The Partnership Plus Service Delivery Option
The Cost Reimbursement (CR) program and the Ticket program are intricately connected, particularly with regard to State Vocational Rehabilitation (VR) agencies. Recognizing VR's long history of serving Social Security beneficiaries with disabilities, the Ticket legislation:
- Granted State VR agencies an automatic status as ENs. VR agencies are not required to respond to the Employment Network (EN) Request for Quotation (RFQ) to be approved to function as ENs. Instead, VR agencies wishing to function as ENs are required to sign the State VR Agency EN Ongoing Support and eProcess Agreement.
- Authorized State VR agencies to choose, on a case-by-case basis, between of serving individual beneficiaries under the CR program or as an EN under the Ticket program. The one exception is if the State VR agency received reimbursement on behalf of the beneficiary any time after January 2002 and that beneficiary is returning to VR for services. In these situations, the new case must be opened as a CR case.
The 2008 Ticket regulations (20 CFR Part 411, issued May 20, 2008) included provisions to create financial incentives for State VR agencies and ENs to work collaboratively to assist beneficiaries to achieve long-term employment success. Both a State VR agency and an EN can now receive compensation on behalf of the same beneficiary using the same Ticket when the VR agency serves the beneficiary under the CR program and the EN secures the beneficiary's Ticket assignment after VR case closure and assists the beneficiary to achieve Substantial Gainful Activity (SGA) level earnings. To ensure some savings to Social Security, this new service delivery model (referred to as Partnership Plus) excludes the payment of Phase 1 milestones to the EN if the beneficiary was employed at the time of VR case closure. A VR agency can close a case as successful if the person was employed a minimum of 90 days prior to case closure.
The assumption behind this Phase 1 milestone exclusion is that the VR agency provided the pre-employment and placement services leading to 90 days of successful employment and the EN should not be compensated for providing the same or similar pre-employment and placement services. Even with this exclusion, the total remaining value of the Ticket (i.e., Phase 2 milestones and outcome payments) is significant: $18,252 for SSI recipients and $19,129 for SSDI beneficiaries in 2014. The Phase 1 milestone exclusion applies to all successful VR case closures since January 2002.
If a beneficiary's VR case is closed unsuccessful, all milestone and outcome payments are potentially available to an EN that subsequently secures the Ticket assignment based on the established rules for payment under the Ticket program.
- When a beneficiary whose VR case was closed successfully achieves gross earnings at the SGA level, the EN with the Ticket assignment can submit for Phase 2 milestone payments. The first month that an EN can qualify for payment is the month following the month that the Ticket was assigned to the EN. When the beneficiary's disability benefits cease due to work and earnings, the EN can begin receiving outcome payments. When the beneficiary achieves earnings above SGA for nine months within a 12 month period, the State VR agency can submit a CR claim.