COUNCIL OF STATE ADMINISTRATORS
OF
VOCATIONAL
REHABILITATION
March 28, 2003
Jo Anne B. Barnhart, Commissioner
Social Security Administration
6401 Security Boulevard
Baltimore, MD 21235
Dear Commissioner Barnhart,
I am writing on behalf of the Council of State Administrators of Vocational Rehabilitation (CSAVR) to seek clarification regarding a SSA policy interpretation concerning the interplay between the traditional cost reimbursement programs authorized in 42 USC 422(d) and 1382d(d)&(e) and the ability of State Vocational Rehabilitation (VR) Agencies to seek cost reimbursement for beneficiaries who have received or are eligible to receive a ticket under the Ticket to Work Program created under the Ticket to Work and Work Incentives Improvement Act of 1999.
The importance of the cost reimbursement program to Public VR and to the people who receive assistance from VR motivated both the Rehabilitation Services Administration (RSA) and the CSAVR to seek assurances, very early in the legislative process, that the proposed Ticket Program would not alter or supplant the traditional cost reimbursement program. Throughout the legislative process, representatives of the Public VR Program were assured that the proposed Ticket Program would augment and in no way diminish the cost reimbursement program. Naturally, we were aware of the Congressional Budget Office (CBO) report predicting a reduction of reimbursement as a result of some diversion of beneficiaries from the traditional cost reimbursement program to Employment Networks (ENs) operating under the Ticket Program. However, we were confident, and the early results of the Ticket Program confirm, that Public VR will continue to be the vocational rehabilitation program of choice for the vast majority of beneficiaries with significant disabilities hoping to become employed.
The issuance of the final Ticket regulations, 20 CFR 411, created a great deal of confusion regarding the effects of the implementation of the Ticket Program on the traditional cost reimbursement program. The issuance of SSA Transmittal No. 17 of the Vocational Rehabilitation Providers Handbook reinforced those concerns.
Section 411.350 of the Ticket regulations states:
“Every State VR agency administering or supervising the administration of the State plan approved under title I of the Rehabilitation Act of 1973, as amended (29 U.S.C. 720 st. seq.), must participate in the Ticket to Work program if it wishes to receive payments from SSA for serving ticket beneficiaries.”
This interpretation, which is similarly reflected in one of the opening sentences of Transmittal 17, provides an immediate and an informative example of the problems CSAVR and others have with the implementation of the Ticket Program. This interpretation clearly conflicts with our understanding of the intent of Congress, the assurances of SSA and the language of the statute as it relates to the right of State VR Agencies to continue to seek cost reimbursement under 42 USC 422(d) and 1382d(d)(e).
Title I, Subtitle A, Section 101(c)(1) of the Ticket to Work and Work Incentives Improvement Act establishes a new Sec. 1148(c) of the Social Security Act and sets forth a special status for State VR Agencies. The provision allows State VR Agencies,
“with respect to disabled beneficiaries that the State agency does not elect to have participate in the Program, the State shall be paid for services provided to that beneficiary under the system of payment applicable under Sec. 222(d) and subsection (d) and (e) of Sec. 1615.”
It is our opinion that the statutory language does not limit the cost reimbursement system to only non-ticket eligible beneficiaries. Rather, it allows the State VR Agency to choose on a case-by-case basis whether to serve the beneficiary outside the Ticket Program and seek compensation through the traditional cost reimbursement program, or to serve the beneficiary under the Ticket Program and seek compensation through the VR Agency’s elected Employment Network Payment System. The Ticket regulations are clear that VR can serve beneficiaries who are not ticket-eligible and seek cost reimbursement under the traditional cost reimbursement system. They are not so clear with regard to beneficiaries who are ticket-eligible.
The real confusion is found in SSA Transmittal 17, which appears to remove VR’s option to assist a ticket-eligible beneficiary, and “not elect to have” the beneficiary participate in the Ticket Program, and “be paid for services provided to that beneficiary under the system for payment applicable under Sec. 222(d) and subsection (d) and (e) of Sec. 1615.” The Transmittal appears to be in direct conflict with Sec. 1148(c) of the Ticket legislation that provides the State VR Agency the option of cost reimbursement payment at its discretion whether the beneficiary is or is not eligible to participate in the Ticket program.
Transmittal No. 17, at 12.1B presents a fundamental tenet of the Ticket Program:
“Beneficiary participation is voluntary. The beneficiary is free to choose when and whether to use the ticket.”
Yet, in its explanatory notes accompanying the final Ticket regulations, 20 CFR 411, SSA presumes beneficiary participation without any affirmative demonstration of intent to participate.
“If a beneficiary with a ticket decides to seek services from the State VR agency, then the beneficiary will in effect be using the ticket for services, even if the State VR agency chooses to be reimbursed rather than being paid under one of the EN payment systems.”
This presumption of beneficiary participation in the Ticket Program has many advocacy groups and service providers up in arms. Advocates, who feel this interpretation violates consumer choice and the voluntary nature of the ticket program, and service providers, who believe this interpretation limits the choices that beneficiaries have available to them, are blaming the Public VR Program for this problem.
CSAVR believes this presumption of beneficiary participation poses several significant problems that will have a direct impact on the cost reimbursement system for State VR agencies. It is important that Public VR and SSA have the opportunity to discuss these issues and together resolve them.
To lay the groundwork to resolve these issues, the CSAVR is requesting, at your earliest convenience, a written explanation of the reasoning and legal basis for the policy interpretation regarding the presumption of beneficiary participation and regarding the traditional cost reimbursement program no longer being available for beneficiaries who are ticket-eligible and who choose not to use their ticket when seeking assistance from the Public VR Program.
While the issues we have identified are significant, they do not constitute an insurmountable barrier to our continued close cooperation on this important initiative. The CSAVR looks forward to working closely with RSA and SSA on resolving these issues through collaborative dialogue. We remain committed to assuring the success of the Ticket Program as it continues to roll out across the Nation.
Sincerely,
Terry Brigance, President
CSAVR
