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

ut had reached only 0.6 percent by March 2004. 2 Participation rates are substantially higherfor some beneficiary groups than others. For example, rates are higher for youngbeneficiaries, those with sensory impairments or some college education, and those who livein certain states or participate in DI or SSI work incentive programs, but no group has anextraordinarily high rate. Even for those with hearing impairments, the group with thehighest identified participation rate, the rate is under 6 percent in the Phase 1 states.It is important to note that the observed participation rates reflect not only abeneficiary’s decision to enter the program but also the beneficiary’s ability to find a providerwilling to accept their Ticket. In other words, the rates reflect beneficiary demand foremployment services as well as the supply of providers willing to accept Tickets under thecurrent payment system. Raising the participation rate is therefore likely to involve targetingboth beneficiaries and providers.Interestingly, there is some preliminary evidence that participation is higher than averageamong the four groups of beneficiaries identified by the Ticket Act as those likely to havedifficulty obtaining services in the performance-based TTW environment: (1) individualswith a need for ongoing support and services, (2) individuals with a need for high-costaccommodations, (3) individuals who earn a subminimum wage, and (4) individuals whowork and receive partial cash benefits. To some extent, this finding reflects the fact that weimperfectly identified these groups on the basis of the available administrative data. As aresult, we have probably included some individuals who do not face substantial barriers togetting services along with those who do. In our next report, we will examine participationrates based on the survey data, which will allow us to substantially refine the definitions ofthese groups.In assessing participation rates, it is important to remember that there has always beensome uncertainty about how many beneficiaries will participate in the TTW program. Theprogram designers saw TTW as a way to change expectations and opportunities, therebyimproving a system under which only one-half of one percent of beneficiaries left the rollsbecause of employment (Mashaw and Reno 1996; Berkowitz 2003). In essence, thereseemed to be a sense that the old system was not effective in helping beneficiaries reach theirfull potential and that the new system could only make things better.In the Ticket Act, Congress did not set out expectations for participation rates, althoughit did refer to the historically low rate of exits due to employment and expressed hopes for adoubling of that rate to at least one percent of beneficiaries. Thus, one way to viewparticipation rates is whether they are high enough to generate an increase in program exitsdue to work. The participation rates are higher than 0.5 percent, so the program has thepotential to increase access to services and thereby increase work-related program exits.Also, as noted in Chapter IV of this report, there is some suggestive evidence that TTW mayhave such an effect. However, any clear conclusions about this issue cannot be drawn untilthe impact findings, presented in the next evaluation report, are available.1572 We do not analyze Phase 3 participation rates in this report, because at the time we conducted theanalysis we only had data from the first 5 months of the Phase 3 rollout.X: Conclusions and Implications