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

xxIn Phase 3, which began in November 2003, TTW was implemented in the remaining 17states and U.S. territories. At the end of the rollout in September 2004, SSA had mailedTickets to more than nine million beneficiaries, who are now free to seek services from anEN or an SVRA, or not to seek services at all.This report, the second from the Ticket to Work Evaluation, provides an interim lookat the program during its second two years of operation, 2003–2004, in order to facilitate theprogram refinement process. The report draws primarily on information collected orcompiled during 2004, including SSA administrative records; a national survey of disabilitybeneficiaries; and interviews with SSA staff, the Program Manager, and representatives ofENs and SVRAs. The report examines beneficiary participation in TTW, beneficiarycharacteristics and outcomes, the implementation activities of SSA and the ProgramManager, and the roles that SVRAs and ENs are playing in the program. It also examinestwo broad policy issues that are central to the design and success of TTW: whether and theextent to which financial incentives are strong enough to encourage ENs to serve disabilitybeneficiaries, and the extent to which the program is reaching beneficiaries who may needmore intensive supports or assistance to succeed in the work force. Finally, the reportfocuses on operations in Phases 1 and 2. It does, however, provide some implementationinformation about the Phase 3 rollout, which was in progress when data for this report werecollected, but most of the report’s statistics pertain only to Phases 1 and 2.MAJOR FINDINGS AND CONCLUSIONSOverall, we found that SSA has successfully implemented the TTW program asdesigned, but some limitations inherent in the design have become apparent and will need tobe addressed.One limitation is the low rate of participation in TTW. Even in the Phase 1 states,where the program has operated the longest, just 1.1 percent of beneficiaries have assignedtheir Ticket to a provider. This participation rate reflects, in part, the paradox inherent inTTW: Its goal is to promote work among a group of individuals judged to be incapable ofsubstantial employment, which is they very basis for receiving disability benefits from eitherthe DI or SSI program. In reality, the vast majority of beneficiaries will not attempt tosecure a job once they are on the rolls. For instance, only about 2.5 percent of anyenrollment cohort will ultimately leave the rolls due to work, and less than 0.5 percent of allbeneficiaries on the rolls at a point in time eventually leave due to work (Newcomb et al.2003; Berkowitz 2003). Nevertheless, our findings from the TTW evaluation surveyssuggest that many more beneficiaries express interest in returning to work and leaving thebenefit rolls. Thus, it seems that TTW has some unfulfilled potential and that it would beworthwhile to investigate ways to increase beneficiary participation.The second limitation is the relatively low rate at which service providers activelyparticipate in TTW. While more than 1,100 providers had registered as ENs by June 2004,60 percent of them have not yet accepted any Tickets, and the program manager reports thatit has become increasingly difficult to recruit more ENs. Our analysis suggests that this lowparticipation rate is at least partially a result of the structure of TTW payments, which doesExecutive Summary