Does Ticket to Work Work?

A special issue of the Journal of Vocational Rehabilitation (volume 27, number 2, 2007), titled "Ticket to Success? Early Findings from the Ticket to Work Evaluation," summarizes the early implementation experiences and impacts of the Ticket to Work (TTW) program. The program, together with other initiatives created by the Ticket to Work and Work Incentives Improvement Act, attempts to develop a new employment services marketplace to increase the level and mix of employment support services for people who receive disability benefit payments from the Social Security Administration (SSA). Rather than setting up a single training program, TTW includes payment mechanisms designed to induce employment-service providers to increase the supply of programs and the range of approaches. Six papers in the special issue, edited by Craig Thornton, Robert Weathers, and David Wittenburg, provide an early picture of both the potential for the TTW program and the challenges involved with reaching this potential:

"Slow Change in the Employment Services Market: The Early Years of Ticket to Work." Craig Thornton and Paul O’Leary. This paper reviews early findings for the three essential ingredients necessary for TTW success: (1) beneficiary demand for employment services that will enable them to eventually leave SSA benefits; (2) an adequate supply of employment service providers that can deliver effective employment support services; and (3) efficient support from SSA to facilitate the new market, including the provision of information to beneficiaries and providers and the management of the ticket payment system. Survey data indicate that many beneficiaries have at least a general interest in employment services that TTW could fill. The supply of new and innovative employment service providers, however, has thus far been anemic because of providers' perception that the new program is too risky and cumbersome relative to potential payments offered. SSA has made strides in implementing the program and continues to offer program changes to improve how TTW functions.

"Social Security Disability Beneficiaries: Characteristics, Work Activity, and Use of Services." Gina A. Livermore, Nanette Goodman, and Debra Wright. This article presents findings from the 2004 National Beneficiary Survey, a nationally representative survey of Social Security disability beneficiaries conducted by Mathematica for SSA as part of its Ticket to Work program evaluation. The data provide an overview of the health and sociodemographic characteristics of Social Security disability beneficiaries, and highlight their employment activity, work aspirations, and use of employment-related services. Although most beneficiaries have significant health problems that limit their ability to work, the data suggest that there is potential demand for employment and employment-related services among Social Security disability beneficiaries. The data also suggest, however, that even if beneficiaries have employment aspirations and attempt to work, many potential challenges need to be addressed. In addition to the activity limitations and poor health associated with their disabling conditions, most beneficiaries have low levels of education that might limit their employment opportunities; are living at or near poverty, suggesting that they and their families may rely on public programs for which eligibility could be jeopardized by earnings; and many have experienced work-related obstacles, such as a lack of reliable transportation, inaccessible workplaces, and discouragement from work either by others or through their own experiences.

"Beneficiary Participation in Ticket to Work." David Stapleton, Gina Livermore, and Jesse Gregory. The authors examine the participation of SSA disability beneficiaries in the TTW program through December 2004. On an absolute scale, participation is very low, and perhaps much lower than many had hoped. Participation is not low relative to the historical rate for program exits due to work, however, and certain groups of beneficiaries participate at higher rates than others. A large majority of participants assign their Tickets to state vocational rehabilitation agencies (SVRAs), predominantly under the traditional, cost-reimbursement payment system. Most SVRA administrators indicate that they have not made major changes to the way they serve their beneficiary clients as a result of TTW. These findings suggest that, through December 2004, TTW does not represent a significant departure from the past. Participants with Tickets assigned to Employment Networks (ENs) are substantially more likely than those with Tickets assigned to SVRAs to earn at a level that will lead to program exit. This finding likely reflects the strong incentives that ENs have to serve only those with a high likelihood of exiting the rolls, but might also reflect greater focus on achievement of high earnings.

"Experiences of State Vocational Rehabilitation Agencies with the Ticket to Work Program." Bonnie O’Day and Grant Revell. The authors examined administrative data from the SSA and the Rehabilitation Services Administration and conducted site visits and telephone interviews with SVRA officials in 25 states as part of a five-year evaluation of the TTW program. The recession of 2001-2002, along with recent financial constraints resulting from increased service demand and shrinking state budgets, has negatively affected implementation. SVRAs have spent significant time and energy implementing TTW, particularly assigning Tickets with little apparent benefit to their clients, according to SVRA officials. They also expressed concerns about conflicts between the necessity to obtain Ticket assignments from new and existing clients to receive SSA payments under the traditional cost reimbursement system and the requirements to provide maximum consumer choice under the Rehabilitation Act. New draft regulations rescind this requirement, and it remains to be seen what the future role of SVRAs will be.

"The Involvement of Employment Networks in Ticket to Work." Tim Silva. A major key to success for TTW would be increasing consumer choice and establishing a competitive market for return-to-work services. State vocational rehabilitation agencies long had been the dominant players in this field, but under TTW, a wide variety of private and public entities can register as Employment Networks (ENs) to accept Tickets from, and provide services to, disability beneficiaries who want to work at a level that will take them off cash benefits. A variety of measures suggest that ENs' involvement has been limited. By June 2005, about 1,400 organizations were registered as ENs, but they were not necessarily readily available to many Ticket-eligible beneficiaries. A majority of ENs had not accepted a single Ticket, and ENs accounted for less than 10 percent of all Ticket assignments. ENs' involvement in TTW has been substantially influenced by three main factors: concerns about financial feasibility, low demand for EN services, and administrative challenges.

"Initial Impacts of the Ticket to Work Program on Social Security Disability Beneficiary Service Enrollment, Earnings, and Benefits." David Wittenburg, Thomas Fraker, David Stapleton, Craig Thornton, Jesse Gregory, and Arif Mamun. This paper presents estimates of TTW impacts on service enrollment, earnings, and benefit amounts during the first two years of program implementation. Estimates indicate that TTW had a small impact on promoting service enrollment during the first year of rollout. However, there is no compelling evidence that TTW affected beneficiary earnings and benefits during its first two years. Impact findings for all outcomes are consistent with the expectation that changes in service enrollment would occur before changes in either earnings or benefit receipt. Additionally, the relatively small size of the service enrollment impacts is consistent with the low TTW participation rate, which was less than 1 percent during the first year of the rollout.