Evaluation of the Ticket to Work Program Initial Evaluation Report

We have also begun to analyze administrative data on beneficiaries in the AOI groups.
The early analysis uses SSA administrative information about beneficiaries’ primary disabling
conditions to identify beneficiaries in two of the AOI groups: those who need ongoing
supports and those who need high-cost accommodations. This preliminary definition is
clearly an approximation because accurate classification requires information on individuals’
functioning, expectations, educational background, and previous work activity; it cannot be
based entirely on their disabling conditions. Nevertheless, this preliminary definition allows
us to initiate the analysis based on the currently available administrative data.
Accordingly, we find that beneficiaries in the AOI groups constitute a majority of all
eligible DI and SSI beneficiaries. The finding is not surprising given that the preliminary
definition places all beneficiaries with mental illness, mental retardation, or other mental
disorder into the AOI groups and that beneficiaries with those diagnoses account for about
38 percent of all beneficiaries. What is surprising, however, is that beneficiaries in our
preliminary AOI groups also account for the majority of beneficiaries using Tickets and that
they have higher participation rates than those beneficiaries not included in our AOI groups.
Most of these beneficiaries are being served by SVRAs under the traditional payment system,
thereby underscoring the agencies’ obligation to try to serve all applicants. It also reflects the
substantial diversity among beneficiaries with the same disabling conditions and illustrates
the need to refine our definitions further as more detailed data become available.
We discuss the findings in more detail starting with information primarily from the
preliminary TTW process analysis (Livermore et al. 2003) and from our follow-up interviews
with eight experienced ENs. We then turn to a statistical description of the characteristics
and experiences of the two AOI groups that can be identified using our preliminary
definition..
A. PRELIMINARY PROCESS INFORMATION ON THE ADEQUACY OF
INCENTIVES
The most obvious process analysis conclusion about the adequacy of incentives is that
the most experienced ENs do not appear to be earning a profit from their TTW activities.
As noted in Chapter V, all eight of the experienced ENs we interviewed for the report
indicated that they were losing money. Without other sources of income or changes to the
payments and payment process, these ENs seem likely to contract their operations further or
drop out of the program altogether. If these ENs are indicative of all ENs, then the current
TTW system clearly does not provide enough of an incentive for ENs to remain in the
program in general, let alone serve individuals perceived as requiring costly, long-term
supports. SSA has taken steps to make the payment system more efficient, but it remains to
be seen if those steps alone will be sufficient to keep the current ENs participating. Thus, it
seems likely that the current system does not provide enough of an incentive for ENs to
serve those beneficiaries who require substantial supports or who currently earn
subminimum wages.
In addition, the available process information suggests that many ENs, as well as some
SVRAs acting as ENs, have established screening and intake procedures that could exclude
119
VI: Adequacy of Incentives Study