Supporting Patients Getting Back to Health and Back to Work
Having a job or career is important to many people with end-stage renal disease (ESRD). Working can provide a sense of value to an individual, income, and purpose to support their family. Qsource ESRD Networks 10 and 12 work with the Centers for Medicare & Medicaid Services (CMS) to support gainful employment for ESRD patients.

We do this by:
  • Providing technical assistance to dialysis facility staff, including the social worker, on ways to educate and encourage patients to return to work or school
  • Sharing both patient and staff education resources on topics including:
  • What is Vocational Rehabilitation?
  • How do I work with an Employment Network?
  • How do I screen and refer patients if they are interested in returning to work or school?
  • How do I document patient status updates in CROWNWeb?
  • Partnering with Employment Networks who are industry leaders in helping individuals with disabilities return to work

Dialysis patients can return to work, maintain their dialysis schedule, and live a full and healthy life by picking the best options for their lifestyle. 
Vocational Rehabilitation Screening at Dialysis Facilities
The Conditions for Coverage for ESRD Facilities provides guidance on how dialysis facilities are to support patients to achieve an appropriate level of productive activity. Productive activity includes evaluation for referral to services, as appropriate for older youth and adult patients who desire to return to work and/or improve independent living. All patients age 18-64 should be screened for interest and provided education on vocational rehabilitation and employment network services. The social worker should have available up-to-date community referral options for services and should make referrals in partnership with the patient. 
What is Ticket to Work?
Ticket to Work is a voluntary work incentive program offered by the Social Security Administration to those receiving Social Security Disability (SSI or SSDI) benefits. Ticket to Work is intended to remove barriers that keep Social Security Disability recipients from attempting to return to work, such as fear of losing health care coverage or being unable to resume benefits if a job does not work out. The goal of the program is to help Social Security Disability recipients who wish to return to the workforce. The Ticket to Work program makes it possible for individuals to test their ability to work without losing their benefits.
Myths vs. Facts Patients Should Know About Returning to Work 
Myths
If I try to go to work, I will lose my Medicare or Medicaid.

If I use my Ticket to go to work, SSA will conduct a medical review and I will lose my benefits.

If my checks stop because I go to work and then I have to stop working because of my disability, I will have to reapply for benefits all over again.
Facts
Beneficiaries do not have to choose between work and benefits.​

It is possible to receive disability benefits again if they are lost due​ to employment.

It is possible to work and keep Medicaid and/or Medicare.​

It is possible to work and come out ahead financially even if public​ benefits are reduced or even ceased.​
What is an Employment Network?  

Employment Networks are a part of Social Security Administration’s (SSA) Ticket to Work program. An Employment Network (EN) is a private organization or public agency (including a State Vocational Rehabilitation agency) which provides employment services, vocational rehabilitation services, and other types of support to beneficiaries with disabilities under the Ticket program. Once you are assigned a Ticket, you can work with an Employment Network to receive needed services and support for returning to work, training for a new job, etc. 
WISE Webinars
The Social Security Administration hosts monthly Work Incentive Seminar Event (WISE) webinars to provide education about the Ticket to Work program and work incentives for people who are age 18 through 64 and receive Social Security Disability benefits. WISE webinars are typically held on the fourth Wednesday of each month.
Meet the Employment Networks Ready to Support Kidney Patients 
This document shares some of the many resources out there for your patients to consider. These organizations have partnered with us to assist you in getting your patients the services they need. Please feel free to reach out to any or all of them as some are regional but many are national. Read the descriptions to find out more.

Patient Stories: Working While on Dialysis
Listen as members of the Network 10 Patient Advisory Council speak with fellow PAC member Quin Taylor about working while on dialysis.

Clarissa Zetina was on dialysis for 15 years before she received a kidney transplant. She is now 4 years post-transplant. While she was on dialysis she earned her degree in Business Management and Accounting, attending school full time and working part time, at the same time juggling the complications of being a dialysis patient.

Samuel Hayes is a Peritoneal Dialysis patient from Champaign, IL who currently works full time. He credits is his success to his family, especially his wife who has been by his side to support him in his journey. He has been able to continue his work throughout his journey with dialysis.
The Network 12 Patient Advisory Council developed Conversations on Demand – live conversations with patient subject matter experts around their journey to returning to work. Listen here.

Hear from Bethany Stevenson, MSSW, LMSW, LCSW a Renal Social Worker as she shares why vocational rehabilitation is important for patients and a great story from her patient Charles on his journey with Vocational Rehabilitation. Listen Here.
Share these Videos With Your Patients

Different people learn in different ways. For those visual learners, here are some videos that you can share with your patients or to your social media sites.


Highlights the benefits of Vocational Rehabilitation for dialysis patients.


Walks you through how to implement a Vocational Rehabilitation Program in your clinic.

A great training tool for new staff when they are approaching patients about going back to work.
Tools to Use at Your Dialysis Facility
It is important for dialysis facilities to have resources available to share with patients and staff on the benefits of returning to work. Use these resources at your facility as conversation starters with patients, to create a bulletin board, or share tips on voc rehab in a staff huddle.
This newsletter was prepared and distributed by Qsource ESRD Network 10 under contract with the Centers for Medicare & Medicaid Services, an agency of the U.S. Department of Health and Human Services (contract number HHSM-500-2016-00010C and HHSM-500-2016-00012C). The contents presented do not necessarily reflect CMS policy. 20.Q-ESRD.20-684
ESRD Network 10: 317-257-8265 | Patient Line: 800-456-6919 | Website
ESRD Network 12: 816-880-9990 | Patient Line: 800-444-9965 | Website