Evaluation of the Ticket to Work Program, Implementation ...

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96SSA payments to SVRAs under the TTW program primarily supplement the caseservice funds used by the agencies to purchase specific services for clients. While SSAdisability beneficiaries account for about 25 percent of SVRAs’ case closures, funds fromSSA account for less than 10 percent of SVRA case services monies. In FY2003, SSAreimbursements paid to SVRAs totaled approximately $80 million, roughly 6 percent of thetotal SVRA expenditures for purchased services of $1.34 billion. Thus, SVRAs have serveddisability beneficiaries through their primary funding sources with a small but nonethelesssignificant supplement provided by SSA TTW funds.To a great extent, SSA payments are a far smaller fraction of total revenue than DI/SSIbeneficiaries are of all people served by SVRAs because SVRAs have received SSAreimbursements for less than 10 percent of the SSA beneficiaries on their caseloads eachyear. SSA reimburses SVRAs (up to a limit) for the costs they incur to serve beneficiarieswho earn at least the substantial gainful activity level (currently $830 per month for mostbeneficiaries) for nine months. 3 Many beneficiaries who receive SVRA services do not earnat the substantial gainful level and so do not generate a payment from SSA.Our initial evaluation report indicated that, at the beginning of the TTW program,SVRAs viewed TTW as a major threat to a funding stream that, albeit relatively small, hadbecome increasingly important over the past two decades. Figure VI.2 provides historicalinformation on the number and amount of SSA payments to SVRAs under the traditionalpayment program. During the early and mid-1990s, SVRAs were reimbursed forsuccessfully serving about 5,600 to 7,300 individuals each year. As of the late 1990s, SVRAsbegan to serve a larger number of individuals. From 1998 to 2002, SVRAs received SSAreimbursements for an average of approximately 10,000 individuals each year, at an annualcost to SSA of over $100 million. Then, in FY2003, the number of reimbursements to statesdropped significantly, to about 6,800.Figure VI.3 presents another view of SSA expenditures on employment services,indicating the total payments made to SVRAs and ENs. Like Figure IV.2, Figure VI.3 alsoshows the decline in payments, from about $130 million in FY2002 to about $85 million inboth FY2003 and FY2004. What is almost invisible are the payments to ENs in 2002–2004(in 2004 those payments were $785,000, which is less than 1 percent of total payments).(continued)and informed choice. An individual may achieve a successful closure yet not meet the SGA earnings level inany given month. An unsuccessful closure occurs when an individual leaves the SVRA service rolls beforeachieving an employment outcome.3 Since 1981, SSA reimbursed SVRAs for services provided to SSA beneficiaries that result in specifiedemployment outcomes. Despite considerable state-to-state variation under the SSA VR ReimbursementProgram (the traditional payment program), the state Disability Determination Services (DDS) Programgenerally referred to SVRA new beneficiaries who appeared to be possible candidates for rehabilitation. If theSVRA was able to assist the beneficiary in achieving employment at or above SGA for 9 months in a 12-monthperiod, SSA reimbursed SVRA for the “reasonable and necessary” costs of providing rehabilitation services toan eligible beneficiary. With the inception of the TTW program, the DDS referral program was eliminated, butSSA continues to reimburse SVRAs for individuals who meet the specified employment criteria.VI: State Vocational Rehabilitation Agency Participation in Ticket to Work
This distribution of payments confirms the growing sense among SVRAs that shrinkingpayments from SSA are not a function of increased payments to ENs. The distribution alsooffers a second perspective on SVRAs’ dominance in the market to support employmentefforts by disability beneficiaries.Figure VI.2. SSA Claims Allowed and SSA Payments to SVRAs Under the TraditionalPayment Program, by Year9712000$140,000,00010000$120,000,000Claims Allowed800060004000$100,000,000$80,000,000$60,000,000$40,000,000Total Reimbursements2000019831984198519861987198819891990Claims Allowed1991199219931994Fiscal Year1995199619971998199920002001200220032004Total Reimbursement Cost$20,000,000$0Source: Social Security Administration 2004.VI: State Vocational Rehabilitation Agency Participation in Ticket to Work
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A CKNOWLEDGMENTSThe Ticket To Work
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viiiChapterVI(CONTINUED)PageF. SUMM
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xChapterPageAPPENDIX A: TICKET TO W
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xiiTableVIII.3IX.1IX.2IX.3IX.4IX.5I
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xivFigureIII.5III.6III.7III.8III.9P
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xviIX.3EARNINGS OF BENEFICIARIES WI
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xviiiMIENBSNPRMOAGPABSSPSUSGASSASSI
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xxIn Phase 3, which began in Novemb
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xxiigroups of beneficiaries that Co
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xxivimprove TTW, therefore, is to f
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2of disability beneficiaries, and i
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4country. Phase 2 began in November
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Page Is Intentionally Left Blank to
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8Only a few beneficiary characteris
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10Figure II.2.Participation Rate, b
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12Figure II.4.First Assignments at
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14before Ticket, it is perhaps surp
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16was selected for Phase 3. This ma
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18All of the statistics in this sec
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Table II.2. Beneficiary Groups with
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22In all Phase 1 and Phase 2 states
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24Figure II.8. Ticket Participation
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26Adjustments for all other charact
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28In general, provider and payment
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30next report, we will conduct more
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32Figure III.2.Living Arrangements
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34• Less likely to have reported
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36Figure III.7.Prevalence of Diffic
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38are more likely than all benefici
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40Table III.1.Income and Program Pa
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42coverage through their own employ
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44sizable percentage of TTW partici
Page 70 and 71: 46Overall, 9 percent of working-age
Page 72 and 73: 48leave the rolls in the next year,
Page 74 and 75: 50next year and in the next five ye
Page 76 and 77: 52in their characteristics, levels
Page 78 and 79: 54percentage points to 3.7 percent.
Page 80 and 81: 56Figure IV.2. Phase 1 Ticket Recip
Page 82 and 83: 58situation described in the preced
Page 84 and 85: 60the end of the follow-up period w
Page 86 and 87: 62Figure IV.6. Average Monthly Bene
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Page 90 and 91: 66ENs were reluctant to expand serv
Page 92 and 93: 68As of July 2004, there were about
Page 94 and 95: 70But most EN representatives saw T
Page 96 and 97: 72Figure V.2. Number of EN Terminat
Page 98 and 99: 74received a total of just about $2
Page 100 and 101: 76Relatively few ENs have received
Page 102 and 103: 78According to their representative
Page 104 and 105: 80Five EN officials recognized that
Page 106 and 107: 82This was particularly true for so
Page 108 and 109: 84• Another EN representative fou
Page 110 and 111: 86• A third EN received 50 calls
Page 112 and 113: 88resolve administrative issues suc
Page 114 and 115: 90• Raise payments for SSI benefi
Page 116 and 117: 92Finally, the real and perceived w
Page 118 and 119: 94efforts to obtain Ticket assignme
Page 122 and 123: 98Figure VI.3. Total SSA Payments t
Page 124 and 125: 100assigning their Tickets to ENs (
Page 126 and 127: 102Table VI.1. SVRA Ticket Assignme
Page 128 and 129: 104case, the counselor selects the
Page 130 and 131: 106• Most of the agreements requi
Page 132 and 133: 108needs of SSA beneficiaries and,
Page 134 and 135: 110to the SVRA under the traditiona
Page 136 and 137: 112Tickets each month from November
Page 138 and 139: 114about submitting virtually ident
Page 140 and 141: 116To make EN recruiting efforts mo
Page 142 and 143: 118E. EN ENROLLMENTThe Program Mana
Page 144 and 145: 120beneficiaries who have achieved
Page 146 and 147: 122quarterly basis if they have rec
Page 148 and 149: 124SSA’s approval of systems spec
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Page 152 and 153: 128have accepted. But even at that
Page 154 and 155: 130For beneficiaries who express an
Page 156 and 157: 132rehabilitation counselors (Burea
Page 158 and 159: 134generated a payment to an EN gen
Page 160 and 161: 136the milestone-outcome payment ge
Page 162 and 163: 138system is used so infrequently t
Page 164 and 165: 140One option is for ENs to try to
Page 166 and 167: 142approximations. Our planned anal
Page 168 and 169: 144Figure IX.1. Ticket-Eligible Ben
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146Table IX.2.TTW Participation Rat
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148Figure IX.3. Earnings of Benefic
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150Compared with other beneficiarie
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152Like all other beneficiaries who
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This kind of mixed success in the e
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C. SVRA PARTICIPATION REMAINS STRON
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serving beneficiaries who are simil
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observe changes in their employment
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Mashaw, Jerry L., and Virginia P. R
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A-2Table A.1 (continued)Time Period
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Table B.1. DefinitionsB-2Variable D
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Table B.1 (continued)B-4Variable De
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Table B.1 (continued)Variable Defin
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B-8Table B.3. Participation Rate by
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B-10C. PARTICIPATION RATES BY BENEF
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Table B.6. Participation Rates by C
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Table B.6 (continued)Group Definiti
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Table B.6 (continued)B-16Group Defi
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C-2survey. Whenever possible, the i
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C-4given the large number of benefi
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C-6• Young SSI recipients who are
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C-8beneficiary may have had with EN
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C-10Table C.2. Overview of the Nati
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C-12Sample completes (n=1,178) and
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C.14Table C.3 (continued)AllIntervi
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C.16Table C.5. Final Weighted and U
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C.18Table C.7. Sociodemographic Cha
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C.20Table C.9. Health Status (Figur
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C.22Table C.11. Program Participati
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C.24Table C.14. Awareness of TTW (F
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C.26Table C.16. Employment Expectat
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D-2Table D.1. Selected Characterist
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D-4information from two pretest int
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