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You're listening to the Disability Law Lowdown, show number 16.

Jacquie Brennan: Welcome to the Disability Law Lowdown. I’m your host, Jacquie Brennan.

In today’s podcast, reporter Jana Copeland interviews Sallie Rhodes and Tom Gloss, Social Security Administration Ticket to Work program specialists, about recent changes to Ticket to Work regulations. Topics included are going to include an overview of the program, a synopsis of the 2008 regulatory changes, benefits of Ticket to Work for SSI and SSDI beneficiaries and employers, and resources for more information. Jana?

Jana Copeland: Hi! Thanks a lot, Jacquie. This is Jana Copeland with the Rocky Mountain ADA Center located in Colorado Springs.

It’s my pleasure to be here today with Sallie Rhodes and Tom Gloss with CESSI Accessible Solutions who are Social Security Administration Ticket to Work program specialists. We’re going to talk a little bit today on this episode about some of the recent changes to the Social Security Administration’s Ticket to Work program.

Sallie Rhodes, one of our speakers today, is part of the CESSI’s team under contract with the Social Security Administration to recruit employment networks and outreach to beneficiaries to participate in the Ticket to Work program. Sallie has over twenty-two years working on a variety of disability issues.

Tom Gloss is also a TIcket to Work program specialist with CESSI. He is also part of the recruitment and outreach team located on-site at Social Security headquarters in Woodlawn, Maryland. He had a long federal career that included positions at the local and national levels of Social Security administration and spent many years working in the area of employment with disabilities.

Thank you for being with us today, Sallie and Tom. Welcome.

Tom Gloss: Thank you.

Sallie Rhodes: Thank you.

Jana: As a way to get started, Sallie, what exactly is the Ticket to Work program?

Sallie: The Ticket to Work program is a voluntary employment program administered by the Social Security Administration that offers beneficiaries with disabilities who receive Social Security Disability Insurance, referred to as SSDI, or Supplemental Security Income, referred to as SSI, increased choices in obtaining services and support to engage in work and achieve their employment goals.

You might wonder what I mean by a “voluntary employment program”. What that means is the beneficiaries can choose whether they want to participate in the program and if they do, they can choose when to use their ticket. Social Security pays participating providers and employers, which are referred to as employment networks, for milestones in outcomes that the beneficiaries they’re working with achieve as they move towards self-supporting employment. The program is free to these beneficiaries and the ultimate goal of the program is to reduce the reliance on social security disability benefits, increase their self-sufficiency and improve their quality of life.

Jana: Wow, Sallie. That sounds like a worthwhile program. Tom, why is everyone talking about Ticket to Work right now?

Tom: Well, the Ticket to Work program was authorized by legislation that was signed back in 1999 called the Ticket to Work and Work Incentives Improvement Act. Social Security created this new program from the ground up and started to roll it out in 2001. There were three phases to that roll-out and the really neat thing was a new approach here that the providers were being paid when the beneficiaries reached certain milestones in outcomes of employment rather than just reimbursing on a fee-for-service kind of basis.

So part of the legislation required Social Security to monitor the program and make changes when necessary. So over the course of years, Social Security issued a few regulatory changes, interim changes. They received feedback from many different sources: from advocates and beneficiaries and their families, from employers and employment networks. They took all of that information. They listened to all of that and they used that to create a final regulation which was just published May 20, 2008 and became effective July 21st.

So what we’re saying is SSA listened, they learned and they responded based on of this input that was received and the new regulations went into effect July 21st. What it really is trying to do is address all the issues that have been raised over the years to make the Ticket to Work program more successful.

Jana: So you guys have been busy then.

Tom: We sure have. (laughs)

Jana: So, Sallie, in light of these new final regulations that were published earlier this year, can you tell us a little about how the Ticket to Work program works?

Sallie: Well, basically, after a beneficiary is determined eligible for Social Security Disability benefits, and under the new regulations that’s all beneficiaries as they’re determined eligible, they will receive a ticket in the mail. They will receive a letter from Social Security Administration explaining a little bit about the ticket program and suggesting that they visit the Maximus website (Maximus is the program support manager that handles a lot of the issues around ticket assignments and beneficiaries) and look at the list of approved employment networks on their website and think about visiting some of them and talking to them about their employment goals and the types of services those employers offer.

Once the beneficiary finds an employment network that looks like it’s going to be a good match with their needs, the beneficiary and the employment network negotiate a service plan which is called an Individualized Work Plan. At that point the beneficiary is assigning their ticket to that employment network.

Then the employment network provides the services and supports that were outlined in the Individualized Work Plan to assist that beneficiary in going to work and moving towards self-supporting employment. When that beneficiary does go to work, the employment network starts collecting evidence of earnings and then submits that, along with a request for payment, to Maximus and gets paid roughly in about thirty days.

It’s a really wonderful opportunity where employment networks are being rewarded for helping these beneficiaries achieve these milestones and outcomes related to earnings and on-going work.

Jana: Well, great. Thank you, Sallie, for that synopsis. That was really helpful. Tom, you had mentioned that the new regulations went into effect late last month on the twenty-first of July. Were there any significant changes to the regulations that our listeners might be interested in that were designed specifically for beneficiaries?

Tom: Yes, there were. Actually, the original ticket program gave tickets to all beneficiaries ages 18-64 except for the group of people who, when Social Security approved them to receive disability benefits determined medical improvement was expected, when there was this expectation that they would recover in a short period of time and the decision was made early on that they would not be included in the ticket program.

Of course, over the past few years, as people thought about that, it didn’t make a lot of sense because you would logically think that somebody who is perhaps going to get better medically would be more likely to go to work. Shouldn’t we support them with a ticket, too?

So these new, these final group of regulations includes that group of people now. There are about three hundred thousand of those who over the past were not included. They will receive their ticket in the mail sometime this fall. As new decisions are made on new disability applications, those folks would get their ticket automatically right up front. Anybody who is in that group of three hundred thousand, they don’t really have to wait until they get their paper ticket in the mail. If they are interested, motivated to go back to work, they can contact Maximus through the yourtickettowork.com website and get their ticket right away.

The other thing that’s important for beneficiaries is that Social Security does periodic reviews of the beneficiary’s medical condition. It’s called a Medical Continuing Disability Review, or CDR. I know from having worked with beneficiaries in the local Social Security office that that can be very stressful. When they get that letter from Social Security saying their medical condition is being reviewed, it may ask them to go to a Social Security doctor, someone that their not familiar with. It can be very stressful and upsetting. So one of the things, if the person is using their ticket and making timely progress in achieving their employment goals, they’re protected from that. They don’t even get the letter. None of that stress happens. They don’t have to go for that review, as long as they’re using their ticket and making progress towards achieving their employment goal.

The ticket program is really about improving choice and opportunities for beneficiaries to get the support and services that they need to go back to work. The changes in the new regulation are really putting more money out there and improving the likelihood that the beneficiaries are going to get those supports and services and therefore be successful in going back to work. That’s pretty neat.

Finally, with the new changes through the new regulations, we think the ticket program is more closely aligned with all the other work incentives that Social Security has in place for people with beneficiaries. One of these things is called the Work Incentive Planning and Assistance Project. They’re out around the country. The WIPA projects are out there with certified counselors, if you will, who can help beneficiaries understand what the work incentives are and how they will specifically help those individual people. So, how does work impact my benefits? There’s a person out there who can answer that question for those beneficiaries. In fact, what Social Security is doing is having these WIPA projects hold WISE events, work incentives events, that will bring beneficiaries who are interested in going to work into the room with local employment networks and other community resources. They can really get their minds wrapped around this concept of going to work and get the information that they need.

Jana: Great. You mentioned the WISE events. On that note, will the new Ticket to Work program really be more advantageous to employment networks as well?

Tom: Yes, we really think that it will. One of things that SSA heard as it was listening was that the way that the program was originally structured, it didn’t get enough money out there, up front, for the employment networks to really serve the beneficiaries. The changes result in the employment networks receiving these milestone payments earlier in the process, more often and at higher rates.

For example, there’s more money for the employment networks up front. The first milestone payment to the employment network comes after the beneficiary earns only three hundred and thirty-five dollars in a one month period. That’s really a significant change, the money right up front. Then there are three more milestone payments after a beneficiary earns six hundred seventy dollars per month in three of six months, six of twelve months, and nine of eighteen months respectively. That level of earnings is consistent with part-time work. Here’s the really good part. Each milestone payment to the employment network is eleven hundred and seventy-seven dollars. That’s a total of forty-seven hundred and eight dollars for the four phase one milestone payments.

Another significant change is that these phase one milestone payments are now identical for beneficiaries who are in the SSDI program and the SSI program. Before there was quite a disparity between those two and employment networks did not receive as much if they were working with an SSI beneficiary. That’s a pretty neat change. In fact, the total amount of potential EN payments are very similar now for both SSI and SSDI beneficiaries.

The phase two milestone payments and the outcome payments, if you add all that together, it puts more than fifteen thousand dollars in employment network payments if the beneficiary earns what Social Security calls “substantial gainful activity” levels of earns which is nine hundred and forty dollars a month for people who are not blind and fifteen hundred and seventy dollars a month for beneficiaries who are blind. Add this all up and it’s over twenty thousand dollars in potential payments to the employment network as a reward, or incentive, if you will, if that beneficiary goes back to work long time.

These phase one and phase two milestone payments are based on gross earnings by the beneficiary. So that means they can use those work incentives that Social Security has in place. Ticket doesn’t replace the existing work incentives; it enhances them or wraps around them.

Another significant change is something we call Partnership Plus. I’m going to let Sallie talk about that.

Jana: So, Sallie, how will employment networks and state vocational rehabilitation agencies function under this new Partnership Plus program that Tom mentioned?

Sallie: This to me is one of the most exciting parts about the new regulations. The state vocational rehabilitation agency is an employment program administered by the Department of Education that’s actually been around for close to ninety years.

Back in 1981, the Social Security Administration started reimbursing state vocational rehabilitation agencies for the services they provided for beneficiaries with disabilities when those beneficiaries received nine months of earnings at net SGA, substantial gainful activity, for the earnings. This was, once again, like I said, a reimbursement for services program which was mentioned earlier whereas the ticket program is the new approach where Social Security pays for milestones and outcomes.

Under the old regulation, the original ticket regulations, state VR agencies were kind of viewed as being in competition with employment networks for tickets. Under the original ticket legislation, VR agencies, because they’d been around so long and had the traditional cost reimbursement program, were given the option, on a case by case basis working with beneficiaries, whether to serve the beneficiary under cost reimbursement or under the new Ticket to Work program.

Well, SSA learned quickly that there was this perceived competition over the assignment of tickets and they responded in the new regulations with some new provisions and the Partnership Plus option which actually really encourages VR agencies and employment networks to work together to meet the needs of beneficiaries. For the first time, under the new regulations, Social Security is willing to pay VR under cost reimbursement and an employment network under the EN payment system whereas before it was one or the other.

What that means is, VR can serve an individual, provide them the services they need to go to work, and VR usually closes a case in about ninety days. When they close the case, that beneficiary can take their ticket to an employment network and assign it and get on-going support services, job retention services, transportation, whatever it is they need to stay on the job and increase their earnings level. As they move forward, the employment network will be able to get the phase two milestones and the outcome payments.

What this really means is, in addition to the cost reimbursement money, Social Security is putting roughly sixteen thousand dollars of new money on the table for SSGI beneficiaries and fifteen thousand dollars for SSI. I’ve been working in employment for people with disabilities for a long time and this is the first new money that has come in from anywhere in many, many years. So, we’re very excited about this and we think this will provide many new opportunities for employment networks and VR agencies to work together.

Jana: Wow! That is really exciting news and the other piece of excitement is that it’s encouraging collaboration the VR and the employment network. That’s refreshing that there are some regulatory kinds of encouragement of that collaboration as well.

Tom, why would a service provider or an employer want to become an employment network under the new Ticket to Work program?

Tom: You know, there are almost twelve million people receiving Social Security disability benefits between both SSGI and SSI programs and historically less than one-half of one percent of beneficiaries leave the rolls because they go back to work. Yet, if you look at the age group of eighteen to thirty-nine, ninety-two percent of that age group say that they have employment goals. They see themselves working in the next five years. It’s a huge disconnect between where people with disabilities want to be and where they’re getting to. And yet we know that providers out there are working with our beneficiaries, so if they’re already serving Social Security beneficiaries, then they should become an employment network because this money is available to them if they just sign up and get approved to be an employment network.

They may already be serving the beneficiaries. If they’re not, we know the beneficiaries are out there and there are many of them who have a desire to work so it’s kind of an easy access to these clients, to these potential clients. In fact, when they sign up and become approved they get access to a CD which contains a list of all of the eligible beneficiaries who have tickets in their service area whether that’s a city, a county, a whole state or the whole country. They have access then to all of the beneficiaries with tickets in their service area so they can market to them. They can also get listed on the Maximus website as an employment network so beneficiaries will contact them. It’s a pretty easy, flexible way to get access to get access to clients or customers. Because there’s more ticket money up front sooner, we think this is going to provide more motivation on both sides, but at a twenty thousand dollar potential value per ticket that’s a pretty sizable reason for an employment network to work with a beneficiary.

These ticket payments are flexible money so Social Security does not mandate how the money has to be used. It’s based on the beneficiary attaining that required milestone or level of employment that brings in the money and then the employment network can use that to hire more staff, to redo the office, expand the office, if they are a profit making company, it can be profit. It’s really a flexible funding stream and we all know that in today’s United States of America funding streams seem to be drying up. This is a new source of money. There is actually no legislative cap on how much money can be spent on this program. It’s really driven by the beneficiaries going back to work and that’s a wonderful thing.

Also, over the last year or so, Social Security has tried to streamline the application process for providers who want to become employment networks and they put in place a lot of supports. For each step of the process there’s help for that employment network to sign up to become approved to serve ticket holders and as they request payment for their service, if there are any problems, there’s a lot of supports in place each step of the way.

Jana: Wow! It sounds like a real win-win situation for both the beneficiaries and potential employment network members, especially in light of everything we keep hearing in the press about the changing labor market, the aging workers, the real employment glut that employers are going to face when we just don’t have enough folks to fill our vacant positions.

Sallie, where can listeners who are interested in learning more about the Ticket to Work program and how to become an employment network, where can they go for more information?

Sallie: Jana, that’s a very important question because what Tom and I have shared with you today is just kind of touching the surface of the Ticket to Work program and the improvements to the regulations and some of the other work incentives that are associated and coordinated now well with the Ticket to Work program.

If you are interested in learning how to become an employment network, you would want to contact CESSI, that’s who we work for, the program manager for recruitment and outreach for the Ticket to Work program. That phone number is 1-877-743-8237. CESSI has on hand account managers who are available to provide one-on-one consultation with anybody who is interested in becoming an employment network. Those account managers have regional assignments as well as what we refer to as vertical assignments. We have one that works with independent living centers, one who works with one-stop centers and a variety of others.

CESSI also has bi-weekly teleconferences that are application walk-throughs, they are free of charge, for people who are participating. They walk you through the application and break it down. They tell you what pages you have to fill out and what pages are just background information. It’s very helpful for anybody who’s thinking about becoming an employment network.

Once you are approved to be an employment network, assistance is available then through Maximus who we mentioned before, that’s the operations support manager. Their phone number is 1-866-949-ENVR and those numbers for ENVR are -3687.

To learn more generally about the Ticket to Work program, you should visit the Social Security’s work site at www.ssa.gov/work or you can also visit the Maximus website which is www.yourtickettowork.com all run together.

If you still have questions after hearing this and looking at some, particularly on the SSA work site there’s many fact sheets available that will go into detail about the Partnership Plus we mentioned, the payment of EN outcome and milestone payments and all that, but if you still have questions after you’ve looked at all that information, we encourage you to submit those questions to a special email address that Social Security has set up just for this purpose. That email address is ticketprogram@ssa.gov.

So, I think that covers quite a bit of information in a short period of time.

Jana: Sallie, Tom, I want to thank both of you for giving us a little bit of an update on some of the changes to the Ticket to Work regulations and what that means for both beneficiaries and employment network and service providers. I do appreciate you guys being with us today.

Tom: Thank you.

Sallie: Thank you.

Jana: If you have any additional questions about the employment of people with disabilities, the Americans with Disabilities Act or other relevant disability legislation, you can also call your regional ADA Center at 800-949-4232 or you can visit us online at adata.org.

Thank you for joining us today and we’ll talk to you soon on future episodes of the Disability Law Lowdown.

Jacquie: Thanks so much to Jana, Sallie and Tom. That was great!

The Disability Law Lowdown is brought to you by the Disability Business Technical Assistance Centers, which are a network of ADA Centers that provide training, technical assistance and materials on the ADA and other disability related laws. Funding for the Centers is provided by a grant from NIDRR, the National Institute on disability and Rehabilitation Research. You can subscribe to the Disability Law Lowdown at our website at DisabilityLawLowdown.com or on iTunes.



The Southwest and Rocky Mountain ADA Centers are part of a program of Independent Living Research Utilization at TIRR - Memorial Hermann in Houston, Texas, and is funded by the National Institute on Disability and Rehabilitation Research. If you have questions about disability law or would like to request materials or training, please call 1-800-949-4232. This podcast is protected by the Creative Commons Attribution Non-Commercial No-Derivative-Works 2.5 License. For more information and transcripts, visit www.ada-podcast.com.