Work Incentive Benefits Services

Work Incentive Benefits Services are intended to assist consumers receiving Social Security disability benefits or other public benefits to navigate benefit, entitlement, and economic assistance programs and move toward self-sufficiency. These services address questions or concerns related to work and earnings and provide individualized guidance based on the consumer's current circumstances and goals. In other words, services should be responsive to the consumer's current needs, reflecting information the consumer would like to know regarding their benefits and/or how earnings could affect their goals.

This service is recommended for all consumers receiving public benefits, including those administered by the Social Security Administration (SSA), FoodShare, Medicaid or BadgerCare, subsidized housing, and other county or state programs. There is no requirement that the consumer be working or have earnings to receive Work Incentive Benefits Services.

Beginning in 2024, Service Providers must demonstrate completion of approved Work Incentive Benefits Counseling training. Service Providers interested in delivering this service should contact DVR, or refer to the list of approved trainings on the DVR Service Provider Training webpage.

Consumer Engagement and Partnerships

A strong partnership between the consumer, Service Provider staff, and DVR is essential to support progress toward employment goals. A productive working partnership includes regular communication, clarity on expectations, and shared problem-solving.

Within DVR Reports, Service Providers should identify and update, as needed, an expected contact standard. The Service Provider and consumer should discuss and agree on this contact standard, including how often they will connect, the type of contact (in person, virtual, phone, or email), and how long meetings will typically last. They should also agree on how any changes to scheduled meetings will be communicated.

Written reports document services provided and progress, but do not replace timely communication with DVR when urgent issues arise. Service Providers must notify DVR as soon as they become aware of situations that present a risk to consumer safety or well-being, or that may require immediate intervention. For less urgent barriers or changes that may affect employment progress, Service Providers should use professional judgment and communicate with DVR as appropriate.

Providers are encouraged to review the DVR Roles and Responsibilities with consumers, to support shared understanding of expectations.

Summary of Services Table

Providers should monitor progress and adhere to the timeframes for delivery of individual services identified in the table below.

Service Delivery Expectations

• Service Providers are required to contact the consumer for whom services have been authorized within five (5) days of the receipt of the purchase order.
• A DVR Authorization for Services is required before any services can begin.
• Services are expected to be completed in accordance with the technical specifications and within required timeframes.
• Services should adhere to competitive, integrated employment (CIE) principles and person-centered planning, and providers must adapt delivery methods to the consumer's preferences and needs.
• Meetings may be in-person, virtual, or by phone. DVR staff attendance is required for either the Portfolio or Plan meeting, as DVR staff attendance is important for providing vocational planning and support to consumers. Based on consumer circumstances, it may be decided to have a combined Portfolio/Plan meeting to cover both the Portfolio and the Plan in a single meeting. DVR staff attendance is not required at the Introductory meeting unless needed by the consumer.

• Work Incentive Benefits Introductory Meeting
• Work Incentive Benefits Portfolio
• Work Incentive Benefits Analysis with Plan
• Work Incentive Benefits Plan Assistance

Work Incentive Benefits Introductory Meeting

Service Overview

The purpose of the Introductory Meeting is to provide general information to the consumer about work incentives, confirm releases for benefit verification, and determine the purpose and scope of future Work Incentive Benefits Services. This service establishes shared understanding between the consumer, the Service Provider, and DVR staff.

Service Components

An introductory meeting should include the following activities:

• Intake of household income and benefits.
• Gather information from DVR and the consumer regarding the consumer's goals, including employment goals, income targets, housing, etc.
• Discussion of next steps with consumer/guardian and DVR.
• Provide preliminary information about benefits and work incentives including SSI, SSDI, Ticket to Work, Medicaid Buy-in options, and Medicare savings programs, as applicable.
• Gather contact information for the consumer's support team members, such as LTC funder, Rep Payee, Guardian and/or Conservator.
• Identify consumer communication preferences.

Service Requirements

• Conduct an introductory meeting to complete intake and obtain signed releases of information from the consumer (or their guardian).
• Schedule follow-up research, contacts, or meetings as needed.
• Provide general benefits and work incentive information.
• Verify information from public entities about the consumer's current benefits.

Documentation/Reporting Expectations

Work Incentive Benefits Introductory Meeting Report (DVR-18046-E)

Work Incentive Benefits Portfolio

Service Overview

The Benefits Portfolio provides a point-in-time summary of the consumer's current benefits, informing conversations about employment goals. If the consumer's goal changes considering the information learned, this updated goal should be used to complete a Work Incentives Plan.

Service Requirements

The portfolio should include verified benefits:

1. Social Security Administration (SSA) disability programs and applicable work incentives
   • Social Security Disability Insurance (SSDI)
   • Supplemental Security Income (SSI)
   • Ticket to Work
2. Health insurance programs
   • Medicare
     • Medicare Savings Programs (MSP)
     • Medicare Supplemental policies
     • Medicare Advantage Plans
     • Medicare Part D Low-Income Subsidy
   • Medicaid
     • Medicaid Purchase Plan (MAPP)
     • Long-Term Care (Medicaid Waivers, Family Care/I Respect I Self Direct/Self Directed Supports, etc.)
     • BadgerCare Plus
   • Private health insurance
   • Other insurance programs as appropriate for the individual
   • Private disability insurance
   • Unemployment Insurance
3. Veteran’s Benefits
4. Worker’s Compensation
5. FoodShare
6. Housing assistance programs
7. Energy assistance
8. Benefits and entitlements for spouse/children, if relevant

Documentation/Reporting Expectations

Work Incentive Benefits Portfolio Report (DVR-19461-E)

Work Incentive Benefits Analysis with Plan

Service Overview

The Work Incentive Benefits Plan combines information from the intake interview and verified benefits to forecast expected changes and guide the consumer in executing work incentives. It will explain actions the consumer needs to take to stay current with the agencies that administer these benefits, and assistance the consumer can access to execute those actions, including assistance from the provider.

Service Requirements

The Plan should include:

1. Timeline for future checkpoints/meetings based on the consumer's work goal.
2. Summary of the assistance provided by benefits specialist.
3. Preparation and delivery of a plan for future consultation.
4. Thresholds for current and expected future benefits.
5. Timelines for anticipated changes:
• End of TWP
• Work review
• End of SEIE
• End of payment status
• TTW Enrollment
6. Reporting schedule and responsibilities

Documentation/Reporting Expectations

Work Incentive Benefits Analysis with Plan Report (DVR-18048-E)

Work Incentive Benefits Plan Assistance

Service Overview

Plan Assistance includes meetings between the consumer and Service Provider within the 12-month period following the Plan review meeting to support implementation of the Work Incentives Benefits Plan.

Service Components

Service Providers assist consumers in managing benefits and entitlement status, wage reporting to SSA, maintaining benefits eligibility, and facilitating warm hand-offs to Ticket to Work. Providers also answer questions, consult as needed, and update the Plan to reflect changing circumstances or additional consumer questions or concerns.

Plan Assistance encompasses assistance related to circumstances that occur during the authorized 12-month period, including, but not limited to:

• Employment
• Changes in wages or hours
• Benefits recalculations
• Support with work incentives – For example, assistance may address:
  • Trial Work Period (TWP)
  • Substantial Gainful Activity (SGA)
  • Extended Period of Eligibility (EPE)
  • Expedited Reinstatement (EXR)
  • Impairment-Related Work Expenses (IRWE)
  • Student Earned Income Exclusion (SEIE)
  • PASS (Plan to Achieve Self-Support) Plan
  • ABLE (Achieving a Better Life Experience) account
  • Medicaid Purchase Plan (MAPP)
    (This list is illustrative; other work incentives may also be addressed as appropriate.)
• Other benefits-related changes impacting Plan implementation

Service Requirements

Service Providers are expected to provide a summary of activities that were completed prior to billing for the final payment. This summary should include:

1. Instances of follow-up with DVR case facilitator.
2. Instances of follow-up with consumer during established checkpoints.
3. Case notes documenting any changes to the initial Work Incentive Benefits Plan.

Additional Considerations

Billing for Plan Assistance may occur at any point during the 12-month service period once qualifying assistance has been provided. Billing does not conclude the Service Provider's obligation to continue delivering Plan Assistance throughout the remainder of the authorized period, as needed by the consumer.

Additional Plan Assistance authorizations are not intended to fund services that fall within the expected scope of Plan Assistance during the same 12-month period. Additional authorizations may be considered only in unforeseen or exceptional circumstances that could not reasonably have been anticipated at the time of original authorization.

Documentation/Reporting Expectations

Benefits Plan Assistance Report (DVR-18045-E)

Fee Schedule Note

Purchase Order Instructions/Timing: WIBS Introductory meeting, Portfolio, and Plan should be authorized together on a single purchase order, listed on three separate lines. The combined timeframe for these three services should not exceed 6 months. When a consumer is already working or has immediate benefits-related needs, the Plan Assistance service should also be authorized concurrently.

Required Reporting Templates

• SSA Ticket to Work Site
• SSA How Ticket to Work Works
• Work Incentive Benefits Services Crosswalk
• Work Incentive Seminar Event (WISE) On Demand
• Virginia Commonwealth University National Training and Data Center
• Employment Resources Inc.
• Yang Tan Institute on Employment and Disability at Cornell University

Qualifications

Providers who are delivering Work Incentive Benefits Consultation services must agree to have qualified personnel complete the services. Starting in 2024, DVR Service Provider staff must complete formal training (CWIC or equivalent) including:

• Determining eligibility for work incentive counseling services.
• Providing information and referrals to programs that support work.
• Gathering information about the beneficiary and verifying their public benefits.
• Providing individualized advisement, including a Benefits Summary & Analysis (BS & A) report; and
• Providing proactive ongoing work-related benefits support.

By 2024, the provider must be able to document training meeting the requirements for the 2024-2026 service agreement, effective July 1, 2024. A provider will be required to have documentation of previous certification via the Community Work Incentives Coordinator (CWIC) program, or similar comprehensive training.

Metrics

DVR has identified service-specific criteria for all statewide services. The list below contains objective information that DVR will collect to establish baseline quality data and, over time, set goals for continuous quality improvement in partnership with Service Providers. DVR recognizes that gathering accurate data, verifying information, and developing meaningful targets will take time and collaboration. These criteria are included in the technical specifications to help Service Providers understand the elements DVR considers important in delivering high-quality statewide services.