Ticket Milestone History 1997 The Oklahoma Milestone Payment System was named a finalist in the Harvard/Ford Foundation Innovations in American Govt competition and as a result The House Social Security Subcommittee incorporated the Milestone Payment System into the Ticket to Work to address concerns of service providers/ENs that Ticket payments are backloaded and risky.

Grading the Ticket on the Milestone Essentials Customer Centric valued outcomes, services, length (B+) –Ticket focus is on good wages and long term retention Consumer Choice/Control over the funding flow (C-) –Customers can reassign Ticket to Vendor who gets better outcomes –BUT No decision support for making this choice like the Okla. Vendor Performance Report Card –If Vendor/EN participation rates are low - may not be a choice Collaborative Stakeholder Planning and Evaluation (C-) –SSA held focus groups and regional meetings Contains Creaming Countermeasures (F) –Reverse Risk Referenced Rates-SSI more difficult= lower rate - this is the opposite of a good Milestone system –the Adequacy of Incentives (AOI) study will evaluate higher payment rates for higher risk, tiered payment system Based on proven Concepts - (C-) Using Milestone payment system but little effort to mine Supported Employment and Choice Projects knowledge base. AOI study should correct this.

Employment Network Risk SSA Beneficiaries have been determined unable to work and therefore are high risk No funds were appropriated for the Ticket - payments come from projected SSA savings when beneficiaries lose their checks. Ticket payments are not based on service cost analysis but on SSA break even analysis. SSA does not expect the Ticket to serve every beneficiary, more like 1 out of 200. The Cream. SSA Adequacy of Incentives study will evaluate higher payments for higher support needs, more difficult cases. To be completed 2003 or 2004.

Ticket EN Payments (2002)

Possible 1Stop Ticket Responses –Option 1 No Risk/Cost - Integrate Ticket response with VR - 1Stop is point of first contact and orientation for Ticket Holders. –Option 2 Low Risk/Cost - Ticket Service Facilitator - Provide a group orientation, assistance in use of resource room, job club/job placement/referrals and tracking. –Option 3 High Risk/Cost - Go it alone - sign up with SSA as an EN, SSA payments go to 1Stop.

Option 1-Integrated with VR Ticket Holders invited to Ticket Orientation meeting by VR and 1Stop Regular Ticket Orientation meetings at 1Stop to brief beneficiaries on the Ticket, the benefits of working, SSA Work Incentives and VR services, Meetings conducted by VR staff VR Application and referral to local VR Counselor 1Stop is an additional source of job leads when Ticket holder is ready for employment.

Option 2 - 1Stop Service Facilitator 1Stop Service Facilitator system developed in Colorado to ensure access to services for people with significant disabilities Could be funded with State VR or SSA Milestone payments Hire a Service facilitator to help: –with Career Exploration, Interest Inventories, and utilization of 1Stop resources –Gather benefits and VR application information, –Develop a basic benefits plan using Work World –write a referral summary for VR counselor –assist VR counselor and customer w/ job search

Option 3 - Go it alone 1Stop can apply as an Employment Network (EN) with SSA SSA will make payments directly to 1Stop when Milestones are achieved Assume that only the Milestone payments will be paid The only new services will be an SSA intake/information gathering function up front and ongoing tracking/case management with quarterly billing for up to 6 years.

For More information on the Milestone Payment System: Questions? Dan OBrien : or