The
Ohio Rehabilitation Services CommissionExploring the potential for an RSC Employment Network
[Click
HERE to Return to the Ticket to Work Page]
This
fact sheet provides background on the Social Security Administration’s Ticket
to Work program, and is a tool to educate and promote discussion about a
proposed RSC Employment Network.
It was developed with input from members of the Ohio Rehabilitation
Services Commission (RSC) Employment Network (EN) Design Group 1 ,consisting
of staff from RSC and community rehabilitation providers, and representatives
from RSC’s Consumer Advisory Council.
For more information, contact Vickie Van Der Kar, RSC program specialist
for Social Security,(614)438-1284,or Kim Linkinhoker, assistant director of RSC
’s Bureau of Vocational Rehabilitation,(614)438-1247.
Background
The
Ticket to Work and Self-Sufficiency Program, administered by the Social Security
Administration (SSA),was created by the passage of the Ticket to Work and Work
Incentives Improvement Act of 1999.This act also includes several provisions,
independent of the Ticket program to improve or facilitate access to Medicare
and Medicaid health insurance, and to Social Security benefits, for working SSDI
2 and SSI 3 beneficiaries.
One of these provisions relates to Medicaid buy-in, which is a state
option to change or eliminate rules for determining financial eligibility of
workers with disabilities.
During
2001,SSA will begin implementing Ticket to Work in 13 states:
Arizona, Colorado, Delaware, Florida, Illinois, Iowa, Massachusetts, New York, Oklahoma, Oregon, South Carolina, Vermont, and Wisconsin.
The
program will be fully implemented nationwide by early 2004.
The goal of the Ticket to Work program is to increase employment among
SSDI and SSI beneficiaries. This will be done by increasing the number of
vocational rehabilitation (VR) providers and by giving the beneficiary (the
ticket holder) his or her choice of provider.
Currently, the primary providers of VR services for people with
disabilities are state VR agencies. Providers operating under the Ticket to Work program are
called Employment Networks (ENs). ENs
supply VR, employment, and support services via a contractual relationship with
SSA. ENs can be single entities or an association of entities, and
must meet SSA qualifications. Participation
in the program is voluntary for both beneficiaries and ENs.
Ticket holders are not obligated to use their tickets, nor are ENs
obligated to serve anyone
A
ticket holder can obtain information
SSA
does not provide up-front or advance funding to ENs for services provided under
the Ticket to Work program. No
payment will occur when a ticket user’s earnings are low or if the ticket user
chooses not to participate. ENs cannot refer their ticket users to the state VR
agency without an agreement stating the conditions under which such referrals
may be made. ENs must choose
between two payment systems:
Outcome
payment is
payment for a month in which the ticket user does not receive a cash benefit due
to earnings. Outcome
payments can be received for a maximum of 60 months, which do not have to be
consecutive. The
monthly payment is 40 percent of the national average monthly benefit for the
previous year (SSDI or SSI, depending on the ticket user’s entitlement).
The
outcome-milestone payment system consists of the outcome payment system
plus two milestone payments.
These are paid when the ticket user’s gross earnings are at or above
the Substantial Gainful Activity 4 level for three and seven months.
Outcome-milestone pays out less than outcome over the long run.
The total payment range for outcome-milestone to outcome for SSDI ticket
users is $14,000-$16,000;for SSI ticket users, it is $9,000-$10,000.
State VR agencies must enroll as ENs, but do not have to function as ENs.
State VR agencies can choose, on a case-by-case basis, the type of
payment to be received: traditional
reimbursement or ticket payment.
RSC
Employment Network
The
schedule for implementing the Ticket to Work program, beyond the first 13
states, is not known yet. Until it is, Ohio has the opportunity to learn from
the experience of those states. The
Ohio Rehabilitation Services
Commission
’s Employment Network Design Group has been meeting to discuss issues related
to forming an RSC Employment Network. This
work group consists of staff from RSC and community rehabilitation providers,
and representatives from RSC ’s Consumer Advisory Council.
Currently,
there are more questions than answers. Who
should be included in the EN? How
does RSC outreach to potential network partners and ticket users? What should
the referral process and service delivery look like?
Who is responsible for what? What
kind of tracking and record keeping is needed?
What kind of payment system should be used?
What is a provider ’s incentive to join an RSC EN?
Assumptions
Following
are the assumptions underlying the proposed RSC Employment Network, as driven by
the legislation and by RSC ’s EN Design Group:
1.The
Social Security Administration will proceed with implementation of the Ticket to
Work program.
2.The
federal/state service delivery system -which includes community rehabilitation
programs (CRPs) and is focused on competitive, community employment -is a tested
successful model for providing quality services to people with significant
disabilities.
3.Because
of the financial risk, individual CRPs might not choose to become independent
ENs.
4.Private
for-profit companies may see Ohio as a lucrative market.
5.RSC
will continue to purchase VR services from private-sector CRPs.
6.RSC
will continue to collaborate with private-sector CRPs to ensure Ohio’s
effective implementation of Ticket to Work.
8.Consumer
choice of providers, goods and services must be addressed and respected in any
network sponsored by RSC.
9.An
RSC EN offers a wide range of services and providers, and therefore provides
greater consumer choice.
10.Greater
consumer choice within an RSC EN could result in greater demand for services
11.Membership
in an RSC EN will be comprised of accredited CRPs.
12.Membership
of accredited CRPs in an RSC EN is a strong marketing tool.
Benefits
of membership in an RSC EN
The
following lists the benefits of joining an RSC EN:
1.Payment
to an RSC EN member is based on fee-for-service rather than on the Ticket to
Work payment options. CRPs minimize
financial risk and maintain normal cash flow for services provided.
2.Capitalization
requirements will be minimized or eliminated for participating CRPs.
3.RSC
EN members may have the opportunity for financial incentives over and above
regular fee-for-service payment.
4.Maintaining
or increasing RSC ’s Social Security reimbursement dollars supports RSC ’s
ability to purchase services from CRPs.
5.New
services may be developed for which RSC EN members may charge a fee.
6.RSC
EN members have first opportunity at marketing their individual services and
performance to ticket holders.
7.CRPs
will continue to maintain a solid network, which will strengthen existing
business relationships and protect market share.
8.A
strong RSC EN will position Ohio to successfully compete with other ENs in the
provision of quality services.
9.Membership
strengthens and improves the currently successful federal/state VR system.
1
Members
of the RSC Employment Network
Design
Group:
Ohio
Rehabilitation Services Commission
John
Connelly, administrator
Carrie
Johnson, VR supervisor, Independence Bureau of Vocational Rehabilitation office
Kim
Linkinhoker, assistant director, Bureau of Vocational Rehabilitation
Connie
O ’Brien, manager, Employer Services
Michael
Ream, Southeast Area manager, Bureau of Services for the Visually Impaired
Bill
Sykes, program specialist for Facilities/Windmills
Vickie
Van Der Kar, program specialist for Social Security
RSC
State Consumer Advisory Council
Debbie
Dase
Marilyn
Donehey
Rehabilitation
Services of North Central Ohio
David
V.Daugherty, president
Ohio
Valley Goodwill
Jo
Ann Decker, vice president of Rehabilitation
Ohio
Association of Rehabilitation Facilities
Jody
River, chair, Vocational Division
Goodwill
Columbus
Marcy
B. Samuel, Sr.vice president
2
SSDI
=Social Security Disability Insurance
3
SSI
=Supplemental Security Income
4
Substantial
Gainful Activity, or SGA, is the level of pay at which the Social Security
Administration considers a person to be gainfully employed.
During 2001,SGA is $740/month for people with disabilities other than
blindness and $1,240/month for individuals who are blind.
The
Ohio Rehabilitation Services Commission
400 E.Campus View Blvd.
Columbus,OH 43235-4604
1-800-282-4536 voice/TTY
(614)438-1200 voice/TTY
The
Ohio Rehabilitation Services Commission does not discriminate on the basis of
age, color, creed,national origin, race, sex or type of disability. 8/10/01
The Ohio Rehabilitation Services Commission