[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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