SI E00870.000 PLANS FOR ACHIEVING SELF-SUPPORT FOR BLIND OR DISABLED PEOPLE SUBCHAPTER TABLE OF CONTENTS Latest Section Transmittal Plans for Achieving Self-Support-- Overview............................ SI E00870.001 TN 5 3-96 Terms Pertinent to PASS............... SI E00870.002 TN 5 3-96 Applicability of PASS................. SI E00870.003 TN 5 3-96 Helping Set Up a PASS................. SI E00870.004 TN 5 3-96 Referrals to Other Agencies........... SI E00870.005 TN 5 3-96 PASS: THE PLAN AND THE EXCLUSIONS Elements of a PASS.................... SI E00870.006 TN 5 3-96 When to Start a PASS.................. SI E00870.007 TN 5 3-96 Exclusions Under a PASS............... SI E00870.008 TN 5 3-96 Related Work Incentive Policies....... SI E00870.010 TN 5 3-96 IMPLEMENTING AND MAINTAINING A PASS Adjudicative Actions When PASS Development is Pending............... SI E00870.020 TN 5 3-96 Documenting and Reviewing a PASS...... SI E00870.025 TN 5 3-96 Modification of a PASS................ SI E00870.030 TN 5 3-96 Initial PASS Notices.................. SI E00870.040 TN 5 3-96 PASS Amendments....................... SI E00870.050 TN 5 3-96 COMPLIANCE REVIEW Compliance Review..................... SI E00870.055 TN 5 3-96 Compliance Notice...................... SI E00870.060 TN 5 3-96 CLOSING OUT A PASS Suspension or Termination of a PASS.... SI E00870.070 TN 5 3-96 Resumption of a PASS................... SI E00870.080 TN 5 3-96 EXHIBITS Exhibits............................... SI E00870.100 TN 5 3-96 PLANS FOR ACHIEVING SELF-SUPPORT FOR BLIND OR DISABLED PEOPLE CITATION: Act as Amended in 1972-Section 1612(b)(4)(A) and (B), Section 1613(a)(4) Social Security Amendments of 1972-Section 301 Social Security Independence and Program Improvements Act of 1994 (Public Law 103-296)-Section 203 Regulations No. 16, Subpart K, Sections 416.1112, 416.1124, 416.1161, and 416.1180-416.1182, Subpart L, Sections 416.1210, 416.1225 - 416.1227. SI E00870.001 PLANS FOR ACHIEVING SELF-SUPPORT - OVERVIEW A. BACKGROUND The Social Security Act permits the exclusion of income and resources of an individual who is blind or disabled if the individual needs such income and resources to fulfill an approved Plan for Achieving Self-Support (PASS). The PASS provision is part of the original supplemental security come (SSI) statute. The legislative history shows that the Congress expressed a "desire to provide every opportunity and encouragement to the blind and disabled to return to gainful employment." Congress intended that the PASS provision " be liberally construed if necessary to accomplish these objectives." Congress has added a number of new work incentive provisions to the SSI program since 1972, each time expressing concern about the low numbers of disabled and blind SSI recipients who eventually enter or reenter the workforce. B. PREVIEW To assist field office (FO) personnel in developing and processing a PASS, this subchapter is generally organized in the following sequential manner: o An overview of the PASS provision and a discussion of the assistance FO's should provide o An explanation of the overall policy and several key issues o Instructions on processing a plan o Instructions on monitoring an approved plan C. INTRODUCTION For income and resources to be excluded as necessary to fulfill a PASS, the plan must at a minimum: o be in writing; o contain the anticipated period of time for reaching the goal; o specify a feasible occupational objective; o indicate specific savings and planned disbursements toward meeting the occupational objective and how these funds will be separated from other funds; and o be expected to increase the individual's prospect for self-support. SI E00870.002 TERMS PERTINENT TO PASS A. INTRODUCTION FO's may encounter some of the terms below below reviewing a PASS or communicating with a rehabilitation agency. B. GLOSSARY 1. Abandonment Abandonment is the loss of intent to pursue the occupational objective. (See SI 00870.055 for an explanation of how this relates to a PASS.) 2. Business A Business Plan is a detailed outline that Plan explains the essence of a proposed business. At a minimum, it explains what the business will do, how it will be set up, how it will operate, what it will need to operate, how it will market its product or service, to whom it will sell, how it will be financed, and what the expectations are regarding profit and loss in the near future. (See SI E00870.006D.8 for a further discussion of business plans.) 3. Compliance Compliance is performing according to the approved plan (or as amended). An individual is in compliance provided he/she is adhering: o to the savings and spending schedule; and o timely to any other steps/activities prescribed under the plan. An individual may also be in compliance if he/she amends the plan per SI E00870.050 to reflect actual: o savings and spending; and o occurrence of other steps/activities, if any, prescribed under the plan. (See SI E00870.055 for an explanation of how this relates to a PASS.) 4. Deferred Deferred Expenses are those expenses for Expenses which approval is tabled for the future and the need for which is contingent upon achievement of one or more milestones. (See SI E00870.006E.4. for a further discussion of deferred expenses.) 5. Entry Level An Entry Level Position is a job that Position reflects the initial rung on the career ladder of a particular business, trade, or profession. (See SI E00870.006E.3.c for a further discussion of entry level positions.) 6. Extended Extended or Follow-Along Services are the or Follow- services needed by a blind or disabled Along individual to continue performing a job Services after reaching stabilization. (These terms are generally used in connection with a supported employment program. See SI E00870.006E.5. for an explanation of how they relate to a PASS.) 7. Job Coach A Job Coach is an individual who provides training and support services to the employee with a disability at the job site. These services may include analyzing the tasks for the employee and teaching the employee each element of the task. In addition, the job coach may act as a liaison between the employee and the employee's supervisor or co-workers. (See SI E00870.006D.4. for an explanation of how job coaching in a supported employment setting relates to a PASS. Also, see SI E00870.006E.3.g. for a further discussion about job coaches.) 8. Milestones Milestones or Interval Steps are or Interval significant and discernible events that Steps depict the individual's progress towards the attainment of his/her occupational goal. (For a further discussion of milestones or interval steps, see SI E00870.006D.3.) 9. Occupational An Occupational Goal or Objective is the Goal or individual's "work goal", i.e., the job or Objective profession that an individual plans to attain. In some situations (e.g., supported employment), the objective may be to reach a particular level of independent performance in the job. (See SI E00870.006D. for discussion of this in terms of a PASS.) 10. Planned Planned Expenditures are the costs incurred Expenditures by the individual for the goods and services determined to be necessary to the occupational objective. (See SI E00870.006E. for a discussion of this in terms of a PASS.) 11. PASS PASS Preparation Fees reflect the charges Preparation agencies may assess individuals for helping Fees them develop a PASS. (For further discussion of such fees, see SI E00870.025C.4.e.) 12. Self-Support Self-Support is an individual's capacity to provide for his/her own welfare; i.e., meeting one's needs by one's own effort or output. For SSI purposes, an individual's self-support is essentially viewed in terms of his/her finances and employability. (See SI E00870.006C. for a further discussion of this concept.) 13. Stabilization Stabilization, in connection with a supported employment program, indicates when intensive job coaching is complete and the individual has reached a designated hourly work goal, but may still need ongoing job coaching and/or counseling to do the job. (See SI E00870.006D.4. for an explanation of how this relates to a PASS.) 14. Start-Up Start-Up Costs reflect those expenses the Costs person incurs in order to begin working or conducting business in the occupational goal. (See SI E00870.006E.3.c. for a further discussion of start-up costs.) 15. Supported Supported Employment is a concept of Employment placing a person with a disability in a series of jobs, providing intensive job coaching and/or counseling, and then giving ongoing support to the person to continue to work. Supported employment seeks to help people with disabilities work in a mainstream setting rather than in the sheltered workshop environment. (For an explanation of how this relates to PASS, see SI E00870.006D.4.) 16. VR VR Evaluation refers to the process whereby Evaluation a public or private vocational rehabilitation agency performs a diagnostic study or evaluation of an individual in order to determine the appropriate services to offer. (See SI E00870.006D.6. for an explanation of how this relates to a PASS.) SI E00870.003 APPLICABILITY OF PASS A. PROCEDURE 1. When to Discuss Initiate a discussion about PASS with anyone who is a likely candidate (see B.1, below). If an individual who is an unlikely candidate for a PASS, per B.2 below, indicates an interest, discuss PASS with them as well. Be sensitive to the person's situation when discussing the inappropriateness of a PASS for an individual who is not considered a likely candidate for a PASS. 2. General Work Explain these general points concerning Incentive work incentives: Points o The Social Security Administration (SSA) is committed to help people become self-supporting o Under certain conditions, blind and disabled individuals can work and still receive SSI and/or Medicaid (See SI E00870.010 for a discussion of the relationship of PASS to other work incentives.) 3. Points About a. General PASS Explain these points regarding PASS: o Under a PASS, the individual can set aside income or resources (including deemed income) for a planned expenditure which would otherwise affect eligibility and/or payment amount o Elements of a PASS as contained in SI E00870.006 o SSA is willing to help people develop a plan, or refer them to an organization that can be of help in setting up a plan o The individual must decide what occupational objective to pursue o When setting aside income/resources, sufficient funds should be retained for living expenses o The individual must agree to pursue the goal, comply with the terms of the PASS and use the set-aside funds only to reach the occupational objective b. Example Not Agreeable to Setting Aside Funds FACTS: Ms. Buffet, who receives a $754 title II disability benefit, inquires about the PASS provision. She would like to set up a consignment shop for children's clothing. She would like to set aside $450 a month for two years under the PASS to pay for the start-up costs which she estimates will be about $12,000. During the discussion she advises you that she has about $10,000 in a savings account. CONSIDERATION: You explain that she may have a PASS but to do so she will have to set aside all but $2000 of her countable resources towards her goal in order to be SSI eligible. You also explain other possible exclusions to her. She does not believe any other exclusion would apply. CONCLUSION: Ms. Buffet tells you that she is uncomfortable committing almost all of her savings to the business. She decides not to pursue a PASS at this time. 4. Related If the individual receives other benefits, Points advise the individual that: o Income/resources set aside under a PASS may be counted under assistance programs administered by other agencies. Advise the person to check with the other agency to determine the effect, if any, a PASS may have on the other benefit. (In most cases, Medicaid, food stamps and housing assistance provided through the U.S. Department of Housing and Urban Development, will exclude income and resources set aside under a PASS.) o Returning to work may affect other benefits. If title II disability benefits are involved, advise the person that the benefits may cease if the individual is found to be performing substantial gainful activity (SGA). If the benefits involved are administered by another agency, advise the person to check with that agency to determine what effect, if any, working may have on the other benefit o SSI eligibility and a PASS will end if the person medically improves (see SI 02301.200) B. LIST OF PERSONS WHO MAY BENEFIT FROM A PASS 1. Likely PASS The most likely candidates for a PASS are Candidates individuals who are blind or disabled and: o Are already receiving rehabilitation services (training, counseling, therapy) from: A State vocational rehabilitation (VR) agency A State agency for the blind Other public agencies (e.g., Department of Veterans Affairs) Private agencies (e.g., United Cerebral Palsy) o Are in school or training programs o Are currently working or seeking work, including self-employment (consider all section 1619(a) and (b) participants) o Express an interest in rehabilitation o Express an interest in becoming self-supporting o Would otherwise have initial eligibility denied, or continued eligibility suspended or terminated, solely due to excess income (including title II benefits) or resources, including a person whose resources are below the SSI limits but exceed those for a state-administered supplement program and the State will recognize the PASS exclusion o Would otherwise have benefits reduced due to income 2. Unlikely PASS Although blind or disabled, individuals who Candidates usually may not qualify for, or benefit from, a PASS include those who: o Already completed a PASS and have not tried to seek employment in the work goal for which they obtained the required items or services that they identified as being sufficient to make them employable o Are ineligible for SSI benefits for any reason other than excess income or resources o Are under age 15 o Do not have any income or resources to set aside and do not expect to have any o Are unwilling to use set aside funds strictly for the PASS o Do not require any additional goods or services to become employed SI E00870.004 HELPING SET UP A PASS A. POLICY SSA will help an individual develop a PASS. B. PROCEDURE 1. Offer During the PASS discussion described in Assistance SI E00870.003, offer to help the individual develop a plan. Regardless of whether the person accepts your offer to help, give the individual a copy of the publication, "Working While Disabled--A Guide to Plans for Achieving Self-Support While Receiving Supplemental Security Income," referred to as the PASS Handbook (SSA Pub. No. 05-11017). 2. Assistance a. Complete the sample outline in Accepted SI 00870.100, Exhibit 1 when the individual: o is interested and wants help; and o has identified an objective; and o knows how to pursue the objective; or o the FO PASS precedent file contains sufficient information for you to advise the individual how to pursue it. b. Refer the individual to a rehabilitation agency or organization which assists people with disabilities, per SI E00870.005, when the individual: o is interested and wants help; and o cannot identify an objective; or o has identified an objective, but neither you (using the FO precedent PASS file) nor the individual knows how to pursue it. c. Obtain signed release forms, such as Form SSA-8510 to obtain information and Form SSA-3288 located in GN 03305.999 to release information, if an organization other than a State VR agency may be involved. If appropriate, should an SSA-3288 be secured, make sure it provides the individual's consent for SSA to release information for the life of the PASS and not just for a one-time release. NOTE: Do not use Form SSA-1696-U4, Appointment of Representative, as a release form. This form should be used only if the individual wants a third party to represent him/her with regard to every aspect of the person's business with SSA, not just PASS. (See GN 03910.001 ff. for more information about representatives.) 3. Assistance Suggest the following sources of information Declined regarding job requirements/responsibilities to someone who is interested in a PASS but declines your offer to help develop a plan or provide a referral: o Someone already working in the occupation o The local unemployment insurance agency o The Dictionary of Occupational Titles (available at libraries) SI E00870.005 REFERRALS TO OTHER AGENCIES A. POLICY SSA will make referrals to appropriate public or private agencies if an individual needs assistance in developing a plan. B. PROCEDURE-- DEVELOP LISTS OF AGENCIES 1. General Through the networking activities of the work incentive liaison, develop and maintain (with the PASS specialist, regional office (RO) and/or neighboring FO assistance, if helpful) a current list of public and private agencies and organizations in your general area that assist individuals in developing a PASS. List as many groups as possible to ensure that the individual has more than one option. See SI E00870.003B.1. and Combined Federal Campaign (CFC) publications for types and names of possible agencies. 2. Content Make sure that the referral list contains: of List o the name and address of the agency/organization; o the name and telephone number of an agency contact person; o the geographic area the agency services; o whether the agency/organization only serves people with certain disabilities (if known); and o any information as to whether the agency is likely to charge for services, including PASS development charges. (See SI E00870.025C.4.e.) 3. Disclaimer If the list is to be provided to potential PASS candidates, make sure it contains a disclaimer to the effect that: o SSA does not endorse any of the listed agencies; o the list is compiled for the convenience of the public; o an individual is not restricted to the agencies on the list; and o the individual is solely liable for any contract signed with the agency. The disclaimer may read as follows: "For your convenience, we have listed below some agencies and organizations that may help you if you want to work. You are welcome to contact any of them. You may also contact agencies and organizations not on the list. We provide this list for your convenience, but we do not endorse anyone on it. If you sign a contract with an agency, you alone are liable." C. PROCEDURE -- REFERRAL 1. Selecting a. If the individual has had prior contact an Agency with a particular agency, refer the individual to that agency, unless he/she prefers a different agency. If so, follow b. below. b. If the individual has had no prior contact with any agency or does not wish to recontact a particular agency: o provide the individual with a copy of the FO's list of agencies which will help develop a PASS; o ask the individual to select an agency from the list or one of the individual's own choosing; and o advise the individual that the referral does not constitute SSA's endorsement of the agency or its services and that fulfilling any contractual obligations will be the person's, not SSA's, responsibility. 2. Referral a. Refer the individual to the agency using Form SSA-1407-U4 located at DI13501.035, Exhibit 1. Add pertinent information to the remarks section of this form, as necessary. b. If the agency is other than a State VR agency, attach a copy of the signed release form (SSA-3288) as explained in SI E00870.004B.2.c. NOTE: Use of Form SSA-1696-U4 requires the agency to represent the person in every SSA-related matter, not just PASS. (See GN 03910.001 ff. for more information about representatives.) PASS: THE PLAN AND THE EXCLUSIONS SI E00870.006 ELEMENTS OF A PASS A. POLICY -- GENERAL 1. One PASS Per An individual may develop only one PASS per Occupational occupational objective. An individual may Objective resume a suspended PASS under certain conditions (see SI E00870.080). 2. Multiple Plans There is no limit to the number of plans an individual may develop provided each plan involves a different occupational objective. However, only one plan can be in effect at a time. A subsequent plan may not be approved until it has been established that the individual is unable to obtain employment in the prior work goal and, if appropriate, additional development is undertaken to determine that a proposed work goal is feasible. Before a new plan may be considered, a final accounting of the prior plan(s) must be completed per SI E00870.070A.4. (For more information about feasibility, see SI E00870.006D.3.) 3. Aged Aged individuals may exclude income or Individuals resources under a PASS only if they received SSI (or aid under a State plan) on the basis of a disability or blindness for the month before turning age 65. 4. Written The individual's plan must be written and Plan signed by the individual and his/her representative payee. The written plan should include all the documentation set forth in this subchapter. 5. Designed Plans must be tailored to the individual's for the circumstances. Individual NOTE: Although each plan is unique, individuals in similar situations may have similar plans. This is especially true when dealing with organizations which provide services to people with similar disabilities or needs. 6. Additional An individual must: Factors o have income and resources (other than SSI) that can be set aside under a PASS and agree to set aside same; o agree to pursue the goal, comply with the terms of the PASS and use the excluded income/resources only as specified in the plan; o meet the requirements in D. and E. below as appropriate; o be expected to benefit from the PASS per C. below; and o otherwise, be eligible for SSI benefits due to blindness or disability; i.e., after the exclusion of resources and income used to fund the PASS. B. POLICY -- TIME CONSIDERATIONS 1. General Because of a statutory change, the 36/48 month absolute time limits discussed in SI 00870.006B are void as of January 1, 1995. Section 203 of the Social Security Independence and Program Improvements Act of 1994 (PL 103-296) requires that the time limits for PASS take into account "the length of time that an individual needs to achieve his/her employment goal." Until new regulations are implemented, 2. or 3. below apply when anticipated completion dates exceed 36 months (or 48 months when a lengthy educational or training program is involved). 2. New Plans For plans beginning on or after January 1, 1995, the following time considerations must be kept in mind: o The plan should specify anticipated beginning and ending dates. It also must include target dates for reaching milestones within the life of the PASS, steps that reflect the individual's progress toward attainment of the work goal. (See SI E00870.006D.3. below for a discussion of the milestones); and o A PASS can be initially approved by SSA for a period up to 18 months but may be stopped at any time during the life of the the PASS due to the abandonment of, or non-compliance with the plan. (For a discussion of abandonment, see SI E00870.002B.1. See SI 00870.002B.3 for a discussion of compliance). 3. Extensions Upon completion of the initial 18 month period, and until the regulations have been revised, the following time considerations should be used: o An 18 month extension may be granted (for a total of 36 months); o Plans for education or training may be extended for an additional 12 months (for a total of 48 months); o A PASS may be extended beyond 36/48 months in intervals up to 6 months; and o Each extension request must meet the requirements in SI E00870.055 in order to be approved. 4. Applicable a. General Months The applicable months of a PASS need not be consecutive. Only months for which the individual is eligible for SSI benefits count toward the total time. Months for which SSA suspends the PASS (per SI E00870.070), or the individual's benefits are suspended for reasons unrelated to the plan, do not count toward the total time. NOTE: Although no SSI payments are made for months of section 1619(b) eligibility, those months still count toward the life of the PASS unless SSA suspends the plan. Months for which SSA approves a PASS with a goal of "VR Evaluation" (per D.6 below) count towards the total time of the PASS. b. Example FACTS: Mr. Appleby had a PASS approved for the period beginning March 1993 with an expected completion date of February 1996. At a redetermination conducted in January 1996 he requests an extension alleging he can not achieve his goal by the end of February. CONCLUSION: You determine that Mr. Appleby is in compliance with his plan per SI 00870.055. Then, you decide that he needs additional time to complete the plan and that he still requires his income to be excluded to pay for the expenses necessary to achieving his goal. Because this review preceded the PASS specialist review process, you approve his request to continue the PASS for 6 months. Notify him per SI 00870.060 that his PASS will continue to be in effect through August 1996, at which time, if still necessary, SSA will consider another extension. C. POLICY -- SELF-SUPPORT 1. Increased a. General Prospect for Self-Support A PASS must be expected to increase the individual's prospect for self-support as defined in SI E00870.002B.12. It should be designed to enhance a person's earnings potential. Individuals in a supported employment situation also may use a PASS to increase their potential for self-support. Generally, such individuals will do so by decreasing their costs for, and their reliance upon, ongoing supports, such as job coaching or counseling, etc., needed to work. (For a further discussion of how supported employment relates to PASS, see SI E00870.006D.4. and SI E00870.006E.4.) b. Higher Earnings Potential An increase in the prospect for self-support is measured in terms of higher earnings potential upon completion of the PASS. It is expected that it will produce additional earned income to eliminate, or at least significantly reduce SSI payments within a reasonable period of time upon achieving the work goal. Higher earnings potential may exist even if the individual will be working in the same job as before the PASS. For example, the individual may be able to work more hours or reduce excludable work expenses (e.g., job coach costs) as a result of additional training funded under the PASS. c. Entry Level Positions PASS is meant to assist an individual in acquiring those items, services or skills the person needs to be able to compete with able-bodied persons for entry level jobs in a professional, business or trade environment. Generally, a person who has graduated from college or a trade/technical school will be considered to have the capacity to obtain such a position without assistance of a PASS. Except in rare instances, as described below, a PASS designed to seek a position beyond the entry level and, thereby, optimize an individual's earnings potential, will not be approved. For example, generally, a work goal to become a management intern in a business would be given due consideration under a PASS, whereas a goal to secure an executive position in the business would not be approved. EXCEPTION: A PASS that seeks a work goal beyond an entry level position may be approved only if the earnings expected at the entry level position would be insufficient to pay those expenses he/she would incur by working as well as the person's other financial obligations. For example, a person who would have to pay monthly attendant care costs of $1000 and whose only other financial obligations reflect monthly household expenses of $550, would not be restricted to an entry level position if the expected earnings from that position in addition to any other income would yield only $1,500 a month. Consideration would be given to approving a goal beyond the entry level position that, along with any other income, would provide for the person's ongoing expenses. 2. Reaching The individual is considered to have reached the Goal his/her goal under a PASS when: o the individual is working in the job as described in the plan and outstanding debts related to the planned expenditures are not an issue (i.e., no further payments for approved PASS expenses are required). Generally, ongoing payments, such as installment payments, are not an approvable PASS expense. (See SI E00870.006E.3.c. regarding start-up costs); or o the VR agency completes its diagnostic study or evaluation of an individual whose goal was "VR Evaluation" (See D.6 below). D. POLICY -- OCCUPATIONAL OBJECTIVE 1. General A plan must specify an occupational objective, the particular job or profession that the person wants to attain through the PASS. In some circumstances, the individual already may have attained an occupational objective but has a goal of working longer hours or with fewer supports as explained in C. above. To facilitate the evaluation at a later date as to whether the individual has reached the goal per C.2 above, the plan should be as descriptive as possible about the occupational objective. (See 4. below, regarding supported employment programs.) NOTE: Completion of education/training programs or the purchase of transportation are not occupational objectives, although they may be a means to attain an objective. 2. Clear The plan should provide a clear statement Statement which: o identifies the particular job/profession the individual is seeking; and o indicates current earnings, if any, and estimated earnings at completion of the goal; and o if appropriate (e.g., in a supported employment situation), describes and quantifies the level of performance which the individual expects to reach (see 4. below, for more information on supported employment and PASS). 3. Feasibility The occupational objective must be feasible for the individual. To be feasible, the individual need only have a reasonable chance of attaining the work goal upon consideration of the following: o nature of the impairment and limitations imposed by it; o prior work history; o age, education and training; o interval steps (and the corresponding time frame to reach each step) required to attain the work goal; i.e., milestones that demonstrate the person's progress towards achieving the goal. These steps must be described sufficiently so that completion of the steps may be readily discernible and, if appropriate, measurable. For example, in order to become a teacher, generally, a person must in sequence: (1) obtain a high school diploma or equivalency, (2) be accepted at a college, (3) maintain an acceptable grade to ensure his/her continuance at the college, (4) adequately complete the college's student teaching requirements, (5) receive a baccalaureate degree from the college, (6) pass any tests required for teacher certification by the locale(s) where the person intends to teach, (7) apply for a salaried teaching position, (8) begin working as a teacher. While the individual may be required to obtain a masters degree in order to maintain or further his/her teaching career, and/or enable the person to advance in an administrative capacity in the school system, a PASS may not be used to assist the individual since not only would this reflect expenses subsequent to the start-up costs of becoming a teacher, but would also reflect a work goal beyond that of an entry level position; NOTE: If needed to obtain a job, the interval steps must include as a step efforts related to securing employment in the work goal. The job search should be considered when determining the total time needed to complete the PASS; o the adequacy of the income and resources to be set aside to cover the planned expenditures; o the individual's ability to continue to pay for his/her ordinary expenses absent the income and resources set aside under the plan; and o the individual's expectation of realizing the goal during the life of the PASS (for a discussion of this issue, see SI E00870.006B.4.). NOTE: A series of unsuccessful plans may be grounds for questioning whether a reasonable chance exists and obtaining additional supporting documentation. EXAMPLE: An SSI recipient has an occupational goal to open an art gallery. The person estimates that it will cost $20,000. The person has only $300 countable income per month and has no other means to raise the additional monies needed (36 months at $300 a month yields $10,800, leaving a balance of $9,200). If possible, the person should modify the PASS to realize the goal with the available set aside. If no modification is possible, the PASS is not feasible. The person is advised to resubmit the plan if additional funding becomes available. 4. Supported a. An individual's occupational objective Employment in a supported employment program is to work in a job at a certain level of independent performance as described in the plan. The goal may be to achieve stabilization or to reach an even higher level of performance; i.e., the individual wishes to increase earnings potential by working more hours or by reducing the supports (e.g., job coaching) associated with his/her stabilization on the job. b. The plan should specify the anticipated level of performance in terms of the supports required. EXAMPLE: An individual in a supported employment program submits a plan with a goal of "Working as a kitchen aide with only 5 hours of job coaching per week." In this instance, the individual will not reach the goal until the number of job coaching hours is reduced to 5hours per week. The individual must estimate the timeframe for reaching the goal. c. The plan may be amended if subsequently it appears that the individual may be able to perform at a higher level (i.e., more independently) than initially anticipated. 5. Basic Working solely towards the attainment or Living improvement of an individual's basic living Skills skills or homemaking capabilities is not an occupational objective. If the individual is undergoing such training while simultaneously pursuing an occupational objective, and such training is necessary to reach the objective, the training may be approved under a PASS. 6. VR As long as all other requirements are met, a Evaluation PASS may have an occupational objective of "VR Evaluation" in order to cover the costs associated with obtaining the evaluation. The PASS is set up initially to last for the period of time a public or private VR agency performs a diagnostic study or evaluation of the individual in order to determine the appropriate services to offer. Based on feedback from several State VR agencies, it usually takes 3 to 6 months to complete an evaluation. Requests for an evaluation period longer than 6 months period must be justified. NOTE: At the end of the evaluation period, the individual must amend the plan to specify a work goal and reflect expenses and set asides related to this amended goal. Otherwise, the PASS will stop. 7. Self- A plan with a work goal of self-employment employment must include a detailed business plan. Because most new businesses fail within the first couple of years, the review of such a plan may require securing the opinions of one or more knowlegeable third parties as to the feasibility of the business in terms of the person's ability to conduct the business and the likely success of the particular type or nature of the business. Some possible contacts may be the individual's physician, vocational counselors, the Small Business Administration, local Departments of Employment and Training, local Chambers of Commerce, local banks and appropriate staff at local colleges. 8. Business The individual seeking a PASS goal of Plan starting a business must include, as part of his/her PASS, an indepth business plan. If assistance is needed in developing such a plan, the individual may want to contact one or more of the experts identified in 7. above. Although not an exhaustive list, the following identifies some of the items that should be addressed in the business plan: o Business name, address, owner o Business form (sole proprietorship, partnership or incorporation) o Description of the principal activity of the business, including a description of the product and/or service to be provided. In addition, it should include an explanation of the specific objective(s) of the business along with timetables for establishing the business and attaining the stated objective(s) o An explanation of how the business will start. For example, whether it will be a new start-up, or the purchase of an existing business or a franchise o An explanation as to why this business should succeed. This may include anything unique about the business, or the individual's background in this area o A description as to who or what is the market for the business as well as the size and geographic location of that market o A description of the mechanism for pricing the product and/or service o A description of the advertising plan to reach the market and sell the product and/or service o A list of any employees and managers and their functions in the business, including any particular qualifications of these individuals which may contribute towards the likely success of the business o A description of the financial plan, including anticipated expenses (e.g., payroll, supplies, equipment, taxes, utilities, insurance) and anticipated revenue (e.g., sales, other funding sources), especially those items not otherwise accounted for under the PASS. This should include a profit and loss projection for the business for the duration of the PASS and at least one year beyond its completion E. POLICY -- SAVINGS/ SPENDING PLAN 1. Plan The plan must indicate: Contents o What money and other resources the individual has and/or will receive and which will be set aside; o What expenses for goods or services the individual will incur in order to attain the work goal; o How the goods and services are necessary to the individual attaining the occupational objective unless apparent from the item's nature. In addition, when the goods and services will be used in relation to the stated milestones; o How the individual will disburse (i.e., pay expenses monthly or save for future payment) the set-aside income/resources; and o How the individual will keep the set aside income/resources identifiable from other funds. 2. Expenses Only PASS expenses for which the individual Paid by or deemor must pay or set aside Individual income/resources may be used to exclude the individual's countable income and resources. Goods or services which the individual can obtain at no cost (e.g., medical expenses covered by Medicaid) cannot be included under a PASS. Money paid or set aside by a deemor for a PASS expense is deducted from the eligible individual's net income after deeming. (See SI 01320.140 and SI01320.710A. regarding deeming and the example in SI E00870.025C.3.c.) 3. Expenses a. General Allowable expenses must be necessary to attaining the work goal and of reasonable cost. The expenses must be in addition to any expenses currently incurred by the person. Furthermore, the expenses must reflect start-up costs. SI E00870.025C.4.g. contains examples of common types of expenses which SSA may allow under a PASS if they meet these criteria. b. Additional Expenses To qualify as "additional", an expense may not be one in existence prior to the beginning of the PASS (e.g., car payments being made prior to pursuit of a work goal). In effect, a PASS should be used only for those expenses, related to a work goal, which the individual otherwise could not afford and would not incur absent the PASS. NOTE: If an expense can not be allowed under a PASS because it existed prior to initiation of the PASS, it may be counted as an IRWE/BWE, if appropriate, during the life of the PASS. c. Start-Up Costs PASS is just the means to acquire the services and items needed for starting work, not the means to make income or resources available for ongoing costs. Start-up costs reflect the costs required to obtain the needed goods or services to enable the person to start the job or to start the business. For some expenses, the start-up cost may reflect just the downpayment on the item. Generally, installment payments would not be considered as part of the start-up costs. The down payment should be sufficient to leave the person with a balance that is manageable given his/her finances. If no ongoing payment would prove financially manageable, the down payment may reflect the full cost of the goods or service. NOTE: One type of expense that may no longer be approved as it does not meet the criteria of a start-up cost is a fee for monitoring a PASS. (See SI E00870.025C.4.e. for a further discussion of the treatment of PASS monitoring fees.) d. Necessary and Reasonable Only those expenses an individual needs to get started in a business or on a job will be considered necessary. In addition to explaining the necessity of the item, a plan under which an item of unusual value is to be purchased, must include a satisfactory justification as to why less expensive alternatives, such as renting or leasing, will not suffice. (See e. and f. below, respectively, if a computer or vehicle is involved.) An item or service must be reasonably priced. The cost must be moderate or fair and not extreme or excessive within the geographic location. e. Computers To meet the requirements in a.- d. above, the plan must reflect the individual's views regarding the merits of the particular computer model and/or peripherals sought; i.e., the individual's particular needs that are expected to be served by that model's hardware and software applications and why less expensive models will not meet their needs. Rentals and leasing should be considered as less expensive alternatives. f. Vehicles To meet the requirements in a.- d. above, the plan must document the individual's views as to why an alternate means of transportation (e.g., public transportation, cab, etc.) will not meet his/her needs. For example, alternate means of transportation may not be: o feasible given the nature of his/her disability and activity (e.g., a person who uses a wheelchair probably cannot use a bus or a cab unless the wheelchair can be accommodated); o available at the times and locations needed; o safely accessible to the person; or o reliable. In addition, the plan must include an explanation as to why the individual views the purchase of the particular vehicle identified in the plan as necessary or appropriate. This explanation should provide a rationale for why purchasing a vehicle would be the least costly alternative and, if appropriate, why purchasing a "new" rather than "used" vehicle is necessary. Also, the plan must explain why buying a vehicle is more appropriate than repairing one currently owned. NOTE: A sports car or luxury car would never be found to be necessary or appropriate for a PASS. If purchasing a vehicle proves to be the least costly alternative, or only alternative, the allowable PASS expenses may include only the amount of a downpayment. The downpayment should reflect an amount that will yield affordable monthly installment payments for the balance. The installments may not be allowed as a PASS expense. Other start-up costs may include registration and licensing fees, insurance and fuel and maintenance costs until the individual is working in the position or business stated as the work goal. Actual costs for insurance, fuel and maintenance may be used, or you may compute them using the mileage as noted in SI E00870.025C.4.g. Costs subsequent to the start-up period, such as ongoing maintenance costs, may not be approved. Also, the relevance and the amount to be excluded for a vehicle may be deferred until such time during the course of the PASS that the individual demonstrates a readiness for the vehicle. (See 4. below for a discussion of deferred expenses.) g. Job Coaches To meet the requirements of a.- d. above, only the cost of actual job coaching services may be allowable as job coach expenses (i.e., any assistance provided the individual relating to completing the tasks required by the job; not, attendant care or other services performed by the job coach). A knowledgable source, such as VR or the employer, may be contacted to verify the necessity for job coaching services as well as the individual's chances of reducing the hours of the job coaching services within a reasonable period of time. Generally, the reasonable charge for these services will reflect the amount the local State VR pays for similiar services. 4. Deferred Not all of the requested expenses may be Expenses allowed at the beginning of the PASS. In some cases, approval of certain goods and services may be contingent on the successful completion of milestones on which the need of the expenses is predicated. No expense will be approved subsequently unless the milestone upon which the expense depends is successfully completed. EXAMPLE: Joe is 40 years old and has been on SSI since early 1992 after he had a heart attack. He quit high school in the 10th grade and was working as a laborer when his illness began. He wants to begin a food delivery service. He submits a detailed business plan with his PASS. His business would involve the delivery of carry out orders to customers from restaurants within a 10 mile radius of his home. Joe has already lined up 4 of the 9 restaurants in his area. Joe is requesting a PASS to exclude his title II disability benefit of $350 a month to pay for the expenses related to obtaining the required commercial driver's license, a van for the deliveries, and advertisement of his delivery service. Joe expects to begin his business in July 1996 and believes that the business can be viable by January 1998. He plans to begin driver's education classes in February and to obtain his license by May 1996. Joe's vocational rehabilitation counselor in conjunction with his doctor has provided documentation stating that this is an attainable goal for Joe. Contact with the local Chamber of Commerce reveals that this type of business has the potential to succeed in the community. Since it appears that the goal is feasible and no CDR is scheduled, the PASS is approved. However, only income sufficient to pay for the expenses related to obtaining the driver's license is excluded as of February 1996. The plan is diaried for May 1996 to see if Joe has acquired a commercial driver's license. At that time, consideration will be given to any advertisement needs as well as to the most cost effective means of obtaining a delivery vehicle; i.e., whether a downpayment on a purchase or lease agreement is the least expensive alternative. 5. Extended The level of performance specified as the or Follow- occupational objective in the plan is a Along factor in determining whether expenses may Services be allowable under a PASS. Expenses incurred in order to attain the work goal are allowable under a PASS even if they are still being paid after the job is being performed. Although extended or follow-along services, generally, would not be allowable under a PASS, they may qualify under a PASS per C. above, if the individual is seeking to increase his/her potential for self-support either by increasing the hours of work, or by decreasing his/her costs for, and reliance upon, ongoing supports needed for work. (See SI E00870.002B.3. for a definition of extended or follow-along services and SI E00870.002B.9. for a definition of stabilization. Also, see D.4 above for a further discussion of how supported employment relates to PASS.) 6. Non- No expenditures will be approved that: Approvable Expenditures o will not be paid by the income or resources being set aside (e.g., items paid for by a VR agency); or o were in existence prior to initiation of the PASS goal; or o were purchased under a prior PASS unless a satisfactory justification is provided (e.g., an individual was unable to complete certain college courses paid for under a prior PASS due to a relapse of his/her illness); or o have already been used to reduce countable income/resources. For example, that part of the cost of an item that is used as a business expense when determining net earnings from self- employment (see SI00820.200 ff.) cannot be used as a PASS expense. Expenses incurred after attaining the goal may qualify as blind work expenses (BWE) or impairment-related work expenses (IRWE) but, normally, will not be covered by a PASS, unless they were approved as part of the PASS and are still being paid when the job is being performed. (See SI E00870.010B. for a brief discussion about BWE and IRWE.) 7. Expenditures Disbursements for goods and services Timetable ordinarily should be made as soon as possible so that the person can begin the steps designed to reach the work goal. If no disbursements are planned during the first 6 months of the PASS, compliance reviews are required every 6 months to ensure that the person's intention to pursue the goal does not change and to verify accrued savings. SI E00870.007 WHEN TO START A PASS A. POLICY A PASS can be made effective with any month of eligibility for SSI or any month of potential eligibility assuming approval of the PASS, subject to the rules of administrative finality in SI 04070.001 ff. B. PROCEDURE 1. Starting Use the month that SSA receives the plan as Month the starting month for the PASS unless another month applies per 2. or 3. below. 2. Retro- Subject to the rules of administrative activity finality, start a PASS with the actual month the individual began pursuing the work goal (i.e., saving, incurring expenses, or working) or any subsequent month. 3. Future Start a PASS in a future month provided Month that: o it is more advantageous to the individual (e.g., using the month SSA receives the plan as the starting month would provide the person with a lower SSI payment than expected due to proration); or o the individual requests it; and o the system is able to accept the future month. NOTE: When no expenditures will be made until some future date 6 months or more in the future, it is more likely that the individual's situation may change. A compliance review must be conducted every 6 months until spending begins. 4. RMA Use up to 2 months prior to the starting Adjustment month to accommodate the retrospective monthly accounting (RMA) cycle for individuals already eligible for SSI, regardless of whether the individual has already saved money or incurred expenses, when: o the exclusion of income under the PASS would not increase the SSI payment amount for 1 or 2 months due to RMA; and o it appears that the individual may need this early exclusion to increase the SSI payment in order to provide a source of funds to set aside for the PASS. EXAMPLE: Martha Franklin, an SSI recipient, submits a PASS in July 1994. She has been working in a sheltered workshop but has an opportunity to begin working in a supported employment setting beginning in August 1994 if she has the additional funds to begin paying her job coach. She proposes to set aside funds from her title II income to do this. Recognizing that she needs the increased SSI before she can afford to pay the job coach, input the PASS exclusion as of June 1994, so that the August 1994 SSI payment will reflect the increase. SI E00870.008 EXCLUSIONS UNDER A PASS A. POLICY 1. General Income and resources set aside under an approved PASS are excluded from countable income and countable resources as long as the plan is in effect and the person is in compliance. See SI E00870.050B.3. for a discussion of how an amendment to a plan may affect excluded income/resources. See SI E00870.070 for a discussion about counting excluded income/resources when a plan is suspended or terminated. 2. Set Aside Income and resources are set aside when they are used to pay for an expense, including expenses already incurred (see SI E00870.007B.2.), or when they are saved for a future expense. Any set aside monies must be identifiable from other funds, particularly, when funds are being conserved for a future use. (See SI 01130.700 for a discussion about commingled funds.) 3. Income a. Income may not be set aside under a PASS if resources to be set aside exceed the planned expenditures. b. Earned and unearned income, including any income deemed to the individual or any in-kind support and maintenance valued under the presumed maximum value (PMV) rule, is excluded under an approved PASS when the income is set aside for planned expenditures. (See SI 00835.300 for information about the PMV and SI 01320.140 when deemed income is involved.) EXCEPTION: The PASS income exclusion cannot be used to reduce the value of the one-third reduction (VTR). 4. Resources Resources owned by the individual or deemed to the individual are excluded when they are set aside for planned expenditures or to be used directly in the job (e.g., equipment). B. PROCEDURE 1. Resources Apply the PASS resource exclusion if the item cannot be otherwise excluded. 2. Income Apply the PASS income exclusion last, per the specified order of exclusions in SI 00820.500 (earned income) and in SI 00830.050 (unearned income). Apply the exclusion against unearned income first with any remaining PASS exclusion applied to earned income. C. REFERENCES o Earned Income Exclusions, SI 00820.500 ff. o Unearned Income Exclusions, SI 00830.001 ff o Resource Exclusions, SI 01130.510 o Systems Input of PASS Exclusion, SM 01005.170 for initial claims and SM 01305.105 for posteligibility situations SI E00870.010 RELATED WORK INCENTIVE POLICIES A. INTRODUCTION PASS is part of a comprehensive work incentive "package." This section discusses the interrelationship of other SSI work incentive provisions with PASS. B. POLICY 1. Impairment- a. The impairment-related work expense Related (IRWE) provision allows for the and Blind exclusion of earned income used to pay Work for work expenses incurred because of Expenses the person's disability. (See SI 00820.540 for more information on IRWE.) b. The blind work expense (BWE) provision allows a blind individual to exclude earnings used to pay for work related expenses (i.e., not necessarily incurred because of the individual's blindness). (See SI00820.535 for more information on BWE.) c. Unlike PASS, neither IRWE nor BWE have a time limit. d. Unlike PASS, neither IRWE nor BWE may be used to reduce countable unearned income or resources. e. Income used to pay for a particular work-related item may not be excluded from countable income under a PASS and under the IRWE or BWE provisions simultaneously. An expense excludable under a PASS for countable income purposes may also be excludable as an IRWE for an SGA determination since these are separate determinations. f. When both PASS and IRWE or BWE apply, use the exclusion most advantageous to the individual. 2. Property a. The property essential to self-support Essential (PESS) provision provides for the total Self- or partial to exclusion of property Support needed for self-support under certain conditions. (See SI01130.500 ff. for more information on PESS.) b. Unlike PASS, the PESS provision has no time limits. 3. Section 1619 Earned income set aside under a PASS is deducted from gross earnings when performing a 1619(a) payment computation or an individualized 1619(b) threshold calculation. (See SI 02302.001 ff. for more information about section 1619.) 4. Substantial a. SGA provisions do not affect or limit Gainful the applicability of the PASS exclusions Activity in any way. EXCEPTION: In an initial claim, a determination that SGA is being performed precludes the need for a PASS determination, since the person would not meet the disability criteria for eligibility. b. The PASS income exclusion is not applied when determining gross earnings for SGA. (See 1.e, above regarding the impact of IRWE on SGA.) IMPLEMENTING AND MAINTAINING A PASS SI E00870.020 ADJUDICATIVE ACTIONS WHEN PASS DEVELOPMENT IS PENDING 1. Individual Do not document the discussion. Declines to Pursue a PASS 2. Individual Assist the individual in developing a PASS Decides to per SI E00870.004. Pursue a PASS If the individual submits a plan review it as quickly as possible per SI E00870.006 and SI E00870.025. If the individual does not submit a plan, make reasonable efforts to contact the individual. If you conclude that further attempts would be futile, discontinue them. Retain in the FO (or in the file if it is in the FO) an RC documenting the results of all followup attempts and why no further attempts will be made. If the person is not receiving SSI and has not applied, send an SSA-L991-U3 per SI 00601.040. If an initial claim is pending which can only be approved if the PASS is allowed, deny the claim and, if appropriate, notify the Disability Determination Services to curtail medical development. SI E00870.025 DOCUMENTING AND REVIEWING A PASS A. PROCESS Once an individual submits a plan for approval, SSA reviews it so that the plan can be approved (with or without modification) or disapproved. B. PROCEDURE -- Develop PASS cases as follows: GENERAL Step Action 1 Begin the review as soon as possible. A delay may result in loss of a job or training opportunity for the individual. Make sure the necessary release forms have been obtained per SI E00870.004B.2.c. Follow C.2.e. below, before proceeding further when the individual has completed a prior PASS. Use the checklist in SI E00870.100, Exhibit 1, to assist with the review and decision making process. 2 Discuss the plan (by phone or in person) with the recipient or representative payee to ensure that he/she understands the purpose of the PASS and his/her responsibilities (including compliance with the PASS terms and saving receipts/cancelled checks). If the person agrees to comply, go to step 3; if the person states that he/she does not intend to pursue the work goal or otherwise comply with the PASS or is no longer interested in the PASS, document the file on an RC or SSA-795, go to step 5. NOTE: The fact that an individual has an authorized representative, does not eliminate this step. However, the representative has a right to be present during the discussion. 3 Determine if all elements of a PASS are properly addressed per SI E00870.006 and C. below. 4 If a modification is needed, follow the instructions in SI E00870.030 before proceeding with the next step. 5 Forward the PASS and all related documentation to the cadre of PASS specialists for review when all development is complete. If the reviewer requests additional as soon as possible. The reviewer will advise the FO as to his/her determination. o If the reviewer approves the PASS, go to step 6 o If the reviewer disapproves the PASS, go to step 10 6 Determine the starting month per SI E00870.007 if the specialist has not provided the starting month in the determination. 7 Compute the income and/or resource exclusion, if the specialist has not provided this information in the determination, as follows: o Determine the total estimated expenditure under the plan; o Subtract the portion of this estimated total to be paid with the resources already accumulated for this purpose; NOTE: It is not necessary for an individual to set aside all of his/her existing resources under the PASS. However, the remaining countable resources must be below the resource limit. o Determine the remaining expenditures which will be paid with the income set aside under the PASS. Determine the amount of income exclusion for the life of the PASS that is most advantageous to the individual considering scheduling of planned expenditures, expected levels of countable income (including title II cost-of-living adjustments (COLA), interest on excluded resources, etc.) and fluctuations in income (seasonal or otherwise); and NOTE: If title II disability benefits are to be set aside, check the trial work period on the MBR. You may need to estimate when the title II benefit may cease due to a finding of SGA when determining the above computations. In addition, be sensitive to the need to amend plans per SI E00870.050 to reflect changes in income (including COLAs) and expenditures. o Determine the highest amount of excluded resources expected to accumulate in any month under the plan by the first diary date. This is the resource amount to be excluded under the plan until the plan is amended, extended, reviewed, terminated, or completed. 8 Input the amount of income (earned and unearned) to be excluded as determined in step 6 as type "D" in the earned income field. (See SM 01005.170, SM 01305.105, and SM 01301.820 for input instructions.) NOTE: Because the system does not record PASSes that are denied or approved with only resources excluded, input zeroes for the "D" amount for these cases to record them on the system. When denying a PASS, input zeroes as the amount of type "D" in the earned income field only for the month in which the denial notice is dated. For PASSes excluding only resources, input zeroes for the "D" amount as a continuing rate. 9 Diary the case using the "SU" diary code as explained in SM 01301.230 for a compliance review per the PASS specialist, or in the abscence of this information or the EXCEPTION below, as of the earliest of the following: o The end of the evaluation period when the PASS objective is a "VR Evaluation;" o The month before the scheduled month of expected attainment of the occupational objective; o In six months if the individual does not plan to disburse any funds within the first 6 months of the PASS to ensure that the person still intends to pursue the objective and to confirm accrued savings; o The 12th month of the plan; or o Another month that you believe is appropriate. NOTE: As of fiscal year (FY) 1995, PASS cases have been selected for redeterminations in the month the SU diary matures. See SI 02305.012 for more information about these PASS profile redeterminations. EXCEPTION: Diary cases that involve self-employment for the period between May and December so that the individual can submit his/her tax return for the prior year provided the business was in existence the prior calendar year. Otherwise follow the above. 10 Send a manual approval or disapproval notice as per the decision made by the PASS specialist and the instructions in SI E00870.040. If the PASS specialist approves the PASS, enclose a PASS Expenditure/Savings Record (SI 00870.100 Exhibit 7) and an SSI recordkeeper folder ("Your Supplemental Security Income (SSI) Folder," SI 00604.110 ff.) for the individual's use unless you know one was previously provided. C. PROCEDURE -- SPECIAL CONSIDERATIONS 1. Review a. Approach to Review Objectives Due to the highly subjective and often complex nature of what constitutes self-support, follow a common sense approach when evaluating written plans. Resolve issues to the reviewer's satisfaction. While you are encouraged to use your judgment to determine the nature and extent of necessary file documentation, the Commissioner has given the cadre of PASS specialists the decision-making authority. Remember, these instructions reflect minimal developmental and documentation requirements. Consult with your WIL, RO staff, or PASS specialist, if known, as warranted. b. Evaluation of Prospect for Self-Support Decide whether attainment of the work goal may increase the individual's prospect for self-support per the instructions in SI E00870.006C., since this is the fundamental purpose for a PASS. If not, follow the instructions in SI E00870.030 for modifying the plan, as appropriate. If modification is not appropriate, go to SI E00870.025B. step 5. 2. Feasibility a. Feasibility Assumed of Occupational Absent evidence to the contrary, assume Objective that an occupational objective is feasible if the goal is "VR Evaluation" or if the PASS was prepared by: o a State VR counselor; o an individual (e.g., public or private vocational counselor, case manager, or social worker) who is licensed/certified by a government agency, or certified by the Commission on Rehabilitation Counselor Certification (CRCC) or Certification of Insurance Rehabilitation Specialists Commission (CIRSC); o an individual acting on behalf of an agency which has been certified by the above or accredited by an appropriate but unrelated local or nationally recognized organization, such as the American Association for Counseling and Development or the National Rehabilitation Association. If not obvious, ask the preparer to submit evidence of his/her credentials or those of the organization for which he/she works. Consider keeping a copy with other FO precedents. Remember, not every PASS preparer has the credentials enumerated above. In such cases, proceed with 2.c. below. If PASSes written by a preparer with the above credentials have proven problematic or the PASS specialist requests additional development, disregard the assumption and follow 2.c. below. b. Evaluation of Feasibility If the assumption in 2.a. above, does not apply, document the feasibility of the occupational objective based on: o your review of medical evidence available in the FO, or the diagnostic code appearing on the SSR or the MBR; o other disability-related factors; i.e., limitations imposed by the impairment; o your review of the prior work history, education and training; o the relationship of interval steps (milestones) to attainment of the work goal, including target dates for attaining each milestone. Advise the individual that the steps and the dates for their completion should reflect the person's or their PASS preparer's best estimate as they will be held accountable for their timely completion; o the individual's familiarity with the requirements and duties of the proposed occupation; o the individual's meeting the criteria of an unlikely candidate for PASS in SI E00870.003B.2; or o the determination of the PASS specialist. Follow c. below, if: o you question the feasibility of the occupational objective based on the above; or o the prior objective was similar in nature to the current goal; or o the individual has had two or more unsuccessful plans; or o the PASS specialist requires additional development. c. Feasibility is Questionable Follow the PASS specialist's specific directions for resolving this issue. If no specific instruction is provided or you are questioning the feasibility prior to the specialist's review, obtain some corroboration from an authoritative source when one of the conditions in 2.b. above applies and you do not apply the assumption in 2.a. above. Use a different authoritative source than the one involved in the writing of the PASS if you decide not to apply the assumption in 2.a. above. Proceed as follows: o If the individual has ever been involved with a rehabilitation agency, with the person's permission, contact the agency regarding the feasibility of the individual's goal. o If no rehabilitation agency has been involved, or the above contact has proven uneventful, contact the local VR agency or available authoritative source (e.g., a therapist or the individual's physician) and request an evaluation of the feasibility of the occupational objective. Document the file with an RC. NOTE: If the authoritative source will not cooperate without payment, the cost for this "second opinion" may be included as an additional PASS expense, provided the individual consents to this arrangement and the PASS is approved. Discuss with the PASS specialist other possible means for payment. If these attempts are unsuccessful or you still question the feasibility of the goal, refer the individual to the State VR agency for an evaluation. d. Questionable Goal EXAMPLE: An SSI recipient submits a plan to become a heating and air conditioning repair technician. The plan involves taking one of the training courses advertised on television. Based on your review of medical evidence obtained as a result of a recent continuing disability review, you question the person's chances of attaining such a goal. Because the assumption in a. above does not apply and you cannot determine if the goal is feasible, you contact the individual's personal physician. The doctor states that he believes the person has a chance to accomplish his goal. You document the file. e. Prior PASS Advise an individual, who has previously completed a PASS, that a new PASS may not be approved unless the individual explains to the satisfaction of the PASS specialist why he/she is not working in that occupational objective and why a new PASS is needed. Unless the person can provide a satisfactory explanation (e.g., the individual's condition has deteriorated to the point that the prior occupational objective is longer appropriate for him/her), advise the individual that he/she must try to seek work in the prior work goal before the new PASS can be reviewed. If the person refuses, advise them that the new PASS will be denied. If the person does not comply or respond within a reasonable period of time, forward the case to the specialist per SI E00870.025B. step 5. 3. Evaluation a. General of Time Table Make sure the plan specifies when: o all PASS activities began or will begin; o each milestone that marks the person's progression towards the work goal; and o the plan should be completed (i.e., when the person expects to reach the goal). b. Assessment of Timetable Check to see when the work goal and the disbursements are expected to be completed. If the planned expenditures are not scheduled to begin within the first 6months, obtain an explanation as to why there will be such a delay in the active pursuit of the goal, unless it is obvious from the information provided by the plan (e.g., the individual needs to save for a down payment on equipment). If not obvious, ask the individual to submit any readily available documentation to support the allegation. Based on this evidence, decide whether the individual's proposed timetable is acceptable. See Step 8 in B above regarding the need for a compliance review in 6 months. If the timetable is not acceptable, follow the instructions for modifying a plan in SI E00870.030. c. EXAMPLE: Acceptable Alternate Timetable FACTS: John Myers is a 16-year old high school 11th grader who receives SSI. He wants to become a computer programmer. Upon completion of high school, he plans to enroll in a 2-year computer programming course at a local community college. His parents are his only source of income. He submits a letter from his school career counselor which indicates that the counselor believes that John upon graduation from high school will have the capability to handle a college curriculum. CONCLUSION: You help John set up a PASS under which he can save money for his college tuition and the purchase of a computer after his graduation from high school. (John is eligible for a 48 month PASS because there is a lengthy educational program involved: completion of high school and the two year college program.) Under this PASS, his parents will set aside money in a separate bank account to save for John's expenses during college. The amount that is set aside is deducted from John's net income. After deeming stops, John's parents intend to give the money directly to John and have him deposit it directly into the account set up to pay for his college expenses. John expects to begin disbursing his set aside funds throughout his college career, beginning with his first semester. Because John may change his college plans and the disbursement timetable will likely extend beyond the PASS, this PASS must be monitored closely. Schedule compliance reviews every 6 months until disbursements begin. 4. Evaluation a. General of Planned Expenditures Make sure the plan contains the following: o Identity and, if necessary, a description of the items (broad categories or groupings as listed in g. below are sufficient); o An estimate of the cost for each item (If the estimate appears unreasonable, obtain verification of the estimate. See d. below); o An explanation of an item's connection to the occupational objective unless apparent from the item's nature. NOTE: Except as discussed in SI E00870.006E.6., it is immaterial what other use or benefit the individual may gain from the item once it is obtained. Neither is the taxable or tax deductible status of any planned expenditure under Federal, State or local law material to PASS. o An indication of the individual's ability to pay for an expenditure with the proposed set-aside income and resources in addition to paying for his/her ordinary living expenses with any remaining income and resources. Documenting the individual's ordinary living expenses on an SSA-8006-F4 or the SSA-8011-F3 may be helpful. (See SI 00835.600 and SI 00835.625 respectively.) NOTE: Because forms SSA-8006-F4 and SSA-8011-F3 reflect a limited definition of shelter under the in-kind support and maintenance rules, the person's daily expenses may involve additional items not listed. o Only the portion of an expense necessary for starting a business or getting the person started in the job, not the continuing costs beyond that start-up point. The continuing costs may be considered as a PASS expense only if there is an issue of meeting ordinary living expenses with income and resources available after the amount excluded for PASS expenses. EXAMPLE: In August 1996, a State VR counselor working with an SSI recipient, who is blind and receives a private insurance benefit of $425 a month, contacts you about setting up a PASS for the individual. The individual plans to start a candy store. He expects to open the store in December 1996. The individual will need the following to reach his work goal of owning a candy store: initial stock of candy and counter supplies valued at $15,000; candy supply orders thereafter at $1,000 per month; liability and fire and theft insurance for $350 per year which must be paid before the store opens; an charge of $150 for utilities plus an anticipated monthly utility cost of $125; and rent at $250 a month, with two months plus a month's rent as a security deposit due before the store can open. The counselor states that the State VR will provide the initial supplies. The individual will be looking to his PASS to provide for the rest. You advise him that the PASS may only be used to help him with his start-up costs. Thus, the PASS may help him pay for the following: the first year's insurance which is required to open the store, the inital 3-months payment of rent, and the initial utility charge of $150. The PASS should not be expected to help the individual pay for restocking the store at $1,000 a month or the ongoing utility bills at $125 a month. b. Relation of Expenses to Work Goal The PASS specialist determines whether each of the planned expenditures are necessary to achieve the goal. Only those that represent an additional expense as explained in SI E00870.006E.3.b. should be allowed. Defer decisions on planned expenditures until such time that the person has achieved the milestone which will permit or require use of the item or service. For example, for someone who intends to become a computer programmer, the issue of purchasing a computer need not be addressed until the person successfully completes training which amply demonstrates to your satisfaction his/her aptitude for working with computers. Follow c. below, if you question the connection of a good or service to the goal. Develop per d. below, the reasonableness of the cost. c. Questionable Connection of Expense to Work Goal Be mindful of the anticipated results/usefulness of a good/service when developing for its acceptability under the plan. If a provider/agency is involved, contact this third party for an explanation. Document the file regarding the contact. If no provider is involved, obtain an explanation from the individual along with any available related documentation. d. Reasonableness of Cost Help the specialist determine whether the cost of an item is reasonable by documenting the file as to whether a less expensive alternative would satisfy the individual's needs. If no alternative is practical, check the FO PASS file described in D. below for precedents. If the cost is comparable, accept the estimate and document the file. If the cost is excessive by comparison, or you can find no similar item determine the current market value (CMV) of the item per SI 01110.400. Charges for services must be based on the actual time spent on the individual's case. Accept a flat fee only if used as an estimate for future services. For allowable services provided prior to the submission of the PASS, obtain a signed statement from the individual (e.g., SSA-795 or a statement on the PASS) confirming the services received. If the individual has already paid for these services, obtain proof of the payment. Follow e. below when one of the services involves the preparation of the plan by a third party. Accept only charges for time units related to the PASS for goods rented, leased or purchased by the hour, day, etc., unless: o the charge reflects a minimum rental/purchase period; or o a longer period is more economical/feasible than frequent use of shorter periods. EXAMPLE: An individual who runs a cleaning service for several area banks needs to use a floor buffer two days per month. The daily rental rate is $40. Therefore, the annual rental would be $960. However, he/she can purchase the buffer for $600. You may allow either the purchase cost as it is more economical than renting the buffer periodically or the rental cost if the recipient does not have sufficient funds to purchase or wishes to rent until he/she is better established. e. PASS Preparation Fees In conjunction with d. above, document the file as to whether the fee (or some portion of it) is reasonable by considering the overall involvement the agency had in the formulation of the plan; i.e., the type of work involved (aptitude testing, counseling, etc.), the number of hours dedicated to the individual and any other pertinent items factored into the fee. NOTE: Beginning with initial PASS requests reviewed by the cadre of specialists, charges by third parties for monitoring PASS compliance will no longer be an allowable PASS expense. SSA is now able to provide the same