42 USC 1320 - The Ticket to Work and Self-Sufficiency Program

View all text of Part A [§ 1301 - § 1320b-26]

§ 1320b–19. The Ticket to Work and Self-Sufficiency Program

(a) In general

(b) Ticket system

(1) Distribution of tickets

(2) Assignment of tickets

(3) Ticket terms

(4) Payments to employment networks

(1) In general

(2) Effect of participation by State agency

(A) State agencies participating

(B) State agencies administering maternal and child health services programs

(3) Agreements between State agencies and employment networks

(d) Responsibilities of the Commissioner

(1) Selection and qualifications of program managers

(2) Tenure, renewal, and early terminationEach agreement entered into under paragraph (1) shall provide for early termination upon failure to meet performance standards which shall be specified in the agreement and which shall be weighted to take into account any performance in prior terms. Such performance standards shall include—

(A) measures for ease of access by beneficiaries to services; and

(B) measures for determining the extent to which failures in obtaining services for beneficiaries fall within acceptable parameters, as determined by the Commissioner.

(3) Preclusion from direct participation in delivery of services in own service areaAgreements under paragraph (1) shall preclude—

(A) direct participation by a program manager in the delivery of employment services, vocational rehabilitation services, or other support services to beneficiaries in the service area covered by the program manager’s agreement; and

(B) the holding by a program manager of a financial interest in an employment network or service provider which provides services in a geographic area covered under the program manager’s agreement.

(4) Selection of employment networks

(A) In general

(B) Alternate participants

(5) Termination of agreements with employment networks

(6) Quality assurance

(7) Dispute resolution

(e) Program managers

(1) In general

(2) Recruitment of employment networks

(3) Facilitation of access by beneficiaries to employment networks

(4) Ensuring availability of adequate services

(5) Reasonable access to services

(f) Employment networks

(1) Qualifications for employment networks

(A) In general

(B) One-stop delivery systems

(D) Single or associated providers allowed

(2) Requirements relating to provision of servicesEach employment network serving under the Program shall be required under the terms of its agreement with the Commissioner to—

(A) serve prescribed service areas; and

(B) take such measures as are necessary to ensure that employment services, vocational rehabilitation services, and other support services provided under the Program by, or under agreements entered into with, the employment network are provided under appropriate individual work plans that meet the requirements of subsection (g).

(3) Annual financial reporting

(4) Periodic outcomes reporting

(g) Individual work plans

(1) RequirementsEach employment network shall—

(A) take such measures as are necessary to ensure that employment services, vocational rehabilitation services, and other support services provided under the Program by, or under agreements entered into with, the employment network are provided under appropriate individual work plans that meet the requirements of subparagraph (C);

(B) develop and implement each such individual work plan, in partnership with each beneficiary receiving such services, in a manner that affords such beneficiary the opportunity to exercise informed choice in selecting an employment goal and specific services needed to achieve that employment goal;

(i) a statement of the vocational goal developed with the beneficiary, including, as appropriate, goals for earnings and job advancement;

(ii) a statement of the services and supports that have been deemed necessary for the beneficiary to accomplish that goal;

(iii) a statement of any terms and conditions related to the provision of such services and supports; and

(iv) a statement of understanding regarding the beneficiary’s rights under the Program (such as the right to retrieve the ticket to work and self-sufficiency if the beneficiary is dissatisfied with the services being provided by the employment network) and remedies available to the individual, including information on the availability of advocacy services and assistance in resolving disputes through the State grant program authorized under section 1320b–21 of this title;

(D) provide a beneficiary the opportunity to amend the individual work plan if a change in circumstances necessitates a change in the plan; and

(E) make each beneficiary’s individual work plan available to the beneficiary in, as appropriate, an accessible format chosen by the beneficiary.

An individual work plan established pursuant to this subsection shall be treated, for purposes of section 51(d)(6)(B)(i) of the Internal Revenue Code of 1986, as an individualized written plan for employment under a State plan for vocational rehabilitation services approved under the Rehabilitation Act of 1973 [29 U.S.C. 701 et seq.].

(2) Effective upon written approval

(h) Employment network payment systems

(1) Election of payment system by employment networks

(A) In general

(B) No change in method of payment for beneficiaries with tickets already assigned to the employment networks

(2) Outcome payment system

(A) In general

(B) Payments made during outcome payment period

(C) Computation of payments to employment networkThe payment schedule of the outcome payment system shall be designed so that—

(i) the payment for each month during the outcome payment period for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable is equal to a fixed percentage of the payment calculation base for the calendar year in which such month occurs; and

(ii) such fixed percentage is set at a percentage which does not exceed 40 percent.

(3) Outcome-milestone payment system

(A) In general

(B) Early payments upon attainment of milestones in advance of outcome payment periods

(4) DefinitionsIn this subsection:

(A) Payment calculation baseThe term “payment calculation base” means, for any calendar year—

(i) in connection with a title II disability beneficiary, the average disability insurance benefit payable under section 423 of this title for all beneficiaries for months during the preceding calendar year; and

(ii) in connection with a title XVI disability beneficiary (who is not concurrently a title II disability beneficiary), the average payment of supplemental security income benefits based on disability payable under subchapter XVI (excluding State supplementation) for months during the preceding calendar year to all beneficiaries who have attained 18 years of age but have not attained 65 years of age.

(B) Outcome payment periodThe term “outcome payment period” means, in connection with any individual who had assigned a ticket to work and self-sufficiency to an employment network under the Program, a period—

(i) beginning with the first month, ending after the date on which such ticket was assigned to the employment network, for which benefits (described in paragraphs (3) and (4) of subsection (k)) are not payable to such individual by reason of engagement in substantial gainful activity or by reason of earnings from work activity; and

(ii) ending with the 60th month (consecutive or otherwise), ending after such date, for which such benefits are not payable to such individual by reason of engagement in substantial gainful activity or by reason of earnings from work activity.

(5) Periodic review and alterations of prescribed schedules

(A) Percentages and periods

(B) Number and amounts of milestone payments

(C) Report on the adequacy of incentivesThe Commissioner shall submit to the Congress not later than 36 months after December 17, 1999, a report with recommendations for a method or methods to adjust payment rates under subparagraphs (A) and (B), that would ensure adequate incentives for the provision of services by employment networks of—

(i) individuals with a need for ongoing support and services;

(ii) individuals with a need for high-cost accommodations;

(iii) individuals who earn a subminimum wage; and

(iv) individuals who work and receive partial cash benefits.

(i) Suspension of disability reviews

(j) Authorizations

(1) Payments to employment networks

(A) Title II disability beneficiaries

(B) Title XVI disability beneficiaries

(2) Administrative expenses

(k) DefinitionsIn this section:

(1) Commissioner

(2) Disabled beneficiary

(3) Title II disability beneficiary

(4) Title XVI disability beneficiary

(5) Supplemental security income benefit

(l) Regulations

(Aug. 14, 1935, ch. 531, title XI, § 1148, as added Pub. L. 106–170, title I, § 101(a), Dec. 17, 1999, 113 Stat. 1863; amended Pub. L. 108–203, title IV, § 405(a), Mar. 2, 2004, 118 Stat. 526; Pub. L. 113–128, title V, § 512(dd)(2), July 22, 2014, 128 Stat. 1718.)