Disability Policy Research

The Center for Studying Disability Policy (CSDP) supplies the nation's policymakers with the information they need to navigate the transition to 21st-century disability policy. CSDP provides leadership and support for research and data collection conducted by Mathematica. To keep our work grounded in the realities facing people with disabilities, we communicate and collaborate closely with leading disability organizations and service providers. CDSP focuses on analyzing and evaluating interventions designed to empower people with disabilities and promote more efficient use of the nation's resources to address two fundamental issues confronting disability policy:

• Fragmentation in financing and service delivery, which can jeopardize well-being, undercut service effectiveness, and waste resources.
• Unintended disincentives, which can discourage people with disabilities from helping themselves, employers from hiring or retaining them, and programs and providers from delivering services.

Policymakers need up-to-date and high-quality information about children with disabilities and their family circumstances to address health care, education, and the transition to adulthood. Our work in this area includes the following:

• A study of how states integrate funding streams to support coordinated systems of care for children with serious emotional disorders. The findings are helping address fragmentation in health care financing and delivery that can overwhelm parents.
• An evaluation of the Youth Transition Demonstration projects that help young people make the transition to adulthood and become more independent and economically secure adults. As they grow older, many of these youth face disincentives to living independently and supporting themselves through work, as well as changes in financing for services and availability of income support. Mathematica has a long history in this area, beginning with the evaluation of the Transitional Employment and Training Demonstration, the first major demonstration to improve adult outcomes for youth with serious intellectual disabilities.

Employment issues are the focus of policy research on working-age adults with disabilities but are intertwined with health care, accommodation, parenting, and other issues. Our work in this area includes the following:

• The evaluation of the Ticket to Work program, a performance-based voucher initiative to help Social Security Disability Insurance (DI) beneficiaries and Supplemental Security Income (SSI) recipients return to work and leave the program.
• A study of state Medicaid Buy-in programs, designed to give workers with disabilities better access to health care without having to enroll in DI or SSI. We are producing implementation statistics and also evaluating Medicaid Demonstrations to Maintain Independence and Employment, which have the same goals as the Buy-In programs.
• The evaluation of the State Partnership Initiative, a major effort to encourage people with disabilities to become employed through a combination of stronger work incentives, benefits counseling, and employment supports.
• A study to help state welfare programs deal with challenges created by the Temporary Assistance for Needy Families program, which requires parents with disabilities to work and provides support to help find work, but also encourages some to apply for SSI benefits. We are helping state welfare agencies address these conflicting objectives.
• An evaluation of a model program in Oklahoma to help people with serious psychiatric disorders discharged from institutions address barriers to services and employment that often result in return to an institution.

Adults of all ages with disabilities face challenges with health care, personal assistance, and community services needed to live independent and fulfilling lives. The following exemplify our work in this area:

• The evaluation of the Cash and Counseling Demonstration. Individuals with disabilities or their guardians received cash payments, empowering them to hire their own personal caregivers, and counseling to support this effort.
• Evaluations of interventions that address fragmentation in service delivery, including the Program for All-Inclusive Care of the Elderly, Social Health Maintenance Organizations, Community Partnerships for Older Adults Program, Medicare Coordinated Care Demonstration, and Medicare Disease Management Demonstration.
• The evaluation of Money Follows the Person, in which state Medicaid agencies help enrollees transition from institutional facilities to the community.

We are at the forefront of efforts to improve disability data and statistics. Our efforts in this area include:

• The long-standing work of our Surveys and Information Services Division to develop best practices for surveys of people with disabilities to ensure that they are fully represented. Two recent surveys exemplify this approach: the National Survey of SSI Children and Families, part of the evaluation of the effects of welfare reform, and the National Beneficiary Survey, which collects data on employment activities of all working-age DI and SSI recipients. The latter is part of our data collection for evaluations of the Youth Transition Demonstration and the Accelerated Benefits Demonstration.
• Development and maintenance of a longitudinal analytic research file on working-age DI and SSI beneficiaries, using the Social Security Administration's Ticket Research File (TRF). The TRF contains information on more than 19 million working-age adults who received at least one month of DI or SSI benefits from 1996 through 2006. We have supported multi-agency efforts to match TRF records to administrative records of Medicaid and Medicare beneficiaries, as well as clients of state vocational rehabilitation programs. Our researchers have used the TRF to conduct the Ticket to Work evaluation, produce statistics on Medicaid Buy-In participants, and help design the Accelerated Benefits and Benefit Offset demonstrations.