Evaluation of the Ticket to Work Program Initial Evaluation Report

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• The first payment for each beneficiary is often difficult and time consuming
because retroactive adjustments to a beneficiary’s record may be necessary. The
process becomes much easier after the first payment for a particular beneficiary.
In an attempt to alleviate problems and shorten the long delay for claims processing, the
Program Manager is suggesting that ENs tell beneficiaries to contact their SSA field offices
and submit the required employment information before the EN submits the first payment
request. In order for SSA to adjust benefits in response to earnings information,
beneficiaries must report their employment status and earnings to SSA. Reports of earnings
to the EN do not replace the requirement that beneficiaries report earnings to SSA directly,
so that beneficiaries must report earnings to both places. In October 2002, Program
Manager staff were also developing a one-page EN training module on payments, which will
be distributed to all ENs.
b. Ongoing Implementation Activities
EN Recruitment. EN recruitment continues to be a challenge for the Program
Manager, which has added additional marketing staff and continues to conduct extensive
recruitment activities nationwide. Program Manager staff members have conducted over 90
EN recruitment fairs and over 200 informational presentations to provider audiences since
beginning operations in 2000. Program Manager interviewees note that they have
aggressively marketed TTW to about 50,000 organizations. At the time of our interview in
September 2003, the Program Manager had successfully recruited just over 1,000 providers
to operate as ENs. While EN recruitment has always been difficult, Program Manager
representatives note that it has become even more difficult as the program has rolled out and
providers have gained experience with the program. Recruiting ENs for TTW continues to
be a “hard sell” for several reasons. The two primary reasons are that the payment system is
perceived as too risky and the program is seen as too complex. In addition, many service
providers remain wary about jeopardizing their existing funding streams with TTW revenue.
In particular, funding from state VR agencies and state Medicaid programs might be at risk.
Finally, many service providers are experiencing difficulty finding jobs for their clients in the
current economy. This, combined with the reasons noted above, makes participation in
TTW unattractive.
The Program Manager has also found it necessary to devote substantial effort to
retaining ENs. Since the beginning of the program, 38 providers have terminated their EN
status. Some of these providers have gone out of business or merged with other
organizations, but others are unwilling to continue participating as an EN. In some cases,
the terminating ENs have been losing money by devoting resources to the program without
experiencing an adequate return. In other cases, the ENs decided that they were not in a
position to service TTW clients, and rather than remain in “on hold” status indefinitely, they
preferred to withdraw. The Program Manager found it necessary to develop “on hold”
status for ENs because many providers that had signed up to be ENs were not yet prepared
to take Tickets, and others taking Tickets were at full capacity. On hold status allows
providers to remain as ENs, however, their contact information is not provided to
III: TTW Early Implementation