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

1095. Elimination of the DDS Referral ProgramThe eight SVRAs differ in terms of how they feel about the extent to which theelimination of the DDS referral program, a consequence of the TTW legislation, has affectedreferrals to them. Two states have examined the traditional program, in which DDS officesreferred individuals directly to the SVRA, and determined that few individuals referred fromDDS (only 4 percent, according to one state) ultimately became SVRA clients. Two statesindicated that the previous link with the DDS program was not only extremely valuable butalso a primary source of referrals, noting that the elimination of the DDS referral programhas led to small but significant decreases in referrals to the agency. The remaining fourstates indicated that it was too early to assess the effect of eliminating the referral program.6. Administrative BurdenThe eight SVRAs all reported that TTW has increased their administrative burden underthe traditional payment system; as a result, their costs have risen as well. Respondentsindicated that central office staff and local rehabilitation counselors spend a substantialamount of time explaining the program to beneficiaries, encouraging them to assign theirTickets to the SVRA, and trying to ensure that beneficiaries exercise informed choice inassigning their Ticket. TTW’s administrative burden is a significant concern because anyincrease in SVRA administrative costs will reduce net revenues.F. SUMMARY AND CONCLUSIONSVRAs continue to play a major role in TTW simply because they are the dominantproviders of employment services for people with disabilities. To date, over 90 percent ofTicket assignments have gone to SVRAs, a trend that has remained steady since programlaunch. While TTW has changed SVRA operations in some respects, the number and typeof core services provided to SSA beneficiaries appear to have remained the same.Furthermore, SVRAs choose the traditional payment system for almost all their Tickets asopposed to one of the two new payment systems. Together, these findings suggest thatmost beneficiaries participating in TTW are doing so under virtually the conditions thatwould have been in place before TTW was created.SVRA officials remain unconvinced that the new payment options will be as lucrative asthe traditional system, and they are not alone. As documented in Chapter V, some ENswould rather operate as vendors to SVRAs under cost reimbursement than as independententities waiting to collect milestone or outcome payments. SVRAs also remain concernedabout the potential impact of lost cost reimbursement payments.SVRA-EN agreements do not appear to foster a positive relationship between the twotypes of providers. Influenced by the current interpretation of comparable benefits, mostSVRAs have drafted agreements that create significant financial risks for ENs. It is notsurprising, therefore, that many ENs have shied away from the agreements.Employment Outcomes for SVRA Clients. The share of SSA beneficiaries that haveassigned their Ticket to an SVRA and met the employment criteria for generating a paymentVI: State Vocational Rehabilitation Agency Participation in Ticket to Work