Evaluation of the Ticket to Work Program Initial Evaluation Report

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One key issue is the general policy of most SVRAs to not provide services to
beneficiaries that have already assigned their Ticket to an EN, except under an agreement in
which the EN would compensate the agency. This policy has been adopted on the grounds
that the Rehabilitation Act prevents the agencies from providing Title I vocational
rehabilitation services to individuals who are receiving comparable services from other
organizations. While the legal debate over this interpretation is continuing, implications of
changing the policy are fairly clear. Making SVRA services available to EN clients, without
compensation from the EN, would substantially increase the value to the beneficiary of
assigning a Ticket to an EN if the beneficiary currently resides in a state with an agency that
refuses to provide services without reimbursement. It would also mean, however, that
SVRAs would provide more services to beneficiaries without the possibility of
reimbursement from SSA.
Still another important issue is the extent to which agreements between SVRAs and
ENs vary among states. In particular, the agreements differ in the extent to which they
encourage EN participation in TTW. To address this issue SSA and RSA could provide
guidance to SVRAs and ENs on the terms of SVRA/EN agreements, or even promulgate
new regulations on these agreements. As previously discussed, these agreements describe the
conditions under which a SVRA will provide services to a beneficiary when the beneficiary is
referred by the EN for services, and cover subjects such as referral procedures, payment
terms and schedules, and dispute resolution. In all instances we know of, the SVRA has
developed a single SVRA/EN agreement, often with minimal input from ENs and other
stakeholders, and has required the EN to sign the agreement prior to referring a Ticket
holder to the state agency. In most agreements we have reviewed the SVRA shares some of
the risk with the EN, but the financial terms tend to be highly favorable to the state agency.
As an alternative, SVRAs could help capitalize ENs, and foster the EN market, by sharing
more of the risk. SSA and RSA could collaborate to develop risk-sharing models, and
encourage their adoption. The federal agencies could also develop regulations that specify
risk-sharing provisions for the VR/EN agreements. Such regulations could be viewed as a
compromise between the two extreme positions on the issue of whether beneficiaries who
assign their Tickets to ENs are still entitled to receive state VR agency services under Title I
of the Rehabilitation Act.
A recent letter from the Ticket to Work and Work Incentive Advisory Panel (2003)
raised the issue of beneficiary choice and asked SSA and RSA to reassess policies about the
ways in which SVRAs can take Tickets. Under Transmittal 17 of the Social Security
Provider’s Handbook, distributed in September 2002, a SVRA can receive a Ticket
assignment by transmitting a signed Individual Plan for Employment (IPE) and an unsigned
copy of SSA Form 1365 (which SVRAs use to register a beneficiary’s Ticket with SSA). The
policy has caused considerable concern on the part of both SVRAs and ENs. Even though
several SVRAs have developed procedures to ensure that beneficiaries are fully aware of the
potential consequences of signing an IPE, the policy may, in practice, allow SVRA to receive
assignments from beneficiaries who may not even know they have a Ticket, who may be
unaware they have assigned their Ticket, or who may be unaware of the consequences of
Ticket assignment. Some SVRAs have expressed concern about this provision, indicating
that the policy seems to conflict with the consumer choice provisions of the Rehabilitation
VII: Conclusions and Implications