Evaluation of the Ticket to Work Program Initial Evaluation Report

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In addition to establishing the internal TTW systems, a major activity of the Program
Manager was to conduct EN recruitment for Phase 1. Between April 2001, when the
request for proposals for ENs was released, and the end of Phase 1, approximately 350 ENs
had been enrolled. Phase 2 recruitment began in February 2002.
Program Manager staff reports that EN recruitment has been an enormous effort.
Enrolling the first 240 ENs as of January 2002, required approximately 37,000 mailings,
14,000 phone calls, and 7,500 in-person contacts.
Program Manager interviewees note that while the delayed rollout allowed more time to
test systems and recruit ENs, it also created staffing issues. Program Manager staff,
particularly the call center agents, required re-training because they forgot what they had
learned while they waited for TTW to roll out. It was also difficult to keep Program
Manager staff fully occupied during the period before Tickets were mailed. The multiple
“false starts” (delays to Ticket rollout and the request for EN proposals) also delayed
marketing efforts. Furthermore, the events of September 11, 2001, caused all September,
October and November EN marketing campaigns and other processing activities to be
delayed until December 2001.
EN Recruitment. According to both SSA and Program Manager interviewees, a
primary implementation challenge has been EN recruitment. A survey conducted for SSA
by the Gallup Organization in 1999 revealed a high level of interest in TTW on the part of
traditional providers. However, the stated interest of providers did not result in significant
numbers of applicants, once the request for proposals was released. The TTW payment
system was a big issue. Initially, Program Manager staff expected that once the final
payment system was established and the fourth milestone payment added, more ENs would
enroll, but these expectations were not entirely met. At the beginning of 2002, 200 ENs
were enrolled to serve Phase 1 states. As of late October 2002, the number was near 400.
Program Manager interviewees had anticipated a response in the range of 500-800 by late
2002.
Program Manager staff reports several factors that have contributed to the difficulty in
recruiting ENs:
• Delays in publishing the final rules and in issuing the request for EN proposals
created uncertainty about the program among providers.
• There is little public awareness about TTW and little published information
available for reference. Thus, the Program Manager has spent substantial time
educating providers about the program’s features, the benefits of participation,
and the details of enrollment.
• SSA did not anticipate that most providers would be engaged in contract work
for SVRAs, rather than being set up to function more independently. According
to the Program Manager staff, providers have relied on VR for their funding and
are not experienced operating as independent businesses. Many smaller potential
ENs are also inexperienced with an outcome reimbursement system and have
III: TTW Early Implementation