Consumer Directed EN
The Consumer Directed Services (CDS) Employment Network (EN) model is defined in the Ticket to Work program (Ticket program) as an EN business model that shifts responsibility for key service decisions from the EN to the beneficiary. In this model, beneficiaries are direct purchasers of a variety of their own employment support services. In the EN Request for Application (RFA), the Social Security Administration (Social Security) requires a detailed description of the processes, support services, and payments for consumer-directed services if the EN indicates in its application that it plans to use this particular service model. The EN's description must address the types of services approved to be purchases, the method of payment, and the accounting procedures the EN plans to use to track these types of expenses so that the EN is able to prove that the money provided "back" to beneficiaries is used for appropriate return to work expenses.
The following three requirements apply to ENs operating a CDS business model.
- The "cash-back" support payments to the beneficiary must be used for services related to that beneficiary obtaining or retaining work and not as a wage supplement.
- Direct payments to the beneficiary are permitted only on a reimbursement basis for allowable expenses. It is important to remember that payments to Supplemental Security Income (SSI) recipients for other than allowable expenses may result in an overpayment of previously paid SSI benefits.
- The EN must provide a detailed accounting for how the funds were spent, and the accounting for the expenditures will be considered as the services provided for documentation that the funds are being used for return to work expenses.
Some examples of acceptable accounting records include the EN's reimbursement records or debit card electronic purchase records, receipts with purchase data and vendor type, and itemized receipts.
In addition, the EN provider must be able to show that support payments to a beneficiary are used for services related to the beneficiary obtaining or retaining work and not to supplement wages or provide cash back to the beneficiary. Direct payments must be based on actual costs or for reimbursement for allowable expenses. Finally, the EN is required to submit detailed accounting for how funds are spent.
If the EN elects to be paid under the Milestone/Outcome payment system, it is required that it establish and maintain a payment disbursement and monitoring process. The EN is also required to include in each Individual Work Plan (IWP) a description of the services and supports to be purchased by the beneficiary and the planned payment arrangements. In addition, for individuals who receive benefits under the Supplemental Security Income program, the EN must report any unearned income for those beneficiaries to the local Social Security office.