Laws: Cases and Codes : U.S. Code : Title 42 : Section 1320b-19


   
U.S. Code as of: 01/19/04
Section 1320b-19. The Ticket to Work and Self-Sufficiency Program

    (a) In general
      The Commissioner shall establish a Ticket to Work and
    Self-Sufficiency Program, under which a disabled beneficiary may
    use a ticket to work and self-sufficiency issued by the
    Commissioner in accordance with this section to obtain employment
    services, vocational rehabilitation services, or other support
    services from an employment network which is of the beneficiary's
    choice and which is willing to provide such services to such
    beneficiary.
    (b) Ticket system
      (1) Distribution of tickets
        The Commissioner may issue a ticket to work and
      self-sufficiency to disabled beneficiaries for participation in
      the Program.
      (2) Assignment of tickets
        A disabled beneficiary holding a ticket to work and
      self-sufficiency may assign the ticket to any employment network
      of the beneficiary's choice which is serving under the Program
      and is willing to accept the assignment.
      (3) Ticket terms
        A ticket issued under paragraph (1) shall consist of a document
      which evidences the Commissioner's agreement to pay (as provided
      in paragraph (4)) an employment network, which is serving under
      the Program and to which such ticket is assigned by the
      beneficiary, for such employment services, vocational
      rehabilitation services, and other support services as the
      employment network may provide to the beneficiary.
      (4) Payments to employment networks
        The Commissioner shall pay an employment network under the
      Program in accordance with the outcome payment system under
      subsection (h)(2) of this section or under the outcome-milestone
      payment system under subsection (h)(3) of this section (whichever
      is elected pursuant to subsection (h)(1) of this section). An
      employment network may not request or receive compensation for
      such services from the beneficiary.
    (c) State participation
      (1) In general
        Each State agency administering or supervising the
      administration of the State plan approved under title I of the
      Rehabilitation Act of 1973 (29 U.S.C. 720 et seq.) may elect to
      participate in the Program as an employment network with respect
      to a disabled beneficiary. If the State agency does elect to
      participate in the Program, the State agency also shall elect to
      be paid under the outcome payment system or the outcome-milestone
      payment system in accordance with subsection (h)(1) of this
      section. With respect to a disabled beneficiary that the State
      agency does not elect to have participate in the Program, the
      State agency shall be paid for services provided to that
      beneficiary under the system for payment applicable under section
      422(d) of this title and subsections (d) and (e) of section 1382d
      of this title. The Commissioner shall provide for periodic
      opportunities for exercising such elections.
      (2) Effect of participation by State agency
        (A) State agencies participating
          In any case in which a State agency described in paragraph
        (1) elects under that paragraph to participate in the Program,
        the employment services, vocational rehabilitation services,
        and other support services which, upon assignment of tickets to
        work and self-sufficiency, are provided to disabled
        beneficiaries by the State agency acting as an employment
        network shall be governed by plans for vocational
        rehabilitation services approved under title I of the
        Rehabilitation Act of 1973 (29 U.S.C. 720 et seq.).
        (B) State agencies administering maternal and child health
          services programs
          Subparagraph (A) shall not apply with respect to any State
        agency administering a program under subchapter V of this
        chapter.
      (3) Agreements between State agencies and employment networks
        State agencies and employment networks shall enter into
      agreements regarding the conditions under which services will be
      provided when an individual is referred by an employment network
      to a State agency for services. The Commissioner shall establish
      by regulations the timeframe within which such agreements must be
      entered into and the mechanisms for dispute resolution between
      State agencies and employment networks with respect to such
      agreements.
    (d) Responsibilities of the Commissioner
      (1) Selection and qualifications of program managers
        The Commissioner shall enter into agreements with 1 or more
      organizations in the private or public sector for service as a
      program manager to assist the Commissioner in administering the
      Program. Any such program manager shall be selected by means of a
      competitive bidding process, from among organizations in the
      private or public sector with available expertise and experience
      in the field of vocational rehabilitation or employment services.
      (2) Tenure, renewal, and early termination
        Each agreement entered into under paragraph (1) shall provide
      for early termination upon failure to meet performance standards
      which shall be specified in the agreement and which shall be
      weighted to take into account any performance in prior terms.
      Such performance standards shall include - 
          (A) measures for ease of access by beneficiaries to services;
        and
          (B) measures for determining the extent to which failures in
        obtaining services for beneficiaries fall within acceptable
        parameters, as determined by the Commissioner.
      (3) Preclusion from direct participation in delivery of services
        in own service area
        Agreements under paragraph (1) shall preclude - 
          (A) direct participation by a program manager in the delivery
        of employment services, vocational rehabilitation services, or
        other support services to beneficiaries in the service area
        covered by the program manager's agreement; and
          (B) the holding by a program manager of a financial interest
        in an employment network or service provider which provides
        services in a geographic area covered under the program
        manager's agreement.
      (4) Selection of employment networks
        (A) In general
          The Commissioner shall select and enter into agreements with
        employment networks for service under the Program. Such
        employment networks shall be in addition to State agencies
        serving as employment networks pursuant to elections under
        subsection (c) of this section.
        (B) Alternate participants
          In any State where the Program is being implemented, the
        Commissioner shall enter into an agreement with any alternate
        participant that is operating under the authority of section
        422(d)(2) of this title in the State as of December 17, 1999,
        and chooses to serve as an employment network under the
        Program.
      (5) Termination of agreements with employment networks
        The Commissioner shall terminate agreements with employment
      networks for inadequate performance, as determined by the
      Commissioner.
      (6) Quality assurance
        The Commissioner shall provide for such periodic reviews as are
      necessary to provide for effective quality assurance in the
      provision of services by employment networks. The Commissioner
      shall solicit and consider the views of consumers and the program
      manager under which the employment networks serve and shall
      consult with providers of services to develop performance
      measurements. The Commissioner shall ensure that the results of
      the periodic reviews are made available to beneficiaries who are
      prospective service recipients as they select employment
      networks. The Commissioner shall ensure that the periodic surveys
      of beneficiaries receiving services under the Program are
      designed to measure customer service satisfaction.
      (7) Dispute resolution
        The Commissioner shall provide for a mechanism for resolving
      disputes between beneficiaries and employment networks, between
      program managers and employment networks, and between program
      managers and providers of services. The Commissioner shall afford
      a party to such a dispute a reasonable opportunity for a full and
      fair review of the matter in dispute.
    (e) Program managers
      (1) In general
        A program manager shall conduct tasks appropriate to assist the
      Commissioner in carrying out the Commissioner's duties in
      administering the Program.
      (2) Recruitment of employment networks
        A program manager shall recruit, and recommend for selection by
      the Commissioner, employment networks for service under the
      Program. The program manager shall carry out such recruitment and
      provide such recommendations, and shall monitor all employment
      networks serving in the Program in the geographic area covered
      under the program manager's agreement, to the extent necessary
      and appropriate to ensure that adequate choices of services are
      made available to beneficiaries. Employment networks may serve
      under the Program only pursuant to an agreement entered into with
      the Commissioner under the Program incorporating the applicable
      provisions of this section and regulations thereunder, and the
      program manager shall provide and maintain assurances to the
      Commissioner that payment by the Commissioner to employment
      networks pursuant to this section is warranted based on
      compliance by such employment networks with the terms of such
      agreement and this section. The program manager shall not impose
      numerical limits on the number of employment networks to be
      recommended pursuant to this paragraph.
      (3) Facilitation of access by beneficiaries to employment
        networks
        A program manager shall facilitate access by beneficiaries to
      employment networks. The program manager shall ensure that each
      beneficiary is allowed changes in employment networks without
      being deemed to have rejected services under the Program. When
      such a change occurs, the program manager shall reassign the
      ticket based on the choice of the beneficiary. Upon the request
      of the employment network, the program manager shall make a
      determination of the allocation of the outcome or
      milestone-outcome payments based on the services provided by each
      employment network. The program manager shall establish and
      maintain lists of employment networks available to beneficiaries
      and shall make such lists generally available to the public. The
      program manager shall ensure that all information provided to
      disabled beneficiaries pursuant to this paragraph is provided in
      accessible formats.
      (4) Ensuring availability of adequate services
        The program manager shall ensure that employment services,
      vocational rehabilitation services, and other support services
      are provided to beneficiaries throughout the geographic area
      covered under the program manager's agreement, including rural
      areas.
      (5) Reasonable access to services
        The program manager shall take such measures as are necessary
      to ensure that sufficient employment networks are available and
      that each beneficiary receiving services under the Program has
      reasonable access to employment services, vocational
      rehabilitation services, and other support services. Services
      provided under the Program may include case management, work
      incentives planning, supported employment, career planning,
      career plan development, vocational assessment, job training,
      placement, follow-up services, and such other services as may be
      specified by the Commissioner under the Program. The program
      manager shall ensure that such services are available in each
      service area.
    (f) Employment networks
      (1) Qualifications for employment networks
        (A) In general
          Each employment network serving under the Program shall
        consist of an agency or instrumentality of a State (or a
        political subdivision thereof) or a private entity, that
        assumes responsibility for the coordination and delivery of
        services under the Program to individuals assigning to the
        employment network tickets to work and self-sufficiency issued
        under subsection (b) of this section.
        (B) One-stop delivery systems
          An employment network serving under the Program may consist
        of a one-stop delivery system established under subtitle B of
        title I of the Workforce Investment Act of 1998 (29 U.S.C. 2811
        et seq.).
        (C) Compliance with selection criteria
          No employment network may serve under the Program unless it
        meets and maintains compliance with both general selection
        criteria (such as professional and educational qualifications,
        where applicable) and specific selection criteria (such as
        substantial expertise and experience in providing relevant
        employment services and supports).
        (D) Single or associated providers allowed
          An employment network shall consist of either a single
        provider of such services or of an association of such
        providers organized so as to combine their resources into a
        single entity. An employment network may meet the requirements
        of subsection (e)(4) of this section by providing services
        directly, or by entering into agreements with other individuals
        or entities providing appropriate employment services,
        vocational rehabilitation services, or other support services.
      (2) Requirements relating to provision of services
        Each employment network serving under the Program shall be
      required under the terms of its agreement with the Commissioner
      to - 
          (A) serve prescribed service areas; and
          (B) take such measures as are necessary to ensure that
        employment services, vocational rehabilitation services, and
        other support services provided under the Program by, or under
        agreements entered into with, the employment network are
        provided under appropriate individual work plans that meet the
        requirements of subsection (g) of this section.
      (3) Annual financial reporting
        Each employment network shall meet financial reporting
      requirements as prescribed by the Commissioner.
      (4) Periodic outcomes reporting
        Each employment network shall prepare periodic reports, on at
      least an annual basis, itemizing for the covered period specific
      outcomes achieved with respect to specific services provided by
      the employment network. Such reports shall conform to a national
      model prescribed under this section. Each employment network
      shall provide a copy of the latest report issued by the
      employment network pursuant to this paragraph to each beneficiary
      upon enrollment under the Program for services to be received
      through such employment network. Upon issuance of each report to
      each beneficiary, a copy of the report shall be maintained in the
      files of the employment network. The program manager shall ensure
      that copies of all such reports issued under this paragraph are
      made available to the public under reasonable terms.
    (g) Individual work plans
      (1) Requirements
        Each employment network shall - 
          (A) take such measures as are necessary to ensure that
        employment services, vocational rehabilitation services, and
        other support services provided under the Program by, or under
        agreements entered into with, the employment network are
        provided under appropriate individual work plans that meet the
        requirements of subparagraph (C);
          (B) develop and implement each such individual work plan, in
        partnership with each beneficiary receiving such services, in a
        manner that affords such beneficiary the opportunity to
        exercise informed choice in selecting an employment goal and
        specific services needed to achieve that employment goal;
          (C) ensure that each individual work plan includes at least -
        
            (i) a statement of the vocational goal developed with the
          beneficiary, including, as appropriate, goals for earnings
          and job advancement;
            (ii) a statement of the services and supports that have
          been deemed necessary for the beneficiary to accomplish that
          goal;
            (iii) a statement of any terms and conditions related to
          the provision of such services and supports; and
            (iv) a statement of understanding regarding the
          beneficiary's rights under the Program (such as the right to
          retrieve the ticket to work and self-sufficiency if the
          beneficiary is dissatisfied with the services being provided
          by the employment network) and remedies available to the
          individual, including information on the availability of
          advocacy services and assistance in resolving disputes
          through the State grant program authorized under section
          1320b-21 of this title;

          (D) provide a beneficiary the opportunity to amend the
        individual work plan if a change in circumstances necessitates
        a change in the plan; and
          (E) make each beneficiary's individual work plan available to
        the beneficiary in, as appropriate, an accessible format chosen
        by the beneficiary.
      (2) Effective upon written approval
        A beneficiary's individual work plan shall take effect upon
      written approval by the beneficiary or a representative of the
      beneficiary and a representative of the employment network that,
      in providing such written approval, acknowledges assignment of
      the beneficiary's ticket to work and self-sufficiency.
    (h) Employment network payment systems
      (1) Election of payment system by employment networks
        (A) In general
          The Program shall provide for payment authorized by the
        Commissioner to employment networks under either an outcome
        payment system or an outcome-milestone payment system. Each
        employment network shall elect which payment system will be
        utilized by the employment network, and, for such period of
        time as such election remains in effect, the payment system so
        elected shall be utilized exclusively in connection with such
        employment network (except as provided in subparagraph (B)).
        (B) No change in method of payment for beneficiaries with
          tickets already assigned to the employment networks
          Any election of a payment system by an employment network
        that would result in a change in the method of payment to the
        employment network for services provided to a beneficiary who
        is receiving services from the employment network at the time
        of the election shall not be effective with respect to payment
        for services provided to that beneficiary and the method of
        payment previously selected shall continue to apply with
        respect to such services.
      (2) Outcome payment system
        (A) In general
          The outcome payment system shall consist of a payment
        structure governing employment networks electing such system
        under paragraph (1)(A) which meets the requirements of this
        paragraph.
        (B) Payments made during outcome payment period
          The outcome payment system shall provide for a schedule of
        payments to an employment network, in connection with each
        individual who is a beneficiary, for each month, during the
        individual's outcome payment period, for which benefits
        (described in paragraphs (3) and (4) of subsection (k) of this
        section) are not payable to such individual because of work or
        earnings.
        (C) Computation of payments to employment network
          The payment schedule of the outcome payment system shall be
        designed so that - 
            (i) the payment for each month during the outcome payment
          period for which benefits (described in paragraphs (3) and
          (4) of subsection (k) of this section) are not payable is
          equal to a fixed percentage of the payment calculation base
          for the calendar year in which such month occurs; and
            (ii) such fixed percentage is set at a percentage which
          does not exceed 40 percent.
      (3) Outcome-milestone payment system
        (A) In general
          The outcome-milestone payment system shall consist of a
        payment structure governing employment networks electing such
        system under paragraph (1)(A) which meets the requirements of
        this paragraph.
        (B) Early payments upon attainment of milestones in advance of
          outcome payment periods
          The outcome-milestone payment system shall provide for 1 or
        more milestones, with respect to beneficiaries receiving
        services from an employment network under the Program, that are
        directed toward the goal of permanent employment. Such
        milestones shall form a part of a payment structure that
        provides, in addition to payments made during outcome payment
        periods, payments made prior to outcome payment periods in
        amounts based on the attainment of such milestones.
        (C) Limitation on total payments to employment network
          The payment schedule of the outcome milestone payment system
        shall be designed so that the total of the payments to the
        employment network with respect to each beneficiary is less
        than, on a net present value basis (using an interest rate
        determined by the Commissioner that appropriately reflects the
        cost of funds faced by providers), the total amount to which
        payments to the employment network with respect to the
        beneficiary would be limited if the employment network were
        paid under the outcome payment system.
      (4) Definitions
        In this subsection:
        (A) Payment calculation base
          The term "payment calculation base" means, for any calendar
        year - 
            (i) in connection with a title II disability beneficiary,
          the average disability insurance benefit payable under
          section 423 of this title for all beneficiaries for months
          during the preceding calendar year; and
            (ii) in connection with a title XVI disability beneficiary
          (who is not concurrently a title II disability beneficiary),
          the average payment of supplemental security income benefits
          based on disability payable under subchapter XVI of this
          chapter (excluding State supplementation) for months during
          the preceding calendar year to all beneficiaries who have
          attained 18 years of age but have not attained 65 years of
          age.
        (B) Outcome payment period
          The term "outcome payment period" means, in connection with
        any individual who had assigned a ticket to work and
        self-sufficiency to an employment network under the Program, a
        period - 
            (i) beginning with the first month, ending after the date
          on which such ticket was assigned to the employment network,
          for which benefits (described in paragraphs (3) and (4) of
          subsection (k) of this section) are not payable to such
          individual by reason of engagement in substantial gainful
          activity or by reason of earnings from work activity; and
            (ii) ending with the 60th month (consecutive or otherwise),
          ending after such date, for which such benefits are not
          payable to such individual by reason of engagement in
          substantial gainful activity or by reason of earnings from
          work activity.
      (5) Periodic review and alterations of prescribed schedules
        (A) Percentages and periods
          The Commissioner shall periodically review the percentage
        specified in paragraph (2)(C), the total payments permissible
        under paragraph (3)(C), and the period of time specified in
        paragraph (4)(B) to determine whether such percentages, such
        permissible payments, and such period provide an adequate
        incentive for employment networks to assist beneficiaries to
        enter the workforce, while providing for appropriate economies.
        The Commissioner may alter such percentage, such total
        permissible payments, or such period of time to the extent that
        the Commissioner determines, on the basis of the Commissioner's
        review under this paragraph, that such an alteration would
        better provide the incentive and economies described in the
        preceding sentence.
        (B) Number and amounts of milestone payments
          The Commissioner shall periodically review the number and
        amounts of milestone payments established by the Commissioner
        pursuant to this section to determine whether they provide an
        adequate incentive for employment networks to assist
        beneficiaries to enter the workforce, taking into account
        information provided to the Commissioner by program managers,
        the Ticket to Work and Work Incentives Advisory Panel
        established by section 101(f) of the Ticket to Work and Work
        Incentives Improvement Act of 1999, and other reliable sources.
        The Commissioner may from time to time alter the number and
        amounts of milestone payments initially established by the
        Commissioner pursuant to this section to the extent that the
        Commissioner determines that such an alteration would allow an
        adequate incentive for employment networks to assist
        beneficiaries to enter the workforce. Such alteration shall be
        based on information provided to the Commissioner by program
        managers, the Ticket to Work and Work Incentives Advisory Panel
        established by section 101(f) of the Ticket to Work and Work
        Incentives Improvement Act of 1999, or other reliable sources.
        (C) Report on the adequacy of incentives
          The Commissioner shall submit to the Congress not later than
        36 months after December 17, 1999, a report with
        recommendations for a method or methods to adjust payment rates
        under subparagraphs (A) and (B), that would ensure adequate
        incentives for the provision of services by employment networks
        of - 
            (i) individuals with a need for ongoing support and
          services;
            (ii) individuals with a need for high-cost accommodations;
            (iii) individuals who earn a subminimum wage; and
            (iv) individuals who work and receive partial cash
          benefits.

        The Commissioner shall consult with the Ticket to Work and Work
        Incentives Advisory Panel established under section 101(f) of
        the Ticket to Work and Work Incentives Improvement Act of 1999
        during the development and evaluation of the study. The
        Commissioner shall implement the necessary adjusted payment
        rates prior to full implementation of the Ticket to Work and
        Self-Sufficiency Program.
    (i) Suspension of disability reviews
      During any period for which an individual is using, as defined by
    the Commissioner, a ticket to work and self-sufficiency issued
    under this section, the Commissioner (and any applicable State
    agency) may not initiate a continuing disability review or other
    review under section 421 of this title of whether the individual is
    or is not under a disability or a review under subchapter XVI of
    this chapter similar to any such review under section 421 of this
    title.
    (j) Authorizations
      (1) Payments to employment networks
        (A) Title II disability beneficiaries
          There are authorized to be transferred from the Federal
        Old-Age and Survivors Insurance Trust Fund and the Federal
        Disability Insurance Trust Fund each fiscal year such sums as
        may be necessary to make payments to employment networks under
        this section. Money paid from the Trust Funds under this
        section with respect to title II disability beneficiaries who
        are entitled to benefits under section 423 of this title or who
        are entitled to benefits under section 402(d) of this title on
        the basis of the wages and self-employment income of such
        beneficiaries, shall be charged to the Federal Disability
        Insurance Trust Fund, and all other money paid from the Trust
        Funds under this section shall be charged to the Federal
        Old-Age and Survivors Insurance Trust Fund.
        (B) Title XVI disability beneficiaries
          Amounts authorized to be appropriated to the Social Security
        Administration under section 1381 of this title shall include
        amounts necessary to carry out the provisions of this section
        with respect to title XVI disability beneficiaries.
      (2) Administrative expenses
        The costs of administering this section (other than payments to
      employment networks) shall be paid from amounts made available
      for the administration of subchapter II of this chapter and
      amounts made available for the administration of subchapter XVI
      of this chapter, and shall be allocated among such amounts as
      appropriate.
    (k) Definitions
      In this section:
      (1) Commissioner
        The term "Commissioner" means the Commissioner of Social
      Security.
      (2) Disabled beneficiary
        The term "disabled beneficiary" means a title II disability
      beneficiary or a title XVI disability beneficiary.
      (3) Title II disability beneficiary
        The term "title II disability beneficiary" means an individual
      entitled to disability insurance benefits under section 423 of
      this title or to monthly insurance benefits under section 402 of
      this title based on such individual's disability (as defined in
      section 423(d) of this title). An individual is a title II
      disability beneficiary for each month for which such individual
      is entitled to such benefits.
      (4) Title XVI disability beneficiary
        The term "title XVI disability beneficiary" means an individual
      eligible for supplemental security income benefits under
      subchapter XVI of this chapter on the basis of blindness (within
      the meaning of section 1382c(a)(2) of this title) or disability
      (within the meaning of section 1382c(a)(3) of this title). An
      individual is a title XVI disability beneficiary for each month
      for which such individual is eligible for such benefits.
      (5) Supplemental security income benefit
        The term "supplemental security income benefit under subchapter
      XVI of this chapter" means a cash benefit under section 1382 or
      1382h(a) of this title, and does not include a State
      supplementary payment, administered federally or otherwise.
    (l) Regulations
      Not later than 1 year after December 17, 1999, the Commissioner
    shall prescribe such regulations as are necessary to carry out the
    provisions of this section.



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