1. 1 Special Session at the 7 th NYAPRS Executive Seminar: Making the Ticket Work for Your Program

2. Our Program for This Evening Brief Ticket-to-Work overview: Joel Middleton, Ticket-to-Work Developing a business model and making good business decisions - Oscar Jimenez, MPH, NYAPRS Implementation experiences: –Federations of Organizations – Tracy Falkner, LMSW, CPRP –Clubhouse of Suffolk – Josh Carpenter, M.Ed., CRC Implementation TA Opportunities: –Ticket-to-Work Technical Assistance Support Center (TASC) – Michael Yozzi, Sr. Account Manager & Joel Middleton, Account Manager –Columbia Univ. Center for Practice Innovations (CPI) – Raymond Gregory, IPS Trainer –NYAPRS – Oscar Jimenez, MPH Q&A– All panelists 2

3. 3 2010 OUTCOME PAYMENT METHOD Payment TypeBeneficiary Earnings Required After Ticket Assignment SSI Ticket-HolderSSDI Ticket-Holder OutcomeEarnings sufficient for zero cash benefits status Up to 60 payments of $409/month Up to 36 payments of $711/month Total of Outcome Payments Available$24,540.$25,596. 2010 MILESTONE-OUTCOME PAYMENT METHOD Payment TypeBeneficiary Earnings Required After Ticket AssignmentSSI Ticket-HolderSSDI Ticket-Holder Milestone 1 Milestone 2 Milestone 3 Milestone 4 $360/ month x 1 month $720/ month x 3 months within 6 months $720/ month x 6 months within 12 months $720/ month x 9 months within 18 months $1275 Total for Phase 1$5,100 OutcomeEarnings sufficient for zero cash benefit status Up to 60 payments of $220/ month Up to 36 payments of $382/ month Total of Outcome Payments Available$13,200$13,752 Total of Milestones + Outcome Payments $22,260$23,054 Phase 2 Phase 1 Milestones Gross earnings at or over $1,000(non-blind)/month (SGA) Gross earnings at or over $1,640 (blind)/month (SGA) Up to 18 payments of $220/ month Up to 11 payments of $382/ month Total for Phase 2$3,960$4,202 Total Phase 1 + 2 Milestones Payments$9,060$9,302 2010 Payments At A Glance

4. TypeTicket Holder EarningsEN Payment for SSDI EN Payment for SSI Phase 1 Milestone 1$360/ two weeks within 1 month $1,275 Milestone 2$720/mo for 3 months within 6 months (cumulative) $1,275 Milestone 3$720/mo for 6 months within 12 months (cumulative) $1,275 Milestone 4$720/mo for 9 months within 18 months (cumulative) $1,275 Total Potential Phase I Milestone Payments$5,100 2010 Rates Milestone-Outcome Payment System: Phase 1 Milestones 4

5. Type Ticket Holder Earnings EN Payment for SSDI EN Payment for SSI Phase 2Gross > SGA ($1000/non-blind; $1,640 for blind) $382/mo. (up to 11 mos.) $220/mo. (up to 18 mos.) Total Phase 2 Payments $4,202$3,960 Total Potential Ticket Payments Phases 1 and 2 $9,302$9,060 2010 Rates Milestone-Outcome Payment System: Phase 2 Payments 5

6. Milestone-Outcome Payment System: Outcome Payments Type Ticket Holder Earnings EN Payment for SSDI EN Payment for SSI Outcome PhaseNet > SGA ($1000/non-blind; $1,640 /blind) AND 0 cash benefit $382/mo. for up to 36 months $220/mo. for up to 60 months Total Outcome Phase Payments $13,752$13,200 Total Potential Ticket Payments $23,054$22,260 2010 Rates 6

7. 7 Does s/he receive SSI or SSDI? NO - Refer to other services (If PROS, serve thru PROS) YES - Assess earnings interest (i.e., Trial Work Level or greater?) NO-Refer to other services (If PROS, serve thru PROS) Does s/he have a previous VESID case? YES - Was the case closed successfully? YES - Desire to work at or above SGA? NO - Refer to other services (if PROS, serve thru PROS YES NO NO - Provide information about the TTW program Verify with MAXIMUS if the Ticket can be assigned NOT ASSIGNABLE- Can this be changed? YES NO - Refer to other services If PROS, serve thru PROS ASSIGNABLE Has s/he worked in the last 18 months at Trial Work level or above? Yes - Fill out '18 Month Prior Earnings Worksheet' Some of Phase 1 available None of phase 1 available - Desire to work at or above SGA? NO - Refer to other services (If PROS, serve thru PROS) YES NO - Entire Ticket left Benefits Assessment Assess readiness to work NOW READY - Assign Ticket Develop IWP NOT READY - Refer to other services (If PROS, serve thru PROS) START HERE Decision Tree for Assigning Tickets

8. Case example # 1: Michael Michael is a 30-year old male that started receiving services at Inspirations in 2008. Michael has little work experience and has been unemployed for the last 6 years. Michael currently receives SSI benefits along with Medicaid insurance. Michael has been receiving Community Rehabilitation and Support (CRS) services from Inspirations PROS program for the past two years. Until recently he had not considered work because he thought he would lose all his benefits, but a month ago he heard that this is not true. So now he is very motivated to become employed again. One of Michaels goals is to live independently and he would like to find a job to help him accomplish this goal. As Michael does not have much work experience, his current goal is to work part-time in a job where he can make between $800-$900/month. He has never received ACESS-VR services and is not interested in applying for ACESS-VR right now. He has begun submitting applications at local retail stores and has an interview for a job at a grocery store next week. 8

9. Case Example # 2: Mollie Mollie is a 45-year old female that came to Inspirations to see if she can receive help returning to work. Mollie currently receives $950/month in SSDI benefits along with Medicare insurance. She has never received services from ACESS-VR. Mollie has an associates degree in paralegal studies and worked for several years in a variety of legal service jobs. She was approved for SSDI benefits in 2005 due to her mental health disability and had been out of work for the last six years until recently. Mollie found a job working for a local law office. She was employed from June through August in 2010, but lost the job due to conflicts with her supervisor. This was her first job since going onto SSDI benefits. Mollie believes, along with her therapist, that working can help her in her process of recovery and that she can be a successful paralegal again. Mollie is very interested in searching for a part-time job (10-15 hrs/wk) in local law office (at $20/hour). 9

10. 1.When an individual has an ACESS-VR case OPEN, the Ticket is considered in use and it cannot be assigned to an EN 2.After VR case is formally closed, then the beneficiary can assign Ticket to an EN 3.If the VR case is closed successfully, then Phase One payments are NOT available 4.If the VR case is NOT closed successfully, then ALL Ticket payments may still be available 10 Partnership Plus at a Glance

11. Case example # 3: Cody Cody is a 40-year old that was referred to Inspirations for continuing employment support. Cody currently receives SSI benefits and Medicaid insurance. Cody has worked with ACESS- VR over the last three years and received vocational training to become an auto mechanic. Four months ago Cody got a job working at a body shop part-time where he earns $800 per/month and his case was successfully closed with ACESS-VR. Cody, however, would still like additional support because he has trouble getting along with his coworkers and sometimes feels overwhelmed with his job responsibilities. Additionally, Cody would like to work full-time in the future so that he can save to buy a car. 11

12. 12 Interested in Pursing Employment? NO Refer to PROS services for non- employment goals (e.g., CRS, IR, Clinical) YES PROS eligible? Interested in PROS? If not, can we serve them? YES Assess readiness for work NOW READY NOW - Refer to IR and See: 'Decision-Tree Tool for Assigning Tickets' NOT READY NOW- Refer to CRS to develop readiness NO See: 'Decision -Tree Tool for Assigning Tickets' or Refer to other services Ticket-to-Work Decision-Tree for NEW PROS participants

13. 13 What PROS services does s/he recieve? CRS Interested in employment? YES - Assess readiness for work NOW READY NOW- Enter: IR and 'Decision-Tree Tool for Assigning Tickets' NOT READY NOW- Stay in CRS NO - Stay in CRS IR Interested in pursuing employment goals now? NO - Stay in IR YES ' ORS Currently working or interested in working at Trial Work Level or greater? NO - Stay in ORS YES Enter: 'Decision-Tree Tool for Assigning Tickets' Clinical Ticket to Work Decision-Tree for CURRENT PROS participants

14. Challenge Ticket Tracker

15. What it Does Organizes all Ticket Holder Demographics at a glance Provides key contact information for Maximus Manually allows tracking of all payments, including Phase 1, 2 & Outcomes Provides automatic tracking of total revenue Includes charts which show total revenue, and break- down of Phase 1, 2 & Outcome payment totals

16. How it Works The Ticket Tracker tool is an excel based database that links data and adds inputs to provide an ongoing picture of revenue your EN has earned Information entered in the Demographics Worksheet will populate key data to all other payment tracking Worksheets Notes through out the Worksheets help to guide your decisions about payment requests

17. 17 Enter EN & Key Maximus contact information here Enter Ticket Holder information here Check boxes for benefits type

18. Job Placement information Industry/Sector Drop-down menu: Matches Annual Periodic Outcome Report (APOR)

19. 19 Data in these fields populates from Demographics Worksheet Phase 1 Milestones Worksheet: Payment Code indicates billing request type submitted, Wages for period is for tracking total wage data for request period you have collected from Ticket Holder

20. 20 Populated Data in these cells Phase 2 Payments Worksheet: Note the red tabs in upper corners for comments that will assist you in making billing decisions

21. 21 Populated data in these cells Outcome Payments are tracked in multiple Worksheets, 10/Worksheet. Note the comments again for assistance in billing.

22. 22 Management Reports help you to see progress as an EN, and identify revenue trends that can guide your EN service delivery methods. Scrolling down on this page will reveal Phase 2 and Outcome Payment Charts.

23. Coming Soon… Maximus is currently working on an EN portal management tool that will assist you in your efforts which should be released early in 2011. SSA is also working with a contractor on another Case Management tool that will be even more sophisticated, release date unkown.

24. Questions about future trainings and technical assistance? Questions or requests for individualized TTW TA for PROS programs? Oscar Jimenez, MPH NYAPRS Director of Community and Economic Development 518-436-0008 oscarj@nyaprs.org Questions about the Challenge Ticket Tracker? Kevin Nickerson Disability Program Navigator/CWIC Tompkins Workforce New York Ithaca, New York (607) 272-7570 Ext. 136 krnickerson@tompkins-co.org 24

25. New York Makes Work Pay is a Comprehensive Employment System Medicaid Infrastructure Grant (Contract No. #1QACMS030318) from the U.S. Department of Health and Human Services, Center for Medicare and Medicaid Services to the Office of Mental Health on behalf of New York State. It is a joint effort of the Burton Blatt Institute at Syracuse University and the Employment and Disability Institute at Cornell University with the collaborative support of the Employment Committee of the New York State Most Integrated Setting Coordinating Council to develop pathways and remove obstacles to employment for New Yorkers with disabilities. 25 New York Makes Work Pay Partnering Organizations