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Tuesday, August 2, 2011

Ticket to Work and Self-Sufficiency Program: Overview and Current Issues

Umar Moulta-Ali
Analyst in Disability Policy

Title I of the Ticket to Work and Work Incentives Improvement Act of 1999 (P.L. 106-170) was signed into law on December 17, 1999, and created a Ticket to Work and Self-Sufficiency program, administered by the Social Security Administration (SSA). Through Ticket to Work legislation, Congress sought to address several major work disincentives for individuals with disabilities. Ticket to Work provides a “ticket” or voucher to working-aged Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI) beneficiaries to obtain employment and other support services. Services are furnished through the current system of state vocational rehabilitation (VR) agencies or a ticket holder’s choice of an approved public or private sector, program-specific employment network (EN) to assist them in entering or reentering the workforce. Additional provisions are briefly described below.

The Ticket to Work program was phased in nationally in three stages over a three-year period, which began January 1, 2001, and concluded in January 2004. By statute, SSA contracts with program managers (PMs) to administer program aspects related to ENs and ticket holders. As of June 1, 2011, SSA had certified 1,321 ENs to provide employment support services for ticket holders in all 50 states and the District of Columbia. Of the approximately 12.7 million tickets that have been issued by SSA since the program inception, 290,189 or approximately 2.3% are “in-use,” that is, the ticket has been assigned to an EN or state VR agency.

P.L. 106-170 also directed SSA to establish grant programs for the purpose of disseminating accurate information to Social Security disability beneficiaries on work incentive programs known as Work Incentives Planning and Assistance (WIPA) projects. SSA has established 102 cooperative agreements with community-based organizations to provide benefits planning, assistance, and outreach services to beneficiaries.

The Ticket to Work program underwent major regulatory changes in July 2008 which, among other adjustments, increased financial incentives for ENs and expanded the eligibility criteria for Social Security disability beneficiaries to participate. The program has come under increased scrutiny by policymakers due to low SSDI and SSI beneficiary participation and lower than expected return-to-work rates among ticket holders. In addition, a May 2011 Government Accountability Office (GAO) assessment reported a lack of oversight of the program that has led to service approaches among some ENs that are out of line with the general goals of the Ticket program, which is to reduce beneficiaries’ dependence on benefits through earnings from work.

Ticket to Work legislation also created state options to eliminate the dilemma faced by many beneficiaries—choosing between work and health insurance coverage—through provisions that allow for additional Medicaid eligibility options and an extension of Medicare eligibility. This report only discusses the Ticket to Work program components administered by SSA and does not address issues related to the Medicaid or Medicare programs.

This CRS report begins with an explanation of the various Ticket to Work provisions, provides an analysis of program performance and return-to-work barriers encountered by ticket holders and ENs. This report concludes with a discussion of program-related issues that may be of interest to Congress. An expanded description of EN payment systems is included in an appendix.

Date of Report: July 25, 2011
Number of Pages: 43
Order Number: R41934
Price: $29.95

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