Evaluation of the Ticket to Work Program Initial Evaluation Report

C HAPTER VI
A DEQUACY OF I NCENTIVES S TUDY
I
n passing the Ticket Act, Congress acknowledged that the TTW program might not be
equally accessible to all disability beneficiaries. Of particular concern was the possibility
that the performance-based payment system might lead providers to serve mainly
beneficiaries who are most ready to return to work while largely ignoring beneficiaries
requiring more intensive or long-term support if they are to become successfully employed.
Such client selection practices could create an efficient program in the sense that payments
made to ENs could be offset by savings from selected beneficiaries exiting from the
disability rolls. But the practices could also create an inequitable program in the sense that
some beneficiaries who want to work may be unable to obtain TTW-financed services that
would enable them to succeed.
To address the equity issue, Congress mandated an Adequacy of Incentives (AOI) study
to evaluate how the TTW program can be used to increase employment among beneficiaries
with significant support needs. The Ticket Act specifies four groups of beneficiaries that
could find it difficult to obtain services in the performance-based TTW environment:
1. Individuals with a need for ongoing support and services
2. Individuals with a need for high-cost accommodations
3. Individuals who earn a subminimum wage
4. Individuals who work and receive partial cash benefits
The statute requires SSA to identify and implement a payment system that would allow
the four groups of beneficiaries to participate in the TTW program. The Commissioner is
mandated to report to Congress on recommendations for a method or methods of adjusting
payment rates to ENs to ensure equitable participation among the above groups.