Evaluation of the Ticket To Work Program - Mathematica Policy ...

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14 Exhibit II.2. Sociodemographic Characteristics of Beneficiaries Age 18 - 24 Age 25 - 39 Age 40 - 54 Age 55+ White Black Other race Hispanic or Latino Female Male Education < high school Education = high school Education > high school Never married Divorced/separated/widowed Married Unmarried lives with own children Lives with spouse and own children Lives with spouse or other relatives, no children Lives alone or with unrelated others Family income < 100%FPL Family income 100 - 299% FPL Family income 300% FPL and over Sourc e: 2004 National Beneficiary Survey. Sample size = 7,603. Note: The applicable federal poverty level (FPL ) is determined by family size and the ages of family members. In 2004, the FPL for a family of one individual under age 65 was $9,827 per year. 13% II: Characteristics of Beneficiaries and Use of Employment Services 5% 6% 7% 8% 11% 17% 22% 23% 35% 33% 34% 33% 36% 39% 39% 38% 42% 50% 50% 49% 49% 71%
Many beneficiaries have characteristics that suggest that they would have difficulty obtaining jobs even disregarding their disabilities. In particular, a substantial share of beneficiaries have less than a high school level of education (42 percent). 5 This rate is much higher than that of the general population of adults ages 25 and over (15 percent) (U.S. Census Bureau 2004). 6 A low level of education is likely to limit beneficiaries’ earnings, regardless of any disability-related challenges that must be overcome to return to work. Nearly half of all beneficiaries (49 percent) are living in families with annual incomes below the federal poverty level (FPL), and another 38 percent have incomes at or near the poverty level (100 to 299 percent of the FPL). The figures on family income are consistent with the figures reported in Exhibit II.1 that showed many beneficiaries receive cash and in-kind assistance from public programs other than SSA. 3. Disability and Health Characteristics Given that a majority of working-age beneficiaries receive DI benefits and that the DI eligibility criteria require beneficiaries to have a substantial work history in order to qualify for benefits, it is not surprising that most disability beneficiaries first experienced the onset of their disabling health conditions during adulthood. Only 23 percent experienced childhood onset. A rather large share of all beneficiaries (42 percent) experienced onset of the disabling health condition after the age of 40 (Exhibit II.3). A later age of disability onset is much more common among DI-only beneficiaries than among SSI-only recipients. 7 A large body of literature examining return to work after illness or injury indicates that age at onset is an important predictor of return to work. 8 Most studies show that the likelihood of returning to work is significantly lower among those who are injured or become ill after age 50 relative to those whose injuries or illnesses occur at younger ages. While the literature points to numerous job-related, health, psychosocial, and economic factors that affect return to work (Krause et al. 2001), it provides little explanation about why older workers are less likely to return to work. Possible reasons might include decreased physiological ability to recover from illness or injury; age discrimination in ways that make access to job accommodations, retraining, or new employment opportunities more limited; access to higher wage-replacement benefits; and different preferences for work and leisure. The large 5 The extremely high rate of low levels of education corresponds with the findings of a previous study, which found that, in 1999, 34 percent of DI beneficiaries and 54 percent of SSI recipients reported having less than a high school level of education (Martin and Davies 2004). We found similar percentages when beneficiaries were disaggregated by program status (Thornton et al. 2006). 6 The percentage of disability beneficiaries with less than a high school level of education (42 percent) is much higher even when compared to the rate in the general population of those ages 25 and older who are not in the labor force (26 percent). Those in the labor force are much less likely to report having less than a high school level of education (10 percent) (U.S. Census Bureau 2004). 7 In our previous evaluation report (Thornton et al. 2006) we showed that 65 percent of DI-only beneficiaries and 25 percent of SSI-only recipients report an age at disability onset of 40 or older. 8 See, for example, Fox, Borba, and Liu (2005); Blackwell et al. (2003); Yasuda et al. (2002); and Krause et al. (2001). II: Characteristics of Beneficiaries and Use of Employment Services 15
Page 1 and 2: Contract No.: 0600-03-60130 MPR Ref
Page 3 and 4: A CKNOWLEDGMENTS This report reflec
Page 5 and 6: C ONTENTS Chapter Page ACRONYMS ...
Page 7 and 8: Chapter Page V (CONTINUED) B. SERVI
Page 9 and 10: Chapter Page X (CONTINUED) B. RECEN
Page 11 and 12: Chapter Page XIII (CONTINUED) 4. Lo
Page 13 and 14: E XHIBITS Exhibit Page I.1 POPULATI
Page 15 and 16: Exhibit Page IV.4 AGENCIES AND INDI
Page 17 and 18: Exhibit Page VI.7 OCCUPATION AND IN
Page 19 and 20: Exhibit Page X.2 REVENUES AND TICKE
Page 21 and 22: A CRONYMS The following acronyms ar
Page 23 and 24: E XECUTIVE S UMMARY The Ticket to W
Page 25 and 26: Beneficiary Demand for Employment S
Page 27 and 28: xxvii obtain Tickets from many of t
Page 29 and 30: IMPACTS OF TTW ON BENEFICIARY BEHAV
Page 31 and 32: xxxi Furthermore, the changes sough
Page 33 and 34: C HAPTER I I NTRODUCTION The Ticket
Page 35 and 36: operating capital and introducing a
Page 37 and 38: 4. Extended Medicare Coverage. Medi
Page 39 and 40: serve beneficiaries whom they think
Page 41 and 42: procedures that accommodate the nee
Page 43 and 44: C HAPTER II C HARACTERISTICS OF W O
Page 45: eport receiving any other non-SSA c
Page 49 and 50: Exhibit II.3. Age at Disability Ons
Page 51 and 52: Exhibit II.5. Percent of Beneficiar
Page 53 and 54: Exhibit II.7. Current General Healt
Page 55 and 56: for not working, although many more
Page 57 and 58: Phase 1 states where TTW had been f
Page 59 and 60: 3. School Enrollment and Degree-See
Page 61 and 62: program like TTW could address. Whe
Page 63 and 64: C HAPTER III B ENEFICIARY P ARTICIP
Page 65 and 66: stands out as a particularly import
Page 67 and 68: the beginning of each rollout, rate
Page 69 and 70: a substantial difference between th
Page 71 and 72: Exhibit III.4. Percentage of Benefi
Page 73 and 74: in-use Tickets were under the tradi
Page 75 and 76: period 8 to 15 months after the sta
Page 77 and 78: South Dakota’s participation rate
Page 79 and 80: • Was already using one of the wo
Page 81 and 82: those with less than a high school
Page 83 and 84: fact that such individuals have ent
Page 85 and 86: experienced disability onset at age
Page 87 and 88: C HAPTER IV E XPERIENCES OF TTW PAR
Page 89 and 90: • Most had positive experiences w
Page 91 and 92: some information on ENs before assi
Page 93 and 94: Exhibit IV.5. Participant Awareness
Page 95 and 96: designated in their individualized
Page 97 and 98:
cited problems with both types of p
Page 99 and 100:
Exhibit IV.12. Participants’ Pers
Page 101 and 102:
C HAPTER V E XPERIENCES OF TTW PART
Page 103 and 104:
participants were aware that they h
Page 105 and 106:
Exhibit V.2. Selected Reasons for U
Page 107 and 108:
procedures), but TTW service users
Page 109 and 110:
C. SCHOOL ENROLLMENT AND DEGREE-SEE
Page 111 and 112:
Exhibit V.8. Phase 1 Beneficiaries
Page 113 and 114:
Exhibit V.9. Service Use Among Bene
Page 115 and 116:
Exhibit V.11. Types of Services Use
Page 117 and 118:
C HAPTER VI E XPERIENCES OF TTW PAR
Page 119 and 120:
have the same level of alternative
Page 121 and 122:
Exhibit VI.1. Employment Rates for
Page 123 and 124:
Exhibit VI.3. Benefits Associated w
Page 125 and 126:
pipeline cases in terms of characte
Page 127 and 128:
Exhibit VI.7. Occupation and Indust
Page 129 and 130:
Exhibit VI.9. Employer-Provided Acc
Page 131 and 132:
Exhibit VI.11. Job Satisfaction Amo
Page 133 and 134:
C HAPTER VII N ONPARTICIPATION IN T
Page 135 and 136:
percentage of beneficiaries worked
Page 137 and 138:
somewhat higher Section 1619(b) use
Page 139 and 140:
Exhibit VII.4. Rates of Unsuccessfu
Page 141 and 142:
children living with them. They are
Page 143 and 144:
Exhibit VII.6. Simulated Probabilit
Page 145 and 146:
The above discussion is not intende
Page 147 and 148:
C HAPTER VIII E MPLOYMENT N ETWORK
Page 149 and 150:
e an “unpopular” program. In ou
Page 151 and 152:
Exhibit VIII.3. Ticket Assignments
Page 153 and 154:
Exhibit VIII.6. Effective Provider
Page 155 and 156:
Exhibit VIII.8. Distribution of EN
Page 157 and 158:
This analysis is limited to earning
Page 159 and 160:
In 2003, SSA introduced the Certifi
Page 161 and 162:
C HAPTER IX E MPLOYMENT N ETWORK R
Page 163 and 164:
eneficiary assigning a Ticket. Howe
Page 165 and 166:
payments, we estimate that follow-u
Page 167 and 168:
for each additional outcome payment
Page 169 and 170:
Exhibit IX.3. Comparison of Current
Page 171 and 172:
percent of the average benefit, kee
Page 173 and 174:
• An EN could break even by reduc
Page 175 and 176:
Exhibit IX.4. Hypothetical EN Reven
Page 177 and 178:
72 percent, increasing revenue by 1
Page 179 and 180:
would have to place into employment
Page 181 and 182:
C HAPTER X E XPERIENCE OF S ELECTED
Page 183 and 184:
2. Financing TTW For nearly all of
Page 185 and 186:
employment services) did not expand
Page 187 and 188:
that would reduce their costs and/o
Page 189 and 190:
Of the remaining 11 ENs, 4 have acc
Page 191 and 192:
3. Funding and Services In general,
Page 193 and 194:
Exhibit X.1. EN Revenues per Ticket
Page 195 and 196:
the rest away is the most essential
Page 197 and 198:
consistently has trouble obtaining
Page 199 and 200:
practices may be worth considering,
Page 201 and 202:
C HAPTER XI E XPERIENCE OF S TATE V
Page 203 and 204:
• Priority category one includes
Page 205 and 206:
Ticket until they know whether the
Page 207 and 208:
may only check in with the client q
Page 209 and 210:
Claims Allowed The number of benefi
Page 211 and 212:
counselors, emphasizing its own eli
Page 213 and 214:
traditional system—a feature in o
Page 215 and 216:
C HAPTER XII TTW PROGRAM I MPLEMENT
Page 217 and 218:
office had more experience processi
Page 219 and 220:
eneficiaries, down from 65,000 to 7
Page 221 and 222:
C. INFORMING PROVIDERS To increase
Page 223 and 224:
The Program Manager has produced tw
Page 225 and 226:
1. Training and Technical Assistanc
Page 227 and 228:
verification, store EN data, and ge
Page 229 and 230:
ehabilitation services. The TTW leg
Page 231 and 232:
C HAPTER XIII TTW OUTCOMES AND I MP
Page 233 and 234:
Additionally, the relatively small
Page 235 and 236:
included an upper age restriction t
Page 237 and 238:
Exhibit XIII.2. Summary of Outcome
Page 239 and 240:
were living in states where TTW had
Page 241 and 242:
D. IMPACTS ON SERVICE ENROLLMENT Th
Page 243 and 244:
The aggregate upper-bound estimates
Page 245 and 246:
eneficiaries (approximately 10 perc
Page 247 and 248:
earlier cohorts indicate the presen
Page 249 and 250:
The opportunities for generating ad
Page 251 and 252:
C HAPTER XIV P AYMENTS M ADE U NDER
Page 253 and 254:
We do not have any data on the exte
Page 255 and 256:
those with no payments) was $258. S
Page 257 and 258:
cohorts. Also considered are the di
Page 259 and 260:
earnings at a level that would redu
Page 261 and 262:
in that group. Each graph shows the
Page 263 and 264:
Exhibit XIV.7. Tickets with Payment
Page 265 and 266:
Even if the percentage of participa
Page 267 and 268:
C HAPTER XV TTW PARTICIPATION BY B
Page 269 and 270:
provider and payment types to which
Page 271 and 272:
cost accommodations. Appendix E sho
Page 273 and 274:
Exhibit XV.2. Selected Beneficiary
Page 275 and 276:
1 and 2 differ in some important re
Page 277 and 278:
etardation as a condition causing l
Page 279 and 280:
Exhibit XV.5 clearly shows the rela
Page 281 and 282:
C HAPTER XVI C ONCLUSIONS AND I MPL
Page 283 and 284:
difference might reflect unrealisti
Page 285 and 286:
TTW has not yet substantially expan
Page 287 and 288:
SSA’s proposed new regulations of
Page 289 and 290:
the administrative and other effort
Page 291 and 292:
oll out gradually over the period,
Page 293 and 294:
R EFERENCES Adequacy of Incentives
Page 295 and 296:
Mashaw, Jerry L., and Virginia P. R
Page 297 and 298:
White, Justin S., William E. Black,
Page 299 and 300:
A PPENDIX A T ICKET TO W ORK T IMEL
Page 301:
Table A.2. States and Territories I
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