Contract No.: 0600-03-60130 MPR Reference No.: 8977 Evaluation of the Ticket to Work Program Assessment of Post-Rollout Implementation and Early Impacts, Volume 1 May 2007 Craig Thornton* Gina Livermore** Thomas Fraker * David Stapleton ** Bonnie O’Day** David Wittenburg* Robert Weathers* Nanette Goodman** Tim Silva* Emily Sama Martin* Jesse Gregory* Debra Wright* Arif Mamun* Staff from Mathematica Policy Research and its subcontractor the Cornell University Institute for Policy Research produced this report. A single asterisk denotes Mathematica staff, and a double asterisk denotes Cornell staff. Submitted to: Submitted by: Social Security Administration Mathematica Policy Research, Inc. Office of Disability and Income 600 Maryland Ave., SW, Suite 550 Support Programs Washington, DC 20024-2512 ITC Building Telephone: (202) 484-9220 500 E. Street, SW, 9th Floor and Washington, DC 20254 Cornell University Institute for Policy Research 1341 22nd Street NW Project Officer: Paul O’Leary Washington, DC 20037 Telephone: (202) 223-7670 Project Director: Craig Thornton This page has been intentionally left blank for double-sided copying. A CKNOWLEDGMENTS his report reflects the combined efforts of many people, only a few of whom are listed as authors. In particular, it reflects the invaluable advice and guidance of our Tproject officer, Paul O’Leary. His perspective on the Ticket to Work (TTW) program, disability policy, and statistical analysis have strengthened the evaluation considerably, as has is careful review of and thoughtful comments on a draft of this report. At Mathematica, Steve Glazerman provided extremely useful comments on the draft, particularly about estimating the effects of TTW on eligible beneficiaries. Lesley Hildebrand, Miriam Loewenberg, Dawn Phelps, Natalie Justh, and Jacqueline Agufa processed millions and millions of SSA administrative data records in order to provide the evaluation with basic data about beneficiaries’ participation in TTW, the payments they generated for providers, eligibility for benefits and benefit receipt, enrollment in vocational services, and earnings. Jennifer Chunn and Allison Roche (at Cornell) processed data from the National Beneficiary Survey (NBS) to produce the many tables about beneficiaries’ characteristics, attitudes, use of services, and views of TTW. Daryl Hall edited the report, and Sharon Clark led the production effort. Our data analysis was greatly facilitated by SSA staff, particularly those in the Office of Research, Evaluation, and Statistics within the Office of Policy. They answered our questions and provided guidance about the most appropriate data sets and variables. Several of them also provided data extracts for the evaluation. We would particularly like to acknowledge the assistance provided by Mary Barbour, Michael Cornelius, Linda Epps, Eileen Hull, Jasmin Kakar, Bill Kearns, Lou Koontz, Linda Martin, Patricia McFadden, Randall Miles, Joel Packman, John Saylor, Charlie Scott, Linda Smith, Joe Steffens, Jim Steiner, Bernie Wasiljov, and Michael Zambonato. Mary Naifeh and Jenn Rigger from the Rehabilitation Services Administration were particularly helpful in giving us evaluation data on people who have been served by state vocational rehabilitation agencies before and after the start of TTW. The evaluation results in this report draw extensively on the Round 1 NBS, which was directed by Susan Mitchell and Julie Ingels at Mathematica. Frank Potter led the team of statisticians who developed the sample for the survey. He also worked with Nuria Diaz to develop the weights and imputations that underlie our analysis of the survey data. Matt Sloan assisted with managing the CAPI effort, and Debra Wright led the data file iv preparation activity. The Survey Operations Center locating, telephone survey, and field operations staff did an excellent job of locating and interviewing NBS respondents. SSA staff from the Office of Operations, the Office of Employment Support Programs within the Office of Disability and Income Support Programs, the Office of Systems, and the Office of the Actuary provided detailed comments on a draft of this report. In particular, we want to thank Dan O’Brien, Anthony Murray, Nancy Sciabarrasi, Carol Brenner, Danzell Cutler, Regina Bowden, Desiree Fitzgerald, Peter Kierpiec, Marianne Daley, Sharon Shreet, Linda A. Walker, Barbara Kirchhausen, and Howard Bradley for their thoughtful comments and suggestions. We want to add a special note of thanks to those individuals who provided the implementation and operational information we used to develop this report, including staff from the SSA central, regional, and field offices; from the Ticket to Work Program Manager; and from the many service providers whose experiences are discussed in this report. We also want to thank the more than 7,500 beneficiaries who responded to the NBS. We hope that this report and the broader Ticket to Work Evaluation will provide information to improve their lives and the lives of other people with disabilities. Acknowledgments C ONTENTS Chapter Page ACRONYMS ..................................................................................................xxi EXECUTIVE SUMMARY ...............................................................................xxiii I INTRODUCTION.............................................................................................. 1 A. TICKET TO WORK AND THE MARKET FOR EMPLOYMENT SUPPORT SERVICES ................................................................................................... 3 1. Efforts to Stimulate Beneficiary Demand for Employment Support Services............................................................................................... 4 2. Increasing the Supply of Employment Support Service Providers.............................................................................................. 6 3. SSA’s Efforts to Enhance Market Functioning........................................... 7 B. THE TICKET TO WORK EVALUATION ................................................................... 7 C. DATA SOURCES FOR THIS REPORT.........................................................................8 II CHARACTERISTICS OF WORKING-AGE BENEFICIARIES AND USE OF EMPLOYMENT SERVICES ..........................................................................11 A. BENEFICIARY CHARACTERISTICS..........................................................................12 1. Program Characteristics................................................................................12 2. Sociodemographic Characteristics...............................................................13 3. Disability and Health Characteristics..........................................................15 B. EMPLOYMENT, REASONS FOR NOT WORKING, AND EMPLOYMENT EXPECTATIONS .............................................................................21 vi Chapter Page II (CONTINUED) C. USE OF HEALTH, EMPLOYMENT, AND EDUCATION SERVICES .......................24 1. Service Use in 2003 and Characteristics of Users .....................................24 2. Reasons for Using Services and Types of Services Among Users..................................................................................................25 3. School Enrollment and Degree-Seeking Behavior ...................................27 D. UNMET SERVICE NEEDS........................................................................................27 E. SUMMARY AND CONCLUSIONS..............................................................................27 III BENEFICIARY PARTICIPATION IN TICKET TO WORK ................................... 31 A. ROLLOUT STATISTICS .............................................................................................33 1. Ticket Mailings and Eligible Beneficiaries with Tickets...........................33 2. Participation Rate...........................................................................................34 3. Participation by Provider Type....................................................................36 4. In-Use Tickets by Payment Type ................................................................40 5. Deactivations and Reassignments ...............................................................42 6. Participation Rates by State..........................................................................43 B. PREDICTORS OF PARTICIPATION ..........................................................................45 1. Findings from Analysis of Administrative Data........................................46 2. Findings from National Beneficiary Survey...............................................47 IV EXPERIENCES OF TTW PARTICIPANTS: THE PARTICIPATION PROCESS ....................................................................................................... 55 A. INFORMATION SOURCES AND PROGRAM KNOWLEDGE...................................57 B. CHOICES REGARDING TICKET ASSIGNMENT.....................................................61 C. INTERACTION WITH TTW PROVIDERS................................................................62 D. OVERALL PERSPECTIVES ON OUTCOMES AND PROVIDERS .............................65 V EXPERIENCES OF TTW PARTICIPANTS: USE OF SUPPORT SERVICES ........... 69 A. EMPLOYMENT SERVICE USE IN 2003 AND CHARACTERISTICS OF USERS ..................................................................................................................71 Contents vii Chapter Page V (CONTINUED) B. SERVICE USERS: REASONS FOR USING SERVICES,