Evaluation of the Ticket to Work Program Initial Evaluation Report

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SVRAs have expressed concern about SSA guidance on new cases. The guidelines
allow SVRAs to submit a signed IPE for Ticket assignment for beneficiaries who have not
knowingly agreed to assign their Tickets to the SVRA. As a result, the guidance is viewed by
some SVRAs as violating the principle of informed consent, and many SVRAs are very
reluctant to use this type of “automatic assignment.” In situations where a beneficiary signs
an IPE but declines to assign the Ticket to the SVRA, the agency must either use the
automatic assignment provision or risk losing the opportunity to receive any type of SSA
payment for the beneficiary.
SVRAs have also expressed a concern that the SSA guidance on new cases may limit
beneficiary choice in Ticket assignment. For example, if at some future point the beneficiary
wants to assign his/her Ticket to an EN other than the SVRA currently holding this Ticket,
the beneficiary will have to initiate a reassignment request to the Program Manager.
However, if the SVRA is already eligible to receive a payment under the Ticket program for
this beneficiary, the value of the Ticket for reassignment is potentially limited because the
TTW payments would have to be shared with the SVRA.
c. SVRA Implementation Strategies
SVRAs used a number of strategies to prepare for the Ticket rollout. Among the 13
Phase 1 states, several SVRAs were initially very excited about TTW and had expressed an
interest in being part of the initial rollout. Others were less enthusiastic. SVRAs that initially
embraced TTW believed that they possessed a strong state infrastructure, including the
presence of Medicaid Buy-In programs, strong benefits planning networks, State Partnership
Initiative projects, DOL Work Incentive Grants, and high quality service delivery systems
that would enable them to effectively operate within the new program. SVRAs in other
states expressed concern about the possible success of TTW and their ability to implement
the program successfully. In anticipation of TTW rollout, most SVRAs participated in
national meetings and received technical assistance from SSA and the Program Manager,
developed state-specific TTW implementation teams, prepared staff development programs,
participated in regional conference calls sponsored by SSA regional offices, modified data
systems to allow tracking of Ticket holders, and conducted outreach to potential ENs.
SVRAs have developed internal organizational structures and allocated resources to
respond to a demand for services by TTW recipients. Implementation strategies have varied
considerably, based primarily on the size of the state, the anticipated demand for services,
and prior experience with the SSA cost reimbursement program. Some SVRAs have
established centralized TTW units, staffed by individuals solely responsible for TTW
activities. Others have chosen more decentralized implementation designs where TTW
duties were added to the work assignments of staff members already responsible for a
number of different activities. Common implementation strategies have included
development of call centers (although most states establishing these centers have closed
them due to a lack of demand), centralized TTW units responsible for all aspects of
implementation, identification of a single Ticket coordinator or regional Ticket counselors,
and decentralized implementation procedures where all beneficiaries are referred to local
SVRA offices.
III: TTW Early Implementation