PART 411—THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM

Subpart A—Introduction
Sec.
411.100	Scope.
411.105	What is the purpose of the Ticket to Work program?
411.110	How is the Ticket to Work program implemented?
411.115	Definitions of terms used in this part.
Subpart B—Tickets Under the Ticket to Work Program
411.120	What is a ticket under the Ticket to Work program?
411.125	Who is eligible to receive a ticket under the Ticket to Work program?
411.130	How will SSA distribute tickets under the Ticket to Work program?
411.135	What do I do when I receive a ticket?
411.140	When can I assign my ticket and how?
411.145	Once my ticket has been assigned to an EN or State VR agency, can it be taken out of assignment?
411.150	Can I reassign my ticket to a different EN or the State VR agency?
411.155	When does my ticket terminate?
Subpart C—Suspension of Continuing Disability Reviews for Beneficiaries Who are Using a Ticket
Introduction
411.160	What does this subpart do?
411.165	How does being in the Ticket to Work program affect my continuing disability reviews?
411.166	Glossary of terms used in this subpart.
Definition of Using a Ticket
411.170	When does the period of using a ticket begin?
411.171	When does the period of using a ticket end?
411.175	What if I assign my ticket after a continuing disability review has begun?
Guidelines for Timely Progress Toward Self-Supporting Employment
411.180	What is timely progress toward self-supporting employment?
411.185	How much do I need to earn to be considered to be working?
411.190	How is it determined if I am meeting the timely progress guidelines?
411.191	Table summarizing the guidelines for timely progress toward self-supporting employment.
411.195	How will the PM conduct my 24-month progress review?
411.200	How will the PM conduct my 12-month progress reviews?
411.205	What if I disagree with the PM's decision about whether I am making timely progress toward self-supporting employment?
Failure To Make Timely Progress
411.210	What happens if I do not make timely progress toward self-supporting employment?
The Extension Period
411.220	What if my ticket is no longer assigned to an EN or State VR agency?
411.225	What if I reassign my ticket after the end of the extension period?
Subpart D—Use of One or More Program Managers To Assist in Administration of the Ticket to Work Program
411.230	What is a PM?
411.235	What qualifications are required of a PM?
411.240	What limitations are placed on a PM?
411.245	What are a PM's responsibilities under the Ticket to Work program?
Evaluation of Program Manager Performance
411.250	How will SSA evaluate a PM?
Subpart E—Employment Networks
411.300	What is an EN?
411.305	Who is eligible to be an EN?
411.310	How does an entity other than a State VR agency apply to be an EN and who will determine whether an entity qualifies as an EN?
411.315	What are the minimum qualifications necessary to be an EN?
411.320	What are an EN's responsibilities as a participant in the Ticket to Work program?
411.321	Under what conditions will SSA terminate an agreement with an EN due to inadequate performance?
411.325	What reporting requirements are placed on an EN as a participant in the Ticket to Work program?
411.330	How will SSA evaluate an EN's performance?
Subpart F—State Vocational Rehabilitation Agencies' Participation
Participation in the Ticket to Work Program
411.350	Must a State VR agency participate in the Ticket to Work program?
411.355	What payment options does a State VR agency have under the Ticket to Work program?
411.360	How does a State VR agency become an EN?
411.365	How does a State VR agency notify SSA about its choice of a payment system for use when functioning as an EN?
411.370	Does a State VR agency ever have to function as an EN?
411.375	Does a State VR agency continue to provide services under the requirements of the State plan approved under title I of the Rehabilitation Act of 1973, as amended (29 U.S.C. 720 et seq.), when functioning as an EN?
Ticket Status
411.380	What does a State VR agency do if the State VR agency wants to determine whether a person seeking services has a ticket?
411.385	What does a State VR agency do if a beneficiary who is eligible for VR services has a ticket that is available for assignment or reassignment?
411.390	What does a State VR agency do if a beneficiary to whom it is already providing services has a ticket that is available for assignment?
411.395	Is a State VR agency required to provide periodic reports?
Referrals by Employment Networks to State VR Agencies
411.400	Can an EN to which a beneficiary's ticket is assigned refer the beneficiary to a State VR agency for services?
Agreements Between Employment Networks and State VR Agencies
411.405	When does an agreement between an EN and the State VR agency have to be in place?
411.410	Does each referral from an EN to a State VR agency require its own agreement?
411.415	Who will verify the establishment of agreements between ENs and State VR agencies?
411.420	What information should be included in an agreement between an EN and a State VR agency?
411.425	What should a State VR agency do if it gets an attempted referral from an EN and no agreement has been established between the EN and the State VR agency?
411.430	What should the PM do when it is informed that an EN has attempted to make a referral to a State VR agency without an agreement being in place?
Resolving Disputes Arising Under Agreements Between Employment Networks and State VR Agencies
411.435	How will disputes arising under the agreements between ENs and State VR agencies be resolved?
Subpart G—Requirements for Individual Work Plans
411.450	What is an Individual Work Plan?
411.455	What is the purpose of an IWP?
411.460	Who is responsible for determining what information is contained in the IWP?
411.465	What are the minimum requirements for an IWP?
411.470	When does an IWP become effective?
Subpart H—Employment Network Payment Systems
411.500	Definitions of terms used in this subpart.
411.505	How is an EN paid by SSA?
411.510	How is the State VR agency paid under the Ticket to Work program?
411.515	Can the EN change its elected payment system?
411.520	How are beneficiaries whose tickets are assigned to an EN affected by a change in that EN's elected payment system?
411.525	How are the EN payments calculated under each of the two EN payment systems?
411.530	How will the outcome payments be reduced when paid under the outcome-milestone payment system?
411.535	What are the milestones for which an EN can be paid?
411.540	What are the payment amounts for each of the milestones?
411.545	What are the payment amounts for outcome payment months under the outcome-milestone payment system?
411.550	What are the payment amounts for outcome payment months under the outcome payment system?
411.555	Can the EN keep the milestone and outcome payments even if the beneficiary does not achieve all 60 outcome months?
411.560	Is it possible to pay a milestone or outcome payment to more than one EN?
411.565	What happens if two or more ENs qualify for payment on the same ticket but have elected different EN payment systems?
411.570	Can an EN request payment from the beneficiary who assigned a ticket to the EN?
411.575	How does the EN request payment for milestones or outcome payment months achieved by a beneficiary who assigned a ticket to the EN?
411.580	Can an EN receive payments for milestones or outcome payment months that occur before the beneficiary assigns a ticket to the EN?
411.585	Can a State VR agency and an EN both receive payment for serving the same beneficiary?
411.587	Which provider will SSA pay if, with respect to the same ticket, SSA receives a request for payment from an EN or a State VR agency that elected payment under an EN payment system and a request for payment from a State VR agency that elected payment under the cost reimbursement payment system?
411.590	What can an EN do if the EN disagrees with our decision on a payment request?
411.595	What oversight procedures are planned for the EN payment systems?
411.597	Will SSA periodically review the outcome payment system and the outcome-milestone payment system for possible modifications?
Subpart I—Ticket to Work Program Dispute Resolution
Disputes Between Beneficiaries and Employment Networks
411.600	Is there a process for resolving disputes between beneficiaries and ENs that are not State VR agencies?
411.605	What are the responsibilities of the EN that is not a State VR agency regarding the dispute resolution process?
411.610	When should a beneficiary receive information on the procedures for resolving disputes?
411.615	How will a disputed issue be referred to the PM?
411.620	How long does the PM have to recommend a resolution to the dispute?
411.625	Can the beneficiary or the EN that is not a State VR agency request a review of the PM's recommendation?
411.630	Is SSA's decision final?
411.635	Can a beneficiary be represented in the dispute resolution process under the Ticket to Work program?
Disputes Between Beneficiaries and State VR Agencies
411.640	Do the dispute resolution procedures of the Rehabilitation Act of 1973, as amended (29 U.S.C. 720 et seq.), apply to beneficiaries seeking services from the State VR agency?
Disputes Between Employment Networks and Program Managers
411.650	Is there a process for resolving disputes between ENs that are not State VR agencies and PMs, other than disputes on a payment request?
411.655	How will the PM refer the dispute to us?
411.660	Is SSA's decision final?
Subpart J—The Ticket to Work Program and Alternate Participants Under the Programs for Payments for Vocational Rehabilitation Services
411.700	What is an alternate participant?
411.705	Can an alternate participant become an EN?
411.710	How will an alternate participant choose to participate as an EN in the Ticket to Work program?
411.715	If an alternate participant becomes an EN, will beneficiaries for whom an employment plan was signed prior to implementation be covered under the Ticket to Work program payment provisions?
411.720	If an alternate participant chooses not to become an EN, can it continue to function under the programs for payments for VR services?
411.725	If an alternate participant becomes an EN and it has signed employment plans, both as an alternate participant and an EN, how will SSA pay for services provided under each employment plan?
411.730	What happens if an alternate participant signed an employment plan with a beneficiary before Ticket to Work program implementation in the State and the required period of substantial gainful activity is not completed by January 1, 2004?

AUTHORITY: Sec. 1148 of the Social Security Act (42 U.S.C. 1320b-19); sec. 101(b)-(e), Pub. L. 106-170, 113 Stat. 1860, 1873 (42 U.S.C. 1320b-19 note).

SOURCE: 66 FR 67420, Dec. 28, 2001, unless otherwise noted.

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PART 411—THE TICKET TO WORK AND SELF-SUFFICIENCY PROGRAM

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