Evaluation of the Ticket to Work Program Initial Evaluation Report

money on their TTW operations. For most of them, the program was not looking
financially viable. One of the ENs was planning to withdraw from the program, and another
had nearly withdrawn but was persuaded by the Program Manager to continue operating in
just one state after having started on a nationwide scale. Some of these ENs found that their
clients were not earning enough to generate a consistent payment stream. The ENs also
complained about the difficulty of obtaining adequate earnings documentation to support
payment requests and about delays in receiving payments. SSA has recently simplified the
documentation required to receive outcome payments, but the eight ENs we interviewed felt
that still more changes would be needed.
Providers Complain About TTW Marketing. Besides financial problems, one of the
more common concerns voiced by representatives from the experienced ENs has to do with
marketing. They feel strongly that SSA and the Program Manager need to do a better job of
both explaining TTW to beneficiaries and reaching out to encourage participation. They
reported being burdened by inappropriate referrals and the continuing need to explain basic
program features to large numbers of beneficiaries. Similar concerns were expressed in an
EN Summit Conference held in 2003. SSA has recently issued a contract to develop a
strategic marketing plan aimed at both improving beneficiary understanding of the program
and promoting Ticket assignments. The effects of this effort, however, will not appear until
2004 or later, and will be examined in future evaluation reports.
TTW Success Is Mixed for Beneficiaries in the Four Adequacy of Incentives
(AOI) Groups. The evaluation pays special attention to the extent that TTW is reaching
beneficiaries in the four congressionally defined groups that were expected to find it difficult
to obtain services under TTW—those who (1) need ongoing support and services, (2) need
high-cost accommodations, (3) earn a subminimum wage, or (4) work and receive partial
cash benefits. The financial problems noted at the eight experienced ENs suggest that
provider incentives are weak overall and so are likely to provide little motivation for ENs to
serve beneficiaries in general, let alone those beneficiary groups identified by Congress. This
possibility has been confirmed by our conversations with providers, through which we
found that while SVRAs have typically agreed to serve any interested beneficiary determined
eligible for services, ENs have commonly screened out those they perceive as requiring
substantial or long-term services because they are seen as unlikely to yield payments
sufficient to offset service costs.
A slightly different picture comes from our preliminary analysis of administrative data,
which we used to develop a rough approximation of the first two AOI groups (those
requiring ongoing support or high-cost accommodations) based only on information about
beneficiaries’ primary impairments. These approximations, which were developed in the
evaluation’s design report (Stapleton and Livermore 2002), suggest that beneficiaries in these
two AOI groups constitute a substantial majority of eligible beneficiaries. Furthermore, we
found that beneficiaries in these two groups have higher participation rates than all other
beneficiaries and that they account for 71 percent of all Ticket users. These results primarily
illustrate the fact that even among beneficiaries who appear to require substantial services in
order to sustain employment, many have been able to find a provider (typically a SVRA) that
will accept their Ticket. It appears that ENs commonly refer candidates that they perceive
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Executive Summary