Ticket to Work and Work Incentive Improvement Act
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 about The Ticket to Work and Work Incentive Improvement Act can be obtained from the Social Security Administration’s Web site or by calling 800-772-1213 (toll free).
Source: U.S. Department of Labor, Office of Disabilitiy Employment Policy, July 2000