**Ticket to Work and Work Incentives Advisory Panel**

**Quarterly Public Meeting**

**Washington Plaza Hotel**

**Washington, DC**

**November 15-17, 2006**

**[Day One -- Wednesday, November 15, 2006]{.underline}**

**Attendees**

[Advisory Panel Members]{.underline}

Berthy De La Rosa-Aponte, Panel Chairperson, Katie Beckett, Libby Child,
Russell Doumas, Loretta Goff, Thomas Golden, Frances Gracechild, Cheryl
Bates-Harris, Andrew Imparato, David Miller, Dorothy Watson, Torrey
Westrom.

[Advisory Panel Staff]{.underline}

Jill Houghton, Executive Director, Debra Tidwell-Peters, Jenn Rigger,
Pat Laird and Tinya White-Taylor.

[Designated Federal Officer]{.underline}

Chris Silanskis

[Members of the Public]{.underline}

Becky Roberts; Jonathan Young; Dorothy Firsching; Gary Hall; Paula
Ville; Cheryl Martin; Peter Mead; Stephen Sachs; Jean Murphy; Harold
Johanessen; Ansen Holton.

**Call to Order**

Chris Silanskis, Designated Federal Officer, called the meeting to order
at approximately 9:02 a.m. and turned the meeting over to the Panel
Chairperson, Berthy De La Rosa-Aponte.

**Welcome, Introductions, and Review of the Agenda**

Berthy De La Rosa-Aponte, Panel Chairperson, began by welcoming Panel
members, staff, consultants and attendees. She continued by asking
meeting attendees to make brief introductions, and she reviewed the
meeting agenda.

**Business Meeting**

Berthy De La Rosa-Aponte, Chairperson, reviewed the business agenda. The
business meeting session was led by Berthy De La Rosa-Aponte.

[Meeting Minutes]{.underline}

The meeting began with the review of the August 2006 meeting minutes and
a motion to accept the minutes into the record.

***Motion: The Panel passed a motion to accept the August 2006 minutes
into the record.***

Next, was a review of the October 2006 teleconference minutes and a
motion to accept the minutes into the record.

***Motion: The Panel passed a motion to accept the October 2006 minutes
into the record.***

[Congressional Briefing]{.underline}

On September 22, Berthy De La Rosa-Aponte, chair and Panel members
Loretta Goff and Thomas Golden met with staff from the Senate Finance
and House Ways and Means Committee and from the Congressional Research
Service. The topics covered were the Beneficiary Summit; the marketing
of the Ticket program and work incentives; Social Security data on the
use of PASS and IRWEs and the 1619(b); employment initiatives from
national disability organizations; the proposed consensus points,
guiding principles and policy objectives of the document prepared by the
Transformation Subcommittee; and the delay in the final Ticket
Regulations. Loretta Goff mentioned that the staff had inquired about
the cost factors related to recommendations resulting from the
Beneficiary Summit. Thomas Golden was impressed with the level of
interest and investment and support for the Beneficiary Summit.

[Outreach Activities]{.underline}

1\. [Annual Florida Conference on Supported Employment]{.underline}

Berthy De La Rosa-Aponte participated on a panel on August 24 at the
annual Florida conference on supported employment. She discussed the
strategic plan and the subcommittee activities of the Panel and SSA's
notice of proposed rule changes to the Ticket to Work Program.

2\. [Meeting with SSA and CESSI]{.underline}

Libby Child reported on a follow-up meeting she had on Sept. 8 with Sue
Suter, Pam Mazerski and staff of SSA and Jane Rath of CESSI concerning
messaging to employers regarding marketing the Ticket and work
incentives. She described a two-prong approach for large and small
employers.

3\. [Meeting with CCD Task Forces]{.underline}

On September 18, Berthy De La Rosa-Aponte and Panel members Loretta
Goff, Thomas Golden, Cheryl Bates-Harris, and Andy Imparato, along with
Panel staff met with the three CCD Task Forces and their Chairs (Work
Incentives Implementation, Employment and Training, and Social
Security). The main items discussed were the activities of the Panel's
subcommittees, improving communication between the CCD Task Forces and
the Panel, and next steps. The following common issue areas were agreed
upon as next steps: 1) New WIPA projects; 2) Publication of the final
Ticket regulations; 3) SSA's Ticket marketing plans; 4) SSA
demonstration projects, particularly the Benefit Offset Demonstration;
5) SSA's administrative budget; and 6) SSA's Ticket marketing plans.

Andy Imparato noted that Curt Decker, chair of CCD, was present and that
he had mentioned the recent Congressional hearing on ADA at which the
low unemployment rate of people with disabilities was emphasized. Mr.
Decker felt this issue required a broad agenda involving the disability
community working together.

4\. [CSAVR Conference, "Futures Meeting"]{.underline}

Berthy De La Rosa-Aponte and Jill Houghton, executive director,
participated in futures planning exercises of the Council of State
Administrators of Vocational Rehabilitation (CSAVR) on September 20 in
Washington, DC. Cheryl Bates-Harris shared that one of the issues
discussed was which population group should VR be serving.

5\. [HSC Foundation Youth Transitions Summit]{.underline}

On September 21, Berthy De La Rosa-Aponte and Jill Houghton, executive
director, participated in the HSC Foundation Youth Transitions Summit
which was held in Washington, DC. The meeting was a think tank to come
up with ideas to promote successful transition from school to work.

6\. [USBLN Conference]{.underline}

Libby Child and Torrey Westrom, Panel members, participated in the
national US Business Leadership Network (USBLN) conference held in
Minnesota. Torrey reported on the job fair held in the morning for
people with disabilities, which over 500 youth attended. Libby remarked
on the high energy carried over into the evening and the numerous
comments about the participation of youth. She presented at a breakout
session on the Ticket program. She felt there was a good mix of
employers and ENs. Andy Imparato was also at the conference presenting
for AAPD to kick off National Disability Mentoring Day. He mentioned
that UCLA's Business School provided a workshop on leadership management
training for people with disabilities who are encountering the glass
ceiling, similar to other subgroups.

7\. [Meeting of ENs in Minnesota and Wisconsin]{.underline}

Torrey Westrom, Panel member, attended the quarterly meeting of the ENs
in his region. The meeting provides an opportunity for the ENs to get
updated and to discuss issues of concern. The following is a list of
issues he heard from the ENs.

1)  Definition of disability -- needs to be updated

2)  More funding for WIPAs -- are performing marketing and planning with
    same amount of funds

3)  Termination of ticket holders who are unable to work full-time as
    required under the program.

4)  New ENs are waiting for new regulations to get involved

5)  Overpayment -- is causing concern among people with disabilities who
    are working, provided suggestion for resolving this issue

6)  Marriage penalty -- loss of Medicaid if one spouse goes to work

8\. [TASH conference]{.underline}

Berthy De La Rosa-Aponte and Jill Houghton, executive director,
presented at the annual TASH conference on November 9. Berthy De La-Rosa
Aponte attended other workshops such as Marty Ford's on Social Security
and CESSI.

[F**ederal Programs that Provide Employment Assistance for
Individuals**]{.smallcaps}

**[with Disabilities]{.smallcaps}**

Marlene Simon-Burroughs, Associate Division Director, Office of Special
Education Programs (OSEP), U.S. Department of Education, reported on
OSEP's Federal partnerships for transition. This program started about a
year ago with a focus on increasing inter-agency collaboration at the
local and State level. She began by sharing performance measures and
indicators that OSEP developed as the result of a comprehensive
Individuals with Disabilities Education Act (IDEA) Part D planning
process. Along with the measurements and indicators are investment focus
areas on transition. In addition, she mentioned "transition indicators"
or State performance indicators that States will be reporting on over
the years. In particular, there is a new indicator #13 that will monitor
the percentage "of youth aged 16 and above with an Individualized
Education Program (IEP) that includes coordinated, measurable, annual
IEP goals and transition services that will reasonably enable the child
to meet the post-secondary goals." She pointed out indicator #14 which
requires States to collect data one year out after graduation of
students with disabilities. She concluded with descriptions of three
centers funded by OSEP related to transition:

1.  The National Dropout Prevention Center for Students with
    Disabilities (NDPC-SD) - focused on increasing rates of school
    completion by students with disabilities.

> [www.dropoutprevention.org/NDPC-SD/index.htm](http://www.dropoutprevention.org/NDPC-SD/index.htm)

2.  National Secondary Transition Technical Assistance Center - provides
    technical assistance and information on scientifically-based
    transition practices.

> [www.NSTTAC.org](http://www.NSTTAC.org/)
>
> 3\. National Post-School Outcomes Center - helping States to collect
> and use
>
> outcome data to improve secondary transition, and postsecondary
> results.
>
> [www.psocenter.org/about.html](http://www.psocenter.org/about.html)

Carol Dobak, Chief, VR Unit, State Monitoring, Rehabilitation Services
Administration (RSA), Office of Special Education and Rehabilitative
Services (OSERS), U.S. Department of Education was the next speaker. She
reviewed four initiatives. The first is assistive technology (AT). Under
the Technology Act there is a shift from OSEP to RSA and a refocus of
the statewide grant program on activities having a direct impact on the
availability of AT for people with disabilities and professionals. These
programs are now required to undertake activities on alternative
financing programs and short term device loan programs. Other activities
they can engage in are device demonstration projects and device
utilization projects. As a result of Hurricanes Katrina and Rita, there
has been funding for reuse of AT and a center focused on this. The
second is transition involving a partnership between the Council of
State Administrators for Vocational Rehabilitation (CSAVR) and the
National Association of State Directors of Special Education (NASDSE) to
enhance collaboration and integration of VR and special education for
transition into employment or postsecondary education. The third
initiative concerns employers. RSA participates in the National
Employment Conference held biennially and in the Business Leadership
Network conferences. It has connected with Monster.com to make hiring
managers aware of RSA and the role of rehabilitation services. The last
is on their new monitoring redesign which is being implemented this
fiscal year and involves numerous stakeholders. She mentioned two
performance measure indicators of interest to the Panel. Indicator 1.5
measures the average wage of those who achieve competitive employment in
comparison to the general population, and indicator 1.6 is the
percentage of individuals claiming own income as their primary source of
support upon entering the VR program as to those who do so when exiting
the VR program. In closing, she stated that 30% of VR clients receive
SSI or SSDI and this data are available at
[http://RSADEV.net](http://RSADEV.net/).

Maria Flynn, Division Chief, Division of One-Stop Operations, Employment
and Training Administration (ETA), U.S. Department of Labor presented on
her agency's efforts on employment training particularly the One Stops
where most people are served. She stated that about half a million using
the One Stops self-identify as having a disability. Under the
President's High Growth Job Initiative there is a \$1 million grant
focused on building the financial services industry for people with
disabilities and access to training through community-based colleges. In
regard to Federal partnerships, the Disability Program Navigator
position will be in every State by January 2007 and DC with a budget of
\$38.5 million. Each State will receive about \$1 million. There are 300
positions in the One Stops and this should increase to 450. Post
Hurricane Katrina, ETA had 54 mobile navigators that reached 3,500
people with disabilities. In the area of youth with disabilities, ETA is
collaborating with RSA, the Substance Abuse and Mental Heath Services
Administration (SAMHSA)/US Dept. of Health and Human Services (HHS), the
Office of Disability and Employment Policy/US Dept. of Labor, and the US
Dept. of Transportation under Federal Youth Vision. This joint action is
trying to replicate Federal collaboration at the State and local level.
ETA's utilizes the same performance measures for all of its programs.
The agency is moving toward a comprehensive streamlined reporting
process known as WISPR (Workforce Investment Systems Performance
Reporting). It will consolidate the state reporting requirements for all
of their programs. It will be tracking SSDI beneficiaries and those with
physical and mental disabilities.

Joe Razes, TWWIIA Program Manager, Disabled and Elderly Health Programs
Group, Center for Medicaid and State Operations, Centers for Medicare
and Medicaid Services (CMS), U.S. Department of Health and Human
Services reported on collaborative activities his agency is involved in.
CMS and the Administration on Aging have jointly funded 18 Aging and
Disability Resource Centers that provide resource information. Since
2000, CMS has given grants to the States to offer supports and for the
Buy-In program. Currently, there are 73,000 people participating in the
Buy-In program. A comprehensive grant is now available that allows the
States to expand services and develop linkages with other agencies. He
offered the following recommendations to the Panel.

1)  Encourage Federal partners to expand services and supports and
    increase

> partnerships.

2)  Encourage joint solicitations.

3)  Promote research component at State level

4)  Require quantifiable outcome measurements.

5)  Include consumers for feedback.

He concluded by describing the performance measures of success at the
local level. The Medicaid Infrastructure Grants (MIGs) are collecting
data on those returning to work and on programmatic data, and CMS has an
agreement with SSA to gather their data.

W. Peter Donovan**,** Special Expert, Center for Mental Health Services,
Substance Abuse and Mental Health Services Administration (SAMHSA), U.S.
Department of Health and Human Services discussed the Federal Action
Agenda that resulted from the Mental Health Commission. This agenda
represents an inventory within each agency on mental health and health
care. The agenda includes five directives or priority areas: labor/

transition, suicide, integration, financing, and disaster recovery and
emergency response. From this five workgroups were created encompassing
career employees from the various Federal departments. One thing that's
missing at this point is access to families and consumers. His agency
has given out nine State Infrastructure grants to the States for five
year period. These are for the development of infrastructure on the
elements of disability, education, Social Security, drugs, alcohol, and
child welfare. In terms of the private sector, his agency is reaching
out to employers who are saying it costs too much to train someone so
they are asking for assistance on maintaining existing employees with
mental health conditions. Performance indicators are being developed by
the five workgroups.

# 

After the presentations the floor was opened for questions and comments
by Panel members.

C**[ommunity Level Infrastructure -- Panel I]{.smallcaps}**

Venessa Fairbairn described her work as a disability program navigator
with WorkSource in Florida. She spends 90% of her time working to assist
individuals with disabilities and beneficiaries of SSA programs in the
One Stop System and in the community. Her One Stop has a collaborative
agreement with the agency having the Work Incentive Planning and
Assistance (WIPA) project, which allows the work incentive specialist to
come into their center as needed. Her One Stop also does a lot of
collaboration and relationship building with community partners and
agencies. In particular it's working with the state vocational
rehabilitation agency since her One Stop is an employment network (EN)
and serves many VR clients who have never heard of the Ticket, work
incentives or ADA. She is also involved with the Job Opportunities
Consortium which is a group of job developers from cross agencies who
share job needs and training. The First Coast Business Leadership
Network is a result of that consortium. Internally, she has worked very
closely with her business services team. When it comes to beneficiaries,
she finds that many are fearful of working and have no information or
understanding of the Ticket or work incentives. She feels it would be
very helpful if we could refer people directly when they become eligible
to receive benefits to the One Stops. She also feels that all One Stops
should automatically become ENs as well as the school systems who would
have more of an incentive to get them to work. She recommended that Job
Corps become ENs because the numbers are very high in Job Corps of
students who may receive benefits or who may be eligible. Other
recommendations given to the Panel were to raise the SGA, to empower
businesses to become providers by offering bonuses or direct payments or
informing them of the work subsidies under Social Security, resource
information needs to be localized, more staff at One Stops to implement
the individualized work plans (IWPs)and to provide support, and direct
access by individuals to the Area Work Incentive Coordinators (AWICs)
and Work Incentive Liaisons (WILs). In measuring success, Florida uses
the One Stop Management Information System (OSMIS). The numbers of
people with disabilities coming into their centers and getting jobs has
increased. Home Depot has been a major employer. All of their One Stop
centers have made their technology accessible. Another form of
measurement is the quarterly reports on the progress of the navigators
regarding systems change, relationship development and increased
collaboration in the community.

Olga Ivnitsky shared her experiences as the Brooklyn WORKS Program
Director for six years. Her agency recently became a WIPA grantee and
will be serving Manhattan/ Staten Island. Her time is divided between
direct services to beneficiaries and supervising her staff. Education of
consumers, the community, teachers and parents of the transition age
youth is key for the BPAO projects as well as for the future WIPA
projects. She attributed the 130 full-time and 65 part-time employed
consumers to the very close working relationship with numerous community
agencies. Everyone who came to her program would get a package of
information about all services available in Brooklyn. In connection with
the Social Security local offices, they worked very closely with the
area work incentives coordinator (AWICs) and were able to place their
flyers and information brochures in the waiting areas. She felt that
quarterly meetings of all entities providing work incentive services to
consumers would be beneficial. She mentioned there are many systemic
barriers to employment in New York City such as housing, transportation.
She provided the following statistics on her program: face-to-face
services to almost 2000 SSI/SSDI beneficiaries, three former
beneficiaries became full-time benefit specialists, and the numbers
employed mentioned above. There's some excellent outcome data from the
New York Works Research Administration Project. This was a collaborative
project with the New York State Department of Labor and the New York
State BPAOs that compared the BPAO data collected with the wage earners
records of the State Labor Department. It compared people one year prior
to the benefits advisement and one year after the initial intake. Those
numbers showed that benefits advisement was one of the most important
features of work incentives. Comparative data is below.

-   Average quarterly wage at intake was \$400; after, \$700.

-   More than 55% of BPAO clients didn\'t have any period of employment
    during the entire year prior to BPAO intake;

> decreased one year subsequent to BPAO intake by 51%.

-   Annual wages increased from \$2,151 to \$2,743 subsequent to BPAO
    services.

-   Most dramatic increase in wages was recorded for those obtaining the
    highest and more complex counseling service of benefits management
    from \$2,462 to \$4,088.

-   For each SSA disability benefit type wages increased after BPAO
    intake: for SSI only, from \$1,555 to \$2,428; SSDI only, from
    \$3,225 to \$3,614; for SSI/SSDI beneficiaries \$1,190 to \$2,480.

Cheryl Martin presented next from Equip for Equality, which is the
protection and advocacy program for beneficiaries of social security
(PABSS). She is a paralegal there providing legal services, legal
advocacy, and representation to persons with disability. She spends 80%
to 90% of her time with beneficiaries and the remainder providing
training to service providers as well as consumers. She has developed a
training package that has an array of information for consumers. She
works very closely with their AWICs, PASS cadre, and their BPAO/WIPA.
She has developed a promising practice done in conjunction with Cornell
University called "Creating Model Partnerships to Promote Employment of
People with Disabilities," which describes an outreach effort to the
African-American community in Illinois by connecting with churches,
grocery stores, laundry operators and others. She has estimated that
this outreach activity has increased the number of calls from the
African-American community by 200 - 300%. Although she established a
presence for her program, there are only two staff people and additional
funding would allow more outreach within the State. She felt it was
imperative to remain in contact with all the agencies you work with and
develop relationships with new agencies. A recent performance
measurement was done in April, 2006, called \"Breaking Down Barriers,
Employment and the Disability Community.\" It was an evaluation done in
conjunction with DePaul University and conducted by Dr. Bridgette
Hernandez. The report reflects that the Ticket to Work incentives are
very complex for customers and service providers to understand. There
were 74 people that were involved in this study and one of the things
they consistently reported on was that Social Security did not market
the Ticket to Work program correctly. Everyone thought the Ticket to
Work gave them access to a job. Most ENs have chosen not to work with
Ticket holders because they need money up front to educate the Ticket
holder, and they don\'t have it. They're feeling that they're being put
into position to accept the Ticket only if VR has involvement.

At the conclusion of the presentations the floor was opened for
questions and comments by Panel members.

**Community Level Infrastructure -- Panel II**

Harold Johanessen, Executive Director of Basic Enterprise, was the first
presenter. The primary mission of his organization is to help
individuals out in the community be able to maintain their own personal
living space. In order to do that, they had to find a methodology to be
able to assist them to become employed. The Ticket program provides an
avenue to help explore employment. However, about 60% of his time is
spent managing highly aggressive and self-injurious behaviors in adults
and children. Due to the nature of services they provide, their work is
integrated with somebody else. His experience with Ticket holders over
the last 5 years has been limited to 4 individuals. He concurred with
other presenters that the greatest barrier to assisting beneficiaries is
their fear of losing benefits especially to pay medications. His measure
of success is keeping people from being institutionalized. His success
rate is 97% and part of that success revolves around the ability of his
organization, through the Ticket program, to help beneficiaries find a
job, get successfully gainfully employed, and make the money needed to
stay in their current home-based living arrangements. His success is
largely due to the reputation he has built with employers of bringing
highly motivated, dedicated applicants. Technically, he would have 24
successes this year if he didn\'t include the fact they can\'t meet the
SGA. He noted that the SGA barrier is too high.

Sharon Julius, who is the Regional Director for the Maryland State
Department of Education, Division of Rehabilitation Services, was the
next presenter. In her role as program manager she ensures that staff
has the training, skills, and resources necessary to provide timely
vocational rehabilitation services to eligible individuals. It's also
her role to advocate for community resources, programs and employment
opportunities that will assist individuals receiving SSDI or SSI become
self-sufficient members of society. Her staff has met staff from the
WIPA program and have arranged for a WIPA person to be in each of the
four VR offices at least once a month to discuss benefits and work
incentives with consumers. Her staff has received training in this area
and literature is available in the VR offices for distribution to
individuals and their families. They also work with transition
specialists and educators at schools. To improve collaboration, she
suggested additional funding for both the VR and WIPA programs. She
reported that at the end of this fiscal year in Maryland, 42% of all
individuals receiving services from her agency were receiving SSDI
and/or SSI benefits. From her perspective, the greatest barrier to their
assisting beneficiaries is the fear of losing the medical benefits. Even
though there is an extension to maintain medical coverage for eight plus
years, it still serves as a disincentive to employment. She would
suggest that a time frame for keeping medical benefits be eliminated.
Instead, the criteria should be that the working individual should
continue receiving medical benefits through the Social Security until
alternative coverage is available either through an employer, a working
spouse or another source. In terms of performance measures, the State VR
program has many performance measures as outlined by the Federal
regulations. Last year, Maryland VR found employment for 3,082
individuals; 38% were SSDI or SSI beneficiaries. In fiscal year \'06,
Maryland VR received \$1.7 million in Social Security reimbursements
funds for services provided to SSDI or SSI beneficiaries who returned to
work. As of November 2006, there were 2,751 Tickets assigned in
Maryland; 2584 were assigned to a Maryland VR agency, which represents
94% of the total assigned in Maryland. The Maryland VR agency currently
has Ticket agreements with five Maryland based employment networks and
have been approached to participate in the Partnership Plus Project.

The next presenter was Nancy Loverin, the Manager of WorkSource Renton,
a One Stop Center in the Seattle-King County area. She used the analogy
of the One Stop as a big house that follows four principles as outlined
in the Federal legislation. Those four critical components are:
integration, customer choice, performance accountability, and universal
access. The Center has 80 staff, they represent over 13 different
partnerships, which means they got 13 different funding streams, and
they provide 6,000 services a month. Her viewpoint on access for people
with disabilities is both physical and programmatic. However, the latter
is more challenging due to program eligibility criterion that screens
out people with disabilities (PWD). Their solution was to access funding
streams specifically for PWD such as VR and the Developmental Disability
agency. She has used her business teams at the Center as a method of
program access by ensuring that disability is integrated into all of
them. In terms of improvement, she would like to see a closer alignment
between all parts of the disability community and the One Stop
community. Other barriers are funding, which flows depending on the
economy, and the lack of disability providers on-site due to the costs
of being a partner. In closing she shared a success story of an
individual with a disability working at Boeing who got laid off but,
through four partners coming together to leverage dollars, he received
accommodations and got retrained in another field.

Louis Ruccolo followed next. He is a program specialist in the
transition for the Broward County Public School District in Fort
Lauderdale, Florida. In this role he provides training and support to
professionals, including ESE specialists, teachers, job coaches,
paraprofessionals, administrators, the business community, and parents
in helping students transition into work. In the matter of employment,
the District has programs that are work based community programs for 18
to 21 year old students on the tech center campuses. The intent of these
programs is to create independence across the board in community
involvement, recreation, leisure, self-sufficiency, self-determination,
and employment depending on a student\'s needs. His work involves him in
developing partnerships to create access for students in both businesses
and on college campuses, acting as a liaison with agencies, and
participating in community groups. Barriers he identified were limited
interagency collaboration and cross interagency cooperation, fear of
losing benefits, lack of benefit planner, disconnect of information to
parents and students and providers, and lack of representation of Social
Security and VR at IEP meetings. The performance measures are data
collected by the District for the state and federal level. Also
assessments, both formal and informal, that indicate the quality
outcomes for postsecondary living in the areas of employment and
postsecondary education.

After the presentations the floor was opened for questions and comments
by Panel members.

**Panel Deliberation and Discussion**

The panel deliberation session was facilitated by Becky Roberts,
President of Catoctin Consulting, LLC. The Panel identified the
following items for consideration by Panel subcommittees.

1\. Need for collaboration and partnerships -- integration

A.  Clarification on prohibition to going into schools early

> Assigned: TC

B. Focus on specific communities -- how to institutionalize focusing on
specific needs

Assigned: BVC

C. Basic collaboration

\-- understand current programs (what they do and don't do)

\-- route proposed changes for comment and coordination

\-- Federal, State and local level

Assigned: TC

D. Job Corps coordination for PWD -- youth transition and collaboration

E. Who should be in lead role in agency collaboration? Entitlement vs.
discretionary

services such as VR, HUD.

Assigned: TC, BVC

F. Partnership at Federal level is fragmented -- need cohesive effort

Assigned: TC

2\. Too little education to enable people to make informed choices
(theme) \-\--

A. Fear, lack of trust -- linked to education and informed choice

3\. Performance measures -- disparate impact on PWD when they access
generic services

(e.g., part-time employment punished)

> Assigned : TC at generic level, BVC at Summit

4\. We do minimal outreach to family and consumer organizations

Assigned: Executive Subcommittee

A. Outreach for next year -- target to marketing of recommendations

Assigned: Executive Subcommittee

5\. Delve into outcome data for the NY State BPAO and SPI data

\-- look at work incentive utilization to inform work incentive report

Assigned: CIC

6\. No consistent method of prioritizing SSI/SSDI issues

Assigned: TC

7\. Disability Program Navigators -- funding/continuation

Assigned: CIC

8\. AWICs and WILs -- Federal vs. local implementation

Assigned: CIC

The meeting adjourned at approximately 4:54 p.m.

**[Day Two -- Thursday, November 16, 2006]{.underline}**

**Attendees**

[Advisory Panel Members]{.underline}

Berthy De La Rosa-Aponte, Panel Chairperson, Katie Beckett, Libby Child,
Russell Doumas, Loretta Goff, Thomas Golden, Frances Gracechild, Cheryl
Bates-Harris, Andrew Imparato, David Miller, Dorothy Watson, Torrey
Westrom.

[Advisory Panel Staff]{.underline}

Jill Houghton, Executive Director, Debra Tidwell-Peters, Pat Laird, Jenn
Rigger, and Tinya White-Taylor.

[Designated Federal Officer]{.underline}

Chris Silanskis

[Members of the Public]{.underline}

Becky Roberts; Dorothy Firsching; Jonathan Young; Susan Goodman; Michael
Morris; Susan Prokop; Gerald Hall; Cheryl Martin; Carey Fay Vandergrift.

**Call to Order**

Chris Silanskis, Designated Federal Officer, called the meeting to order
at approximately 1:30 p.m. and turned the meeting over to the Panel
Chairperson, Berthy De La Rosa-Aponte.

**Welcome Introductions and Review of the Agenda**

Berthy De La Rosa-Aponte, Panel Chairperson, began by welcoming Panel
members and meeting attendees to Day Two of the meeting. She then asked
meeting attendees to make brief introductions.

**Beneficiary Perspectives on Community Level Infrastructure**

Amber Carey began the panel by expressing her concern that if it wasn't
for her mother

who is a social worker, she wouldn't have known where to start to get
the services she

needed as someone with a psychiatric disability. In trying to get back
into the workforce, she has discovered the large disconnect between the
various service providers and professionals. There's no network; no
sense of the reality of how things work. None of them can speak from
experience. She went to VR but was told she needed a referral from
unemployment. She has tried working but has been unable to find or hold
a job with the benefits structure necessary to receive the care that she
needed and also to maintain herself. She did consider a PASS for higher
education but after doing the math she couldn't make more than \$9 an
hour in order to continue receiving Social Security benefits. She needs
someone who can help her lay out her options and knows how things work.
It appears from her experience that the information available on
programs and resources isn't disseminated to the people who are at the
front end receiving the calls. She recommended there be some pamphlet
that could be given out containing basic information people need to
determine their options.

Ardis Bazyn first described the difference in State VR service systems
when she moved from Iowa to California. The latter was more interested
in getting you the education and you finding the job. In doing so, she
learned that many of the public employment services are unprepared to
serve people with all disabilities. Staff at these places are unaware of
how to use the technology for people who are blind. Many of the web
sites are inaccessible. Another problem she encountered is
discrimination when you apply for jobs. Although she has a masters
degree and had been self-employed for many years, many viewed this as
having no job history. She applied for numerous jobs and had many
interviews but she felt people placed the blame upon her for not being
employed. She felt that the employment service systems don't know the
best method for helping you. There has to be interaction between the VR
system and these other systems. Also, VR has limited mechanism in
helping you set up your own business, there isn't any financial
assistance for startup costs, and the PASS doesn't have an option for
self-employment.

Yvonne Smith had been on medications since age 7 but never considered
herself disabled until at age 39 she had a major episode forcing her to
leave her job. She remarked that it took her 2 years to get SSDI and
once she did, she was fearful of losing benefits. Providers told her to
remain on benefits. She commented that SSA is a place of fear because of
the overpayment issue. Currently, she's employed as a contractor due to
her own resilience. Her experience with VR has been negative since they
gave her misinformation about eligibility and initially wouldn't take
any information she offered about her education and work history. The
SSA Redbook is useful but it needs to be bigger. For people with mental
health conditions, they often don't know what it is they want to do
because they became ill at a young age. Also, living in poverty doesn't
provide you the knowledge to know what careers exist. Thus, people need
lots of chances to explore different kinds of careers. Talking to her
peers was what helped her the most. She feels the EN process needs to be
simpler so that non-profits doing good work could apply and be allowed
to charge a fee for particular services needed by clients. The SSA
reporting process needs to be user-friendly and there needs to some kind
of moratorium on reporting without a penalty while people try out
working. It took her many years to work up to 40 hrs. a week and that's
why many work under the radar screen. Special providers for people
returning from institutions need to be encouraged to become ENs since
they understand the different set of circumstances involved when serving
people who have been institutionalized. Also, ENs have to be more
visible and hire beneficiaries since they know the system. One last
point was putting materials in Spanish and other languages.

After the presentations the floor was opened for questions and comments
by Panel members.

**Briefing on the Social Security Advisory Board Report, "A Disability
System for the**

**21st Century"**

Dorcas Hardy, member of the Social Security Advisory Board, began with a
review of

the background of the Board\'s examination of disability, which goes
back to its

October 2003 Report. The trends show in 2002 program costs to
Federal/State of

\$276 billion and increases in the numbers of SSDI/SI beneficiaries. She
pointed out that this report is the vision for the 21^st^ century and is
in alignment with ADA. She gave a description of the conceptual model
for adults, which is based on those with and without a work history. It
would involve a triage assessment and case management with various
transition services offered by public and private providers to assist in
the work process.

Timely intervention and work incentives are critical for this model. And
beneficiaries would continue to have attachment to the program. A
conceptual model was also provided for SSI youth. This model has an
expectation that all children with disabilities will work and be
independent. A life progression plan would be developed based on
multidisciplinary assessment. The administration of these models
wouldn't be SSA. She emphasized that we must get away from the silo
mentality. She then presented the challenges and opportunties. She
concluded by saying there are no simple answers, but that it's time for
all the disability programs to fulfill the goals of the ADA. The full
report can be accessed at: [www.ssab.gov](http://www.ssab.gov/).

The Panel members then had an opportunity for questions and answers.

**Public Comment**

Paula Viellet from Employment Options in Florida spoke about the
experiences she has had as an EN since 2003. It has expanded its scope
nationally. Her agency is looking forward to the new regulations coming
out since this will help with her cash flow. Her placement rate has been
66% which attributes to her screening process. She is very supportive of
the Ticket program.

Kenneth Upshaw represents the Marriott Foundation, which operates a
program called Bridges From School to Work. It serves young people with
disabilities between the ages of 17 to 22, approximately. It has been an
EN since August of 2001. However, with the current payout structure it's
insufficient to cover their cost of administering the program. In the
past five years, it has received just over \$30,000 in payments serving
approximately 18 Ticket holders, and their cost has been well over
\$150,000. He was very excited about the proposed new regulations. The
foundation recalculated what their experience would have been over the
last five years if the proposed regulations had been in effect. It only
looked at those youth in their database who indicated they were
receiving SSI or SSDI. It discovered that, instead of \$32,000 over that
five year period, we probably would have generated about \$363,000. The
foundation intends to roll-out the Ticket to Work program from their
Chicago office to six other Bridges Programs around the country as soon
as the new regulations are in effect.

Alaine Perry from United Spinal Association shared some of her
organization's reactions to the Social Security Advisory Board Report.
Their first concern is whether the adult model would be voluntary
leaving the choice to the individual as to their ability to work at any
particular point in time. She would suggest some kind of try and fail
approach. Her organization is confused over the proposed change in the
definition if the new program was an option. Lastly, her organization
doesn't think the SSA disability programs are in conflict with the ADA
since each have different purposes.

Peter Mead of the National Employment Network Association reported that
at a recent meeting in San Francisco where Martin Gerry, Deputy
Commissioner of SSA, made a statement that the proposed regulations
would be delayed by three to four months because there needed to be a
new NPRM concerning questions about Ticket in use. The earlier NPRM
would be coupled with the second one. He felt further delay in issuing
the proposed new regulations is destructive to SSA\'s partnership with
the private sector, specifically with employment networks. He mentioned
the frustration over the existing program rules has generated abysmal
participation by employment networks in the Ticket program. By delaying
the Ticket rules again creates further mistrust among the ENS and SSA.

The meeting adjourned at approximately 4:42 p.m.

**[Day Three -- Friday, August 18, 2006]{.underline}**

**Attendees**

[Advisory Panel Members]{.underline}

Berthy De La Rosa-Aponte, Panel Chairperson, Katie Beckett, Libby Child,
Russell Doumas, Loretta Goff, Frances Gracechild, Cheryl Bates-Harris,
Andrew Imparato, David Miller, Dorothy Watson, Torrey Westrom.

[Advisory Panel Staff]{.underline}

Jill Houghton, Executive Director, Debra Tidwell-Peters, Pat Laird, Jenn
Rigger, and Tinya White-Taylor.

[Designated Federal Office]{.underline}

Chris Silanskis

[Members of the Public]{.underline}

Becky Roberts, Dorothy Firsching, Susan Prokop, Jane Rath, Peter Mead,
Carey Fay Vandergrift, Jeanette Shell, Ardis Bazyn, Michelle Thompson,
Jessica Sadowski, Dan O'Brien, Ryan Hess, Peggy Hathaway, Jean Murphy,
and Valerie Riggs.

**Call to Order**

Chris Silanskis, Designated Federal Officer, called the meeting to order
at approximately 8:30 a.m. and turned the meeting over to the Panel
Chairperson, Berthy De La Rosa-Aponte.

**Welcome Introductions and Review of the Agenda**

Berthy De La Rosa-Aponte, Panel Chairperson, began by welcoming Panel
members and meeting attendees. Panel members, staff, and guests were
asked to make brief introductions.

**Social Security Administration Update**

Martin Gerry, Deputy Commissioner on Disability and Income Security
Programs and Sue Suter, Associate Commissioner, Office of Employment
Support Programs, SSA presented an update of SSA activities. They
presented the Panel with several highlights of SSA activities, outreach
and marketing efforts, field office initiatives and national studies and
demonstrations.

Martin Gerry began by discussing the initial NPRM which asked for
comments on four topics. Two of those topics involved specific
provisions of the proposed regulation where SSA proposed to make changes
and asked for comments on those changes. In two other areas SSA asked
for comments on topics that were identified and discussed, but hadn\'t
proposed any particular changes. The two topics were, first, the rules
governing the so-called Ticket in use, where the question of under what
circumstances will a Ticket be considered to be in use, particularly for
purposes of CDR protection. And the second area asked for public comment
involved the question of Partnership Plus, which would allow for both a
vocational rehabilitation agency and an EN to provide services to the
same individual sequentially. When the general counsel of the Agency
reviewed what was being proposed on the Ticket in use language, its
opinion was that to proceed to issue rules on Ticket in use where
nothing had been actually proposed, but had simply identified the issue,
without giving the public an opportunity to comment on those proposed
changes was in violation of the Administrative Procedures Act. After
much discussion, he concluded general counsel\'s opinion was correct and
the Agency should be careful to allow the interest of the public to
comment on the rules before they become final. He explained at that
point there were two choices: 1)issue final rules on all the other items
and then issue a NPRM on the Ticket in use with a final rule on the
Ticket in use issued later, but the earlier final rule would need to be
amended because it didn\'t include changes in Ticket in use; or 2)
publish the NPRM limited to the changes and the Ticket in Use. The
Agency has decided to proceed with the second choice and he anticipates
that the NPRM will be published by the end of this calendar year with
probably a 60 day comment period. The final rule would be published
early to mid-spring 2007.

Sue Suter reported on the status of the Ticket program. She is still
working with the Office of Systems to ensure everything is ready when
the regulations become effective. She discussed their partnership with
Council of State Administrators of Vocational Rehabilitation (CSAVR) and
with National Employer Network Association (NENA). She gave an update on
the status of the WIPAs. An RFA was issued in October for the 7 gap
areas and she expects awards to be made by March 2007. In the meantime,
services are being offered to beneficiaries in those areas through
Imagine, an experienced WIPA in Texas, who put together a cadre of
trainers and WIPA experts who are answering an 800 number. Her office is
continuing to make plans for the WIPA seminars.

Martin Gerry shared his views on the last step in the expansion of the
Ticket to Work program as it relates to the four topic areas of the
NPRM. He explained 3-4 situations where people would need supports at
various times to work. He related this to beneficiaries and their
ability to work above SGA for a sustained period of time. He thinks SSA
has a significant number of people for whom work on a sustained basis
would require, for some period of time, other supports that might be
available. This is the concept of permanent, partial disability where we
recognize that there are people who can work who have significant
disabilities and for whom work involves necessarily the expenditure of
significantly more resources because of the supports that are needed.
This will be discussed in the NPRM. He doesn't have demonstration
authority for this but there may be a legislative opportunity. He then
moved on to the current demonstration projects. The Benefit Offset
Demonstration envisions a national target population of probably about
20,000 beneficiaries and expects to begin enrolling people in 2007. SSA
is gathering data and learning from the 4 State projects. Abt Associates
has involved some subcontractors such as Cornell. The Mental Health
Treatment Study has begun a rolling enrollment for the next 8-9 months.
Each participant will be in the study for two years. The HIV Immune
Disorder Demonstration project has benefited from the medical and VR
expertise in the development of a health insurance package for this
population. The Accelerated Benefits Demonstration project is
progressing well on the design issues. The whole thrust of the
demonstration is a forward looking positive approach to how can we
provide the healthcare and other employment supports that would be
needed to help people go back to work. The Pediatric Medical Units
project will ultimately have 12 sites around the country that would
provide pediatric medical expertise to the adjudication process. The
project is considering using the expertise of the University Centers on
Disability (UCDs), located at universities, to advocate on behalf of
parents and children for support services through transition. Lastly, he
mentioned the disability program navigator activity, which has been
taken over by Department of Labor. There are now 324 full-time
navigators in 30 states, and the District of Columbia.

After the presentations there were questions by Panel members.

**Business Meeting**

Berthy De La Rosa-Aponte, Chairperson, welcomed everyone back and
reviewed the business agenda. The business meeting session was led by
Berthy De La Rosa-Aponte.

[Executive Director Report]{.underline}

Jill Houghton first acknowledged the hard work and commitment of the
Panel staff especially in supporting the work of the Beneficiary Voice
subcommittee in preparation for the Summit. She reminded members about
the dates of the Summit and the next full Panel meeting. There has also
been a lot of staff work associated with the Continuous Improvement
subcommittee in preparation of letters to the Commissioner. For the
Transformation subcommittee, staff helped pull together a small
teleconference think tank around long term supports and services.
There's work being done on a draft of the Year Seven Annual Report.
Finally, there's been outreach to stakeholders to identify ways of
working together on issues that support the Panel\'s strategic plan.
That outreach was extremely helpful in the applications that the Panel
received for the beneficiary summit.

**Committee Reports**

Berthy De La Rosa-Aponte requested committee chairpersons to give
reports on recent committee activities.

[Beneficiary Voice Subcommittee]{.underline} -- David Miller,
chairperson, began his report by stating the themes will be in their
final format by the end of the week; there will probably be eight
subcategories. In December, staff will start doing the training
materials for the participants. The agenda is almost finished. Regarding
the participant selection process, we had over 300 applicants
representing a very diverse group in terms of diversity measures. They
hope to finalize the selection process by Dec. 1. The last thing we\'re
working on, is our ongoing project where we\'re looking at how currently
Social Security evaluates input coming back from beneficiaries, whether
its coming back through the Office of Operations or whether it\'s coming
back through one of the other units. We have decided to reformulate our
questions and resubmit them to the SSA offices.

[Continuous Improvement Subcommittee]{.underline} -- Libby Child,
chairperson, reported her subcommittee had a draft priority list of 14
priorities that was scaled down using the Ticket legislation, the
Strategic Plan and Congressional items. The first priority is gradual
benefit reduction, benefit offset advice report. The second is work
incentives utilization advice report, which includes the Medicaid Buy-In
program. And, the third one we are referring to as monitoring in three
areas (marketing activities, early intervention demos, Ticket
evaluations and regulations). Also, included in that is the four groups
in the AOI Report.

[Transformation Subcommittee]{.underline} -- Andy Imparato, chairperson,
passed out two visuals. One was from the Center for Health
Transformation, which the subcommittee thought was a useful graphic to
conceptualize how the subcommittees relate to each other. The other was
a one pager containing a snapshot on some of their thinking with regard
to a national employment investment policy, which is being called
"Enabling Work for People With Significant Disabilities. He then went on
to further describe the two visuals. The latter represents conceptually
the subcommittee's thinking about three populations. One is adults who
have been living with significant disabilities for a while. Another is
youth with significant disabilities; and then a third category, which is
adults who are transitioning into a disability status, a new onset of
disability. He explained the use of the term significant disabilities
refers to a population that has a disability that\'s significant enough
that they would likely be eligible for disabilities benefits as
currently constructed. He continued describing his subcommittee's
thinking on a work support program, which is a voluntary program that
would be available to people after they have qualified for SSI or SSDI.
This program could really be thought of as an effort to provide a real
robust array of services to people who think they can work above SGA
with appropriate supports. There will be another think tank in
mid-January with employers to hear their thoughts on what types of
incentives would work best from their perspective to make them want to
hire people with significant disabilities, including people who are
currently receiving disability benefits.

**[PANEL DELIBERATIONS]{.smallcaps}**

The Panel session was led by Berthy De La Rosa Aponte and facilitated by
Becky Roberts, President of Catoctin Consulting, LLC. The Panel
identified the following items for the Congressional briefing.

The Panel made the following motion after a long discussion about the
delay in the proposed Ticket regulations.

***Motion:*** ***The Panel send a letter to the Commissioner of Social
Security requesting that she reconsider the decision not to issue the
final rule pending the resolution of the Ticket in use issue and an
offer to meet with the Commissioner to have dialogue.***

[Issues for Congressional Briefing]{.underline}

1\. Regulations

2\. Marketing

3\. Beneficiary Summit update

4\. CIC has set direction and priorities based on Congressional letter

5\. TC think tanks

6\. Year 7 Report

7\. Reiterate support for extending demo authority and status of demos
-- link to SSAB

8\. Coordination issues

9\. Stories from beneficiary panel (Nov.)

10\. Marriott EN story

**ADJOURNMENT**

The meeting was adjourned at 11:52 a.m.