Evaluation of the Ticket to Work Program Initial Evaluation Report

C HAPTER VII
C ONCLUSIONS AND I MPLICATIONS
I
n this chapter, we draw some tentative conclusions based on the early evaluation data
presented in the report. We also highlight some implications of the findings and identify
several issues that deserve close attention as the TTW program continues to unfold. In
particular, while TTW is now operational, several pressure points could limit its
effectiveness. SSA has already taken some steps to address those points, but careful
monitoring is essential during the next few months and additional steps are likely to be
required. Given that TTW is a program that was implemented from scratch without a pilot
or demonstration and is still in its infancy, operational problems are hardly surprising.
A. SSA HAS IMPLEMENTED TICKET TO WORK
Despite substantial obstacles, SSA has, in fact, implemented TTW in the Phase 1 and 2
states and began to roll out the program in the remaining (Phase 3) states as of November
2003. Although the rollout is a year behind schedule, that is not surprising given the
Agency’s resource limitations, the enormity of the task facing SSA in implementing a
national program that proved to be much more complex than initially understood when the
original schedule was developed, a change of administrations, and other external events. The
Ticket concept as envisioned by the NASI panel and enacted by Congress appears simple,
but it overlies a set of already complex rules and systems associated with the work incentive
provisions of SSA’s two disability programs. Moreover, the legislation left those provisions
largely unchanged. In addition, SSA had to address the interests of a wide variety of
stakeholders through the regulatory process and other administrative actions.
In the process of implementing TTW, SSA has made substantial operational changes
that are likely to support beneficiary efforts to return to work. The mailing of Tickets to over
5 million adult beneficiaries in the Phase 1 and 2 states represents the first time that SSA has
invited most of these beneficiaries to obtain employment services potentially funded by SSA.
This approach stands in contrast to past policy, under which SSA invited and required a
small share of new awardees to seek rehabilitation services through SVRAs and did not
directly extend an offer of assistance to others. For the first time, beneficiaries can attempt
to work without fear of triggering a medical CDR. It appears that TTW has substantially
expanded beneficiary ability to seek services from non–SVRA providers who could then be
paid for the rehabilitation by SSA without a referral, that beneficiaries have better access to
information about SSA’s work incentive programs through the Benefits Planning Assistance
Outreach (BPAO) grantees, and that providers have better knowledge of how returning to