Evaluation of the Ticket to Work Program Initial Evaluation Report

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In developing an analysis of the AOI groups, we have to solve two issues. First, the
Ticket Act does not define the specific AOI groups in a way that allows accurate
identification of beneficiaries using SSA administrative data. Second, SSA administrative data
do not enable us to differentiate between those who do not participate because they are not
interested in doing so (voluntary non-participants) and those who would like to participate
but cannot find and EN willing to accept their Ticket (involuntary non-participants). If many
beneficiaries in the AOI groups possess such severe health conditions or impairments that
they feel work is not possible or desirable under any reasonable circumstances, then the
evaluation will substantially overstate the extent to which the needs of AOI beneficiaries are
not met by TTW. Fortunately, the evaluation surveys, which will start in January 2004, will
provide more detailed information for identifying AOI groups and assessing their
knowledge, attitudes, and expectations about work.
Until the survey data become available, the evaluation must face the challenges involved
in using administrative data or other empirical approaches to identifying the AOI groups.
Using available SSA data and the definitions developed in the evaluation design (Stapleton
and Livermore 2002), we developed preliminary definitions of the first two AOI groups:
beneficiaries who require ongoing supports and those who require high-cost
accommodations. These preliminary definitions are based solely on beneficiaries’ primary
disabling conditions as recorded in the SSA data and are mutually exclusive. In particular,
the definition of the group that requires ongoing supports includes impairments that are
likely to result in:
! A frequent need for personal assistance or coaching (e.g., cognitive disabilities,
autism, other developmental disabilities, traumatic brain injury, other severe
cognitive disorders, quadriplegia)
! A tendency to be able to work only episodically (e.g., psychiatric disorders)
! Possible disruptions of a person’s work activity (e.g., uncontrolled seizure
disorders)
! Gradual reduction of an individual’s functional capacity over time so that longterm
employment retention may be difficult (e.g., multiple sclerosis, degenerative
arthritis)
The intent of the definition of the group that requires high-cost accommodations is to
include beneficiaries who require supports such as assistive technologies, workplace
modifications, job coaching, personal assistance services, and interpreter or reader services.
It includes impairments that result in the inability to use two or more limbs, severe
neurological impairments (e.g., spinal cord injuries), deafness and severe auditory
impairments, and blindness and severe vision impairments. Appendix C details the relevant
sections from SSA’s lists of impairments used to construct these definitions, along with the
associated SSA impairment codes.
Using administrative data about other beneficiary characteristics such as educational and
employment history, we will eventually refine and expand our preliminary definitions. For
example, we could use longitudinal SSI earnings data or even historical FICA tax reports to
VI: Adequacy of Incentives Study