Evaluation of the Ticket to Work Program Initial Evaluation Report

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x MRTW NASI NPRM OESP OIM PABSS P&A PC-CDR RSA SGA SPI SSA SSI SSN SVRA TTW TWP WIA WIAP Modernized Return to Work software National Academy of Social Insurance Notice of Proposed Rule Making SSA Office of Employment Support Programs SSA’s Office of Information Management Protection and Advocacy for Beneficiaries of Social Security Protection and Advocacy Personal Computer Continuing Disability Review software Rehabilitation Services Administration Substantial Gainful Activity (in 2004 SSA defined this as earnings of $810 per month) State Partnership Initiative Social Security Administration Supplemental Security Income (Title XVI of the Social Security Act) Social Security Number State Vocational Rehabilitation Agency Ticket to Work Trial Work Period Workforce Improvement Act Ticket to Work and Work Incentives Advisory Panel Acronyms
E XECUTIVE S UMMARY T he Ticket to Work and Work Incentives Improvement Act of 1999 (Ticket Act) established the Ticket to Work and Self Sufficiency program (TTW) to increase access to, and the quality of, rehabilitation and employment services available to Social Security disability beneficiaries and ultimately to increase the number of such beneficiaries who become economically self-sufficient. Very few beneficiaries now leave the rolls as a result of having found work, and TTW tries to help more beneficiaries do this by changing the way the Social Security Administration (SSA) pays for employment services. The Ticket Act also creates some new rules that let beneficiaries explore work opportunities without jeopardizing their benefit status. Somewhat paradoxically, the goal of the TTW program is to promote work among a group of individuals judged to be incapable of working in any substantial way. People who receive disability benefits from either SSA’s Disability Insurance (DI) or Supplemental Security Income (SSI) programs have been judged to have a medically determinable impairment that is expected to last at least 12 months or result in death, and that renders them unable to engage in substantial gainful activity. The majority of these beneficiaries do not attempt to engage in any work once they are on the rolls. Only about 2.5 percent of any enrollment cohort will ultimately leave the rolls because of having found work, and less than 0.5 percent of all beneficiaries on the rolls at a point in time eventually leave because of work. It has proven difficult to raise the low employment rates among disability beneficiaries. Nevertheless, many people with medical conditions that would make them eligible for disability benefits do in fact work, and advances in technology and rehabilitation techniques make it feasible for many people with very severe disabilities to obtain and hold jobs. This has generated a continuing interest in promoting employment among DI and SSI beneficiaries, which in turn has led to a consensus that no person with a disability should be denied the right to participate fully in society, including work, because of external barriers that can be removed with a reasonable effort. The TTW program and other elements of the Ticket Act provide new means to help beneficiaries become employed and financially self-sufficient. In particular, it introduces a new financing system for providers and gives beneficiaries a choice in which provider to use. The new financing system adds two payment options to the traditional system that SSA has used to pay state vocational rehabilitation agencies (SVRAs) for rehabilitation services provided to beneficiaries. The traditional system reimburses an agency’s costs, up to a limit,
Page 1 and 2: Contract No.: 0600-03-60130 MPR Ref
Page 3 and 4: A CKNOWLEDGMENTS This report benefi
Page 5 and 6: C ONTENTS Chapter Page ACRONYMS ...
Page 7 and 8: vii Chapter Page V (continued) D. C
Page 9: A CRONYMS ABIL AIDS AWICs AOI BPAO
Page 13 and 14: Overall, we found that SSA has impl
Page 15 and 16: money on their TTW operations. For
Page 17 and 18: xvii CONCLUDING OBSERVATIONS SSA fa
Page 19 and 20: C HAPTER I O VERVIEW OF THE T ICKET
Page 21 and 22: The TTW program and other elements
Page 23 and 24: A. EVALUATION COMPONENTS: GOALS, SC
Page 25 and 26: 7 ! How many beneficiaries particip
Page 27 and 28: 9 B. PURPOSE AND ORGANIZATION OF TH
Page 29 and 30: C HAPTER II S TRUCTURE AND B ACKGRO
Page 31 and 32: In reality, however, the success of
Page 33 and 34: MAXIMUS to serve as the Program Man
Page 35 and 36: 17 4. Participate in the activities
Page 37 and 38: N Decision Reversed Request SSA Rev
Page 39 and 40: 21 c. Dispute Resolution In a progr
Page 41 and 42: Table II.1: Outcome-Only and Milest
Page 43 and 44: milestone payment is equal to 34 pe
Page 45 and 46: Unemployment Insurance (UI) wage da
Page 47 and 48: 29 3. Related Initiatives TTW has n
Page 49 and 50: SSA Demonstrations. SSA plans to im
Page 51 and 52: Protection and Advocacy. The SSA-fu
Page 53 and 54: C HAPTER III TTW EARLY I MPLEMENTAT
Page 55 and 56: 37 Table III.1: TTW Implementation
Page 57 and 58: Ticket-eligible beneficiaries were
Page 59 and 60: 41 TTW. In the past, SSA systems ha
Page 61 and 62:
information in SSA’s records cont
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work period automation and tracking
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Systems and Infrastructure. The Pro
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49 asked the Program Manager for a
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51 • The first payment for each b
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currently being addressed relate to
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payment system. Only one SVRA (Okla
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SVRA personnel have consistently ex
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59 • Are SVRAs permitted to requi
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Table III.4: ENs and ENs with Ticke
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Payment System. Many ENs do not bel
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example, reporting lags inherent in
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eceived only small amounts thus far
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SVRA services for Ticket clients; (
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C HAPTER IV E ARLY P ARTICIPATION P
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73 Figure IV.2: Cumulative Number o
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point in the Phase 1 rollout. For P
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77 Figure IV.7: First Assignments a
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79 Figure IV.8: Ticket Participatio
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81 Figure IV.10: Ticket Participati
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83 states. This finding suggests th
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There is a strong negative relation
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C HAPTER V C ASE S TUDIES OF E IGHT
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89 A. SERVICE MODELS AND TARGETED C
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Although the director was initially
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Clients who assign their Tickets to
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session. Those who miss their appoi
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interview. While this is time consu
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claim employer tax credits. Through
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these individuals, because they typ
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103 F. RELATIONS WITH OTHER ORGANIZ
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eneficiaries to meet that standard.
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IDR representatives said that to da
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substantiate wages, and clients are
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services? Unfortunately, for ENs to
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Manager. At present, this is only p
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stubs: the need for beneficiaries t
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C HAPTER VI A DEQUACY OF I NCENTIVE
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We have also begun to analyze admin
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viewed as lacking the productive ca
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assist in the identification of ind
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eneficiaries. In examining results
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127 E. CONCLUDING OBSERVATIONS The
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C HAPTER VII C ONCLUSIONS AND I MPL
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noticeably low, and, among the very
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Act. At the same time, some ENs hav
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Another change requiring considerat
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C HAPTER VIII N EXT S TEPS FOR THE
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prior to September 2003 and had not
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R EFERENCES Adequacy of Incentives
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A PPENDIX A D ATA T ABLES C ORRESPO
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A-3 Table A.2 Cumulative Number of
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A-5 Table A.4 Percentage of Tickets
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A-7 Table A.6 Percentage of Tickets
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A-9 TABLES SHOWING CHARACTERISTICS
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A-11 Table A.10 Ticket Participatio
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A-13 Table A.12 Ticket Participatio
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A-15 Table A.14 Percentage of In-Us
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A PPENDIX B P ROVIDER-SPECIFIC C AS
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informed beneficiaries that state V
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e considerably more successful if S
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them for employment. It was during
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working but are still receiving SSI
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B.11 client over a four-year period
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B.13 placing SSA beneficiaries than
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B.15 that came in for an initial ap
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B.17 all benefits; therefore, EES d
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B.19 outreach program. As noted pre
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B.21 remained employed. 3 Because o
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B.23 estimate of the financial loss
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B.25 Social Security benefits. IDR
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B.27 have to submit pay stubs twice
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B.29 Bridges still provides the 10-
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B.31 While she used to have a polic
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B.33 8. Oklahoma Department of Reha
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B.35 Beneficiaries interested in as
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B.37 permits agency budgets to be c
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A PPENDIX C D EFINING THE F OUR A D
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B. IDENTIFYING INDIVIDUALS WITH A N
Page 219:
“work and receive full cash benef
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Evaluation of the Ticket to Work Program Initial Evaluation Report

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