1 1 Ticket to Work 2 >> JOHN: Good afternoon, this is 3 John Lancaster and I'm the executive 4 director of the national counsel on 5 independent living and welcome to our 6 simultaneous teleconference call and 7 webcast, leveraging the new Ticket to 8 Work for your CIL or your SILC. So, 9 we welcome all of you from the 10 independent living movement and any 11 of our friends that we may have from 12 the broader disability community or 13 vocational rehabilitation agencies 14 around the country. 15 We have a very important program 16 for you today and we're Going to be 17 talking about the new regulations and 18 how they can work for cil's and 19 silc's. So, without further ado, i 20 want to welcome joel middleton, The 21 account manager at the social 22 security administration's ticket to 23 work recruitment and out reach. So, 24 Joel, welcome to the call. 25 >> JOEL: Thank you. Thank you, 2 1 John. Hello, everybody. First I 2 want to remind everyone that the mute 3 feature is not automatically enabled. 4 So, in order to reduce some 5 background noise, it may be a good 6 idea to mute your phone by pressing * 7 6. You can unmute at the end when we 8 start q and a by pressing pound six. 9 Okay. Ticket to work 101. The 10 Ticket to Work program is a voluntary 11 employment program where people with 12 disabilities can receive 13 supplementary income or SSI or SSdi 14 benefits are issued tickets by the 15 social security administration. 16 Tickets can be taken to any 17 employment network or state 18 vocational rehabilitation agencies to 19 secure services needed to enter or 20 reenter the workforce. The ticket 21 represents SSA's commitment to pay 22 en's and state vr agencies as the 23 beneficiaries they are serving 24 accomplish various milestones and 25 outcomes as they move toward 3 1 self-support employment. An 2 employment network is any government 3 or private entity that's qualified to 4 provide employment services such as 5 job placement, job coaching, job 6 training job support, counseling, 7 etc., ultimately the goal of the 8 program is to reduce reliance on 9 social security benefits and to 10 increase self-sufficient efficiency. 11 It expands the options available to 12 them to secure services enter or 13 reenter the workforce. Therefore in 14 keeping with the independent living 15 philosophy, beneficiaries who wish to 16 return to work have more choices to 17 do so. For providers, the program is 18 designed to provide a financial 19 initiative to serve beneficiaries to 20 pursue benefits. Here's how it 21 works: A ticket holder decides he or 22 she wants to pursue employment and he 23 or she takes the ticket to an en of 24 choice. The en and the beneficiary 25 discuss the beneficiary's employment 4 1 goals and negotiate the services that 2 the en will provide in achieving 3 those goals. They are recorded in an 4 individualized work plan. The en 5 provides the services and once the 6 ticketholder begins working, the en 7 collects evidence of earnings that 8 are submitted to maximus, the 9 operations support manager for the 10 Ticket to Work program along with the 11 request for payment. Employment 12 networks must choose one of two 13 payment systems when an agreement is 14 signed by the social security 15 administration. The payment system 16 choices are the outcome payment 17 system and the outcome milestone 18 payment system. The en may change 19 the selected payment system once in a 20 calendar year. Maximus pays the en 21 through a direct deposit to the en's 22 bank account. Currently, the 23 processing takes about 30 days. 24 Currently, 10.5 million beneficiaries 25 are in possession of a ticket. About 5 1 17.5 percent of those beneficiaries 2 want to work their way off the rolls 3 in the next five years. That creates 4 a market of about 1.8 million people 5 nationwide. Currently 200,000 6 beneficiars have assigned their 7 tickets. This number is expected to 8 grow by between 200,000 and 250,000 9 due to the new regulations. To date 10 $11.5 million have been paid to 411 11 employment networks serving 4,100 12 beneficiaries. The best part for you 13 is that many independent living 14 centers are already serving 15 beneficiaries in providing a variety 16 of services or at least are equipped 17 to provide services that can assist 18 beneficiaries in their efforts to 19 secure employment. Therefore little 20 to no money may be required for start 21 up costs; And in many instances, 22 staff may be already in place to 23 provide these services. 24 If you're worried that your center 25 won't be able to provide services to 6 1 meet the needs of all beneficiaries 2 with tickets in your area, you can 3 stop worrying. In addition to 4 beneficiaries choosing when or 5 whether to use their ticket, there's 6 another voluntary aspect of the 7 ticket to work program -- en's, 8 other than state vr agencies, can 9 choose whether or not to accept 10 ticket assignments from a particular 11 beneficiary. That means the choice 12 is up to you whether or not you are 13 the right en to provide the services 14 and support a particular beneficiary 15 needs to accomplish his or her 16 employment goals. 17 At this time, I'm going to turn 18 the call over to Sallie Rhodes to 19 discuss improvements seen in the new 20 regulations that reflects some 21 feedback that's been given by en's 22 and beneficiaries. 23 >> SALLIE: Thank you, joel. As 24 you probably are aware, the service 25 delivery model that Joel just 7 1 described is a new approach to 2 service delivery where you have 3 payments based on milestones and 4 outcomes occurring after job 5 placements rather than reimbursing 6 providers for services. 7 Because it was a new approach to 8 service delivery, congress instructed 9 the social security administration to 10 use this regulatory authority to make 11 changes based on lessons learned 12 during early implementation. 13 SSA is listening, SSA is learning 14 and SSA is responding. They have 15 changed their programs to more 16 effectively provide opportunities for 17 beneficiaries with disabilities who 18 want to work. 19 Who have they listened to so far? 20 Beneficiaries and their family 21 members, advocates, employment 22 networks, state vocation 23 rehabilitation agencies and other 24 types of providers, employers and 25 other state partners and SSA 8 1 conducted a formal evaluation -- 2 contracted to have a formal valuation 3 of the Ticket to Work program. 4 Through all of this input and 5 through issuing notices of proposed 6 rule making, SSA has learned a number 7 of things. One, a mix of benefits 8 payments and earnings is what many 9 beneficiaries need to be comfortable 10 in taking that initial step towards 11 employment. SSA also learned that 12 self-sufficiency is an incremental 13 multistep process for most 14 beneficiaries. 15 They learned that part-time work 16 is a very good start on the road to 17 self-supporting employment. And 18 they've learned that ongoing support 19 may be necessary for some 20 beneficiaries to maintain employment 21 over a period of time. They've also 22 learned that community partnerships 23 work. For many beneficiaries it 24 takes more than one provider and more 25 than one person to give them the 9 1 things that assist them with the 2 systems and services they need to 3 accomplish their employment goals. 4 What are some of the features of 5 the new ticket regulations that we 6 all feel are very important 7 improvements to the ticket program? 8 One is the movement where tickets 9 will now be available to all adult 10 beneficiaries with disabilities who 11 are age 18 through 64. 12 Many people may be aware that 13 prior to this there was a category of 14 beneficiaries called medical 15 improvement expected that could not 16 get tickets until they had been 17 through their first continuing 18 disability review. Now when a person 19 is determined eligible for disability 20 benefits, they will be eligible for a 21 ticket immediately regardless of what 22 kind of category they are put in in 23 terms of benefits. 24 The new ticket also has a better 25 alignment of programs. That includes 10 1 the Ticket to Work program, work 2 incentives in planning assistance 3 programs, the protection advocacy for 4 beneficiaries of the social security 5 program and a variety of other work 6 incentives are now better coordinated 7 and more in line with each other and 8 provide a more comprehensive pack of 9 services, support services for 10 beneficiaries. 11 Another important change that's 12 targeted for beneficiaries in the new 13 regulations is improvements to the 14 timely progress requirements. 15 If any of you have been working 16 with a ticket program or are aware of 17 it, you are aware that maximus, which 18 is called the operations support 19 manager for the ticket to work 20 program, maximus conducts timely 21 reviews to determine if beneficiaries 22 are advancing toward their employment 23 goals. They must be making progress 24 for their tickets to be considered in 25 use. And the important thing here is 11 1 that the in-use status is associated 2 with protection in the ticket 3 legislation against medical 4 continuing disability reviews. 5 So while a beneficiary has a 6 ticket that is assigned to an 7 employment network or state VR agency 8 or working with state VR under a new 9 category that I'll talk about in a 10 minute, and while they are making 11 timely progress, they will not be 12 subjected to regularly scheduled 13 continuing medical disability 14 reviews. 15 Timely progress reviews are done 16 once each progress certification 17 period which is once every twelve 18 months under the new regulation. 19 This will improve timely progress 20 requirements by patterning them after 21 the work requirements associated with 22 employment network and milestone 23 payments and they also allow for 24 certain levels of educational 25 achievement and that would include 12 1 getting a GED, post secondary 2 education and vocational and 3 technical training. 4 These things can now be used to 5 demonstrate timely progress or 6 self-supporting employment. I'm 7 going to give you one example of a 8 timely progress review to show you 9 how it's in line with the e npayment. 10 The first twelve month review, what 11 they are looking for is that a 12 beneficiary has worked three months 13 at the trial work period level which 14 is $670 a month during that twelve 15 month period or that the 16 beneficiaries earn 60 percent of a 17 full-time college credit load for a 18 full year. 19 I'm not going to go into all the 20 timely progress reviews, but as you 21 can see, that three-month trial 22 level, that's equated pretty closely 23 to some of the phase one milestones 24 which I'll discuss later. 25 So, the rules now in addition to 13 1 allowing for education to count 2 towards timely progress and work, 3 they also allow for a mixture of 4 education and work to go towards 5 timely progress as long as the 6 percentages of the education and the 7 work equal more than 100 percent. 8 There's also a 10 percent variance 9 tolerance. So if you're looking at 10 the educational requirement of 11 60 percent of a full time class load, 12 there's a 10 percent variance that's 13 allowed. 14 One thing you need to be aware of 15 is that the first new timely reviews 16 under the new regulations will occur 17 in July, 2009. 18 So, beneficiaries that would 19 normally have a timely progress 20 review coming up in September, that 21 review will be delayed until July, 22 2009. 23 So, there's a while for people to 24 get used to these requirements and 25 for beneficiaries to get familiar 14 1 with what's expected of them. 2 There are also very important 3 improvements to the en payment 4 systems and as Joel mentioned, 5 there's two en payment systems, one 6 is what we referred to as outcome 7 only and one is outcome milestone. 8 Improvements to the outcome only 9 system include an increase in the 10 potential outcome payments. 11 Prior to this they were set at 12 40 percent of what they called the 13 payment calculation base which is 14 the average payment last year to SSI 15 beneficiaries or SSDI beneficiaries 16 so there's one for each type of 17 beneficiary. 18 They've increased it from that 19 40 percent to 67 percent of the 20 payment calculation base. That's a 21 pretty significant increase. They've 22 also shown that the total potential 23 en payments for SSI and SSDI are now 24 almost the same. 25 If you would look at the payments 15 1 before, you would see a pretty 2 significant difference in the total 3 amount available. So, this will 4 encourage people to work with both 5 types of beneficiaries. 6 The SSDI beneficiaries under the 7 outcome only payment system, if they 8 get to making more net income that's 9 over substantial activity and 10 basically are off the rolls and zero 11 cash benefit status is what we call 12 it, then the en can get $670 a month 13 for up to six months, which is 14 $23,652 if they stay at work that 15 entire 36 months. 16 For SSI it's $377 a month for up 17 to 60 months which equals $22,620. 18 so, you see it's very close to the 19 total amount that's available. 20 Changes to the outcome milestone 21 payment system are pretty 22 significant, too. In fact, very 23 significant and very friendly towards 24 things like part-time work and 25 beneficiars who are going to move 16 1 slowly toward getting off of 2 benefits. 3 Basically the milestone system 4 provides for employment payments for 5 workers attainment of certain 6 employment milestones then you have 7 the outcomes too when they get to the 8 zero cash benefit status. 9 En's earn milestones earlier more 10 often and at a higher rate. 11 Milestone payments based on gross 12 earnings encourage the use of work 13 incentives. Prior to this if you 14 were going to get a milestone 15 payments, social security would 16 subtract things from the 17 beneficiary's earnings before they 18 would determine whether you would get 19 a milestone. 20 This is a very important 21 improvement for beneficiaries and for 22 the employment networks. Similar to 23 the outcome only system, the total 24 potential payments for SSI and SSDI 25 under the outcome milestone payment 17 1 system are almost equal. 2 SSDi, the total potential payments 3 are $21,299, and SSI, is $20,542. 4 Some of the milestone payments are 5 now available based on part-time 6 work. The first phase one milestone 7 payment is based on earnings that are 8 50 percent of the trial work period 9 level. 10 So, that means a beneficiary who 11 is earning $335 in a month would 12 trigger the ability for an employment 13 network to request the first phase 14 one milestone payment,. 15 There are up to three additional 16 milestones, payments based on 17 earnings at the trial work period 18 level which is $679 a month. 19 So, if you look at this, the first 20 phase one milestone earning level is 21 $335 of earnings in one month, the 22 payment would be $1,177. 23 Milestone two is $670 of earnings 24 for three months cumulative. So, 25 that includes the milestone one 18 1 earnings, if they happen to be $670 a 2 month, another en payment of $1,177; 3 milestone 3, $667 for six months, 4 again cumulative. You get to count 5 the three months that you counted for 6 milestone two, another $1,177 en 7 payment. 8 And then the fourth milestone is 9 nine months of earnings at $670 a 10 month cumulative. So, you're looking 11 at those four phase 1 milestones for 12 $4,708 for beneficiaries who are 13 working at nothing more than the 14 trial work period of $670 for the 15 2008 numbers. 16 The phase one milestones are 17 associated with initial efforts of 18 self-supporting employment. That's 19 why they count for part time work. 20 And all work and earnings counted 21 towards reaching the milestones must 22 occur after the ticket is assigned to 23 the en and before the beginning of 24 the beneficiary's outcome payment 25 period. 19 1 Then there's a whole set of phase 2 two milestones. In this case the 3 beneficiary earnings, they are 4 looking for gross earnings at the 5 substantial gainful activity level 6 and that's $940 a month for 7 beneficiaries who have disabilities 8 other than blindness and $1,570 for 9 beneficiaries who have blindness as 10 their disability. 11 So, in the phase two milestones 12 you are looking at SSI would bring in 13 if they reach these levels of 14 earnings to the employment network up 15 to 18 payments of $203 a month 16 totaling $3,654. For SSDI it's up to 17 11 payments of $353 a month, totaling 18 3,883. 19 Once again, milestones must occur 20 after ticket assignment and before 21 the start of the outcome payment 22 period. 23 Then you have the outcome payments 24 under the milestone outcome payment 25 system two. Once again, this is 20 1 similar to the outcome only payment. 2 The beneficiary's earnings must have 3 net earnings that are above 4 the substantial gainful activity 5 level and the beneficiary must have a 6 zero cash benefit status. When this 7 happens under the outcome milestone 8 payment system you have up to 36 9 payments of $353 for SSDI totaling 10 $12,708 and up to 60 payments of $203 11 for SSI totaling $12,108. 12 So, if you look at all this in the 13 perfect scenario when a beneficiary 14 goes to work, gets off benefits and 15 maintains that employment, the total 16 payments are $21,000 and for SSI, 17 it's 29,542. 18 If you're interested in exploring 19 how this might look for your 20 independent living centerer, look 21 back on the beneficiaries served last 22 year. You can use tools that's 23 available on line called an en 24 revenue estimator. Plug in your 25 numbers and it would figure out -- 21 1 looking at the people you served last 2 year that goes into effect on 3 July 21st and it would give you an 4 idea of how much money you would have 5 earned. 6 The website is http: 7 //www.CESSI.net/en_ estimator/, and 8 I'm sure Deb will send that out. But 9 it is a tool you can play with and 10 figure out what kind of net worth you 11 may be bringing in. I want to give 12 you an important reminder, actual en 13 payments depend on a number of 14 variables and may be different for 15 different beneficiaries. 16 I'm going to give you a couple of 17 those variables. One is something in 18 the final regulations called the 19 recent work rules. Basically what 20 this does is it looks at a 21 beneficiary whose ticket has been 22 assigned to you as an employment 23 network and looks at the 18 months 24 prior to ticket assignment to 25 determine whether or not they would 22 1 get the phase one milestones. 2 These are patterned after these 3 work rules -- are patterned after, 4 again, the phase one milestones. I'm 5 only going to give you the first one, 6 but it would not be available if the 7 beneficiary was working in the month 8 prior to ticket assignment at a level 9 that is the trial work period level. 10 Then the phase one milestone would 11 not be available because I mentioned 12 before the phase one milestones are 13 associated with initial efforts at 14 employment and this beneficiary came 15 to you with a month of employment 16 under their belt just prior to 17 assigning their ticket. 18 There are four rules, one for each 19 milestone. If you look at this 20 further, you apply each rule 21 independently and you can look at 22 when you become an approved 23 employment network, maximus sends you 24 a CD with a list of beneficiary names 25 in your area who have tickets 23 1 available for assignment and there is 2 some information on their recent work 3 history. 4 In addition if you're going to be 5 working with a beneficiary to help 6 them achieve their employment goals, 7 you're most likely going to sit down 8 with them at the onset and talk about 9 their work experiences. At that time 10 you can get their recent work history 11 and figure out whether or not which 12 of the phase one milestones you may 13 get. 14 Another thing is this rule does 15 not apply to transition cases and 16 that's cases you were already serving 17 as an employment network when the 18 regulations go into effect on 19 July 1st. 20 There is another -- I think is a 21 very positive thing -- in the final 22 regulations that effects your 23 milestone and outcome payments, 24 primarily your milestone payments and 25 it's called the milestone 24 1 reconciliation payment. 2 In some cases you're going to work 3 with a beneficiary and they will go 4 to work and they may get to the 5 outcome phase before they go through 6 these part-time steps that would take 7 you through the phase one milestones 8 -- or even the phase two milestones, 9 they may get quicker than that to the 10 outcome payment stage where they are 11 at zero cash payments. 12 In that case, when you get to the 13 twelfth outcome payment SSA will look 14 at what milestones would have been 15 available to you at the time the 16 ticket was first assigned to you and 17 remain unpaid because the beneficiary 18 got to payment status quicker than 19 expected and they will give you a 20 reconciliation payment that includes 21 those milestones that you would have 22 gotten if they had completed those 23 steps at a slower rate. 24 Some additional improvements of 25 interest to an employment network, 25 1 SSA will not seek an adjustment if 2 there is a retroactive decision that 3 a beneficiary should have been -- had 4 caused an overpayment to the 5 beneficiary. This is new. They 6 would have asked the en's to pay back 7 money in the past. 8 En's must now report to maximus 9 when they want a ticket to be taken 10 out of assignment and payments to 11 beneficiaries are allowed. As many 12 of you may have heard the triple A 13 take charge employment network that 14 pays 75 percent of the outcome 15 payments to the beneficiary to keep 16 them employed so that they can on 17 their own purchase the services that 18 they need to remain employed. 19 These payments currently are being 20 treated as unearned income. 21 A really exciting thing in the new 22 regulations is some new opportunities 23 for en partnerships with vocational 24 rehabilitation agencies. Under the 25 new regulations, VR cost 26 1 reimbursement payments and en 2 milestone and outcome payments are 3 both possible for the same 4 beneficiary. 5 Under the prior regulations, it 6 was one or the other; it couldn't be 7 both. And if both the agency and the 8 en served a beneficiary, they had to 9 figure out a way to share payments. 10 So, what SSA is saying now is they 11 will pay for sequential but not 12 concurrent services. 13 So when vr chooses to serve a 14 beneficiary under the cost 15 reimbursement option and they have 16 the choice on a case by case basis to 17 choose traditional cost reimbursement 18 or elected payment system. When they 19 choose cost reimbursement, the 20 beneficiary's ticket is not assigned 21 to VR, but it is also not available 22 for assignment to another en while 23 the case is open. 24 They created a new in use state vr 25 status so that the protections 27 1 against continuing medical reviews 2 are extended to beneficiaries who are 3 being served by VR under cost 4 reimbursement. 5 After VR closes the case, the 6 beneficiary can take their ticket and 7 assign it to an en and receive 8 ongoing support services, job 9 retention services, transportation 10 services or whatever they need to 11 remain employed. 12 However, because VR closed the 13 case with the beneficiary employed, 14 the phase one milestones would not be 15 available to the en because VR did 16 the initial work that got them into 17 employment. 18 But the phase two milestones and 19 the outcome payments would 20 potentially be available to the 21 employment network. In addition 22 there are some VR agencies that are 23 looking at this and saying, well, if 24 we have an employment network pick 25 this case up and continue working 28 1 with this beneficiary for three or 2 four years and share with us the wage 3 data and get the beneficiary to the 4 point that VR can apply for cost 5 reimbursement, which their standard 6 is nine months of substantial gainful 7 activity net earnings, then they're 8 going to have more people they're 9 getting cost reimbursement for. 10 So, some vr agencies are looking 11 at possibly reimbursing a network for 12 those one, two, three, or four phase 13 one milestones. It's just an being 14 explored. We're hoping more will 15 look at it. 16 No matter how you look at it 17 though, even with the phase one 18 milestones off the table, when you 19 have this partnership plus option, 20 the en/vr partnership, there is new 21 money on the table that was never 22 there before in terms of the phase 23 two milestones and the outcome 24 payments; and that new money runs 25 about $15,000 for sSI beneficiaries 29 1 and 16,000 for SSDI beneficiaries. 2 VR can still choose to serve a 3 beneficiary as an employment network. 4 When they do that the ticket is 5 assigned to the VR agency. They must 6 operate as any other employment 7 network and if upon case closure the 8 beneficiary decides to assign their 9 ticket to an employment network, 10 there would need to be some kind of 11 agreement or negotiation through 12 MaxiMUS for the VR agency and 13 employment network to share the 14 milestone and outcome payments 15 because the new money is off the 16 table. There is no cost 17 reimbursement; you only have the 18 potential of the en milestone and 19 outcome payments. 20 There have been some process 21 improvements that are associated with 22 the regulations but have more to do 23 with ssa processes and procedures. 24 They have simplified the en payment 25 process. Basically there are two 30 1 ways to request milestone and outcome 2 payments. For both you must submit 3 the en payment request form and you 4 must submit evidence of earnings and 5 there are two options right now. 6 One is called the evidentiary 7 payment request and one is called 8 certification. Evidentiary, just 9 real quickly, is submitting the 10 actual documentation such as pay 11 stubs or an employment prepared 12 statement of earnings or a record of 13 monthly earnings through the what's 14 called the work number. 15 The certification process is a 16 little more lengthy but it requires 17 less work on the part of the en. It 18 could include documentation of 19 earnings in terms of a recent dated 20 contact with the beneficiary or the 21 beneficiary's employer stating that 22 they are still working; it could be a 23 response from an earnings information 24 request that is submitting to SSA. 25 It could be information from 31 1 what's called the national directory 2 of new hires and there is also a 3 self-employment form. 4 SSA is also working on a third 5 option for submitting payments which 6 is called the auto pay process. It's 7 in the developmental stages but once 8 it is in place, employment networks 9 would have to wait longer, up to nine 10 to twelve months to get any payments, 11 but they don't have to do anything. 12 SSA does the work and once it's 13 established they can go back to their 14 payment process to see that a 15 beneficiary is in zero payment status 16 and the payments keep coming to the 17 en without the en having to follow 18 the beneficiary's earnings. 19 So, if you look at it, there are 20 many opportunities for success here. 21 I know independent living centers, 22 like so many others, have shrinking 23 budgets; there's extensive 24 competition for discretionary funding 25 across the board. 32 1 This money coming in could be 2 opportunities to fund long-term 3 support; it's flexible funding that 4 can be used to meet a variety of 5 needs; you could serve more people, 6 you could hire a job coach, create a 7 flexible job support fund or hire a 8 work incentive planner, even buy new 9 equipment if that's what you needed. 10 So, what does all this mean? It 11 means the new ticket to work is more 12 profitable for employment networks; 13 it's an additional revenue new 14 source. 15 More employment networks 16 participating mean more choices for 17 beneficiaries. Opportunities for 18 en/vr partnerships will expand the 19 scope of services available to 20 beneficiaries and improve the 21 coordination of services and service 22 providers and beneficiaries will have 23 more control over employment services 24 and their flexible design. 25 That was a quick overview. Deb 33 1 will probably send out some 2 information with linkss to more 3 information where you can get more 4 details. But at this point I'm going 5 to turn it over to Peter darling who 6 is vice president of employment 7 services at granite state independent 8 living center to talk about becoming 9 an employment network from the center 10 for independent living status. 11 Peter? 12 >> PETER: Thank you very much, 13 Sallie. First of all, thank you Joel 14 and thank you Sallie. We are in fact 15 an employment network but with these 16 new regulations and all these very 17 positive changes, I was writing as 18 fast, I imagine, as everyone else 19 was. 20 So, great job and we all probably 21 need to hear it a few times before we 22 truly understand it. 23 >> SALLIE: Peter, real quick, I'm 24 also going to have Deb send out the 25 links to a couple of previous 34 1 teleconferences that were revorded. 2 So, there will be plenty of 3 opportunities of written material and 4 new listen to material. 5 >> PETER: Great. Hi, everybody, 6 again. My name is Peter darling. I 7 work for granite state independent 8 living. We are New Hampshire's 9 ndependent living center. New 10 hampshire only has one. We serve the 11 entire state. We have offices in six 12 different geographical locations and 13 a staff of approximately 100. 14 We are comprehensive in our 15 offerings and support services. I 16 realize that may be more than you 17 want to know but I think this will 18 lend a perspective. And I'm sure 19 some of you will say you're way 20 bigger or way smaller. Be that as it 21 is, let me tell you some more stuff. 22 My job here is to administer the 23 employment department. How we have 24 it structured and how it operates 25 administratively is that perhaps the 35 1 largest single component is sort of 2 our job placement programs. 3 Those exist through a fee for 4 service arrangements. We certainly 5 have some contracts in the area of 6 developmental services and we have 7 some grant funded programs. 8 Also in our department is the wipa 9 program, that's the work incentives 10 planning and assistance-- or the old 11 benefits counseling which is clearly 12 an important part of this, and gives 13 us some special responsibilities 14 being both of those -- being both an 15 employment network and a wipa. We 16 have to be careful how we proceed. 17 The third area is transition. We 18 do a lot of work supporting high 19 school students with disabilities as 20 they transition from their high 21 school experience into the world of 22 work. If you're wondering out there, 23 that doesn't sound like us, let me 24 give you some more background. If it 25 isn't -- I think it could potentially 36 1 sound just like you. 2 In 2004 granite state independent 3 living was looking to add employment 4 services because they at that point 5 did not have any offerings. The 6 reasons they wanted to do this were 7 pretty simple and straightforward, 8 for persons with disability to fully 9 achieve economic self-sufficient 10 efficiency, our feeling was that work 11 was one of the better vehicles to 12 achieve that. 13 We are also acutely aware of the 14 less than positive numbers around the 15 unemployment rate for individuals 16 with significant disabilities. 17 So, to proceed, granite state 18 independent living had to decide 19 whether it wanted to develop 20 employment services on its own or 21 partner with the someone else in the 22 community or in the state who is 23 providing that. 24 We did have a unique experience in 25 that in 2004. I was working for an 37 1 employment service. We weren't 2 statewide but we served a great 3 portion of the state and we were 4 experiencing, oh, the funding 5 challenges that I'm willing to 6 imagine all of us were facing then 7 and continue to face. But what this 8 did was present on opportunity rather 9 than having granite state independent 10 living develop an employment service, 11 they could acquire or somehow 12 partner-join with us to do that. 13 So, we went through a process 14 where we actually were acquired 15 versus a merger. That's a longer 16 story, but what it ultimately meant 17 was that we could begin to look at 18 complimenting each other. They 19 picked up instantly contracts, 20 CREDIBILITY, awareness and resources 21 around the areas of employment and 22 for us as an employment vendor, 23 suddenly, we had access to additional 24 supports that had not, prior to that 25 experience, existed for us outside of 38 1 the funding that we received for just 2 sort of the general things like 3 preparing individuals for work, 4 finding them work and then maybe some 5 period of support. 6 As employment providers, we had 7 been frustrated by sort of that lack 8 of wraparound services, lack of 9 access to an individual or supporting 10 them as significantly as some 11 individuals need outside of that work 12 environment and saw this as a great 13 opportunity for us. 14 I think, the independent living 15 center was feeling some frustration 16 in that they had lots of folks 17 looking to explore the possibility of 18 work but they lacked that resource. 19 So we feel it was a great marriage. 20 The employment programs, as i said, 21 lacked that . The -- 22 >>: (indiscernable) phone number. 23 Do you have the number for 24 (indiscernable) 25 >> PETER: Yeah, I think at the 39 1 end of the conference we're going to 2 take questions and provide contact 3 information is that correct? 4 >>: My colleague wants to join 5 now. 6 >> PETER: Okay. I think we'll 7 get to that as we go forward. 8 >>: Have you got that number for 9 video phone number? 10 >>: We have a staff member who is 11 deaf and we need to either have 12 closed caption or video relay or 13 something so she can join in. 14 >> PETER: Niloce -- deb, are you 15 there? 16 >>: Yes, if you go to the website 17 and click on trainings, there's a 18 link to the trainings. 19 >>: Which website do i go to? 20 >> it's Http: /www.NCIL.org and 21 for national counsel on independent 22 living and just click on trainings 23 and then you'll see a link for this 24 training which is the Ticket to Work. 25 >>: Okay. All right she can join 40 1 in, right? 2 >>: Yes. That'd be great. 3 >>: Thank you. 4 >> PETER: Thank you, Deb. 5 I'm assuming we're all back on. 6 Again, what did all that background 7 have to do with becoming an 8 employment network? Hopefully it 9 just gives you a sense of where you 10 might be organizationally, where we 11 were and some of the rationale in 12 moving in the direction that we did. 13 So, with that in mind, let me just 14 reiterate some of this. Being an en 15 gives you access as Sallie clearly 16 pointed out, to increased and new 17 revenue streams and sources to assist 18 individuals interested in returning 19 or starting to look at work. Being 20 an en and an independent living 21 center gives you access to more 22 support resources and experiences. 23 And I think again both entities an 24 old employment entity, an IL center, 25 we both see this as the way to go. 41 1 We talk about the application 2 process. Nobody has referenced that 3 specifically, when you go to the 4 sight that you'll be directed to and 5 downloaded, you hit your print 6 button, you're going to sit there and 7 go, oh my gosh. 8 It is a very long document. I 9 believe it is 62 or so pages. This 10 will potentially make you wonder why 11 you even hit that print button. It's 12 not as arduous and as difficult as 13 that might seem. The actual part you 14 need to fill out and complete is much 15 shorter than that and might be in the 16 neighborhood of 20 pages, but within 17 that 20 pages, a lot of it is 18 somewhat redundant because you have 19 to answer questions over in different 20 fashions. 21 Some of it is just lengthy in that 22 it just asks you who you feel your 23 organization is most comfortable 24 serving or what parts of your state 25 or region you feel most comfortable 42 1 in serving. 2 So, again, even the 20 pages is 3 not as overwhelming as it may sound. 4 It will take you a period of time to 5 complete. you will have to do some 6 outside research And talk to some 7 others in your organization. But it 8 truly isn't the monster that it may 9 appear to be. 10 Once you do that, you send it in 11 and we filed it -- our application 12 was responded to much more quickly 13 than I had anticipated our acceptance 14 and moved frd there. Some of the 15 things you need to know and it sort 16 of reiterates what Sallie said -- 17 from your perspective, you might say 18 we're not that big or we're not 19 statewide. We don't want to mislead 20 individuals from parts of our region 21 or state that we don't serve very 22 well. 23 What that ticket offers is choice 24 on both sides. As an en you name 25 your geographical limits or lack of 43 1 limits so that if you feel 2 comfortable only serving a town or 3 county, you can so designate. Also, 4 in terms of population types, 5 individuals with some disabilities 6 may or may not present challenges to 7 or for your organization that you 8 don't feel you're ready to take on at 9 that particular time. 10 Therefore, you wouldn't have to 11 say that you serve those folks and 12 certainly would not have to accept a 13 ticket from someone. 14 So, again, I think the flexibility 15 of the ticket program both in terms 16 of your accepting those tickets and 17 again it's very positive that an 18 individual doesn't have to give a 19 ticket to an en if they don't feel 20 they can meet their needs. 21 I think part of this process, the 22 unspoken, is there are not enough 23 employment networks out there now to 24 give the kinds of choice that most of 25 us feel need to be available to 44 1 individuals and hopefully as this 2 rolls out and it's sort of second 3 coming we'll see more opportunities 4 on both sides. 5 In terms of the negotiation of 6 services, that's a very friendly 7 process. When you meet with a ticket 8 holder, you really can match with 9 that person's true needs, meet your 10 abilities to provide that service. 11 As noted by Sallie, a VR sometimes is 12 and should be a partner in this 13 particular situation going forward 14 and it may, in fact, be the only way. 15 As an en you may not have the 16 resources of the depth of such to 17 really meet an individual's needs. 18 So, this is really going to provide 19 us an opportunity to work hand in 20 hand in true partnership. That's 21 very exciting. 22 Some other things that i think you 23 will find, with these new regs, 24 there's a clear initiative of rollout 25 outreach. Many states, i believe 16 45 1 states have been identified where 2 very significant activity, for 3 ticketholders and recruitment of en's 4 will be taking place this summer. 5 Why I bring that up, as an en or 6 potential en, that's higher 7 probability that you will be informed 8 but ticket holders will also be 9 informed. 10 >>: (indiscernable). 11 >> PETER: I can tell you this: 12 If you know that you're in one of the 13 16 largest states, I believe it's 14 state one through 16 in the 15 population is where they're starting. 16 But, again, Sallie or Joel when we 17 get to Q and A will probably answer 18 that more specifically. 19 Also, I would sort of like to end 20 my portion by stating that when the 21 sort of information is given, contact 22 information at the end of this phone 23 conference, I would be more than 24 happy and I really mean this, to 25 speak with anyone by phone or e-mail. 46 1 There obviously is more to this 2 story and I don't mean negative, but 3 more to this story than I have the 4 opportunity or the need to inform you 5 with today. I guess my message is it 6 just really opens up an opportunity 7 for an independent living center and 8 gives you access to so much more than 9 we've had in the past. 10 We are very, very excited by what 11 it has brought to us by what we think 12 clearly the new regs will bring to 13 all of us. Again, feel very 14 comfortable to contact me with your 15 issues and your circumstances. I 16 think we are not unique either in our 17 size or our scope. I can talk to you 18 about how I think you could make it 19 work for you. I'm going to end it 20 here around put myself on mute. 21 As we go forward, I believe now 22 John Lancaster, executive director of 23 NCIL will talk to you about some of 24 the recruitment process. Thank you 25 all. 47 1 >> JOHN: Yes, thank you very, 2 very much, Peter. As the executive 3 director of the national counsel on 4 independent living, I want to say 5 that we are thrilled with Peter's 6 participation and work with social 7 security administration and becoming 8 an en and for helping us here today 9 to talk about the benefits of SILC's 10 and CILs becoming an employment 11 network. 12 We think there's a lot to be 13 gained. We all have shrinking 14 resources. We all have the need for 15 additional staff and this provides a 16 unique opportunity to bring aboard 17 people to help us do the work of CILs 18 and SILCs and to get an offset, a 19 significant offset against their 20 wages during a training period and 21 while they might stay working for you 22 or while you're assisting them in 23 finding a job out there in a local 24 business or in some other endeavor in 25 the community in which you serve. 48 1 So, we think that there's a real 2 great opportunity here for the 3 independent living movement to really 4 complete the full array, if you will, 5 of independent living services to 6 make employment become a reality for 7 people who have been on SSI and SSDI. 8 A good friend of ours, Susan 9 Daniels, who used to be the associate 10 commissioner for employment support 11 programs at the social security 12 administration and long a proponent 13 of independent living was always fond 14 of saying that independent living is 15 a hollow props without employment and 16 economic self-sufficient efficiency. 17 Unless you are independently 18 wealthy, economic self-sufficiency 19 usually means a job. 20 So, this is a great opportunity 21 for us to really close the loop, if 22 you will, on the full array of 23 independent living services. 24 That being said, NCIL has joined 25 in partnership with the social 49 1 security administration and CESSI to 2 try and roll these new regulations 3 out to all of our CIL and SILC 4 members and also to promote the fact 5 that we think it'd be a good idea for 6 them to become an employment network. 7 We have been working hard to that 8 endeavor. We have presented SILCs 9 and CILs to various parts of the 10 country. Deb Cotter attended the 11 SILC conference back in January and 12 had an exhibit in the program and was 13 talking it up there. I personally 14 have been to southern California, to 15 Seattle, to Atlanta Georgia speaking 16 with CILs on my travel and I will be 17 doing that every place I go with NCIL 18 to reach out to the CILs in that area 19 to talk fo them about becoming an 20 employment network. 21 We also recently have done an 22 employment survey of our CILs to find 23 out issues and other concerns they 24 might have around the Ticket to Work 25 regs and their feelings about it and 50 1 also to try to identify whether they 2 are already an en. We have also been 3 able to go over the list of 4 employment networks that are 5 currently registered with the social 6 security administration and we are 7 pleased to say that there are 8 currently at least -- and we think we 9 have identified them all -- at least 10 38 CILs that are active employment 11 networks. 12 Now, we would like to see that 13 number much, much higher. As you 14 know there are 336 direct Federal 15 grant recipients in terms of centers 16 for independent living around the 17 country that get an independent 18 living grant directly from RSA on an 19 annual basis. 20 There's probably as many as 21 another hundred CILs that are either 22 subpart B funded or some other 23 mechanism of state funding that are 24 also -- a few of whom are also 25 employment networks. 51 1 So, we are pleased that the 2 independent living movement is 3 starting to become active in the 4 ticket to work program, and our 5 purpose is to try and expand that and 6 to see if we can't get a lot more 7 employment networks doing that. 8 Now, also we have introduced this 9 program on our regional policy calls. 10 We are doing this call to introduce 11 it to our network. We are going to 12 be having a page on our website 13 dedicated to this. We've already got 14 some links up on the website. We're 15 going to be getting out more 16 information to you as we go along 17 throughout the year and into the 18 future. 19 We have a very exciting program 20 for all of you that are coming to our 21 annual conference in July. We are 22 going to be doing a great workshop on 23 the Ticket to Work program and 24 included in that workshop are going 25 to be some CILs who can speak about 52 1 the benefits of being an employment 2 network and we're going to have with 3 us the current associate commissioner 4 for employment support programs, sue 5 suitor. I know many of you know sue. 6 Sue herself used to run an 7 independent living program in the 8 state of Illinois. She was the 9 commissioner of rehab services there 10 and has been very active in the 11 independent living movement and in 12 rehabilitation services and knows 13 these programs extremely well and 14 will add a lot to our conference and 15 to this particular workshop. 16 So, we urge you to attend that 17 workshop. 18 Additionally, our employment and 19 social security subcommittee has been 20 working on these issues, Deb Cotter, 21 our policy analyst that follows these 22 issues and is the one kind of leading 23 our efforts on this partnership that 24 we have with cessi and SSA and you 25 should all feel free to contact Deb 53 1 if you need links to resources or 2 information that you don't have and 3 obviously Sallie Rhodes at CESSI is 4 also available to you and again at 5 the end of this conference call, 6 we'll be giving you contact 7 information to write down. 8 We are aware that the regs are a 9 little bit daunting and kind of 10 lengthy at times and maybe a little 11 bit complicated. But working through 12 them and tackling the things that you 13 need to tackle to master them can be 14 a tremendous benefit to CILs and/or a 15 SILC in putting together a good 16 program that will result in revenues 17 for your CIL and doing great things 18 for consumers that you're serving in 19 your community to get them into 20 employment, maybe even into your own 21 workforce and your own CIL. 22 One thing that NCIL is going to do 23 and we have not set it up yet -- 24 it'll be something we tackle after 25 our annual conference, but we are 54 1 going to become an employment network 2 ourselves, NCIL is. 3 What we are going to do is 4 actually bring someone off of the 5 rolls and train them to be our 6 employment network coordinator. And 7 then we are going to market to all of 8 the CILs and SILCs across the country 9 that if they would like to become an 10 employment network in partnership 11 with NCIL but not deal with all the 12 administrative and filing of reports, 13 et cetera, and would rather just do 14 the grassroots working with the 15 consumer piece of it, doing the 16 outreach, providing whatever services 17 would be necessary to provide the 18 benefit counselling, etc. and 19 actually taking the ticket, then NCIL 20 will handle the administration end of 21 things and then we will split the 22 payments as they come from social 23 security when we start actually 24 placing clients through it. 25 NCIL will take a small percentage; 55 1 we haven't decided what that will 2 need to be yet but I would get in the 3 neighborhood of 10 to 20 percent for 4 administering the program, then the 5 CIL or the SILC that joins the 6 partnership with us would get the 7 balance of payments on each consumer 8 for the work that they do and for 9 actually assisting the live client in 10 the field, if you will. 11 We feel this will be of great 12 benefit to small CILs and SILCs who 13 might not have the staff or the 14 wherewithal to deal with the 15 administration that might go with the 16 program or just may not want to, even 17 if they could handle it, they may 18 rather a pay someone to do that for 19 them and just do the client service 20 piece of it. 21 So, we will be offering that down 22 the road. That will be another 23 opportunity for you-all to come in 24 and participate in these exciting 25 efforts. 56 1 So, we're trying to get 2 imaginative. That is also something 3 the silc could do for the cils in 4 their state, to become kind of an 5 employment network coordinator, take 6 one person and themselves off the 7 rolls and then act as the 8 administrator, if you will, for the 9 other CILs in their state. 10 So, I think there's lots of ways 11 that this could be worked. We are 12 looking forward to other models that 13 might show up and see how we might be 14 able to promote those. We want you 15 to know that NCIL is here to provide 16 you with assistance and technical 17 assistance with connections to help 18 you get started if you want to become 19 an employment network. 20 Again, in the future, not too 21 distant future, to actually partner 22 with NCIL in becoming a kind of 23 independent living movement 24 employment network, if you will. 25 So, we are excited about this. I 57 1 couldn't encourage you more to get 2 involved and to support these efforts 3 and we look forward to working with 4 you all. 5 Again, if you're going to be at 6 our annual conference, please do not 7 miss the workshop that we're going to 8 be doing with SSA and CESSI that will 9 be highlighted by the presence of sue 10 from the social security 11 administration. 12 So, thank you all and we are 13 thrilled that you joined this call 14 and just know that we are there to 15 support you in becoming an employment 16 network. Thank you. 17 >> JOHN: I think at this point 18 we're going to turn it back over to 19 Sallie Rhodes and Joel Middleton, who 20 are going to give us some additional 21 resources. 22 >> SALLIE: Joel, I'm going to 23 take a minute to highlight a couple 24 of things and I'll let you do the 25 specifics if that's All right. One 58 1 of the things I think you're going to 2 find out is that you're going to 3 receive timely and responsive support 4 from social security and CESSI and 5 from Maximus. 6 The streamlined en application 7 process with personalized support 8 available to help you -- and Joel 9 will tell you more about that. 10 SSA can track your claims through 11 payment and resolve any payment 12 problems. Ssa has decreased the 13 average payment processing time. 14 It's running about 30 days, i think. 15 And training is available on how to 16 make the program work for you. 17 Joel, do you want to give some 18 specifics on some of these resources? 19 >> JOEL: Yeah. Like you said, 20 training for the RfP, at CESSI we 21 facilitate application walk-through 22 calls which can attend. We will go 23 through the rfp page by page. 24 Peter discussed it in terms of it 25 being 62 pages being somewhat 59 1 intimidating, but that is a false 2 assessment because it's not that bad 3 and we're here to help and we go 4 through it page by page. 5 If you're unable to attend one of 6 the application walk-through calls, 7 for a group, we do them on a personal 8 basis as well. You can contact me at 9 CESSI and I'll give you my contact 10 information now because I'm sure 11 you've all been waiting for some 12 contact information. The phone 13 number is 703-448-6155, the extension 14 is No. 223. 15 I'll go ahead and repeat it. 16 (703)448-6155, extension 223. You 17 can e-mail me at 18 jmiddleton@CESSI.net. It's 19 JMIDDLETON@ CESSI.net. 20 Peter, actually, if you want to 21 give your contact information as 22 well. I appreciate that you've made 23 yourself available as an example of 24 how it can be a successful program 25 for an independent living center. 60 1 I'll go ahead and let you do that 2 now. 3 >> SALLIE: Peter, go ahead. 4 >> PETER: I forgot which one was 5 demute. You can reach me at 6 603-224-1130. So that's 7 (603)224-1130. And my e-mail address 8 is Peter.darling@GSIL.org. 9 >> SALLIE: This is Sallie Rhodes, 10 my e-mail is Sallie.rhodes@SSA.gov. 11 Even though I am a CESSI employee, I 12 am on site at social security. My 13 phone number is (410)965-1309. 14 Joel, you want to tell a little 15 bit more about the resources and 16 things? 17 >> JOEL: Yeah, sure. As I 18 mentioned, we are here at CESSI. We 19 are the program marketing and 20 outreach team. We are available to 21 you to answer any questions and help 22 you with the RFP. I'll go ahead and 23 tell you where you can locate the 24 rfp, the request for proposal, and 25 that is at www.SSA.gov/work/enrsp/ 61 1 html. 2 >> .Html. 3 >> .html And if you're unable to 4 retrieve it that way, contact me at 5 the information I just gave you. I'd 6 be happy to e-mail you a copy and 7 work with you to get it done. 8 Also, once you complete your 9 application, we're available if you 10 want to give it to us to review 11 before you submit it to the social 12 security administration just to make 13 sure everything is in line so to 14 speak. 15 We are available to do that as 16 well. So, that's what we do in terms 17 of helping with the RFP. I think we 18 have some time left on the call for 19 some Q and A. So, if you guys want 20 to unmute your line and begin with 21 questions, I think we have some time 22 to answer them. 23 >>: Well, since we don't have any 24 questions, this is Sallie. I think 25 John asked about the ticket express 62 1 state and that's what we're calling 2 this thing, a ticket express. We are 3 going into -- 4 >>: I have a question. 5 >> SALLIE: Okay. Go ahead. 6 >>: My name is (indiscernable). 7 I'm from Denver, Colorado. 8 (indiscernable). When we give 9 people -- on this Ticket to Work, how 10 much money do the (indiscernable) 11 get? 12 >> SALLIE: Okay. This is Sallie. 13 I went through the payment things, 14 it's the milestone payments, the four 15 phase one milestones were $1,177 each 16 when they reached certain levels of 17 earnings over certain periods of 18 time. 19 I encourage you to visit the SSA 20 work site and you will see there's a 21 fax sheet called overview of the 22 ticket -- the new Ticket to Work 23 regulations that has the chart on the 24 back that has the whole payment 25 process laid out. Or i guess 63 1 maybe -- deb, do you want to send 2 that to people in follow-up to the 3 call? 4 >>: Absolutely and also want to 5 add, people can submit questions to 6 me directly. I plan on sending out 7 all the information and all of our 8 contact information, as well. For 9 people like me who don't write very 10 quickly, don't worry, we will be 11 sending out this information to you. 12 I want to mention if people have 13 questions on the call now, they could 14 submit them to me now as well and you 15 guys can answer them. My e-mail 16 address is Deb@NCIL.org. 17 >> SALLIE: I do want to stress 18 about the payments, that it's not 19 payments for services. This is 20 payments for beneficiaries achieving 21 milestones and outcomes. I mentioned 22 the part-time work and the amount of 23 money you get if a beneficiary works. 24 If they earn $335 in a month then 25 you're going to get the first 64 1 milestone payment if VR did not work 2 with that case in close the person in 3 employment and if they did not work 4 the month prior to assigning that 5 ticket to you and that's $1,177. 6 So, you will see when she sends 7 out that sheet there is a whole lay 8 out of each milestone, the criteria 9 for that milestone to be earned and 10 the amount of each milestone. Okay? 11 Other questions? 12 >>: I have a process question. 13 So, basically, if I'm kind of 14 understanding an overview -- I'm 15 actually from Oregon. So, what we 16 could do is we could become part of 17 the employment network by filling out 18 a 60 page RFP. We would have access 19 to data of people who have tickets 20 that aren't open in our area and we 21 could establish some kind of 22 relationship or not with community 23 partners as to how that ticket would 24 be assigned and services provided, 25 right? 65 1 >> SALLIE: That is correct. 2 Actually, to me, the opportunities 3 are unlimited. You, your independent 4 living center, could be an 5 independent living center on its own. 6 You fill out the 60 plus page RFP. 7 You become the employment network of 8 record. You could also partner with 9 another service provider and the two 10 of you could become partners as an 11 employment network. You could join a 12 coalition of providers. 13 >>: We could have vr assign a 14 Ticket to Work and we could provide 15 the employment support of the Ticket 16 to Work through some kind of joint 17 assignment; is that correct? 18 >> SALLIE: There is nothing that 19 prevents you as an employment network 20 from working with VR as a regular 21 vendor, which many of you have 22 already done, and VR would pay you 23 the way they always have and in 24 another situation and another 25 individual you might be the 66 1 employment network and only you are 2 working with that individual. 3 And John mentioned to you the fact 4 that NCIL is going to become an 5 employment network and for those 6 smaller independent living centers 7 that don't feel they have the staff 8 to handle the administrative stuff 9 involved in requesting payments and 10 tracking earnings and stuff like 11 that, you could join into that 12 coalition of providers that NCIL is 13 going to be and then you're a local 14 site but NCIL submits the application 15 and lists you as a local site 16 providing services and you are part 17 of the NCIL employment network, okay? 18 >>: My concern is getting the 19 benchmark payments. Providing 20 services and then being -- and this 21 actually came up at our last SILC 22 meeting when we talked about en's. 23 Any thoughts there or would that be a 24 better question to ask Peter? 25 >> SALLIE: Can you be a little 67 1 clearer on what the question is? 2 >>: My only concern is that we 3 would provide the employment services 4 and once the -- what do you call -- 5 basically the benchmarks, I guess, we 6 would be compensated under the 7 ticket, right? 8 >> SALLIE: Yes, if the ticket was 9 assigned to you and milestones were 10 accomplished after ticket assignment 11 and once again, I mentioned those 12 phase one milestones but if VR wasn't 13 involveD and they didn't have a work 14 history for the past 18 months, you 15 would potentially get all those 16 milestones. 17 >>: I'm clear. Thank you. 18 >> SALLIE: Other questions? 19 Other questions? 20 Okay. John did ask, I think, 21 about the ticket express states and I 22 want to give a little more -- CESSI 23 is the program manager for 24 recruitment and outreach. We're 25 speaking at national conferences; 68 1 john mentioned we're going to speak 2 at NCIL, we're speaking at lots of 3 national conferences trying to 4 recruit more employment networks. 5 The ticket express is a 50 state 6 strategy to go into individual states 7 to create a state infrastructure that 8 would be trying to help us recruit 9 employment networks to bring 10 potential providers in to talk about 11 the opportunities of the Ticket to 12 Work. 13 The first five states are as was 14 mentioned earlier, the most populous 15 states and the ones that have the 16 largest beneficiary populations and 17 they are California, Texas, New York, 18 Illinois and Florida, which we are 19 working on things -- today there is 20 an Illinois en event going on; 21 Florida, there was one last Friday, 22 Texas we're identifying opportunities 23 to go into the state. 24 A second tier of states include 25 Georgia and Virginia. But that does 69 1 not prevent us from coming into your 2 state if you're a smaller state if 3 there are opportunities where there 4 are already things going on that 5 would bring together a good number of 6 potential providers that might be 7 interested in becoming employment 8 networks, we would come in then and 9 try to tack on to an existing event. 10 We did this in Wisconsin back in 11 early April, Wisconsin had a 12 statewide transition and 13 rehabilitation conference. We went 14 in and prior to the beginning of the 15 conference, we had an en recruitment 16 fair and a workshop, sue did a 17 (inaudible) of the workshop. In 18 Florida last Friday, there was a 19 meeting of state agency 20 representatives, then Florida 21 networks, then a workshop at the -- a 22 conference that's held in Florida 23 every year. 24 So, even if you're not one of the 25 larger states, if there's something 70 1 coming up in your state that we can 2 tack on to, we would be very 3 interested in doing that. But we are 4 going to try to hit all 50 states. 5 Other questions? 6 >> PETER: Sallie, this is Peter 7 again and I don't want to stop 8 questions, but I want to support what 9 you just said. For anyone 10 considering this, there is so much 11 information and support, it is highly 12 unusual to have this much. If you 13 get in touch with CESSI, CESSI will 14 hold your hand and almost fill it out 15 with you. They are that good at it. 16 There is no stupid question. In 17 terms of other kinds of support, 18 Maximus' website, if you just type in 19 Ticket to Work or Google it, there's 20 training Tuesday's and Thursdays, 21 there is just so much information. 22 It is overwhelming at first and it 23 does take a couple of sit through's 24 to truly start to be clear about what 25 some of these payments are. But it 71 1 is there and that is unusual and 2 unique and I just needed to say that. 3 >> JOEL: This is Joel at CESSI 4 and I appreciate you saying that and 5 I want to emphasize to all the 6 smaller CILs or those thinking of 7 partnering with NCIL that I am 8 absolutely available to you. I've 9 given you my contact information and 10 Deb will include that when she sends 11 a follow-up e-mail. We are 12 absolutely here to hold your hand the 13 entire way and I look forward to 14 working with each of you that remain 15 on the call. Sallie, I'm going to 16 pass it back to you. 17 >> SALLIE: I do want to mention a 18 couple of things. One is that mostly 19 we've been talking about recruiting 20 employment networks. But CESSI is 21 also involved in outreaching to 22 beneficiaries to tell them about the 23 work incentives, to tell them about 24 the Ticket to Work and to connect 25 them with employment networks and vr 72 1 agencies. 2 Cessi is sponsoring a whole series 3 of what we call work incentive 4 seminars or wise events that are 5 locally based where invitations are 6 sent out to roughly 1,000 7 beneficiaries in the immediate local 8 area in hopes of getting anywhere 9 from 20 to 40 beneficiaries to come. 10 Employment networks are also 11 inviteded and other types of work 12 incentives planning staff are 13 invited, the area work incentives 14 coordinators are invited; state vr 15 agencies are invited. 16 There's a presentation on work 17 incentives, a discussion of the 18 ticket and then beneficiaries have an 19 opportunity to sit down with the 20 representatives of these various 21 programs and talk about their 22 employment goals. 23 So, if you go on the SSA work 24 site, www.socialsecurity.gov/ work 25 and look for the wise events; and you 73 1 might have to Google it, you will see 2 that one may be coming to your area. 3 The intent is to do a hundred this 4 calendar year and probably more next 5 calendar year. 6 So, that's another thing to be 7 aware of. The other thing is people 8 aren't asking many questions and it's 9 a lot of information to process, a 10 lot. Deb is going to send out a lot 11 of information afterwards. But if 12 you come up with questions after this 13 call and you can submit them if 14 they're kind of more meaty questions 15 that have policy implications, you 16 might want to submit them to a 17 specific e-mail that SSA has 18 established for questions around the 19 ticket program. That address is 20 ticketprogram, as one word at 21 SSA.gov. And, so, if you have 22 questions that are more kind of 23 policy oriented that you want to ask 24 questions about, you might want to 25 submit it there. 74 1 Questions about the application 2 process is Deb or Joel; questions 3 about the independent living centers 4 and what to think about and what that 5 meanss for them, you want to probably 6 talk to Peter and I want to emphasize 7 what Peter said; there's lots of 8 resources. Don't hesitate to ask for 9 help. 10 Are there any other questions? 11 Okay. I would like -- I think 12 you've heard a lot. Opportunities 13 abound. I want to encourage you if 14 you're thinking about doing this, 15 talk to other providers, employment 16 networks, your state VR agency, talk 17 to people on this call; consider 18 using the en estimator to look at 19 what kind of revenue you might 20 generate; read the materials and see 21 what happens. 22 It's a wonderful opportunity and I 23 encourage you to consider becoming an 24 employment network. 25 >>: This is Deb. We are aware 75 1 that there is a problem with the 2 webcast display and we have been 3 unable to correct it for today's 4 presentation. We apologize for the 5 inconvenience. All webcast 6 participants will be e-mailed a full 7 transcript within 24 hours of the end 8 of the call and we thank you for your 9 patience. 10 I did have a question, though, 11 from Amy of the northern Nevada 12 center for independent living in 13 fallon. This says has there been any 14 concern about VR losing revenue to 15 CILs that may make purchase 16 partnerships difficult? 17 >> SALLIE: I think the 18 partnership plus has just the 19 opposite opportunity. Under the 20 prior regulations, there was some 21 competition over ticket assignment. 22 Under the new regulation since vr 23 can get cost reimbursement and en's 24 can get milestone payments, there are 25 tremendous opportunities for VR and 76 1 independent living centers to work 2 together. Nationwide, VR serves 3 many, many beneficiaries; but only 4 about maybe 10 to 15 percent of them 5 ever get to the point that VR can 6 submit for cost reimbursement. 7 And their criteria is the 8 beneficiary has to make nine months 9 of earnings that are above 10 substantial gainful activity before 11 VR can submit. VR usually closes the 12 case at three months. 13 If the beneficiary then assigns 14 the ticket to an independent living 15 center and they keep that beneficiary 16 on the job, I envision that the cost 17 reimbursement could double or 18 quadruple within the next three or 19 four years. 20 I think if we all focus on the 21 opportunities and focus on the needs 22 of the beneficiary which we're all 23 here for this purpose, I think it's 24 only going to be good stuff. Okay? 25 Any other questions, Deb? 77 1 >>: No, let me just double check, 2 though. 3 I want to reiterate that we will 4 be sending out speakers contact 5 information as well as additional 6 links to more information and we will 7 go ahead and send out the transcript 8 to everybody so that everybody can 9 look at the call. 10 >> SALLIE: I am going to send you 11 information on three previous 12 national teleconferences that people 13 can look at. It's a lot of 14 information to take in in an hour and 15 a half. Each of them has a little 16 different twist to it. Some of them 17 are more policy oriented comparing 18 the old regs and the new regs. Some 19 of them are higher level and talk 20 about ticket 101. 21 So, I encourage you to take 22 advantage of these opportunities. 23 Okay? 24 >> JOHN: This is John Lancaster. 25 If there aren't any more questions, I 78 1 think we've come to a conclusion here 2 today and I just want to thank 3 everyone for their participation. 4 I in particular want to thank Joel 5 Middleton, Sallie Rhodes and Peter 6 darling for their participation and 7 for their very, very informative 8 presentations and answers to 9 questions; and, again, we hope that 10 all CILs will join up and SILCs to 11 work to become employment networks 12 to, if appropriate, partner with NCIL 13 or to partner on the local level with 14 your VR agency or other employment 15 agency and to really make this thing 16 work or just be an employment network 17 by yourself. 18 So, we're going to be continuing 19 to get this word out to the 20 independent living movement. Again, 21 we encourage you if you're at our 22 annual conference to attend a session 23 with sue. Again, we want to thank 24 you for participating in this 25 important call today and thank you 79 1 all very, very much. And that will 2 conclude our call today. 3 Thank you. 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25