[Federal Register Volume 62, Number 84 (Thursday, May 1, 1997)]
[Notices]
[Pages 23820-23822]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 97-11240]
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SOCIAL SECURITY ADMINISTRATION
Social Security Disability Program Demonstration; Referral System
for Vocational Rehabilitation Providers Demonstration Project
AGENCY: Social Security Administration (SSA).
ACTION: Notice.
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SUMMARY: The Commissioner of Social Security (the Commissioner)
announces the Referral System for Vocational Rehabilitation Providers
(RSVP) demonstration project. This
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demonstration project will test using an outside contractor to carry
out certain administrative functions for an expanded vocational
rehabilitation (VR) referral and reimbursement program. Under titles II
and XVI of the Social Security Act (the Act), this expanded program
permits public and private providers of VR services (called alternate
participants) to join with the 82 State VR agencies to provide greater
access to VR services for Social Security disability insurance (SSDI)
beneficiaries and disabled or blind Supplemental Security Income (SSI)
recipients to the end that these beneficiaries and recipients can
secure employment and reduce or eliminate benefit dependency. The
demonstration project will be conducted under the authority of section
505(a) of Pub. L. 96-265 (the Social Security Disability Amendments of
1980), as amended, and section 1110(b) of the Act. These statutes
authorize the Commissioner to conduct demonstration projects to test,
among other things, ways to increase the availability of VR services
leading to employment opportunities for SSDI beneficiaries and disabled
or blind SSI recipients. We are publishing this notice to comply with
20 CFR 404.1599(e) and 20 CFR 416.250(e) which provide for publication
of a notice in the Federal Register before placing certain
demonstration projects into operation.
FOR fURTHER iNFORMATION CONTACT: J. Kenneth McGill, Social Security
Administration, Office of Disability, 560 Altmeyer, 6401 Security
Boulevard, Baltimore, Maryland 21235, Phone (410) 965-3988.
SUPPLEMENTARY INFORMATION:
Sections 222 and 1615 of the Act require SSA to refer SSDI
beneficiaries and disabled or blind SSI recipients to State VR agencies
for rehabilitation services. SSA is authorized under these sections of
the Act to reimburse State VR agencies for the reasonable and necessary
costs of VR services provided to SSDI beneficiaries and disabled or
blind SSI recipients when the services contributed to their performance
of substantial gainful activity (SGA) for nine continuous months.
Regulations published on March 15, 1994 (59 FR 11899), entitled
``Payments for Vocational Rehabilitation Services,'' allows SSA to
refer an SSDI beneficiary or disabled or blind SSI recipient to an
alternate participant if a State VR agency has not accepted the SSA-
referred individual for services. Alternate participants are any
approved public or private VR service providers other than the
designated State VR agencies.
Under the Act and regulations, SSA must refer an SSDI beneficiary
or disabled or blind SSI recipient initially to the State VR agency for
services. However, the regulations provide that if the State VR agency
does not accept the individual for services following such referral,
SSA may refer the beneficiary or recipient to an alternate participant
for VR services and may reimburse the alternate participant for the
cost of services furnished to the beneficiary or recipient under the
same terms and conditions that apply to the reimbursement of State VR
agencies.
We anticipate that the use of alternate participants under the
expanded VR referral and reimbursement program will increase the
provider base from the current 82 participating State VR agencies to
several hundred or even several thousand providers.
This new referral option will require recruitment of these
additional providers, increased handling and tracking of referrals,
interaction with a greatly expanded provider base, and more VR
reimbursement claims activity. Consequently, the new process must be
managed in a manner different from that for managing the former
program.
Project Objectives
This three-year demonstration will determine whether expansion of
the provider base can best be accomplished by the use of an outside
organization to carry out the necessary activities to implement the
provisions of the March 1994 regulatory changes affecting SSA's VR
referral and reimbursement programs. The project also is intended to
determine whether an outside organization can carry out activities to
assure that VR services are more readily available to SSDI
beneficiaries and disabled or blind SSI recipients. The project will
determine whether it is more efficient and cost-effective to have a
contractor manage parts of the referral process and the reimbursement
claims process.
Description of the Project
Under the demonstration project; SSA will award a contract for one
year plus a potential option year(s). The demonstration will be
conducted nationwide.
No waivers of any of the provisions of the Social Security Act are
required to carry out this demonstration. During the base year of the
demonstration, the basic functions of the contractor shall include:
Developing and implementing a marketing plan that will
enhance the marketing campaign begun by SSA to expand the alternate
participant base, including activities to improve the knowledge and
understanding of SSA's VR referral and reimbursement program and work
incentive provisions among potential new alternate participants;
Maintaining and increasing the network of qualified
alternate participants who are ready to provide rehabilitation services
to SSDI beneficiaries and disabled or blind SSI recipients;
Assisting VR providers with the application process to
become alternate participants in SSA's VR program, including review of
VR provider credentials;
Maintaining a process for determining that new and
previously approved alternate participants retain their qualifications
to provide VR services under SSA's VR program;
Implementing and managing a secure, automated system that
will include the database developed by SSA to re-refer beneficiaries
and recipients to alternate participants;
Training alternate participants who are ready to serve our
beneficiaries and recipients on SSA's policies, procedures, processes,
etc. that are related to SSA's VR referral and reimbursement program;
Developing and staffing a toll-free telephone number to
disseminate information about the SSA VR referral and reimbursement
program, work incentives, types of VR services available to SSDI
beneficiaries and disabled or blind SSI recipients, and information
about alternate participants in our VR program;
Developing surveys and other data analyses to monitor and
evaluate provider, beneficiary, and recipient satisfaction; and
Developing and implementing procedures to monitor and
review the claims submitted by alternate participants for completeness
of documentation.
After the base year of the demonstration, the contractor will
expend fewer resources on recruiting and training alternate
participants. However, the contractor will continue activities to
operate the toll-free telephone number, assist in the application
process, increase the number of alternate participants, ensure that
they retain their qualifications, and evaluate provider, beneficiary,
and recipient satisfaction. In addition, the contractor's basic
functions shall include:
Assuming complete responsibility for SSA's established
database for
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referring beneficiaries and recipients to alternate participants for
services;
Assuming complete responsibility for providing management
information; and
Developing and implementing procedures to monitor and
review reimbursement claims submitted by alternate participants for
completeness of documentation and compliance with SSA filing
requirements.
At the conclusion of the RSVP demonstration project we will have
determined: (1) The feasibility of a contractor performing certain
administrative functions of SSA's VR referral and reimbursement
program; (2) what type of VR service providers are willing to serve SSA
beneficiaries and recipients under the expanded VR referral and
reimbursement system; (3) what types of disability groups, alternate
participants are willing to serve; (4) whether using alternate
participants resulted in greater numbers of SSA beneficiaries and
recipients engaging in SGA; (5) if a greater understanding of SSA's
work incentive provisions both by providers of services and by
beneficiaries and recipients resulted; (6) whether SSA received more
claims for reimbursement; (7) if there is an improvement in the quality
of claims filed for reimbursement which can be attributed to the
contractor's reviews of claims for completeness of documentation and
compliance with SSA filing requirements; and (8) whether beneficiaries,
recipients, alternate participants, and SSA are satisfied with the
management of the process by an outside organization.
Authority: Section 505(a) of Pub. L. 96-265, as amended by
section 12101 of Pub. L. 99-272, section 10103 of Pub. L. 101-239,
section 5120 of Pub. L. 101-508, and section 315 of Pub. L. 103-296;
and section 1110(b) of the Social Security Act.
(Catalog of Federal Domestic Assistance Programs Nos. 96.001, Social
Security-Disability Insurance; 96.002 Social Security-Retirement
Insurance; 96.004 Social Security-Survivors Insurance; 96.006-
Supplemental Security Income.)
Dated: April 21, 1997.
John J. Callahan,
Acting Commissioner of Social Security.
[FR Doc. 97-11240 Filed 4-30-97; 8:45 am]
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