What is Partnership Plus?
In the past, SSA either reimbursed a State VR agency under the traditional Cost Reimbursement (CR) program for successfully serving a beneficiary or paid an EN or a State VR agency acting as an EN for successfully serving a beneficiary under the Ticket program. SSA did not make payments under both the CR program and the Ticket program on behalf of the same beneficiary.
As of July 21, 2008, a beneficiary may receive services from both a State VR agency and then an EN, and, if the State VR agency is serving the beneficiary under the CR program, both agencies may seek compensation from SSA on behalf of the same beneficiary using the same Ticket. To ensure some savings to the Social Security Trust Fund and the General Revenue Fund, the regulations are written so that SSA can only compensate for the provision of sequential, not concurrent, services. Thus, Partnership Plus allows a beneficiary to receive VR services to meet his/her intensive up-front service needs and, after the VR case is closed, assign his/her Ticket to an EN to receive ongoing support services or job retention services.
Under the prior Ticket regulations, SSA required State VR agencies to obtain Ticket assignments in order to qualify to submit CR claims on behalf of Ticket Holders. The new regulations eliminate this requirement, making the CR program a free-standing program. Since VR no longer needs a Ticket assignment to submit a CR claim, State VR agencies no longer need to complete the SSA 1365 form when a beneficiary is going to be served under the CR program.
While State VR agencies can still choose on a case-by-case basis whether to serve a beneficiary under the CR program or as an EN under the Ticket program, there are significant incentives in the new Ticket regulations that will make it more profitable for both State VR agencies and ENs when the State VR agency chooses to serve Ticket Holders under the CR program. These incentives create exciting new opportunities for State VR agencies to partner with approved ENs to meet the service and support needs of beneficiaries after they go to work.
SSA also created a new “in-use SVR” status that extends the protection against medical Continuing Disability Reviews (CDRs) to beneficiaries being served by State VR agencies under the CR program. As with Ticket assignment, a beneficiary must be progressing towards his/her employment goal to maintain the CDR protection from year to year. The new Ticket regulations expanded the criteria used to measure “timely progress” to include educational attainment. Check out the new timely progress requirements.
While a beneficiary’s Ticket is in the “in-use SVR” status, it is not otherwise available for assignment to another EN. Learn more about the “in-use SVR” status in the section on “Changes in Administrative Processes Resulting from the New Ticket Regulations.”
Remember, Partnership Plus is specific to EN-VR partnerships. If two ENs serve the same beneficiary due to a change in Ticket assignment, an agreement may be developed to determine how EN payments will be shared or MAXIMUS, SSA’s Operations Support Manager for the Ticket to Work program, can assist the ENs in determining how to split the EN payments based on the services provided by each EN.
How Does Partnership Plus Work?
After a VR case is closed, the beneficiary has the option of assigning his/her Ticket to an EN in exchange for job retention services and other ongoing support services. If VR served the beneficiary under the CR program, the EN would then be eligible to receive Milestone and Outcome payments as the beneficiary reaches the designated levels of work and earnings for EN payments.
If the CR case was closed with the beneficiary in employment (regardless of the hours of work or the beneficiary’s earnings), the Phase 1 Milestone payments are not available to the EN that accepts the beneficiary’s Ticket assignment. This is because the Phase 1 Milestone payments are designed to provide compensation to ENs for the initial services, including job placement, which resulted in the beneficiary’s entry into employment. Since VR will be able to submit a CR claim when the beneficiary reaches 9 months of SGA earnings within a 12 month period, SSA will not compensate both the VR agency and the EN for providing the services that led to the job placement. However, the EN can submit for Phase 2 Milestone payments as soon as the beneficiary’s gross earnings exceed the applicable SGA level.
If a beneficiary assigns his/her Ticket to an EN after VR closes a CR case and the EN is operating under the Outcome only payment system, all Outcome payments are available to the EN as the beneficiary attains the required levels of work and earnings.
In 2009, the total potential for Phase 2 Milestones payments and Outcome payments combined is $17,061 for SSDI and $15,146 for SSI, per beneficiary. Even with the loss of the Phase 1 Milestones, this represents potential new revenue for individual ENs as well as a significant influx of new monies to support the infrastructure of service providers that make up the state’s service delivery system.