Ticket to Work: Helping People with Disabilities Find and Keep Jobs

Mathematica and its subcontractor Cornell University are conducting a five-year evaluation of the Ticket to Work (TTW) program, a major initiative of the Social Security Administration to increase disability beneficiaries' employment and reduce their dependence on benefits.

The TTW program increases beneficiaries' choice of employment-support providers by expanding the types of organizations that SSA will pay to assist beneficiaries' work efforts. Prior to TTW, SSA essentially funded only state vocational rehabilitation agencies to help beneficiaries. Now, it will pay a wide array of public and private providers, called employment networks (ENs). TTW also introduces a new financing system for the ENs. This system provides performance incentives for ENs because they receive full payment only when a beneficiary they served earns his or her way off the rolls and stays off for 60 months. The old system for state vocational rehabilitation agencies, which still exists, did not require beneficiaries to actually leave the rolls, only that they accrue earnings for nine months at a level consistent with SSA's definition of substantial gainful activity.

Service delivery in TTW is constrained, however, by providers' desire to limit expenditures to a level that fits within the payments they expect to receive. Service delivery is also constrained by providers' perceptions of whether the services they provide are likely to result in a beneficiary leaving the rolls. In fact, providers can refuse to serve beneficiaries they view as unlikely to leave the rolls for work.

Mathematica is assessing program implementation and effects on employment, earnings, and benefit receipt. Special attention is being paid to how well the program serves beneficiaries who may have difficulty finding a provider. The evaluation includes a series of surveys: one focused on a nationally representative sample of all beneficiaries and another focused only on beneficiaries who have used their Ticket to Work. In total, we are conducting more than 20,000 beneficiary interviews on a range of issues, including disability and work status, awareness of TTW and other work incentive programs, program experiences, employment services used, health and functional status, health insurance, income and other assistance, sociodemographic characteristics, and other issues.

A 2007 report to Congress notes that TTW slightly increased beneficiary use of employment services in 2002, the first rollout year. However, the increase did not appear to produce a corresponding increase in beneficiary earnings or a reduction in benefit payments during the first two years. The authors note that impacts for 2004 and later may be larger—participation rates continue to increase, and many nonparticipants say they plan to assign their Tickets. Nevertheless, analysis of trends in TTW payment data suggests that the program would have to induce future shifts in beneficiary behavior that are much larger than what has been observed so far in order to generate the level of exits from the program envisioned by Congress. In particular, meeting the exit goal will require TTW participation to increase substantially and a larger share of participants to earn enough so that they no longer receive cash benefits.

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