Subcommittee on Social Security
Ticket to Work and Work Incentives
Improvement Act
Public Hearing
September 26, 2002
Testimony Submitted for the Record by
Carl Suter,
Executive Director
Council of State Administrators of
Vocational Rehabilitation
Chairman Shaw, Ranking Member Matsui, and Members of
the Subcommittee, I am Carl Suter, the Executive Director of the
Council of State Administrators of Vocational Rehabilitation,
known as the CSAVR.
The CSAVR is composed of the chief
administrators of the public rehabilitation agencies serving
persons with physical and mental disabilities in the States,
District of Columbia, and the Territories. These agencies
constitute the state partners in the State-Federal program of
rehabilitation services provided under the Rehabilitation Act of
1973, as amended. The State Agencies supervise the
rehabilitation of more than 1.2 million eligible individuals
with disabilities annually. Of those eligible individuals served
each year, by the State Agencies, more than 233,000 are placed
in competitive employment.
On behalf of the CSAVR, I
submit this written testimony in response to the September 26,
2002, oral and written testimony provided by the National
Association of Protection & Advocacy Systems (NAPAS) before the
Subcommittee on Social Security of the House Committee on Ways
and Means.
My response is focused on the section of NAPAS’
testimony that addresses the State Vocational Rehabilitation
Agencies’ (VR) implementation of the Ticket to Work. I
respectfully request that this testimony be entered in its
entirety into the September 26, 2002, permanent hearing record
of the Subcommittee.
First, I would like to provide some
background information on the unique role that the Public VR
Program plays in the Ticket to Work Program. The Ticket to Work
and Work Incentives Improvement Act of 1999 (TWWIIA) was
designed to increase employment opportunities for beneficiaries
who receive cash benefits under the Social Security Disability (SSDI)
and Supplemental Security Income (SSI) programs to encourage
them to enter or re-enter the workforce. According to the U.S.
General Accounting Office, less than one percent of these
individuals leave the SSDI and SSI rolls each year as a result
of paid employment. While State VR Agencies serve thousands of
beneficiaries with disabilities each year, a majority will
choose not to seek assistance from VR for fear of losing needed
health care coverage, which has been the pervasive and
persistent problem for SSI and SSDI beneficiaries not entering
or returning to work.
Prior to the Ticket, the Social
Security Administration (SSA) would reimburse VR for client
services and administrative costs when VR was successful in
placing individuals on SSDI and SSI in employment that is
sustained over a nine-month period with earnings equal to
substantial gainful activity (SGA). I am pleased to report that
for FFY ending 9-30-2002, the amount of reimbursement from SSA
to the State VR Agencies was $131,014,755. This was the largest
amount ever received, and an increase of $27,000,000 over FFY
2001. This record reimbursement demonstrates the State
Vocational Rehabilitation Agencies’ commitment to serving
individuals who are SSDI and SSI recipients and substantiates
the results.
The Ticket to Work Program expands SSA’s
options for providing compensation to State VR agencies, and for
the first time, permits SSA to compensate private providers,
when the provision of services and supports results in an
individual working and earning SGA. Private providers can apply
to SSA for approval to serve beneficiaries with tickets and
receive compensation, either through an outcome payment or
milestone and outcome payments combined, when a beneficiary’s
earnings from work result in the discontinuation of cash
benefits. Approved providers are referred to as Employment
Networks (ENs).
Since VR is the only program that will be
automatically approved to provide services to beneficiaries
under the Ticket Program, the impact on the Public VR Program is
likely to be dramatic. Over the next two years, tickets will be
mailed to eligible beneficiaries along with information on how
to use the ticket to obtain training and employment services.
Many beneficiaries will call local VR agencies to find out more
about the Ticket Program. With the complementary work incentives
provisions in TWWIIA, it is expected that larger numbers of
beneficiaries will be willing to attempt work than in the past.
State VR Agencies were extremely disheartened by the
manner in which they were portrayed by the oral and written
testimony presented by NAPAS on September 26, 2002, in
implementing the Ticket to Work Program. The State VR Agencies
in the first 13 states to implement the Ticket had to move
forward in planning for Ticket implementation before issuance of
the final regulations governing the Program. In the case of the
Ticket to Work Program, many difficult policy decisions were
left up to the Social Security Administration (SSA) to interpret
through regulation. The final regulations were published in the
Federal Register in December 2001.
Part of SSA's
interpretation of the Ticket Program is that State VR Agencies
must participate in the Ticket to Work Program to receive any
type of payment for successfully serving a beneficiary with a
disability who has a ticket. There are many policy questions
inherent in VR’s participation in the Ticket Program. The CSAVR
has been in discussions with SSA over a number of policy issues
since tickets were first mailed in February 2002. TWWIIA is
clear, however, that State VR Agencies must still operate in
compliance with the requirements of Title I of the
Rehabilitation Act and its governing regulations. This means
that the interface between the requirements in Title I of TWWIIA
and Title I of the Rehabilitation Act must be clarified and
addressed through policy guidance.
In August 2002, SSA
issued a new chapter to the procedures manual that State VR
Agencies must use to secure compensation from SSA for
successfully serving beneficiaries with disabilities. The SSA
chapter specifically addresses what State VR Agencies must do to
participate in the Ticket to Work Program, establishing both
policies and procedures for VR’s participation. For example, the
chapter establishes a policy whereby a beneficiary who
approaches VR for services after receiving a ticket, and who,
through informed choice, decides to sign an Individualized Plan
for Employment (IPE) with VR, has, for SSA's purposes, assigned
their ticket to VR. This policy interpretation has led some
advocates to believe that VR Agencies are “forcing”
beneficiaries to assign their tickets to VR, when in fact; VR is
merely following SSA’s procedures.
State VR agencies,
like all stakeholders involved with the Ticket implementation,
have acknowledged that implementing the Program is a work in
progress. To date, approximately 80 percent of the beneficiaries
who have decided to participate in the Program have assigned
their tickets to State VR Agencies. Since the structure of the
Ticket Program does not provide any “upfront” funding to serve
beneficiaries, EN’s who want to participate in the program will
have to absorb considerable costs, pending payment from SSA,
after the beneficiaries they serve obtain and maintain
employment at SGA. In some states, the State VR Agency is
partnering with other providers to form a coalition which
functions as a single EN. In other States, the State VR Agency
will be operating independently and competitively with other ENs.
Some State VR Agencies acknowledged that early on, missteps
might have occurred in information communicated to VR customers.
These missteps, however, were remedied as quickly as possible,
upon receipt and clarification of information from the SSA.
That said, State Agencies, have not now nor ever have been
“raiding” the Ticket program as alleged by NAPAS in their
written testimony. Relatedly, the State Agencies have not and do
not pressure existing clients into assigning their tickets to VR.
Indeed, some State VR Agencies have reported that EN’s are
referring individuals to VR that they are choosing not to serve.
These are predominantly individuals with the most significant
disabilities and high support needs, who are and will be more
costly to serve and individuals who need services that are not
available through the EN.
It is difficult to comprehend
how NAPAS has determined that VR Agencies are “raiding,” the
ticket program, when it is the Public VR agencies who serve
eligible individuals with the most significant disabilities,
among others, unlike all of the other Employment Networks who
can refuse to serve any individual with disabilities who may
seek services and supports from them. In some States, State VR
Agencies have entered into Memoranda of Understanding with other
EN’s, which define how they will share in the costs of services
for mutual clients and share in the reimbursement from SSA.
NAPAS stated in their testimony that State VR Agencies who
are operating under an Order of Selection (OOS) are taking
tickets from beneficiaries and placing them on waiting lists, if
they do not meet the States’ OOS criteria to receive services.
SSDI and SSI recipients who want to work are presumptively
eligible for VR services, and, in most cases, are also
individuals with the most significant disabilities. These
individuals are among the first to be served under any States
OOS, second only to serving existing VR clients and providing
diagnostic services to new clients.
NAPAS implied in
their testimony that State VR Agencies adopt an OOS at will. You
should be aware that implementing an OOS is not an option at the
discretion of the State Agency, but a requirement under the
Rehabilitation Act of 1973, as amended, if VR Agencies have
insufficient resources or staff to serve all eligible
individuals who seek services from VR.
On more than one
occasion, staff from the CSAVR have invited NAPAS staff to work
with us on identifying State Agencies that they have reason to
believe may not be serving Ticket customers appropriately. We
have assumed, and will continue to assume, a leadership role in
working with these Agencies to identify—not by innuendo as NAPAS
did during the hearing—but by actually identifying the alleged
instance(s) of non-compliance and working in concert with one
another to correct a misinterpretation or problem.
Anecdotal accusations and criticisms cannot—and should not—be
tolerated by anyone, including the Congress. Individuals who
have inflated the size and scope of anecdotal incidences and
unsubstantiated charges should be held accountable for making
them.
In this regard, the CSAVR has requested from NAPAS
that we be made privy to any and all information that suggests
or implies that VR Agencies are not in compliance with the law
in their implementation of the Ticket to Work.
Notwithstanding these unsubstantiated charges, the CSAVR plans
to continue to work with State VR agencies and other
stakeholders to remedy any alleged missteps or misinformation
that may, or may not, be occurring at the VR Agencies and
elsewhere.
Like hundreds of thousands of others, we are
very proud of the Public VR Program, a proven, evidence-based
service delivery system that is indisputably the most successful
employment program in the history of the workforce.
Perhaps that is the reason so many individuals with disabilities
continue to choose overwhelmingly the Public VR Program for the
services and supports they need to enter the world of work.
Thank you for the opportunity to share our concerns with you
on the testimony presented at the September 26 hearing regarding
State Vocational Rehabilitation Agencies’ implementation of the
Ticket to Work program.
We look forward to working with
you in ensuring that beneficiaries with disabilities– including
those with significant disabilities – are served and served well
by all employment networks.
In closing, we again
acknowledge that there are isolated incidences where
misinformation may have occurred; however, these do not
translate to the overwhelming negative criticism of State VR
Agencies’ implementation of the Ticket to Work for thousands of
beneficiaries with disabilities.
