Evaluation of the Ticket to Work Program Initial Evaluation Report

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48 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
49 asked the Program Manager for a business model. Program Manager staff believe that it will take time before expertise is gained and/or consultants become available to advise small enterprises on how they might be successful under TTW. • Providers perceive the payment system as risky. Providers are wary of not having start-up money to fund services, noting that many beneficiaries they choose to serve might be unsuccessful in their attempts to return to work. Providers are also concerned about the administrative difficulties of tracking earnings in order to receive payment. • Extreme variations in the state political landscapes (e.g., presence of a Medicaid Buy-In, VR posture, presence of TTW committees, coalition activity) have also presented a challenge to Program Manager marketing, along with the fact that different organizations involved in the program have competing priorities. Each state represents a new and different environment. • Marketing activities are easily influenced by the health of the existing economy and labor market. For example, the Program Manager began conducting a new outreach strategy to recruit ENs from the business community in March 2001, but after September 11, interest in the program waned due to the economic downturn. Another Program Manager challenge in the Phase 1 implementation of TTW was devoting sufficient time and resources to help SVRAs solve issues related to the internal administrative changes and burdens associated with TTW so that they would help facilitate the program. SSA and Program Manager interviewees indicated that, early on, rumors abounded that SVRAs had “strong-armed” other community providers in ways that dissuaded them from participating as ENs. Program Manager staff noted that they had no direct evidence to substantiate those rumors, and that they have continuously worked closely with the Rehabilitation Services Administration and the Council of State Administrators of Vocational Rehabilitation to keep them apprised of the rumors. Program Manager staff noted, however, that many times “perception is reality” and that the perception that becoming an EN is an attack on the SVRA appears to be an issue. From the Program Manager’s perspective and role in EN recruitment, it is helpful when no such rumors exist in a state and when the perception is that the SVRA is either neutral towards or supportive of TTW. EN Payments. Program Manager staff members responsible for EN claims reported some difficulty in conveying to EN staff the particulars regarding earnings evidence requirements, including the difference between primary and secondary evidence, and required elements of each. For example, some SVRAs have stated that they only have quarterly Unemployment Insurance data to submit. While such data provide secondary evidence of earnings, additional investigative development is required to verify earnings by III: TTW Early Implementation
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Contract No.: 0600-03-60130 MPR Ref
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A CKNOWLEDGMENTS This report benefi
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C ONTENTS Chapter Page ACRONYMS ...
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vii Chapter Page V (continued) D. C
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A CRONYMS ABIL AIDS AWICs AOI BPAO
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E XECUTIVE S UMMARY T he Ticket to
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Overall, we found that SSA has impl
Page 15 and 16: money on their TTW operations. For
Page 17 and 18: xvii CONCLUDING OBSERVATIONS SSA fa
Page 19 and 20: C HAPTER I O VERVIEW OF THE T ICKET
Page 21 and 22: The TTW program and other elements
Page 23 and 24: A. EVALUATION COMPONENTS: GOALS, SC
Page 25 and 26: 7 ! How many beneficiaries particip
Page 27 and 28: 9 B. PURPOSE AND ORGANIZATION OF TH
Page 29 and 30: C HAPTER II S TRUCTURE AND B ACKGRO
Page 31 and 32: In reality, however, the success of
Page 33 and 34: MAXIMUS to serve as the Program Man
Page 35 and 36: 17 4. Participate in the activities
Page 37 and 38: N Decision Reversed Request SSA Rev
Page 39 and 40: 21 c. Dispute Resolution In a progr
Page 41 and 42: Table II.1: Outcome-Only and Milest
Page 43 and 44: milestone payment is equal to 34 pe
Page 45 and 46: Unemployment Insurance (UI) wage da
Page 47 and 48: 29 3. Related Initiatives TTW has n
Page 49 and 50: SSA Demonstrations. SSA plans to im
Page 51 and 52: Protection and Advocacy. The SSA-fu
Page 53 and 54: C HAPTER III TTW EARLY I MPLEMENTAT
Page 55 and 56: 37 Table III.1: TTW Implementation
Page 57 and 58: Ticket-eligible beneficiaries were
Page 59 and 60: 41 TTW. In the past, SSA systems ha
Page 61 and 62: information in SSA’s records cont
Page 63 and 64: work period automation and tracking
Page 65: Systems and Infrastructure. The Pro
Page 69 and 70: 51 • The first payment for each b
Page 71 and 72: currently being addressed relate to
Page 73 and 74: payment system. Only one SVRA (Okla
Page 75 and 76: SVRA personnel have consistently ex
Page 77 and 78: 59 • Are SVRAs permitted to requi
Page 79 and 80: Table III.4: ENs and ENs with Ticke
Page 81 and 82: Payment System. Many ENs do not bel
Page 83 and 84: example, reporting lags inherent in
Page 85 and 86: eceived only small amounts thus far
Page 87 and 88: SVRA services for Ticket clients; (
Page 89 and 90: C HAPTER IV E ARLY P ARTICIPATION P
Page 91 and 92: 73 Figure IV.2: Cumulative Number o
Page 93 and 94: point in the Phase 1 rollout. For P
Page 95 and 96: 77 Figure IV.7: First Assignments a
Page 97 and 98: 79 Figure IV.8: Ticket Participatio
Page 99 and 100: 81 Figure IV.10: Ticket Participati
Page 101 and 102: 83 states. This finding suggests th
Page 103 and 104: There is a strong negative relation
Page 105 and 106: C HAPTER V C ASE S TUDIES OF E IGHT
Page 107 and 108: 89 A. SERVICE MODELS AND TARGETED C
Page 109 and 110: Although the director was initially
Page 111 and 112: Clients who assign their Tickets to
Page 113 and 114: session. Those who miss their appoi
Page 115 and 116: interview. While this is time consu
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claim employer tax credits. Through
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these individuals, because they typ
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103 F. RELATIONS WITH OTHER ORGANIZ
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eneficiaries to meet that standard.
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IDR representatives said that to da
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substantiate wages, and clients are
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services? Unfortunately, for ENs to
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Manager. At present, this is only p
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stubs: the need for beneficiaries t
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C HAPTER VI A DEQUACY OF I NCENTIVE
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We have also begun to analyze admin
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viewed as lacking the productive ca
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assist in the identification of ind
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eneficiaries. In examining results
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127 E. CONCLUDING OBSERVATIONS The
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C HAPTER VII C ONCLUSIONS AND I MPL
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noticeably low, and, among the very
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Act. At the same time, some ENs hav
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Another change requiring considerat
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C HAPTER VIII N EXT S TEPS FOR THE
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prior to September 2003 and had not
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R EFERENCES Adequacy of Incentives
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A PPENDIX A D ATA T ABLES C ORRESPO
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A-3 Table A.2 Cumulative Number of
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A-5 Table A.4 Percentage of Tickets
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A-7 Table A.6 Percentage of Tickets
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A-9 TABLES SHOWING CHARACTERISTICS
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A-11 Table A.10 Ticket Participatio
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A-13 Table A.12 Ticket Participatio
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A-15 Table A.14 Percentage of In-Us
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A PPENDIX B P ROVIDER-SPECIFIC C AS
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informed beneficiaries that state V
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e considerably more successful if S
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them for employment. It was during
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working but are still receiving SSI
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B.11 client over a four-year period
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B.13 placing SSA beneficiaries than
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B.15 that came in for an initial ap
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B.17 all benefits; therefore, EES d
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B.19 outreach program. As noted pre
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B.21 remained employed. 3 Because o
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B.23 estimate of the financial loss
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B.25 Social Security benefits. IDR
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B.27 have to submit pay stubs twice
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B.29 Bridges still provides the 10-
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B.31 While she used to have a polic
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B.33 8. Oklahoma Department of Reha
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B.35 Beneficiaries interested in as
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B.37 permits agency budgets to be c
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A PPENDIX C D EFINING THE F OUR A D
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B. IDENTIFYING INDIVIDUALS WITH A N
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“work and receive full cash benef
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