSA to determine if
  beneficiary is still disabled under Social
  Security guidelines
• Medical CDR determines whether beneficiarys
  medical condition continues to meet disability
  eligibility requirements
• Work CDR determines whether disability has ended
  because of SGA

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The Ticket and CDRs

• If a Ticket is currently assigned, the SSA will
  not begin a Medical CDR during the period the
  Ticket is in use
• Services may begin and the Ticket may be assigned
  if a CDR has already begun
• The CDR will be completed on schedule
• Benefits usually will no longer be received if
  the individual is found to no longer have a
  disability

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Individual Work Plans as an Element of the
Ticket to Work Program
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Individual Work Plan Defined

• A written agreement signed by both the
  beneficiary and the EN that describes employment
  and support services needed to reach an
  employment goal

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Components of the IWP

• Vocational goal
• Services and supports to reach the goal
• Terms and conditions relating to these services
  and supports
• EN may not request or accept compensation from
  the beneficiary
• Conditions for amending or terminating the IWP
• Beneficiarys rights under TTWP
• (continued on next slide)

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Components of the IWP

• Remedies available to the client
• Clients right to privacy and confidentiality
• Clients right to have a copy of the IWP
• Only qualified providers can provide services
• Medical services are provided under supervision
  of licensed personnel

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Effective Date of an Individual Work Plan

• The IWP becomes effective when the following
  conditions are met
• MAXIMUS verifies that the beneficiary has a
  Ticket that is eligible for assignment
• IWP is signed by the beneficiary (or a
  representative) and a representative of an EN

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Timely Progress Toward Self-Supporting Employment
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Progression Through the Ticket Program Includes
Four Periods

• Initial 24-month period
• First 12-month work review period
• Second 12-month work review period
• Third 12-month work review period

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Initial 24-Month Period

• Beneficiary receives full benefits
• No work requirement, but beneficiary must be
  actively participating in work-related activities
  on the IWP

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First 12-Month Period

• Beneficiary is expected to work 3 months (not
  necessarily consecutive)
• Achieve earnings at a specific level depending on
  the benefits the individual is receiving for the
  3 working months

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Second 12-Month Period

• Beneficiary is expected to work 6 months (not
  necessarily consecutive)
• Achieve earnings at a specific level depending on
  the benefits the individual is receiving for the
  6 working months

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Third 12-Month Period

• Beneficiary is expected to work 6 months (not
  necessarily consecutive)
• Achieve earnings at a specific level depending on
  the benefits the individual is receiving for the
  6 working months

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Progress Reviews

• Each progress period ends with a Progress Review.
  
• The purpose of these reviews is to determine
  whether the beneficiary is make timely progress
  toward self-supporting employment and whether
  continued progress is expected
• All reviews are linked to the beneficiarys work
  record as well as earnings, except the 24-month
  Progress Review.

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24-Month Progress Review

• MAXIMUS considers 3 questions in determining
  whether the beneficiary is making timely progress
• Is the beneficiary actively participating in the
  IWP?
• Does the IWP have a goal of at least 3 months of
  work during the next 12 months?
• Given current progress, can the beneficiary
  expect to reach the goal of 3 months of work in
  the next 12 months?

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If Timely Progress is not Made During the
24-Month Period

• MAXIMUS sends written notice to beneficiary
  giving him/her choice to resume participation or
  place Ticket in inactive status
• If beneficiary chooses to resume active
  participation, then he/she will be allowed three
  months to demonstrate active participation to
  MAXIMUS

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Annual Work Reviews

• Two step process consisting of
• Retrospective Review
• Were work requirements in the last 12-month
  period completed?
• Anticipated Work Level
• Do the beneficiary and the EN/State VR Agency
  expect that the beneficiary will work at the
  required level during the next 12-month work
  review period?

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If Timely Progress is Not Made During the
12-Month Period

• MAXIMUS sends written notice to beneficiary
  telling him/her that timely progress is not being
  made and so his/her Ticket is considered not
  in-use
• If beneficiary resumes participation, then he/she
  must complete requirements of the next progress
  period
• If beneficiary successfully completes the
  subsequent progress review period, then Ticket is
  reinstated to in-use status and next work review
  period begins

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Four Work Review Periods
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Exception to the Timely Progress Guidelines

• If beneficiary is unable to participate in the
  IWP during initial 24-month period, then Ticket
  can be placed in inactive status

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Exception Guidelines

• While in inactive status, Ticket is not in use so
  months do no count toward time limitations for
  making timely progress toward self-supporting
  employment
• Beneficiary is subject to CDRs during inactive
  Ticket status
• Ticket can be placed in inactive status only
  during the initial 24-month period
• (continued on next slide)

42
Exception Guidelines

• Beneficiary must submit request, with statement
  from EN to MAXIMUS to place Ticket in inactive
  status
• Inactive status begins on first day of first
  month after request received

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Practice Exercise Timely Progress

• Select a Learning Partner.
• Using the information provided by your Trainer,
  work through the phases of Timely Progress Toward
  Self-Supporting Employment
• Debrief the exercise by presenting your assigned
  case to the larger group