Statement of Mary Satterfield, Project Director,
MAXIMUS Program Manager, Ticket to Work and Self-Sufficiency Program, Alexandria, Virginia

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

Program Manager’s Briefing on the Ticket to Work Program Implementation

As the Ticket to Work Program Manager, MAXIMUS functions as a trusted agent of the Social Security Administration (SSA).  SSA retains Program authority, decides Ticket eligibility, schedules the roll out phases and the graduated delivery of Tickets during each roll out phase, proposes regulations, creates and interprets policy, and approves providers to become Employment Networks (ENs).  The Program Manager executes all tasks critical to the operational administration of the Program, including:

• Serving as a centralized information source for beneficiaries, Employment Networks (ENs), and the general public, primarily through our nationwide toll-free call center;
• Marketing the Ticket to Work concept to service providers and recruiting them to participate as ENs;
• Facilitating the link between beneficiaries and ENs;
• Providing training to a variety of customers including ENs;
• Developing and maintaining a secure and robust information technology (IT) system;
• Collecting Program data; and
• Reviewing EN requests for payment.

All aspects of the initial start-up for Ticket went very smoothly.  This included the complicated undertaking of a systems link with SSA via which we exchange information necessary to the operation of the Program on a daily basis, as well as the start up of the national call center, which has been operational since March 2001.  To date we have logged over 150,000 calls, almost 90 percent of which were received after the release of the fist Tickets.

We commenced the marketing and recruitment campaign immediately and aggressively after the release of the first EN Request for Proposal (RFP) in April 2001.  This included in-person meetings and presentations at conferences, exhibits at large disability related events, targeted mailings, phone call campaigns, e-marketing strategies, and any other method that represented an opportunity.  Our Marketing team makes presentations on Ticket to Work at dozens of events every month, including the recruitment conferences MAXIMUS hosts in conjunction with SSA, numbering 50 to date throughout the Phase I and Phase II states, with an additional 35-40 planned for next year.  To date, we have made well over 100,000 marketing contacts with a broad array of traditional and nontraditional providers including employers and educational institutions.

Although the marketing effort has not been without challenges, we are encouraged by the 542 applications received from providers, including several providers serving all states.  SSA has already contracted with 438 ENs, and the remaining applications are currently in the review pipeline and we expect them to be approved soon.

Last year, recruitment was particularly hampered by provider dissatisfaction with the proposed payment systems.  Certainly, the more robust payment system presented in the final regulations was positively received.  Additionally, the release of Tickets in February served as a catalyst for this market-driven Program.  However, we continue to find that providers remain focused on concerns about sufficient start up capital, and while there are always various marketing and recruitment challenges specific to each state, these financial concerns traverse state boundaries, impairment groups, and affiliations.

We know this Program represents tremendous change for beneficiaries and providers.   Transitioning providers from what is a deeply rooted fee-for-service mindset to the outcome-based concept of Ticket to Work is taking time.  Providers continue to be reluctant to actively participate in the Program because they may not be able to afford the up front costs of providing employment services, either because outcomes are far from certain or they may have to wait a substantial period of time before payments based on outcomes are received.

Ticket is a new way of doing business for them.  They must become accustomed to the idea of forming partnerships and sharing risk, as well as receiving clients who have not been pre-screened.  And while beneficiaries have been overwhelmingly optimistic and positive about the opportunity Ticket presents, they remain fearful of ultimately going off benefits.  Ticket is a mindset change for them as well.

We are encouraged by early success indicators such as the number of Tickets assigned, the number and mix of providers participating, and the number of payment requests received.   We continue to focus strongly on recruitment and supporting the ongoing needs of both ENs and beneficiaries.