11/29/10 CHIIP Webinar Transcript – Part 2

We are now referring to slide 32, referral from an employment network to VR or vocational rehabilitation. To facilitate the referral from the employment network to DOR and back to the employment network or the EN the Department of rehabilitation has developed and is implementing the use of the BR 4B 40 3A site of the VR agency referral form which is slowing on a site at this time. In the DR 4343 the referral to employment network which revolves (inaudible) but later on. Have you used this form? The employment network search uses for minor for a beneficiary to the local DOR office or to the counselor. This would help the counselor retained the EN information so that the counselor can refer the consumer back to you, employment network, with the counselor is going to case. Now what is happening right now is that there are some informal referrals that are being made and sometimes the client or the beneficiary is a self referring in the employment network doesn't know that the beneficiary has come to Department of rehab. So we are hoping that having a formalized process will help referral back and forth between EN and the VR and VR back to the employment network. Next slide. Okay now slide 33 is a picture is of the second referral form, which is titled referral from VR to employment network or DR 343B. The next form which is pictured on this slide called the referral to employment network or for counselors to use when referring that consumer back to the employment network. Now, employment networks, you can also use this form as proof of closure when you send me your individual work plan... so the consumer can assign the ticket to you right away without having to wait for the monthly closer files. I get that information contained in this form has all the necessary information that Maximus can accept as proof of closure. So DOR counselors, where did you find these forms? These forms have been released into the G Drive user resources forms folder and will also be posted on the DOR Internet forms section. It's not the Internet forms section yet, but it will be there soon. But this time they are in the G Drive user resources forms folder. We also sent you a Doral or Department of rehab memo on November 17 announcing the release of these referral forms. Again, counselors if you have any questions on the use of this form or where to locate this form, you can also call the Social Security program section or send us an e-mail at TGW. info@DOR.ca.GOP and we will be happy to help you and provide technical assistance. Now for the... where did you find the forms? They will be posted on the Department of rehab websites. We are working on that. In the meantime what we will also do is send it out to all of you California ENs an e-mail attachment as soon as possible hopefully before the end of November we will send out to you so you has affect access to those forms. I didn't think it would employment networks if you have questions on the use of the forms you can contact Department of rehab Social Security section at 916-558-5400 and ask to be transferred to either Megan Alamo or Abby Medina or you can send us an e-mail at TGW. info@DOR.ca.GOV. So those are the referral forms that we are implementing again to help facilitate a smooth referral back and forth and a smooth handoff back to the employment network in case closure. So now we are going to talk to you about the timely progress review and I think this is a good time to actually discuss the timely progress review since the Social Security is starting these timely progress reviews this month. And they will turn you over to Megan for that.

Okay under the new ticket to work program beneficiaries are expected to progress toward self-supporting employment while they are using their ticket. So timely progress reviews or TPR is Social Security's way to ensure ticket holders are making progress toward employment. And it was expanded under the new regulations effective July 2008. Now, the timely progress reviews will be conducted at the end of every 12 months.. In the months and with in which they are conducted is the month of the anniversary date of when the ticket was placed in use SVR, with the state VR agency or the money that was assigned to any end. And those of you who are service providers or counselors in the audience, this is happening every 12 months. So your consumers we've been working with for one year, two-year, three are, for your, five years, all these individuals will now start to get timely progress reviews. And I do want to make sure that it's clear that if an individual is not making timely progress it does not end to their ticket use. They can still continue to receive services from the employment network or from the Department of rehab. The only effective not making timely progress is that the beneficiaries continued medical CDR suspension will not continue. So, what counts is timely progress? Social Security Administration counts work and earnings. Educational or training requirements, such as a vocational training program, or some combination of these things. There's a different criteria for each 12 month period. In the specific criteria in the TPR guidelines can be found that Maximus website which is on the slide at www.yourtickettowork.com. We are going to talk a little bit about the timely progress review process. First, Maximus is going to check Social Security is earning records to see if the guidelines are met. From that information. If the earnings to meet the TPR guidelines that no further action is taken and that person has essentially had a timely progress review even though they have not received an official notice in the mail. If the earnings do not meet the TPR guidelines or if there are no earnings in the Social Security databases, then the beneficiaries contacted by Maximus. So November this month 2010 Maximus has started to send out the official timely progress review notices to beneficiaries and again the beneficiaries who have tickets assigned to duty in or in use SVR with DOR or another state agency will be receiving the timely progress notices. This slide has a snap shape of the part of timely progress review notices that beneficiaries will receive. This is just a portion of the letter. There is of course a cover letter and it includes the specific guidelines as to what criteria Social Security is looking for each 12 month period. But they are reviewing. And this is just a snapshot. This was something for DOR counselors in the audience, should look familiar, we did send a memo out to the counselors and field staff earlier this month, November 12, giving you the full TPR notices going out so that you can have a look at those so you know what your consumers are going to be receiving here shortly. Now the beneficiary needs to return this form with the information filled out within 30 days. And when the form is returned within 30 days, Maximus reviews the information and makes a determination. So if the guidelines have been met, if the earnings are sufficient, or if they have been participating in some sort of education or vocational training program and they have met the guidelines, then the service provider, the EN, or state VR agency will be notified by biweekly status reports. Now the information that the beneficiary provides is not enough to make a favorable decision, Maximus will send a second notice and the second notice was for any additional information that the person may have forgotten to respond within the first response to the timely progress notice. So that they can ask them a second chance to provide more information if they have it. So if the form is not returned, or if the results of the second notice that is returned doesn't have sufficient information to make a favorable determination of timely progress, then at that point is when the medical CD-R production will be lost. Also if the beneficiary just does not return the initial form within 30 days, then the medical CD-R production would be lost. Now the medical CD-R production can be reinstated if the beneficiary catches up in essence on the TPR guidelines later on. Like I said before, it doesn't mean that the beneficiary is going to not be able to use their ticket. They are still going to be able to receive services from DOR or from an employment network, the only effect is the loss of the medical CD-R suspension. Now, this really is just a taste of the timely progress reviews. There is a full TPR presentation available online. It is self-paced and it's a PowerPoint presentation that stung by Maximus. And that is available again at their website which is www.yourtickettowork.com. And it is under the NPR education training link. Under the timely progress presentation. So that is available if you are interested in more of the details as far as TPR is concerned. Okay I'm going to turn it back over to Abbey. We had mentioned earlier that there is a relationship that a DOR vendor can have, a DOR vendor can also be an employment network and Abbey is going to double open about how exactly that works.

Okay we know that we have some service providers that are participating in this webinar. Some service providers or vendors of the Department of rehab and not yet an employment network, and some service providers or vendors and also now an employment networks. So this question comes up all the time and we wanted to dedicate some time to clarify that being a unemployment network does not negatively impact your current vendor relationship with the Department of rehab. So I say that because we have some vendors who are questioning whether it would be to their best interest to become an employment network or will that have some kind of impact with the correct fee for service relationship that they have with the Department of rehab. So the bottom line answer to that question is no, it doesn't. If you are a current vendor of the Department of rehab and a counselor in the consumer has chosen you as a service provider, fee for service as the vendor who will be providing that service while the case is open, for example, job placement or job seeking skills training, the Department of rehab counselor if you are the chosen vendor, by the client and the counselor, that service will be authorized as usual if it is fee for service it is before service. So you provide that service as a vendor in a vendor capacity. And are paid by the Department of rehab. When the Department of rehab case is closed and if the consumer chooses to work with you at the close of VR services and assigned a ticket to you that at the close of VR services you will then be functioning as an employment network and providing ongoing support and retention services to that consumer in an employment network capacity. We have given you an example of that scenario here on the slide. A similar example to what I had just explained, so hopefully that will explain how that works regarding your vendor relationship and EN. We do, if you are a DOR vendor and you are not yet an employment network we do encourage you to take advantage of this opportunity to become an employment network. Because like we said earlier this is an additional source, can be an additional source of program revenue for you. And through EN payments when the Department of rehab cases close. The next slide is like 41. We want to provide you graphical representation of all the services and resources that is available to SSI, SSDI beneficiary and also some benefits planning resources, because as you know choosing to go to work a lot of SSI, SSDI beneficiary's needs and benefits planning resources where they need their questions answered, if I go to work what will happen to my cash payments and my health benefits. So we just wanted to give you a graphic representation, the SSI, SSDI beneficiary being in the middle in the available resources that are available to the beneficiary starting from the bottom left if your SSA area work incentives chord majors in the past specialists and these are individuals that actually work for the Social Security administration to help with incentives issues or provide assistance, utilization of work incentives such as the plan to achieve self-support or path. The self-support. The next one, the next boxes and Maximus, and sassy, the ticket program manager for ticket to work, and BHF is actually Booth Allen Hamilton which is going to be the new contractor that will be replacing sassy after November 2010. Also the next books you have work planning assistance or would does that is a grant provided by the Social Security Administration for community work incentives chord majors to provide drug benefits counseling to SSI, SSDI beneficiary's and protection and advocacy. Department of rehab employment networks, community-based organizations and partner agencies are all available to provide services to SSI, SSDI beneficiary's. And again, very important resource here is the disability benefits one-to-one services and benefits calculator. Website, www.DB101.org. This is a very California specific website that provides a love, wealth of information on disability benefits. And the public and private benefits and also has some benefits calculators that can be utilized to determine what would come out the impact of work on, the impact of working and benefits I get disability program benefits next slide, the last slide gives you some very useful resources that is available to you as a service provider, community-based agency, or also as a beneficiary. One thing I would like to point out here is Department of rehabilitation website is there for you and Department of rehab to get to work mailbox, if you have any questions specific to take it to work and Department of rehabilitation you can send us an e-mail at TTW info@DOR.ca.gov. Megan Alan and I actually respond to those questions and Department of rehabilitation ticket line is generally used by beneficiaries. They call and we've received about 30 calls a day on the average if they have any questions on Department of rehabilitation and ticket to work they want to be referred to our local Department of rehab office, how can they apply for services. The ticket line provides general ticket to work information and again, the client assistance program is information and contact information is available therefore Department of rehab consumers that need assistance and advocacy and also if they are having issues with others of the case or progress of their case or they can contact the client assistance program and the CEP advocates can help facilitate that or provide assistance. And this concludes our training in the next thing that we want to do is go ahead and take question and answers and we are actually going to do that now by first, Nagin is going to read the questions that we have received so far and then we are going to address that one by one.

Okay, so the first question does the SSI, SSDI beneficiary have to access their services before giving their ticket to and EN, or can they go directly to the EN for ticket services without accessing VR services?

The answer to that is no, I beneficiary can go directly to the employment network for ticket to work services without accessing VR services and in fact we have a lot of cases like that you know if the employment network can provide the services without the client needing Department of rehab services then that individual or the beneficiary can choose to go directly to the employment network and receive services solely from the employment network.

Okay, the second question, you mentioned that the EN can give an incentive payment to the consumer. Does this affect their SSI benefit in any way?

Okay so this question earlier mentioned that there are some employment networks that are sharing part of the payments that they are receiving from the EN, the outcome milestone payment where the beneficiary has financial incentives. So I guess this question is asking does that affect their SSI benefit in any way. And the entity that is according to the SSA, these incentive payments are considered unearned income, and are subjected to the same SSI reporting requirements, so of course though wages for the phase 2 outcome payments should already be taking the beneficiary out of cash payment status, therefore this unearned income among other however it may affect the beneficiary's receipt of 1619 B. and the provision of continuation of Medi-Cal, 1619 B. that can affect the beneficiary's receipt of 1619 B. Medi-Cal depending on the amount of the unearned income as opposed to the earned income so bottom line is these incentive payments are considered by the Social Security Administration has unearned income and should be reported to the Social Security Administration when they are reporting their changes to their SSI or monies that they are receiving that would impact their SSI.

The third question can you please tell me what does EN stand for?

EN stands for employment network. Again, these are service providers approved by the Social Security Administration to serve the SSI SS DI beneficiaries who are participating in the ticket to work program so EN is employment network.

The fourth question, what are some examples of services and EN could offer to assist a beneficiary in maintaining employment.

So that depends on the employment network. Some examples are benefits counseling, advocacy. We have EM, or a couple EMC actually providing assistance with tax preparation, assistance with reporting the earnings to the Social Security Administration, job placement, assistance with exploring reasonable accommodation with it employers, job coaching and also some counseling and guidance. The EN direction a directory on the Maximus website that we gave you earlier www.yourtickettowork.com also includes a listing of services provided by each employment network

And as a follow-up question, what are some examples of ongoing support and retention services that we can provide as an EN for a beneficiary who has the coolest case with the ER.

Again, there isn't a singular list of services that any and can provide, but the typical services can provide include job placement job development, job search skills, resume writing interview techniques, training and other similar services who come to you and are not yet employed. I'm retention services for beneficiaries who are working or employed when they come to the employment network for retention services often take the form of benefits planning. Assistance in reporting income to Social Security, assistance with tax preparation assistance with exploring reasonable accommodation needs with employers. Could be advocacy, job coaching, being available to help with any issues that arise at work. And in either of these cases the services that the EN art provided any allied and individualized workplan API WP that the EN and beneficiary can work on together.

Okay the sixth question here, as, could you explain if the DOR counselor has any reporting responsibilities on the beneficiary's timely progress

Obviously it is apparent that this question came from a DOR counselor so basically the counselor is asking do I have any responsibilities on the missionaries, beneficiary Stanley progress while you are SSI or the SS DI beneficiary may come to you for assistance decide to come to you for any assistance with letters a slave from Social Security or not they have questions, they can come to for assistance and you might want to provide them some technical assistance on not as far as your understanding on timely progress so while the SS DI consumer made them to for assistance it is the consumers responsibility to report on the can timely process to Maximus. It within 30 days if the consumer wants to maintain their consumer medical review protection. And with counselors we ask you to please refer to the November 12, 2010 DOR member guided timely progress review notices for it to get to work consumers and attached to the memo that we sent you is a copy of the TPR or timely progress review notice that SSA will mail to SS I SS DI consumer so that you are aware of what you're counselors will be receiving. Again it is the beneficiary or the consumer's responsibility to make sure that the letter, that they respond to the letter or the notices received that they want to continue the medical CD-R protection. It's not that counselors responsibility to submit that form however if you are consumer needs assistance you should provide them assistance or clarification and in a few as accounts or need technical assistance or guidance you can contact us the Social Security protection section and we'll be happy to answer any questions that you might have.

Okay the next question, if a consumer is placed on the waiting list is there a time limit or a maximum number of months before there is a change in status?

Okay, waiting list question. No there is no set time limit on how long a DOR consumer is placed on a waiting list also known as the status so forth. It would depend on when there are enough funds and when the order of selection priority categories reopened. As we stated earlier in the web in the deal are currently has priority category one, most significantly disabled and priority category to significantly disabled open trade so what that means is SSI, SSDI consumers who make the presumptive eligibility criteria are considered to be at least significantly disabled, and they are not waitlisted at this time. So, from the time that they've been determined, presumed eligible in the category ratings have been completed by the counselor, SSI/ SSDI consumers are not waitlisted at this time. So they can move forward with the IP or individualized plan for employment development. And so at this time is not a concern for SSI, SSDI consumers.

And the next question, if the client is not reporting his or her income does the vocational rehab agency successful case closure also trigger a request from Social Security reminding the client to report his income

Short answer to that is no. ER case closure does not trigger the SSA to remind a beneficiary to report their earnings, however on much of the correspondence that the beneficiary has received from Social Security Administration they are reminded that they must report their income monthly with any change in their living situation.

The next question, DDR services include ASL or American sign language interpretation for a client?

Okay, this question is specific to Department of rehab services. Whether you are on SSI, SS DI or not, and I assume this question is specifically, I'm going to respond to this question under the assumption that this question is specifically asking about, for those individuals who are engaged in training, college training or what have you because this question comes up a lot, so much so that we actually have a memo guidance on the provision of ASL interpretation for a client. So to DOR services included ASL interpretation for client? The California community colleges and state universities and you see us come University of California are required to provide deal are consumers with interpreting services as reasonable accommodation under the California education code 673108. These educational institutions also have agreed to do so in a signed demo you or memorandum of understanding with POR. Now if we are talking about private schools private schools are places of public accommodations and also are subject to the provisions of title three of the ADA or the Americans with disabilities act. However unlike public schools they do not have to provide auxiliary aids including interpreters if it is unreasonable. If a private school representative states that the school will not be providing an interpreter because it is unreasonable in light of their budget restraints that DOR will coordinate and pay for an interpreter provided that no other comparable services are available. Now if the counselor or supervisor believe I'm talking about a DOR counselor or supervisor believe that in light of what they know of the school that it is taking advantage of the Department of rehab by refusing to pay, or violating the ADA, then the DOR District administrator may follow-up through legal affairs. In the meantime, the consumer must receive the necessary and timely services to support his or her ability to successfully participate in their individualized plan for employment IPE. The consumers are responsible to fully participate by actively seeking out and applying interpreting services that may be available to them through other sources. Okay, they tend to question his, and this came from a one-stop career Center obviously in question is our career Center is in the process of applying to the employment network. We have a consumer who was dissatisfied with VR services and would now like to utilize his ticket to work to pursue job search and vocational training options. What are the primary differences between utilizing IVR, and in EN for ticket to work services.

The differences really do depend on the employment network because there is such a variety of EN models out there, but one common difference from the beneficiary's perspective is the level of service that can be provided. DR is able to provide intensive services that often have across the typical EN is not able to cover. So for example, assistive technology medical restoration vehicle modifications, training and other services short of employment that can really carry quite a high cost. So of course not all DOR consumers need this level of service in order to gain employment and now consumers are successful with POR services. This is one of the many benefits of the ticket to work program because it expands the options that beneficiaries have for service providers so they can go to an employment network if they were not successful or when I'm satisfied for some other reason with the Department of rehab.

The next question is, which is question alive as how often does the EN or employment network need to provide those services in order to receive reimbursement from milestones?

Okay. The answer to that, since the EN payment system is outcome based, that is it is based on the earnings level of the beneficiary there is no requirement for how long the EN must provide services before being eligible to receive payments. So for example the phase 1 milestone pavements are defined as the beneficiary earning trial work level earnings for this year that is $720 for a certain number of months. So the first level requires this level of earnings for one month when the beneficiary meets this requirement in EN is eligible to submit for the first payment of $1275. As the beneficiary continues and earns $720 for three months the EN can apply for the second payment and so on the face to outcome payments are associated with different levels of earnings in the payments to the EN will also increase as the beneficiary continues employment and earnings increase. As mentioned in the webinar this is one payments are not available to the EN when the beneficiary has worked with the state agency and was successfully employed at disclosure also notices status 26. Of these two payments and outcome payments are still available in this case. If the beneficiary was unsuccessful or closed status to any in the phase 1 milestone payments are available. This information can be provided in much more detail by Maximus. You can call the toll-free number which is 1-866-968-7842 or 1-866-949-3687 and I do just want to clarify the question had mentioned briefly reimbursement, he ends are not reimbursed for the costs associated with providing services to a beneficiary buyer paid that amount on the beneficiary meets certain earnings milestones defined by Social Security. And I know we mentioned a couple times in the webinar by Maximus website does have several training resources about the EN payment system and other good information on that website again is your ticket to work.com/training.

Okay, the next question is someone mentioned work incentives for beneficiaries provided by the EN, or employment network. Can you give me some examples?

Okay. Some mediums provide services such as benefits planning and some even have staff who are certified work incentives coordinators oversee works or certified Dell beneficiaries understand the Social Security work incentives that may be available to them. So the ticket to work program is only one work incentives are available to SSI SSD I beneficiaries. Many beneficiaries are able to benefit from the employment supports the other work offers such as employment related work incentives, climate to which you so support, student... inclusions and on and on, the Social Security Redbook is a really good resource that provides a basic high level overview of the different incentives and how they can be used to maintain cash payments while pursuing employment. And the Redbook online can be found at www.SSA.GOP\Redbook. Often helping beneficiaries to understand all the different employment supports that are in important to them via employment works and other resources... can be helpful since it uses the fears of losing benefits prematurely when returning to work.

Okay, question number 13. Can you tell me if POR offenders who also EN will receive payment for phone services through a delegation when they have the consumers to get or if they will receive no payment until the EN milestones are achieved. I think just by the nature of this question, this question is coming from a supported employment service provider.

The answer to that, Social Security is very clear that the outcome milestone payments available to GEN's are additional revenue and are not meant to supplant current POR fee for service or habilitation funding that happens after the DOR case closure. But the supported employment service providers are receiving. As far as we know supported employment service providers who are currently receiving payments through provision of rehabilitation funded follow-on services continue to do so irrespective of ticket payments. And just one final question about how to get the CRC credit for attendance at the webinar, and this is available at the webinar archives which is, you can access at www.hadtalentknowsnolimits.info and that includes the webinar. I'm going to turn it back over to Carla Del to wrap it up.

Thank you Megan and Abby, this is Carla Bell with a California health incentives improvement project and I take, like to take a moment to think Abby and Megan for this excellent training and answering everyone's really great questions. Thank you so much for joining us for this webinar, or for viewing the webinar archives on the website. And as mentioned to certified rehabilitation counselors CRC credits are available on our website www.talentknowsnolimits.info, the link to the website is also on the last resources-PowerPoint. Once you go to the home page click on webinars and from there you can click on the archives page and find our CRC quizzes are attached to each of our webinars. We look forward to having you join us for future chip webinars and thank you so much. This concludes the Department of rehabilitation and of the new ticket to work program webinar.