|
In late 1999, the Congress enacted and the President signed the
Ticket to Work and Work Incentive Improvement Act (TWWIIA). This legislation
represents a significant opportunity for increasing the employment of people
with disabilities. The Social Security Administration (SSA) has until December
2000 to complete the regulations necessary to implement the Ticket to Work
sections of the TWWIIA. The health care component of the TWWIIA is administered
by the Department of Health and Human Services (HHS).
The TWWIIA provides for two landmark measures that have the
potential of enabling millions of Americans with disabilities to join the
workforce. The first is the creation of the Ticket to Work Program administered
by the SSA. This program modernizes employment-related services offered to
Americans with disabilities. Through the Ticket Program, individuals with
disabilities will be able to get job-related training and placement assistance
from an approved provider of their choice. This provision enables individuals
to go to providers whose resources best meet their needs, including going
directly to employers. The second measure expands health care coverage so that
individuals with disabilities will be able to become employed without fear of
losing their health insurance.
The information provided below highlights how the TWWIIA can
benefit both Americans with disabilities who want to work and employers in need
of qualified workers.
The Ticket to Work Program
Q: When will the Ticket Program start?
A: The first Tickets will be distributed in early
2001.
Q: Will the Ticket Program start everywhere at the same
time?
A: No. Initially the Ticket Program will only be available in
certain states. Under the terms of the Act, the program will be available
throughout the country by January 1, 2004.
Q: How will the Ticket Program advance the employment of
individuals with disabilities?
A: Recipients of Supplemental Security Income (SSI) and Social
Security Disability Insurance (SSDI) will have greater choice in getting the
services and technology they need to obtain employment. The law gives them the
right to choose their job training, employment placement and other service
providers from a list of providers approved by the SSA. Individuals with
disabilities will receive a “Ticket” which they will be able to
present to an Employment Network provider they feel best meets their needs. The
objective of the Ticket Program is to work with businesses, state vocational
rehabilitation agencies and other traditional and non-traditional service
providers to prepare individuals with disabilities for work and link them with
employers who want to hire qualified employees.
Q: How will the Ticket Program work?
A: Benefit recipients will receive a paper document
representing the Ticket and a letter of explanation with instructions and
information about the Ticket Program. If the recipient chooses, he or she can
take the Ticket to an “Employment Network.” The recipient will
receive a list of approved Employment Networks from the SSA and can choose the
one whose resources best fit her or his needs. Recipients can also choose not
to use the Ticket. This will not affect their disability benefits. A benefit
recipient electing not to use the Ticket may still use the services that are
otherwise available through state vocational rehabilitation
agencies.
Q: What is an Employment Network?
A: An Employment Network is a public or private entity
approved by the SSA to provide job training, employment services and other
support services needed to facilitate entry or reentry into employment for
individuals with disabilities. The Employment Network acts as the “Ticket
Taker”and may provide services directly or by entering into agreements
with other providers. It may be a single provider of such services, an
association of such providers or a one stop delivery center establishedu nder
the Workforce Investment Act of 1998. A state vocational rehabilitation agency
(VR) may be an Employment Network with respect to each individual with a
disability to whom it provides services. The state VR may also accept referrals
from an Employment Network, provided the referral is made by prior written
agreement.
Q: How will Employment Networks be paid?
A: The payment structure is incentive-based and intended to
ensure that individuals receive the ongoing services needed to maintain
employment and succeed at work. The TWWIIA authorizes Employment Networks to be
paid a percentage of the national average SSI or SSDI benefits under either an
outcome payment or outcome milestone payment system. Under the outcome system,
the Employment Network will be paid for each month a beneficiary does not
receive a benefit check because of work or income for a period not to exceed 60
months. The 60 months need not be consecutive. The milestone system is similar.
However, it provides for payments when the beneficiary reaches specified
milestones while preparing for, or seeking, permanent employment, at which
point the outcome payments begin.
Q: How will Employment Networks be selected?
A: The Commissioner of the Social Security Administration will
select several Program Managers who will recruit and recommend Employment
Networks. Program Managers will be public or private organizations. The
criteria for an Employment Network are established in the Act and will be more
fully defined under the regulations which must be completed by December of
2000.
Expanded Health Care Coverage
Q: How does the TWWIIA enable a person with a disability to
work without losing health insurance coverage?
A: The possible loss of health care coverage is one of the major
barriers for individuals with disabilities who want to work but have no
alternative health coverage. The TWWIIA removes the need for individuals with
disabilities to choose between health insurance and work by allowing states to
provide Medicaid coverage to more people and extending Medicare coverage for
Social Security beneficiaries.
Q: What changes does TWWIIA make to Medicaid Health
Coverage?
A: Effective October 1, 2000 states will have the option to
provide Medicaid coverage to more people ages 16-64 with disabilities who work.
States will be permitted to liberalize limits to income, previously 250% of
poverty, and resources. States also will be allowed to provide employed
individuals who have certain medically determined impairments, as determined by
the Secretary of HHS, the opportunity to buy into Medicaid even though they are
no longer eligible for SSDI or SSI disability benefits due to medical
improvement. For the purpose of the Medicaid buy-in, the states are authorized
to require individuals to pay premiums, or other cost-sharing charges, set on a
sliding scale based on income.
Q: What impact does the TWWIIA have on Medicare health
coverage?
A: Effective October 1, 2000, the law extends Medicare Part A
(Hospital) premium-free coverage for a total of eight and a half years after
the beneficiary returns to work.
Additional Information
Additional information about The Ticket to Work and Work Incentive
Improvement Act can be obtained from the Social Security Administration’s
Web site at: <
http://www.ssa.gov/work/Ticket/ticket_info.html
> or by calling 800-772-1213 (toll free).
July 2000
Updated April 2004 |
