Table of Contents

Title Page

Acknowledgments

Exhibits

Acronyms

Executive Summary

I. Introduction

A. Ticket to Work and the Market for Employment Support Services

1. Efforts to Stimulate Beneficiary Demand for Employment Support Services
2. Increasing the Supply of Employment Support Service Providers
3. SSA's Efforts to Enhance Market Functioning

B. The Ticket to Work Evaluation

C. Data Sources for This Report

II. Characteristics of Working-Age Beneficiaries and Use of Employment Services

A. Beneficiary Characteristics

1. Program Characteristics
2. Sociodemographic Characteristics
3. Disability and Health Characteristics

B. Employment, Reasons for Not Working, and Employment Expectations

C. Use of Health, Employment, and Education Services

1. Service Use in 2003 and Characteristics of Users
2. Reasons for Using Services and Types of Services Among Users
3. School Enrollment and Degree-Seeking Behavior

D. Unmet Service Needs

E. Summary and Conclusions

III. Beneficiary Participation in Ticket to Work

A. Rollout Statistics

1. Ticket Mailings and Eligible Beneficiaries with Tickets
2. Participation Rate
3. Participation by Provider Type
4. In-Use Tickets by Payment Type
5. Deactivations and Reassignments
6. Participation Rates by State

B. Predictors of Participation

1. Findings from Analysis of Administrative Data
2. Findings from National Beneficiary Survey

IV. Experiences of TTW Participants: The Participation Process

A. Information Sources and Program Knowledge

B. Choices Regarding Ticket Assignment

C. Interaction with TTW Providers

D. Overall Perspectives on Outcomes and Providers

V. Experiences of TTW Participants: Use of Support Services

A. Employment Service Use in 2003 and Characteristics of Users

B. Service Users: Reasons for Using Services, and Types, Amounts, and Usefulness of Services Received

1. Reasons for Using Services
2. Types and Volume of Services Used
3. Usefulness of Services

C. School Enrollment and Degree-Seeking Behavior

D. Unmet Service Needs

E. Service Use by TTW Rollout Phase

1. Overall Rates of Service Use
2. Reasons for Using Services
3. Types of Services Used

VI. Experiences of TTW Participants: Job Characteristics of Employed Participants

A. Employment Rates

B. Hours, Earnings, Benefits, Tenure, Self-Employment, Industry, and Occupation

1. Hours, Wages, and Earnings
2. Employee Benefits
3. Job Tenure, Sheltered Employment, Self-Employment, Industry, and Occupation

C. Use of Special Equipment or Assistance and Employer Accommodations

D. Job Satisfaction

VII. Nonparticipation in TTW

A. Employment-Related Goals

B. Awareness of TTW

C. Involuntary Nonparticipants

D. Expectation of Future Participation In TTW

E. Targeting Potential TTW Participants

VIII. Employment Network Availability and Ticket Acceptance

A. Overview of EN Availability and Ticket-Taking Behavior

B. Payment Receipt Under the New Payment Systems

1. EN Payments Through July 2005
2. Payment Lag Time

IX. Employment Network Revenue and Costs

A. EN Financial Perspective under Current Regulations

1. Framework for Calculating EN Costs
2. Provider Experience Two Years after Rollout

B. Proposed Regulatory Changes to EN Payment System

1. Modifications in SVRA Participation
2. Modifications to Milestones-Outcomes and Outcomes-Only Payments
3. Expanding TTW Eligibility

C. Possible Effects of Proposed Regulatory Changes

1. Scenarios Where ENs Could Generate Profits
2. Likelihood of an EN Breaking Even Based on Available Data

D. Conclusions

X. Experience of Selected Employment Networks

A. Experience of Phase 3 ENs

1. How and Why Organizations Became Employment Networks
2. Financing TTW
3. Finding and Serving Ticket Holders
4. Administrative Experience
5. Current and Future Involvement in TTW
6. Suggestions for Program Improvement

B. Recent Experience of Phase 1 ENs

1. Marketing and Call Volume
2. Ticket Taking
3. Funding and Services
4. Collecting Paystubs and Obtaining Payments
5. Recommendations for Program Improvement

C. Financial Viability and Potentially Promising Practices

1. Potentially Promising Practices
2. Financial Viability

D. Summary and Conclusions

XI. Experience of State Vocational Rehabilitation Agencies

A. Resource Constraints

B. Ticket Assignments

1. Assignments from New Clients
2. Assignments from Pipeline Cases
3. Promoting Consumer Choice in the SVRA Application Process
4. Administrative Effort Associated with Ticket Assignments

C. Payments to SVRAs

D. Effect of TTW on Service Delivery

E. SVRA/EN Agreements

XII. TTW Program Implementation by SSA and the Program Manager

A. Implementation Overview

B. Informing Beneficiaries

1. Ticket Distribution and Toll-Free Telephone Call Center
2. Marketing to Beneficiaries

C. Informing Providers

1. Marketing to Providers
2. Training and Technical Assistance for ENs

D. Operating an Efficient Payment System

E. Systems Enhancements

1. Training and Technical Assistance to Regional and Field Office Staff
2. Systems Automation
3. Rules and Regulations
4. Summary

XIII. TTW Outcomes and Impacts

A. Overview of Approach to Estimating Impacts

B. Data Description

1. Administrative Data Includes Multiple SSA and RSA Administrative Data Files
2. Sample Includes All TTW Eligibles and Is Stratified by Age and Program Subgroups
3. Outcome Measures Include Annual Measures of Service Enrollment, Earnings, and Benefit Amounts

C. Econometric Model for Estimating Impacts

D. Upper- and Lower-Bound Impacts on Service Enrollment

1. Impacts by Age and Program Group Indicate Positive Upper-Bound Impacts of TTW on SVRA and EN Service Enrollment
2. Projections of Aggregate Upper-Bound Impacts Illustrate Modest Effects of the TTW on SVRA and EN Service Enrollment for Overall SSA Caseload
3. Sensitivity Tests Indicate that the Upper Bound Estimates are Robust
4. Lower-Bound Estimates Using Alternative Service Enrollment Measures Indicate Smaller Impacts

E. Impacts on Earnings and Benefit Amounts Are Too small to Differentiate from Historical Variation

F. Analyses of Impacts in Future Reports Will Focus on the State Level

XIV. Payments Made Under the New Payment Systems

A. Methodological Issues

1. The Payment Process
2. Traditional Payments

B. Payments for Tickets Assigned in the First Two Years

1. Statistics for the First Assignment Cohort
2. Later Assignment Cohorts

C. Payments for Earnings in the First Two Years in Phase 1 States

D. Inferences About Impacts on Exits Due to Work

XV. TTW Participation by Beneficiaries in Adequacy of Incentives Groups

A. National Beneficiaries Survey AOI Definitions and Overview of AOI Groups

1. Characteristics of AOI Group Members
2. Characteristics of AOI Group Members and TTW Participation Rates
3. TTW Participation among AOI Group Members

B. Provider and Payment Types among TTW Participants in AOI Groups

C. Conclusions

XVI. Conclusions and Implications

A. Key Findings Related to Market Operation

1. Beneficiary Demand for Employment Services
2. The Supply of Employment Services
3. TTW Market Implementation

B. Impacts of TTW on Beneficiary Behavior

C. The Future of the TTW Market

References

Appendices: