Partnership Plus Agreement Regarding the Social Security Administration Ticket to Work Program

1 | P a g e

Partnership Plus Agreement Regarding the Social Security Administration Ticket to Work Program Between

The Virginia Department of Rehabilitative Services (DRS) And ______

I. Introduction

The new "Ticket to Work" regulations that went into effect on July 21, 2008 create an opportunity for the Department of Rehabilitative Services (DRS) and ______(Employment Network) to improve employment outcomes for beneficiaries of Supplemental Security Income (S SI) and/or Social Security Disability Insurance (SSDI). This agreement establishes a "Partnership Plus" program. This agreement is effective from the date of the latest signature by the parties involved.

II. "Partnership Plus" Program

A. Purpose

The purpose of this Partnership Plus proposal is to develop an agreement between ______and Department of Rehabilitative Services (DRS) under the SSA Ticket to Work Program. This partnership is proposed for instances where a Ticket Holder has assigned his/her ticket to DRS and the Ticket is in use. The proposed agreement establishes the basis for coordination of vocational rehabilitation services under the Ticket to Work Program between DRS and ______. This proposed partnership agreement would not preclude DRS and ______from entering into an individual agreement for services for a specific client.

The Partnership Plus proposal:

· Builds on and strengthens the existing partnership around the provision of vocational services for clients.

· Ensures best practices and ethical standards are maintained and that the client's rights and informed choices are respected.

· Maximizes appropriate Outcome/Milestone and cost reimbursement systems available under the Ticket to Work Program.

B. Duration

From date of final signature until December 31, 2014

C. Roles and Responsibilities DRS will register a ticket as "IN USE SVR" with the program manager Maximus for all clients who choose to assign their Ticket to this Partnership while the DRS case is open. Once the client

is successfully employed at Substantial Gainful Activity (SGA) or has the likelihood that Substantial Gainful Activity will be achieved within the next several months, DRS will assist the client, with their full choice, involvement and consent, to transfer his/her Ticket to ______once the DRS case is closed. At the point of transfer, ______will perform the administrative functions associated with the Ticket Program including enrollment, reporting, and billing functions

DRS roles and responsibilities will include the following:

1. Based on order of selection and appropriateness of services, DRS will identify potential clients for this Partnership agreement. This is most appropriate for clients with a high likelihood of reaching Substantial Gainful Activity.

2. DRS will open cases as appropriate and explain the Ticket and Partnership process. DRS will review with each client determined eligible for vocational rehabilitation services his or her options under the Ticket Program including the following: · Partnership Plus: To sign the IPE with the understanding that the Ticket will be considered in use at DRS; followed by assigning the Ticket to an EN based on informed choice once DRS is closed; · To assign the Ticket to another EN (initially or after closure from DRS); or · To choose not to participate in the Ticket program;

3. DRS will establish "Tickets in use" with the Program Manager Maximus for all clients who choose to assign their Ticket to this Partnership.

4. DRS will develop and maintain Individualized Plans for Employment (IPE) on all clients in the Partnership Plus agreement with ______.

5. When/if vendor services are needed (situational assessment, job development, and/or job training), DRS will refer and authorize to an appropriate vendor according to typical processes and procedures.

6. Once the client has been placed and stabilized, DRS will assist the client, with their full choice and involvement, to re-assign his/her Ticket to the most appropriate EN for follow along services once the DRS case is closed.

7. DRS and ______will coordinate information in an effort to facilitate all the required reporting for the Partnership Plus agreement to the Program Manager.

8. DRS will bill the Social Security Administration (SSA) for all appropriate Cost Reimbursement expenditures for the Partnership Plus agreement. 3 | P a g e

9. DRS will provide, with appropriate client consent, a copy of the closure letter to ______to facilitate the “hand-off” to ______as an EN. The closure letter will contain the closure date, closure status as successfully employed, and note the potential for post employment services and ongoing employment supports.

______'s roles and responsibilities will include the following:

1. ______will identify a staff person(s) to be a liaison for each office associated with this agreement.

2. ______will develop and maintain Individual Work Plans (IWP) on all clients in the Partnership Plus Agreement and submit them to the program manager, Maximus, for approval and assignment of the Ticket to______.

3. Once the client has been placed and stabilized, ______will provide longterm follow up with the client and employer, depending on need and appropriateness, including short- term support and services when necessary to assure continued employment success of the client.

4. Once the DRS case is closed and DRS has assisted the client to re-assign their Ticket to ______, ______will establish "Ticket Assignment" with the Program Manager Maximus. ______is then able to submit for Phase 2 Outcome Payments as achieved.

5. DRS and ______will coordinate information in an effort to facilitate all the required reporting for the Partnership Plus agreement to the Program Manager.

6. ______will either provide monthly status reports including wage data, pay stubs and other information or will provide certification of Ticket-holder earnings under the current Certification Payment Request method pertinent to SSA Trust Fund reimbursement. Status report also includes written documentation to DRS pertinent to meeting monitoring requirements of Maximus regarding the client.

Joint Responsibilities:

1.Partners (DRS and______) will establish Ticket liaisons who will work together as needed to ensure client's informed choice is respected. This will include informing clients of the options spelled out under Roles and Responsibilities of this agreement, including their option not to participate in the Ticket to Work program and still receive DRS services, if eligible.

2. Partners will coordinate with the local community work incentives coordinator (CWIC) to ensure on-going work incentives planning and assistance services are provided for clients with information on how to maximize their earnings potential, utilize Social Security work incentives, and fully understand the impact of employment on their federal and state benefits and healthcare coverage. 3. Partners will work together to determine the most efficient mechanism for tracking client wages and benefits status data for the Ticket Programs and benefits status data for Ticket Program participants over the long term. Outcome/Milestone payments available under the Ticket to Work program and DRS Cost Reimbursement program depend on the accurate reporting of this data.

III. Client Rights and Responsibilities

Services provided or paid for by DRS entitle the Ticket holder to all the protections available through the Rehabilitation Act of 1973 to include Client Assistance Program Services. Client disputes with ______(Partner) provided services shall follow ______administrative processes as appropriate. In those cases where clients choose to delay activation of their Ticket or where Tickets are in use with DRS with the client's knowledge of assignment of tickets, these clients will be informed by DRS of the impact such a decision can have on available CDR protections. Nothing in this agreement will have an impact on a client's rights and responsibilities under the Ticket to Work Program.

IV. Payment

A. Payments from the Ticket as an EN

Under this Partnership Plus agreement, DRS will choose Cost Reimbursement payment option. This is most appropriate for clients with a high likelihood of reaching Substantial Gainful Activity. Costs are reimbursed after the DRS client has 9 months of SGA.

2. ______will choose Outcome/Milestone payment option, and be eligible for Phase 2 and Outcome payments once the Ticket is in use by ______(after DRS closes).

A. Benchmark Employment Retention Payment

When the client exits the DRS system with wages above Substantial Gainful Activity (SGA is $1,000.00 for 2011) and the client attains a minimum of eight consecutive months of Substantial Gainful Activity; ______is eligible for a $1,000 benchmark job retention payment. This Job retention payment requires that ______provide monthly status reports including wage data, pay stubs, or other information pertinent to SSA Trust Fund reimbursement until such time as the beneficiary attains eight consecutive months of Substantial Gainful Activity.

2. When the client exits the DRS system with wages under Substantial Gainful Activity

a. The DRS client attains 3 consecutive months at Substantial Gainful Activity; ______is eligible to receive a $500 benchmark post employment/employment enhancement payment. This Job retention payment requires that ______provide monthly status reports including wage data, pay stubs, or other information pertinent to SSA Trust Fund reimbursement. 5 | P a g e

b. The DRS client attains 8 consecutive months of Substantial Gainful Activity, ______is eligible for an additional $1,500 benchmark job retention payment. This Job retention payment requires that ______provide monthly status reports including wage data, pay stubs, or other information pertinent to SSA Trust Fund reimbursement until such time as the beneficiary attains eight consecutive months of Substantial Gainful Activity.

V. Evaluation

______and DRS will evaluate the effectiveness of the Partnership Plus service model created by this agreement six months after assignment of the first ticket and annually thereafter to determine what adjustments are necessary.

Specifically the parties will evaluate the following: · The administrative burden associated with the Ticket Program; · Patterns or trends of Ticket Assignment; · The equity and appropriateness of the payment provisions; · The earnings and hours worked of clients who choose to assign their Ticket; · If client rights and choices are being respected under this agreement.

VI. Amendments and Exit Clause

The parties may agree to amend the agreement at any time. However, such amendment shall not take effect until the agreement is in writing and signed by the parties.

Either party can terminate the agreement by providing the other party thirty (30) days written notice of termination of the agreement. A. General Statement · The agreement will not in any way impede any of the parties from entering into other agreements regarding the Ticket to Work and Work Incentives Improvement Act of 1999.

· Nothing in the agreement shall in any way take precedent over the requirements of the Rehabilitation Act of 1973 as amended. Signed:______Date:______

______President and CEO

Signed:______Date:______

Commissioner, Department of Rehabilitative Services ______