Statement of James Wallace, Louisiana Rehabilitation Services, Department of Social Services, Baton Rouge, Louisiana

Louisiana Rehabilitation Services (LRS) has taken a very active role in promoting Ticket to Work (TTW) in the state of Louisiana.  Our agency, which is located in a second phase Ticket rollout state, began training our personnel statewide in 2001.  The agency has done follow-up training in 2002.  Louisiana Rehabilitation Services (LRS) personnel also participated in providing training to beneficiaries, potential Employment Networks (ENs), and other entities in 2002 in conjunction with the Medicaid Buy In (MBI) program.  The MBI training was repeated in 2003 with LRS participation. Furthermore, the agency was involved in statewide teleconference training in 2003.

In our agency training, beneficiary options with special emphasis on informed choice to the consumers was stressed.  Additionally, the training stressed that Rehab Act guidelines preclude denying services to any eligible consumer even if a Ticket is assigned to another entity.

The LRS does have EN agreements with four Employment Networks throughout the state.  The agreements do call for Ticket assignment to LRS and payment to the EN on typically a fee-for-service basis.  LRS would be reimbursed under the traditional cost method.  Any excess payments from Social Security would be split on a 50/50 basis. 

The LRS has neither solicited ENs nor coerced them into partnerships to “control competition.”  ENs in the state appear to be reluctant to accept Ticket assignments because of the uncertainty and duration in payment and tracking.  ENs and LRS negotiated so that in instances where the EN can independently serve the recipient, that recipient will not be referred to LRS.  That said, current TTW procedures do allow appeals to Maximus and Social Security when Ticket assignment and payment is in question.

The LRS, as a whole, is as well trained or in many cases better trained on Ticket issues, including informed choice, as any other entity in the state.  In our state, as in many others, LRS has over 90% of the Ticket assignments.  It is our viewpoint that Ticket indifference is due to the payment system for ENs and the burdensome administrative and tracking system.   Further the lack of marketing to recipients by ENs contributes to the very low number of cases handled through them.

Thank you for the opportunity to respond to this very topical subject.