Statement of Sarah Wiggins Mitchell, Chair,
Ticket to Work and Work Incentives Advisory Panel, Social Security Administration

Testimony Before the Subcommittee on Social Security
of the House Committee on Ways and Means

Hearing on Fourth in a Series on Social Security Disability Programs' Challenges and Opportunities

September 26, 2002

Good morning Mr.  Chairman, members of the Committee. On behalf of the Ticket to Work and Work Incentives Advisory Panel, we would like to thank you for this opportunity to speak to you today. The Panel is very appreciative of the high level of interest this committee shows regarding implementation of the Ticket to Work and Work Incentives Improvement Act. The Panel would also like to take the time to recognize the tremendous amount of support this committee demonstrates for not only this important law, but for the well being of people with disabilities in general.

When you passed the Ticket to Work and Work Incentives Improvement Act, you recognized the desire of  many people with disabilities currently receiving benefits to work. You  also recognized that certain policies and procedures acted as disincentives and prevented people from attempting to work. Further, you saw both within SSA, and in the rehabilitation and employment support arena in general, that customer service supports were not available to assist with the transition off benefits. It was also clear to you that with the proper supports, people would want to attempt to go to work. Indeed, the early implementation of the programs authorized by the Ticket legislation is certainly proving your vision to be true.

Although  the Ticket program got off to a later start than anticipated in the statute, SSA has now mailed out over two million tickets to SSI and SSDI beneficiaries in 13 states. The response from beneficiaries has been unexpected. Although ticket distribution did not begin until February of this year, over 7000 beneficiaries have signed up with Employment Networks, or ENs, for services.

There are now 428 ENs available to serve ticket holders. The Panel focused last month’s quarterly meeting on ENs. We heard that the response from beneficiaries has been greater than expected. As one director put it, “If I had to express one word that represents the Ticket program in South Florida, it would have to be “surprise”. When the Tickets were first mailed out last February, it was my understanding few of the Florida beneficiaries would want to work. I have received over 500 telephone calls from beneficiaries inquiring into the Ticket program and asking how they may participate.”  Although this was the experience of a particular EN, we heard a very similar response from all the other ENs that participated in the Panel’s quarterly meeting.

People with disabilities also obviously needed somewhere to go for information and advocacy on SSA work incentives and how returning to work will affect their benefits. The programs established by the Ticket legislation are clearly helping to meet the need of beneficiaries for information. Almost thirty-one  thousand beneficiaries have sought information and assistance from the Benefits Planning Assistance and Outreach program. Thirty-one  thousand - a significant number of people. And over 17 thousand of those people were not currently employed and were looking to work. A service provider who visited a benefit planner said,  “The benefits specialist was able to present the information clearly and in simple terms. For the first time I really understood how SSI and SSDI works.” A beneficiary commented to a benefits planner, “ You were enormously helpful, not to mention knowledgeable.…I have a great challenge in front of me and you have given me a lot of good information. We shall see what lies ahead.”

The Protection and Advocacy Program has also proved enormously helpful to people with disabilities. At the end of last year, more than ten thousand people had been served by the P& A programs across the country  Obviously, advocacy was another service needed by beneficiaries of Social Security disability programs.

A significant barrier to employment for people with disabilities has always been access to health care. Twenty-three  states now have operational Medicaid buy-ins, enacted under the authority created by both the Balanced Budget Act and the Ticket legislation.  An additional ten states have passed legislation to establish a buy-in but they are not up and running yet. The best news is that more than sixteen thousand five hundred people with disabilities are working in these twenty three states and participating in the Medicaid buy-in.

The programs authorized by the Ticket legislation are off to a good start and are beginning to meet the customer service needs of SSA beneficiaries that have long been neglected. However, the Panel has serious concerns about whether SSA is devoting sufficient resources to these programs to allow them the chance to fulfill their  potential. In addition,  the Panel is concerned that SSA will not build the infrastructure and capacity needed to support the programs as they grow.

To begin with, we believe the resources allocated to public education, training and marketing of the Ticket to Work Program are insufficient to support the programs through this critical start up period. The Ticket program represents a dramatic change in the role of SSA and its relationship to its customers with disabilities and rehabilitation providers. No longer will SSA only process claims and disburse checks. It will also offer employment support and direct help for beneficiaries who return to work. Based on public comment, the Panel believes many beneficiaries who receive a ticket do not know what it is, what to do with it or why it has been sent to them. The Panel has heard at public meetings from ENs, White House staff and senior SSA executives that a campaign to market the ticket to beneficiaries, providers and employers is crucial to the success of this program. As far as the Panel can determine, no resources have been allocated to marketing the Ticket Program,  except to recruit new ENs.

Not only must beneficiaries, employers, providers and all other relevant stakeholders know about the Ticket to Work Program, the Panel believes that for the program to succeed they must be well educated about it. The Benefits Planning Assistance and Outreach grantees are doing an excellent job, but they simply do not have the resources to educate everyone about the program. As far as the Panel knows, SSA has not developed a campaign to educate the public about the Ticket to Work Program.

The training budget allocated to these programs by SSA is also problematic. SSA is spending less than four million dollars on training. For a new program relying on both beneficiaries and providers to make informed choices, and relying on many Federal, state and private strategic partners to coordinate their efforts, an intensive and comprehensive training regimen is crucial. The Panel believes the amount of resources dedicated to training is terribly inadequate. In comparison, one program, the Federal and State Vocational Rehabilitation program, spends about forty million dollars per year on training activities.

The Panel also thinks that SSA may not be creating the service capacity, both inside the agency and out, to adequately support the programs and work incentive improvements of the Ticket legislation. One major concern involves the requirement in the Ticket legislation for SSA to “establish a corps of trained, accessible and responsive work incentives specialists within the Social Security Administration… (emphasis added)” In order to meet the requirement, SSA established a pilot program to test the utility of full time permanent SSA staff  to fill that role called Employment Support Representatives or ESRs. The pilot involved 36 ESRs. The preliminary findings for the pilot program were extremely positive. The Panel heard positive feedback from SSA beneficiaries who interacted with ESRs. In addition, SSA’s own evaluation report made  positive recommendations regarding the ESR position.

The future of the ESR position, however, is unclear. SSA has not to date told the Panel how it intends to proceed. Will SSA expand the pilot to full coverage?  Hire outside contractors? Will SSA use claims representatives who are part-time work incentive specialists? The Panel strongly believes that the establishment of  work incentives specialists who are full-time, permanent employees of SSA, like the ESR pilot,  is essential. The Panel  has expressed its concern to Commissioner Barnhart and we are waiting for a response. We do not know whether SSA  intends to continue the ESR program.

The second capacity issue involves ENs. As we said, there are now over 400 ENs to serve beneficiaries around the country. While this represents a good start and Maximus should be commended for the work they have done so far, a lot remains to be done. The Panel is concerned there are not enough providers, with a diversity in both geographic location and specialization,  to meet the needs of beneficiaries. The geographic location of the EN’s is a major concern. As one EN told the Panel at our last meeting, “There are 58 employment networks in Illinois… surprisingly very few, maybe eight in the metropolitan area of Chicago where we provide our service. The other side of that coin is that the majority of beneficiaries, of course, live in the metropolitan area of Chicago.”  If the ENs are not located where the beneficiaries are, then beneficiaries will not be able to participate in the Ticket Program.

The Panel has also been told that not very many of these ENs are new providers. A primary goal of the Ticket program was to expand the universe of service providers to allow real choice for people with disabilities. We think the program has a long way to go to make true choice a reality. As that same Illinois EN reported to the Panel, “ ….Very, very few new players have come in, which I think is not what the intent was…it is the same network of players that has always been there.”

Finally, the Panel is concerned that SSA has not developed the capacity to handle increased numbers of beneficiaries returning to work without exacerbating the overpayment problem. As you know, in fiscal year 1999, SSI beneficiaries owed SSA more than 3.8 billion dollars in overpayments (GAO-01-778, Social Security Administration: Status of Achieving Key Outcomes and Addressing Major Management Challenges, June 2001, p.12).  Many beneficiaries who have returned to work in the past, or unsuccessfully attempted to do so, received overpayments and are required to repay the benefits. If this issue is not resolved, fear of being charged with an overpayment could act as a powerful disincentive to participation in the Ticket Program.  A variety of factors may contribute to overpayments, but having the staff capacity to record and process earnings reports in a timely manner is essential to any return to work effort, including the Ticket Program.

The Panel is aware that SSA has finite administrative funds and the agency must meet all of its needs with the dollars appropriated by Congress. The Panel is also mindful of the increased demand for customer service that will be placed on SSA as the baby boomers begin to retire. We know that SSA must establish priorities and the activities surrounding implementation of the Ticket legislation must compete with all the other service needs of the agency.  However, if the resource and capacity issues the Panel has brought to your attention here are not addressed the Ticket program may in fact fail – not because people with disabilities don’t want to work and not because the program could not be effective, but rather because it was never given the chance to truly succeed. Thank you.

Panel Members

Mary Katherine (Katie) Beckett,  IA
Richard V. Burkhauser Ph.D.- Cornell University, Chair, Dept. of Policy Analysis and Management. NY
Thomas P Golden, MS –Cornell University, Program on Employment and Disability. NY
Kristin E. Flaten, INITIATIVES/Lifetrack Resources, Mental Health and Benefits Advocacy Specialist. MN
Frances Gracechild, MA, Resource for Independent Living, Inc., Executive Director. CA
Christine Griffin, Disability Law Center, Executive Director. MA
Jerome Kleckley, MSW, CSW- Eastern Paralyzed Veterans Association, Director, Hospital Services. NY
Bryon MacDonald- World Institute on Disability, Project and Policy Development Manager. CA
Sarah Wiggins Mitchell, Chair- New Jersey Protection and Advocacy, Inc., President/Executive Director. NJ
Vince Randazzo, The Business Roundtable, Director of Public Policy. VA
Stephen L. Start, S.L. Start & Associates, Inc., President/CEO. WA
Susan Webb, MBA-ABIL Employment Services. AZ