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

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66ENs were reluctant to expand services or otherwise alter their processes and structuresfor a revenue stream they viewed as shaky. Although we discovered a few innovative servicemodels, most ENs provide the same services to SSA beneficiaries that they always have.Some provide low levels of service, such as assisting with resume preparation and referral tojob openings. Other ENs simply refer Ticket holders to SVRAs, who then refer thebeneficiary back to the EN for payment under an existing service agreement. Almost all ofthe ENs we interviewed had served SSA beneficiaries before TTW was initiated.ENs typically were paying for overhead and direct services out of other existing fundingsources, not with revenues from Ticket payments. Only 31 percent of ENs nationwide whohad accepted Tickets had received any payments; 76 percent of them had received less than$5,000. Not surprisingly, the ENs we interviewed for this report overwhelmingly suggestedchanges to the payment systems, such as larger milestone or up-front payments. We returnto this issue in Chapter VIII which simulates the financial incentives TTW provides to ENs.A. OVERVIEW OF EN AVAILABILITYA major goal of the TTW legislation is to increase the supply of rehabilitation providersby offering payments to ENs who assist SSA beneficiaries to leave the benefit rolls. Beforethe TTW legislation was passed, SSA offered payments to SVRAs (and, for a few years,organizations in the Alternate Participant Program) for serving beneficiaries. The legislationis based upon the assumption that agencies with the potential to serve SSA beneficiaries willparticipate as ENs to the extent that there is demand for return-to-work services and thepayments cover their costs. The purpose of this section is to review the availability of ENsand draw conclusions as to whether the supply of rehabilitation providers has actuallyincreased through their participation.Since the initial evaluation report was prepared in fall 2003, the number of providersparticipating in TTW as ENs has continued to grow, reaching 1,164 at the end of June 2004(Figure V.1). The slower pace of EN enrollment in spring 2004 was, according to theProgram Manager, the result of market saturation and increasing difficulty in selling “aproduct that nobody wants to buy.” In early fall 2004, as TTW neared full implementation, 1the Program Manager was beginning to focus EN recruiting efforts on specific providergroups, such as nontraditional or faith-based providers, and on ENs in major metropolitanareas where large numbers of beneficiaries reside.Although the number of ENs has grown over time, most ENs still have not acceptedany Tickets, continuing a trend discussed in the initial evaluation report (Figure V.1). Of themore than 1,100 ENs enrolled in TTW at the end of June 2004, only 454 (40 percent) hadany Ticket assignments (Table V.1). Furthermore, most of the ENs that have acceptedTickets have accepted 4 or fewer. Less than 3 percent of ENs had 30 or more Tickets.1 Phase III was fully implemented by October 2004.V: EN Participation in Ticket to Work
67Figure V.1.Cumulative Number of ENs, by Month1400120010008006004002000Jan-01Mar-01May-01Jul-01Sep-01Nov-01Jan-02Mar-02May-02Jul-02Sep-02Nov-02MonthActive ENs with Ticket(s)Jan-03Mar-03May-03Jul-03Active ENsSep-03Nov-03Jan-04Mar-04May-04Jul-04Source: EN provider file, June 2004.Note: The figure excludes 73 ENs that have formerly withdrawn from the TTW program.Table V.1. Ticket Assignments to ENsNumber of Ticket AssignmentsNumber of ENs with Each Levelof AssignmentsPercent of ENsNone 681 60.01-4 253 22.35-29 171 15.130-50 14 1.250-100 8 0.7> 100 8 0.7Total 1,135 100.0Source: Ticket Research File, March 2004, and EN Provider File, June 2004.V: EN 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
Page 40 and 41: 16was selected for Phase 3. This ma
Page 42 and 43: 18All of the statistics in this sec
Page 44 and 45: Table II.2. Beneficiary Groups with
Page 46 and 47: 22In all Phase 1 and Phase 2 states
Page 48 and 49: 24Figure II.8. Ticket Participation
Page 50 and 51: 26Adjustments for all other charact
Page 52 and 53: 28In general, provider and payment
Page 54 and 55: 30next report, we will conduct more
Page 56 and 57: 32Figure III.2.Living Arrangements
Page 58 and 59: 34• Less likely to have reported
Page 60 and 61: 36Figure III.7.Prevalence of Diffic
Page 62 and 63: 38are more likely than all benefici
Page 64 and 65: 40Table III.1.Income and Program Pa
Page 66 and 67: 42coverage through their own employ
Page 68 and 69: 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 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 120 and 121: 96SSA payments to SVRAs under the T
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
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116To make EN recruiting efforts mo
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118E. EN ENROLLMENTThe Program Mana
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120beneficiaries who have achieved
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122quarterly basis if they have rec
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124SSA’s approval of systems spec
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128have accepted. But even at that
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130For beneficiaries who express an
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132rehabilitation counselors (Burea
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134generated a payment to an EN gen
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136the milestone-outcome payment ge
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138system is used so infrequently t
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140One option is for ENs to try to
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142approximations. Our planned anal
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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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