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23–796 2005

THE SOCIAL SECURITY ADMINISTRATION’S 

MANAGEMENT OF THE 

TICKET TO WORK PROGRAM 

HEARING 

BEFORE THE

SUBCOMMITTEE ON SOCIAL SECURITY 

OF THE

COMMITTEE ON WAYS AND MEANS 

U.S. HOUSE OF REPRESENTATIVES 

ONE HUNDRED EIGHTH CONGRESS 

SECOND SESSION 

MARCH 18, 2004 

Serial No. 108–58 

Printed for the use of the Committee on Ways and Means 

( 

ii 

COMMITTEE ON WAYS AND MEANS 

BILL THOMAS, California, Chairman 

PHILIP M. CRANE, Illinois 

E. CLAY SHAW, JR., Florida 

NANCY L. JOHNSON, Connecticut 

AMO HOUGHTON, New York 

WALLY HERGER, California 

JIM MCCRERY, Louisiana 

DAVE CAMP, Michigan 

JIM RAMSTAD, Minnesota 

JIM NUSSLE, Iowa 

SAM JOHNSON, Texas 

JENNIFER DUNN, Washington 

MAC COLLINS, Georgia 

ROB PORTMAN, Ohio 

PHIL ENGLISH, Pennsylvania 

J.D. HAYWORTH, Arizona 

JERRY WELLER, Illinois 

KENNY C. HULSHOF, Missouri 

SCOTT MCINNIS, Colorado 

RON LEWIS, Kentucky 

MARK FOLEY, Florida 

KEVIN BRADY, Texas 

PAUL RYAN, Wisconsin 

ERIC CANTOR, Virginia 

CHARLES B. RANGEL, New York 

FORTNEY PETE STARK, California 

ROBERT T. MATSUI, California 

SANDER M. LEVIN, Michigan 

BENJAMIN L. CARDIN, Maryland 

JIM MCDERMOTT, Washington 

GERALD D. KLECZKA, Wisconsin 

JOHN LEWIS, Georgia 

RICHARD E. NEAL, Massachusetts 

MICHAEL R. MCNULTY, New York 

WILLIAM J. JEFFERSON, Louisiana 

JOHN S. TANNER, Tennessee 

XAVIER BECERRA, California 

LLOYD DOGGETT, Texas 

EARL POMEROY, North Dakota 

MAX SANDLIN, Texas 

STEPHANIE TUBBS JONES, Ohio 

SUBCOMMITTEE ON SOCIAL SECURITY 

E. CLAY SHAW, JR., Florida, Chairman 

SAM JOHNSON, Texas 

MAC COLLINS, Georgia 

J.D. HAYWORTH, Arizona 

KENNY C. HULSHOF, Missouri 

RON LEWIS, Kentucky 

KEVIN BRADY, Texas 

PAUL RYAN, Wisconsin 

ROBERT T. MATSUI, California 

BENJAMIN L. CARDIN, Maryland 

EARL POMEROY, North Dakota 

XAVIER BECERRA, California 

STEPHANIE TUBBS JONES, Ohio 

ALLISON H. GILES, Chief of Staff 

JANICE MAYS, Minority Chief Counsel 

Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public hearing records 

of the Committee on Ways and Means are also published in electronic form. The printed 

hearing record remains the official version. Because electronic submissions are used to 

prepare both printed and electronic versions of the hearing record, the process of converting 

between various electronic formats may introduce unintentional errors or omissions. Such occurrences are inherent in the current publication process and should diminish as the process 

is further refined. 

iii 

C O N T E N T S 

Page 

Advisory of March 11, 2004, announcing the hearing .......................................... 2 

WITNESSES 

U.S. Department of Education, Troy R. Justesen, Acting Deputy Assistant 

Secretary, Office of Special Education and Rehabilitation Services ................ 28 

Social Security Administration, Martin H. Gerry, Deputy Commissioner, 

Disabiltiy and Income Security Programs ......................................................... 21 

Arizona Employment Network Association, Susan Webb .................................... 80 

Benjearlene Nelson, Ticket to Work Participant; accompanied by Ron Rattay, 

Gulfstream Goodwill Industries, Inc. ................................................................. 8 

Charmaine Teri Hancock, Ticket to Work Partcipant .......................................... 10 

Consortium for Citizens with Disabilities, Paul J. Seifert ................................... 66 

Health and Disability Advocates, John Coburn .................................................... 84 

Integrated Disability Resources, Inc., Tom Foran ................................................ 71 

Ticket to Work and Work Incentives Advisory Panel, Sarah Wiggins Mitchell . 55 

Ticket to Work and Work Incentives Advisory Panel, Thomas P. Golden .......... 55 

VR Services, Richmond Area Arc, Quintin M. Mitchell ....................................... 76 

SUBMISSIONS FOR THE RECORD 

California Department of Rehabilitation, Sacramento, CA, Catherine Campisi, 

letter ...................................................................................................................... 97

Council of State Administrators of Vocational Rehabilitation, Chicago, IL, 

Robert Kilbury and Louis Hamer, statement .................................................... 98 

Indiana Vocational Rehabilitation Services, Indianapolis, IN, Mike Hedden, 

statement .............................................................................................................. 99 

Louisiana Rehabilitation Services, Department of Social Services, Baton 

Rouge, LA, James Wallace, statement ............................................................... 99 

Maryland Division of Rehabilitation Services, Baltimore, MD, Robert A. 

Burns, letter ......................................................................................................... 100 

Massachusetts Rehabilitation Commission, Boston, MA, Elmer C. Bartels, 

statement .............................................................................................................. 100 

Oklahoma Department of Rehabilitation Services, Oklahoma City, OK, Dan 

O’Brien, statement ............................................................................................... 102 

Pennsylvania Office of Vocational Rehabilitation, Harrisburg, PA, Stephen 

R. Natsui, letter ................................................................................................... 104 

South Carolina Vocational Rehabilitation Department, West Columbia, SC, 

Larry C. Bryant, statement ................................................................................. 105 

Tennessee Division of Rehabilitation Services, Nashville, TN, Carl Brown, 

letter ...................................................................................................................... 106 

Texas Department of Assistive and Rehabilitative Services, Austin, TX, 

Terrell I. Murphy, statement .............................................................................. 107 

Utah State Office of Rehabilitation, Salt Lake City, UT, Blaine Petersen, 

letter ...................................................................................................................... 107 

Washington Department of Social and Health Services, Division of Vocational 

Rehabilitation, Lacey, WA, Michael O’Brien, statement .................................. 109 

West Virginia Division of Rehabilitation Services, Charleston, WV, statement 110 

(1) 

THE SOCIAL SECURITY ADMINISTRATION’S 

MANAGEMENT OF THE 

TICKET TO WORK PROGRAM 

THURSDAY, MARCH 18, 2004 

U.S. HOUSE OF REPRESENTATIVES, COMMITTEE ON WAYS AND MEANS, SUBCOMMITTEE ON SOCIAL SECURITY

Washington, DC. 

The Subcommittee met, pursuant to notice, at 10:08 a.m., in 

room B–318, Rayburn House Office Building, Hon. E. Clay Shaw, 

Jr. (Chairman of the Subcommittee) presiding. 

[The advisory announcing the hearing follows:] 

2 

ADVISORY 

FROM THE COMMITTEE ON WAYS AND MEANS 

SUBCOMMITTEE ON SOCIAL SECURITY 

FOR IMMEDIATE RELEASE CONTACT: (202) 225–9263 

March 11, 2004 

No. SS–8 

Shaw Announces Hearing on 

the Social Security Administration’s 

Management of the Ticket to Work Program 

Congressman E. Clay Shaw, Jr. (R–FL), Chairman, Subcommittee on Social Security of the Committee on Ways and Means, today announced that the Subcommittee 

will hold a hearing on the Social Security Administration’s (SSA’s) management of 

the Ticket to Work Program. The hearing will take place on Thursday, March 

18, 2004, in room B–318 Rayburn House Office Building, beginning at 10:00 

a.m. 

In view of the limited time available to hear witnesses, oral testimony at this 

hearing will be limited to the SSA, the U.S. Department of Education, and other 

invited witnesses. However, any individual or organization not scheduled for an oral 

appearance may submit a written statement for consideration by the Subcommittee 

or for inclusion in the printed record of the hearing. 

BACKGROUND: 

The Ticket to Work and Work Incentives Improvement Act of 1999 (P.L. 106–170), 

signed into law on December 17, 1999, established the Ticket to Work and Self-Sufficiency Program, expanded the availability of health care coverage, and provided 

for demonstration projects and studies. The Ticket to Work Program, administered 

by the SSA, increases choice in obtaining rehabilitation and vocational services, and 

provides greater opportunities for Disability Insurance (DI) and Supplemental Security Income (SSI) recipients to receive assistance to help them return to work. 

As part of the program, individuals receive a ‘‘ticket’’ from the SSA, which they 

may voluntarily assign to their State Vocational Rehabilitation Agency (SVRA) or 

to an Employment Network (EN) of their choice. An EN is a public agency or private organization that provides employment services, vocational rehabilitation services, or other support services necessary to achieve a vocational goal. The ENs are 

paid by the SSA for results, and choose between two payment systems—one based 

on the individual no longer receiving cash benefits because of work, the other based 

on attainment of certain vocational milestones. The program is being phased in over 

a 3-year period and will be in place nationwide in September 2004. 

Most Social Security DI and SSI adult disability beneficiaries are automatically 

eligible to receive tickets, and to date, almost 7 million tickets have been issued. 

Some 40,000 beneficiaries have chosen to assign their tickets to service providers. 

Of these, 10 percent have been assigned to one of more than 1,100 ENs and 90 percent have been assigned to a SVRA. 

The bipartisan Ticket to Work and Work Incentives Advisory Panel, established 

in law to advise the President, the Congress, and the Commissioner of Social Security on issues related to work incentive programs, is monitoring the implementation 

of the ticket program. It has expressed growing concerns about the SSA’s management of the program. In particular, the panel is deeply concerned that too few ENs 

are willing to accept tickets and assist beneficiaries to return to work. It’s recently 

issued report to the Congress and the Commissioner entitled, ‘‘The Crisis in EN 

3 

Participation—A Blueprint for Action,’’ http://www.ssa.gov/work/panel/ 

panel_documents/pdf_versions/CrisisEnParticipation.pdf made a number of recommendations, including: clarify the Ticket Program as a funding source that supplements, rather than displaces, other existing funding sources; improve the EN 

payment system and EN claims administration; expand EN and beneficiary marketing; and improve EN training and communication. 

In addition, unresolved issues between ENs and many SVRAs may also be discouraging ENs from participating in the Ticket Program. These issues include: questions regarding automatic ticket assignments to SVRAs; pressure for ENs to contract with SVRAs rather than accepting tickets themselves; ineffective cooperative 

agreements between SVRAs and ENs; and lack of consumer information. 

In announcing the hearing, Chairman Shaw stated, ‘‘Work—essential for individuals with disabilities to achieve their goals and support their families—won’t happen without an effectively run Ticket to Work Program. The Social Security Administration’s management of this important program must fully meet the needs of 

those wanting to return to work as well as those assisting them in this effort.’’ 

FOCUS OF THE HEARING: 

The Subcommittee will review the SSA’s management of the Ticket to Work Program, including results achieved to date and challenges hampering program success. 

DETAILS FOR SUBMISSION OF WRITTEN COMMENTS: 

Please Note: Any person or organization wishing to submit written comments for 

the record must send it electronically hearingclerks.waysandmeans@mail.house.gov 

along with a fax copy to (202) 225–2610, by close of business Thursday, April 1, 

2004. In the immediate future, the Committee website will allow for electronic submissions to be included in the printed record. Before submitting your comments, 

check to see if this function is available. Finally, due to the change in House mail 

policy, the U.S. Capitol Police will refuse sealed-packaged deliveries to all House Office Buildings. 

FORMATTING REQUIREMENTS: 

Each statement presented for printing to the Committee by a witness, any written statement 

or exhibit submitted for the printed record or any written comments in response to a request 

for written comments must conform to the guidelines listed below. Any statement or exhibit not 

in compliance with these guidelines will not be printed, but will be maintained in the Committee 

files for review and use by the Committee. 

1. All statements and any accompanying exhibits for printing must be submitted electronically 

to hearingclerks.waysandmeans@mail.house.gov, along with a fax copy to (202) 225–2610, in 

WordPerfect or MS Word format and MUST NOT exceed a total of 10 pages including attachments. Witnesses are advised that the Committee will rely on electronic submissions for printing the official hearing record. 

2. Copies of whole documents submitted as exhibit material will not be accepted for printing. 

Instead, exhibit material should be referenced and quoted or paraphrased. All exhibit material 

not meeting these specifications will be maintained in the Committee files for review and use 

by the Committee. 

3. All statements must include a list of all clients, persons, or organizations on whose behalf 

the witness appears. A supplemental sheet must accompany each statement listing the name, 

company, address, telephone and fax numbers of each witness. 

Note: All Committee advisories and news releases are available on the World 

Wide Web at http://waysandmeans.house.gov. 

The Committee seeks to make its facilities accessible to persons with disabilities. 

If you are in need of special accommodations, please call 202–225–1721 or 202–226– 

3411 TTD/TTY in advance of the event (four business days notice is requested). 

Questions with regard to special accommodation needs in general (including availability of Committee materials in alternative formats) may be directed to the Committee as noted above. 

f 

4 

Chairman SHAW. Good morning. Today our Subcommittee will 

examine the Social Security Administration’s (SSA’s) management 

of the Ticket to Work Program. The Ticket to Work and Work Incentives Improvement Act (P.L. 106–170) was signed into law in 

December 1999. The goal of this landmark legislation is to remove 

barriers and increase incentives for individuals with disabilities to 

seek work. These incentives empower beneficiaries with choices of 

job training and placement services. 

Prior to enactment of the bill, less than 1 percent of the individuals with disabilities receiving Social Security Disability Insurance 

(SSDI) or Supplemental Security Income (SSI) left the rolls to return to work. Now the SSA is reaching the end of its three-phase 

implementation plan of this program. To date almost 7 million tickets to individuals with disabilities in all 50 States have been distributed and all program components are operational. This has 

been no small effort and I commend the agency for extraordinary 

efforts. 

I have a sample of a ticket right here and you can see that it 

allows the ticket holder to obtain employment services by turning 

the ticket to a State Vocational Rehabilitation (VR) agency or Employment Network (EN). So far 40,000 tickets have been assigned 

yet 90 percent of these tickets have been assigned to State VR 

agencies and only 10 percent have been assigned to ENs. In the 

Ticket to Work Program choice is paramount. To continue to grow 

the success of the program we need to understand why a market 

of ENs has failed to materialize. 

[The information follows:] 

The bipartisan Ticket to Work and Work Incentives Advisory 

Panel has been examining issues relating to the service providers 

marketplace since it first convened. Today we will hear the panel’s 

latest recommendation, along with the testimony from three ENs 

that are currently accepting tickets and helping the individuals return to work. Although the low number of ENs participating in the 


Insert 23796a.001
5 

Ticket to Work Program is troubling, we must not lose sight that 

this program is having a positive impact on the lives of many individuals who do have disabilities. 

Therefore, I think it is only fitting that our hearing begin with 

the testimony of two individuals who have changed their lives by 

taking advantage of the Ticket to Work Program. Following their 

testimony, we will hear from representatives of the SSA and the 

U.S. Department of Education, and then from other key stakeholders. Taking the first step to try to work is one of the most difficult decisions someone with a disability can make. Our challenge 

is to ensure that the Ticket to Work Program helps make this decision easier, not harder. I look forward to hearing the thoughtful 

counsel of each of our witnesses today and I thank you for joining 

us. Now I would yield to the gentleman from Maryland, Mr. 

Cardin. 

[The opening statement of Chairman Shaw follows:] 

Opening Statement of The Honorable E. Clay Shaw, Jr., Chairman, and a 

Representative in Congress from the State of Florida 

Good morning. Today, our Subcommittee will examine the Social Security Administration’s management of the Ticket to Work Program. 

The Ticket to Work and Work Incentives Improvement Act was signed into law 

in December of 1999. The goal of this landmark legislation is to remove barriers and 

increase incentives for individuals with disabilities to seek work. These incentives 

empower beneficiaries with choices for job training and placement services. 

Prior to enactment of the bill, less than 1 percent of individuals with disabilities 

receiving Social Security Disability Insurance or Supplemental Security Income left 

the rolls to return to work. Now, the Social Security Administration is reaching the 

end of its three-phase implementation plan of this program. 

To date, almost seven million tickets to individuals with disabilities in all 50 

states have been distributed and all program components are operational. This has 

been no small effort, and I commend the Agency for its extraordinary efforts. 

I have a sample of a ticket here and you can see that it allows the ticket holder 

to obtain employment services by turning in the ticket to a State Vocational Rehabilitation Agency or an Employment Network. So far 40,000 tickets have been assigned, yet ninety percent of these tickets have been assigned to State Vocational 

Rehabilitation Agencies and only 10 percent have been assigned to Employment 

Networks. 

In the Ticket to Work Program, choice is paramount. To continue to grow the success of the program, we need to understand why a market of Employment Networks 

has failed to materialize. 

The bipartisan Ticket to Work and Work Incentives Advisory Panel has been examining issues related to the service provider marketplace since it first convened. 

Today, we will hear the Panel’s latest recommendations, along with testimony from 

three Employment Networks that are currently accepting tickets and helping individuals return to work. 

Although the low number of Employment Networks participating in the Ticket to 

Work Program is troubling, we must not lose sight that this program is having a 

positive impact on the lives of many individuals with disabilities. 

Therefore, I think it is only fitting that our hearing begin with testimony from 

two individuals who have changed their lives by taking advantage of the Ticket to 

Work program. Following their testimony will we hear from representatives from 

the Social Security Administration and the Department of Education and then from 

other key stakeholders. 

Taking the first step to try work is one of the most difficult decisions someone 

with a disability can make. Our challenge is to ensure that the Ticket to Work Program helps make this decision easier, not harder. I look forward to hearing the 

thoughtful counsel of each of our witnesses today, and thank them for in advance 

for joining us. 

f 

6 

Mr. CARDIN. Let me thank Chairman Shaw for calling this 

hearing. It is very important that this Committee follow-up on the 

Ticket to Work Program. I thank you for convening this hearing 

and for calling these panels so that we can hear from all of the different stakeholders, from people who are in the program, to the 

agencies that administer it at the Federal level, as well as other 

interested parties. 

The Ticket to Work Program was one of the major accomplishments passed by Congress in 1999. It was an effort to reward individuals who were willing to take a risk to work. They had certain 

protections while on the disability rolls and they would have to give 

up to enter the employment market. We recognized that and 

passed the Ticket to Work Act to give them more opportunity for 

VR and to provide certain safety nets, particularly in regard to 

their health care benefits. We passed the law in 1999. It is now 

2004. In my own State of Maryland, we just started receiving the 

tickets in November of 2003. So, Mr. Chairman, we do not yet have 

a lot of experience as far as people who are participating in the 

program. One of our objectives today is to determine how we can 

expedite the program and make it as effective as possible. 

When we look at the individuals who are participating in the 

ENs, we find that the success rates are pretty much what we had 

predicted. Yet we think those rates can be even higher, if we improve the program’s effectiveness. 

So, there is more that we need to do. We have to encourage 

greater participation in the program. We have to provide necessary 

administrative support to the agencies. I am concerned that the 

agencies’ budgets have not been realistic for carrying out this mission. It has been reported to us that, in some instances, the ticket 

may be replacing access to VR services rather than supplementing 

those programs. That certainly was not the intent of Congress. 

No amount of outside assistance can convince beneficiaries to attempt to work if they believe that working will lead to a loss of 

vital health benefits and income support before they are financially 

ready. The Ticket Act recognized the importance of these incentives 

in helping beneficiaries work and the importance of SSA administering the work rules promptly and accurately. Although the SSA 

has taken some steps in the right direction, much remains to be 

done. Beneficiaries can not yet be confident that if they go to work, 

the SSA will adjust their checks in time to prevent a large overpayment of benefits. 

Some of the obstacles can be addressed by the SSA and the Department of Education, which are charged with the administrative 

responsibilities. Others may require direction or clarification from 

Congress. This hearing will give us an opportunity to hear firsthand how the program is being implemented, so that the agencies 

can take the appropriate steps and we, in Congress, can carry out 

our oversight responsibilities. 

Mr. Chairman, I want to raise one additional issue that was recently brought to my attention. It is my understanding that nearly 

a decade ago, officials at the SSA were made aware of a situation 

involving more than 500,000 SSI recipients who subsequently became eligible for Social Security disability benefits. Due to a computer error, these recipients were never identified. So, for over the 

7 

last 10 years there have been literally thousands, hundreds of 

thousands of SSI recipients who were entitled to additional payments, but did not receive them. 

The SSA is now trying to identify these individuals, but because 

of the lack of administrative support they have had to prioritize the 

group they are going after in trying to correct the situation. As a 

result, in some cases, these corrections will not take place for 

many, many years to come, obviously causing a major problem for 

the people who are entitled to additional benefits. I might point out 

it also affects our States, because if these beneficiaries were eligible 

for SSA disability they would have been covered by the Medicare 

Program rather than the Medicaid program. This means that our 

States are overpaying and are entitled to some adjustments. 

Mr. Chairman, I would hope that in the future we would have 

an opportunity to review this issue and to try to expedite the process of correcting this error since it has been 10 years and we really 

need to clear up this record and do what is right for the beneficiaries and for our States. I look forward to hearing the testimony 

of all the witnesses today and working with the Chairman and the 

Members of this Committee to carry out our very important oversight responsibility and to see what we can do to make the Ticket 

to Work Program as effective as possible. Thank you, Mr. Chairman. 

Chairman SHAW. Thank you, Ben. We now have our first panel. 

I will introduce Ms. Nelson, and Mr. Collins will introduce Ms. 

Hancock. Benjearlene Nelson is a Ticket to Work participant from 

my own area of West Palm Beach, Florida and she is accompanied 

by Ron Ratty, who is with Gulfstream Goodwill Industries (GGI), 

West Palm Beach, Florida. Ms. Nelson has had some pretty rough 

sledding. She has shown a tremendous amount of courage and I 

think her story should be an inspiration to all of us. Mr. Collins? 

Mr. COLLINS. Thank you, Mr. Chairman. It is my pleasure to 

welcome Ms. Teri Hancock from Newnan, Georgia. I spoke with 

Ms. Hancock briefly before the hearing began and she has a very 

impressive resume that I have already read. Just listening to her, 

talking to her, the things that she has overcome based on a problem that she had several years ago and would not let it be something that would end her desire to be a career person again, because she has, as I say, a very impressive resume. She also is a 

very special strong advocate for this program, the Ticket to Work, 

and we appreciate that very much. I think you are going to find 

her testimony very interesting. 

I regret to say, though, that she may be leaving Georgia in the 

very near future. She is formerly from the Washington area here 

and she may be moving back to the city rather than staying in 

some of the rural areas of Georgia. That will be our loss but it will 

be Washington’s gain. Ms. Hancock, thank you very much for being 

here and for your testimony. It is very impressive, and your background is very impressive, and I know your future will be very impressive. Thank you. 

Chairman SHAW. Mr. Rattay will be our first witness. 

8 

STATEMENT OF RON RATTAY, GULFSTREAM GOODWILL 

INDUSTRIES, INC., WEST PALM BEACH, FLORIDA 

Mr. RATTAY. Thank you. First, let me say that I am extremely 

privileged in having Benjearlene ask me to escort her here today. 

The GGI became an EN in November of 2001; it has been in the 

business of changing people’s lives for approximately 105 years. We 

have many programs that are suited to individual’s specific needs. 

Basically our mission is, and always will be, to help people with 

disabilities and other barriers to return to employment and become 

working members of our communities. So, becoming an EN was a 

natural transition for us. Approximately 7 months ago GGI engaged a fill team to implement and launch the Ticket to Work selfsufficiency program. We have researched, we have studied, and we 

learned the Ticket to Work self-sufficiency program in order to better it toward self-sufficiency. 

With the support of our program manager, Maximus, national 

Industries for the Severely Handicapped (NISH), and, specifically, 

the local West Palm Beach Social Security office and the advisory 

panel, we have moved forward. Today we hold 26 people, all of 

whom want to become self-sufficient. Ten of these people have succeeded far beyond Substantial Gainful Activity (SGA), either in the 

milestone or outcome status. The others are only a job away, and 

we have yet to scratch the surface. We recognize the concerns and 

issues of the Ticket to Work Program but for now GGI continues 

to be proactive and place the needs of our participants first. With 

this said, please allow me to introduce one of our heroes and participants, Ms. Benjearlene Nelson. 

Chairman SHAW. Ms. Nelson? 

STATEMENT OF BENJEARLENE NELSON, TICKET TO WORK 

PARTICIPANT, WEST PALM BEACH, FLORIDA 

Ms. NELSON. Thank you. I am very honored to be here today. 

My name is Benjearlene Nelson. I am 33 years old. I am a mother 

of two wonderful children, a loving mother—I have a loving mother, and I am also the loved one of a very supportive family. I am 

here today to testify for the Ticket to Work Program and to let you 

know how the Ticket to Work has worked for me. I am also a Social 

Security beneficiary. Because of my disability, I have had a lot of 

downfalls in life. It has affected me mentally, emotionally and 

physically 

I am here to let you know that I have always been a striver to 

reach for the hills. Because of my disability, it has taken a lot from 

me, but with the Ticket to Work and GGI, I tell you they have 

given me an inner strength to continue to go on. Back in 2002 I 

was faced to pull out my Ticket to Work. I had received it 9 months 

ahead of time. I looked at it and put it away. At the time I was 

married, had a husband that was supporting the family. Because 

of my disability, I did not feel the need to work or to experience 

the outside world. I had kind of put myself in a closet and just felt 

that I did not need to be exposed to the world. 

Back in 2002 my husband, who is an alcoholic, attempted to set 

the house on fire while my children and I were sleeping. By the 

grace of God I am here today. I want to say that at that time he 

was taken away I knew that I had to stand up and step out and 

9 

stand on my own to support my family. I used my Ticket to Work. 

I went to GGI. I told them what my situation was and they were 

there with open arms. Goodwill has given me the strength that I 

needed to stand up. They have encouraged me. They have given me 

confidence and motivation to continue to go on and to lead my family as the head of the household. 

I also want to say that I have come to some very low points in 

life where I did not feel that I could accomplish different things 

and in certain areas. I just did not feel that I was good enough. 

Being encouraged through the Ticket to Work and GGI, they have 

just inspired me. A lot of times I went in there feeling down and 

did not know what I can do. I know that I have a disability with 

my eyes, as well, and I had a long road ahead of me and I could 

not even see it. Goodwill has guided me in the direction that I 

needed to be in. Together, I know that they are a great team and 

I also want to say that through the Ticket to Work I have achieved 

a position at Crystal Marketing where I am working now, where 

I am the top seller. I enjoy working there. I look forward to moving 

on and going to better places. 

I also want to let you know that without the Ticket to Work, I 

do not think that I would have stepped forward. I do not know 

where I would have been at this point in my life. The Ticket to 

Work gave me courage. They explained the Ticket to Work with 

me. It sounded like a great idea. They have backed me the whole 

way and I just want to say that the Ticket to Work is such a great 

program. It lets you know that they are standing behind you. You 

do not have to worry. I just think that more people should know 

about the Ticket to Work Program who are disabled so that they 

can get their life on the road and accomplish some of the things 

that I have in life. 

[The prepared statement of Ms. Nelson follows:] 

Statement of Benjearlene Nelson, Ticket to Work Participant, West Palm 

Beach, Florida; accompanied by Ron Rattay, Gulf Stream Goodwill Industries Inc., West Palm Beach, Florida 

Let me first say I’m privileged in having Benjearlene ask me to escort her and 

be with her on this very important day. 

Gulfstream Goodwill become an Employment Network in November of 2001, 

Goodwill Industries has been ‘‘in the business of changing peoples lives’’ for about 

105 years. We have many programs that are geared to the individual’s specific 

needs. Basically, our mission is to help people with disabilities and other barriers 

to employment to become self-sufficient, working members of our community. So becoming an Employment Network was a natural transition. 

Approximately seven months ago GGI engaged a full time team to launch the 

TTW program. We have researched and studied the TTW program in order to make 

it geared toward self-sufficiency. With the support of Maximus, NISH, the local 

WPB SSA office, and the Advisory Panel we have moved forward. Today we hold 

26 tickets for people who want to become self sufficient. Ten of these people have 

succeeded far beyond SGA and are in the ‘‘milestone’’ or ‘‘out-come’’ status; the others are only a job away. 

We recognize that there are concerns and issues with the TTW Program, but for 

now GGI continues to be proactive and place the needs of our participants first. 

With this said, please allow me to introduce to you one of our participants 

Benjearlene Nelson. 

How Gulfstream Goodwill Industries and Ticket to Work Helped Me 

It was the night in 2002 that changed my life forever. My husband attempted to 

set our house on fire while my children and I were sleeping. 

10 

I am not a person that likes to talk a great deal about misfortune. I am not a 

negative person. It is because of this, and my loving Mother, that I have stayed 

strong. 

I became disabled in 1991. It wasn’t until I came down with pneumonia in 1995 

that the reality of my condition hit me. I lay in the hospital and heard the shocking 

words from my doctor, ‘‘Prepare a Living Will. You are not expected to live.’’ Because I want to hang on long enough for my two children to be able to live without 

me, I fought. And I survived. But I was exhausted, both physically and emotionally. 

I hadn’t worked a steady job in fifteen years. The burden of supporting Adrian (then 

8 years old) and Greivondra (then 6 years old) in a fire-ravaged home was overwhelming. To add to this, my children and I were forced to jail ‘‘Dad,’’ which meant 

an additional fight and family upheaval. 

I reached my lowest point after the arson and attempted murder by my husband. 

I had no energy, no direction, and no future. Looking about my room I saw a ‘‘Ticket 

to Work’’ certificate on my dresser that I had received about eight months before 

the fire. I don’t believe it was a coincidence that I hadn’t thrown it away. And it 

wasn’t a coincidence that I knew about Goodwill either. I know Goodwill has a reputation for ‘‘doing good things,’’ and I know they help people find jobs. 

I took control again. Meeting with Elizabeth Jennings at Goodwill in May of 2003 

was a good experience. She gave me encouragement and told me that I could get 

a job right away. I was in an emergency situation because I really needed to get 

a job and fast. There were bills to pay and no food to eat. It had to be a job with 

good pay, but one that would allow me to keep my Social Security benefits. To add 

to my worry, I don’t have a high school diploma. It felt like I was walking another 

tight rope, and I was scared. 

Goodwill was there for me. Judy Roy took over once Elizabeth completed the 

paper work. I told Judy about my work experience and how I always wanted a better education. (I have taken several courses from local universities.) Goodwill gave 

me benefits counseling, and Judy’s job search produced three job opportunities for 

me within the first week. I decided that I wanted to go to the job interviews alone, 

even though Judy told me that she would go with me. I wanted to prove to myself 

that I COULD! I was offered all three jobs, and I took the one that paid the best: 

a telemarketing job at Kristel Marketing where I invite people to a vacation resort 

in the Poconos. 

Today I look forward, not backward. I have a good job, and achieved ‘‘Best Sales’’ 

within my company last year. I have two wonderful children who know the importance of a good education, and a fantastic mom, who has been supportive in the 

worst of times. And I have my Goodwill family. 

It is important to have my Goodwill family because my fight isn’t over. To keep 

my disability at bay I am forced to take medication that has attacked my joints and 

liver. I have been diagnosed with Avascular Necrosis of the hip and a chronic liver 

disease. Hip replacements are in my future, and I know Goodwill will be there for 

me again. 

The ‘‘Ticket to Work’’ program has proved invaluable to me. Because I didn’t believe in myself after all that happened to me, I really needed a helping hand. I think 

of Goodwill as offering me a much-needed hand up. The Ticket to Work program 

and Goodwill people gave me a lift so I could get up, work and support my children 

on my own. 

f 

Chairman SHAW. Thank you, Ms. Nelson. Ms. Hancock? 

STATEMENT OF CHARMAINE TERI HANCOCK, TICKET TO 

WORK PARTICIPANT, NEWNAN, GEORGIA 

Ms. HANCOCK. Good morning, everyone. I am Teri Hancock and 

my story is a shade different. I, on the other hand, was at the 

height of my career when my injury happened, and because of that, 

I was in rehabilitation for about 4 years. I was in a wheelchair, 

couldn’t walk, and I had to develop my muscles at the bottom of 

my body all over again. Having to learn how to walk is quite a 

task, believe me. 

When you are young and you think you are invincible and you 

have everything to live for, your life goes from sugar to poop, and 

11 

that is the thick of it. When you find yourself in a situation where 

everything is a gray area, you look around—I looked around because I wanted my old life back and I was willing to do anything 

to get that old life back. The problem was, society would not allow 

me to have that life back. There was no one there to listen, because 

I had a big white brace at the time. Mind you, I have had seven 

surgeries to correct my injury. 

You would be surprised at how you are viewed when you have 

a handicap. Employers do not listen to you. People ignore you. You 

are ostracized. While working at the national Cancer Institute after 

my return to work after the initial injury, I was ridiculed, taunted, 

made fun of, poked fun at, the butt end of a joke. For someone that 

has come from my background, which is radio-television, behind 

the camera, in front of the camera mostly, talk show host, it was 

devastating. My self-esteem went to just about zero. 

With my will and determination, I wasn’t going to stay there 

long. I was looking for an out. I was looking for a helping hand. 

I was looking for an avenue to stroll that would bring me back to 

where I was. Actually, in the fifth year, I got a letter in the mail 

from Ticket to Work, Social Security. I said to myself, hmmm, a 

government agency. That means they are going to be around. I said 

to myself, an opportunity for the government to take a listen to 

what I have to say. Somebody is finally paying attention. I was 

very happy about that, very elated. 

To find the right program—you get a list when you get your letter. When I got my list, I went through four—three agencies before 

I found the fourth one. Now, Integrated Disabilities Resources 

(IDR) in Connecticut—I live in Georgia—but not all Ticket to Work 

Program vendors are good, and I will have to tell you that. Not everybody does what they are supposed to do. There are some that 

do what they are supposed to do, and they are superior. For a win 

situation for myself, people like myself, we need the program to 

come back into life, to be reborn again. 

Now, I worked with a woman by the name of Meg Moran, and 

Meg Moran understood where I was going, where I had come from, 

my level. Others may say to you, well, I want to teach you how to 

write a resume. I can teach you how to write a resume. You don’t 

need to teach me that. I can set up an interview. I can set up my 

own interview. I didn’t need that. I needed contacts. I needed somebody to listen. I needed a voice. They supplied the voice. Social Security backed it. The IDR was there to make the contacts. I went 

forward, got it done. 

When you are called terrible names because of your handicap or 

made fun of, which I cannot even repeat the things I was called, 

the only thing you want to do is show them they are wrong. Well, 

I was able to show them that they were wrong with Ticket to 

Work. Not only do I counsel, not only do I counsel other people, not 

only have I written a book, not only do I tour with my book, but 

my self-esteem is back up to 100 percent. No more big white brace. 

Ticket to Work listened. They heard my cry. There are thousands, 

probably millions of people like myself out there. They need Ticket 

to Work. They need a voice. They need an entry. I am here to say, 

thank God for them, and if you have a position for me at Ticket 

12 

to Work, Social Security, you had better come get me because here 

I am. 

[Laughter.] 

I can say nothing except the program is a viable program. You 

have, as I said, a million intelligent people out here that want to 

go to work. Yes, we do have people that don’t want to go to work, 

but we have so many that still want life. I am crying for life for 

these people, for myself, and I am saying, whatever you do, God 

bless Ticket to Work and that is where we want to be. Thank you. 

[Applause.] 

[The prepared statement of Ms. Hancock follows:] 

Statement of Charmaine Teri Hancock, Ticket to Work Participant, 

Newnan, Georgia 

The challenge to move forward in life and live it as you once knew it after the 

affects of serious illness or injury, brings about idle yet common reflections of what 

could have been. Living and adjusting to life as it now presents itself, challenges 

the will to live, the necessity to thrive, the purpose of one’s being and poses the ageold question of devastation—why? Or why me? 

One never knows what may lie ahead in life, we live each day in health as if it 

will be there forever. We often times choose to close our eyes and minds to what 

does not directly effect us at that given moment but when the unexpected happens 

and life turns a sharp and warningless curve the cold hard vengeance of reality can 

hit you like a brick. 

Which brings us to my own reality. After having had a massive cerebral hemorrhage totally out of the blue, while at the height of my success, life for me went 

from sugar to poop! On top of the world one day and flat on my back the next, helpless with no relief or hope in sight. 

Once I was finally lucid enough to understand the condition I was left in immediate depression consumed me, leaving me breathless, lost and very alone. I really 

did not know who I was or what life held for me. 

Well, after countless years of rehab, pain staking surgeries, endless therapies, 

never ending questions and people treating you like a mangled yarn, I ventured to 

pick myself up and get back I the race. 

For over four years I tried to break back into the work force on my own. Between 

operations (seven to be exact) the healing process, the rehabilitation’s, the weakness 

and the struggle to exist. But at many points because of how I was treated by others 

I viewed myself as less than whole, even a waste, and certainly not the person I 

use to be. I questioned who or what had I become anyway? Moreover why was this 

foreigner living in my body invading my wonderful life and when was it leaving? 

I wanted to get back in the work force, but doors are often close to cripples, people 

seen as less than perfect, people who’s presence one might find disturbing. During 

my period of healing I was indeed one of those people. 

Although I held a wealth of knowledge, experience and information, it did not 

matter because my physical presentation was less than acceptable (hard on the eye) 

the public viewed me as less than whole, less than perfect. 

I tried to get back into Telecommunications at MCI only to be taunted, laughed 

at and made fun of, always the butt end of a crippled joke. 

My self-esteem totally destroyed, my sprit broken. Over and above all of this, I 

was still there inside of this broken body, no one would listen or give me the time 

of day. 

TTW came in my life at a time when I had exhausted every avenue, literally. So 

for me this program was a ‘‘God send’’ my rescue from the hell of disablement. A 

real voice, a real person to join forces with. After receiving my ticket I view my options, spoke with four venders and settled on Integrated Disabilities Resources 

(IDR). Understand, not every ticket holding agency is equipped nor do they really 

understand their job. So IDR was the right choice for me. 

This outfit seemed to understand my level and mindset really connecting with me. 

This is where I linked with an individual who seriously wanted to support me and 

understood my cry for help. This woman was Meg Moran of IDR, she saw me as 

a crop that simply needed to be harvested, a bountiful land full of nutrients and 

aid to bestow. 

13 

I started working Meg at IDR and soon people started listening because I now 

had a connected voice. Using IDR’s connections, assistance and referral systems, 

new avenues of opportunity were made available. 

In fact, working with one of their consultants (Dan T. Mcaneny) opened up a 

whole new world. Mr. McAneny helped me realize just how much I did have to offer; 

I was amazed with myself once we explored just what jewels I did posses. I realized 

that I had allowed society to beat me down like a bush in a rainstorm. 

After working with IDR I took on new challenges and capitalized on what I had 

already had under my belt. As an air personality, I had lectured and counseled on 

radio and television before my injury and developed quite a following. While these 

people were still out there and hundreds more, people who needed my help as much 

as I needed to help them for my own esteem. With the help of Dan McAneny I 

turned my lectures into a book, did something constructive and came back into the 

forces of life. Thank goodness for the TTW program. 

Much like myself there are thousands of people who have so much to give, so 

much to share, teach, produce, contribute, so much life to still live but with no practical means to display or showcase their abilities. Therefore they sit and waste, 

many are so beat down by the barriers of society until they have lost their fight 

or so terrified of rejection until they simply give up and concede. 

So, Social Security developed an incentive program for the displaced, handicapped 

and physically challenged individuals to display their capabilities as to redeem their 

self worth. I think their original idea or mindset may have been to get able-bodied 

people back to work, off the system and help relieve the deficit. However the real 

gem of this program is that millions of Americans that lost who they use to be before that devastating injury or illness can once again become viable, productive, 

happy salary earning individuals! 

Thus still helping with the world’s deficits and financial crunch. Which leads into 

just what having a ticket has done for my life. 

The Ticket to work Program provides an entry back to a productive life. It supplies one with direction, hope and guidance granting a solid home base to rise from. 

Because TTW is part of our Government its stability speaks for itself, the injured 

can trust and take refuge in a program such as this. Therefore, We really do need 

TTW and agencies with caring hard working advocates for the disabled such as IDR. 

TTW/IDR helped save my sanity and got me on track because I certainly could not 

do it alone. 

Please, help me help others get their life back and be productive, whole individuals who contribute to the face of this universe. 

Save TTW, help Social Security help its contributors and please save the agencies 

that give human beings back their dignity and self worth. 

f 

Chairman SHAW. I can tell you that applause applies to both of 

you ladies. I can’t recall a single time in my 24 years of Congress 

where a panel has been applauded. 

[Laughter.] 

Social Security, if you need somebody to sell your stuff, I think 

you have found her. 

[Laughter.] 

Mr. Collins? 

Mr. COLLINS. I told you, Mr. Chairman, she was going to be 

very impressive. I really have no questions other than just to thank 

each of you for being here. You have very humbling stories to tell 

and we appreciate the fact that you had the will not to take these 

roadblocks and let them stand before you, but knock them down 

and get things done, and I would appreciate your support for the 

program and we wish you the best in the future, which I know it 

will be. Thank you. 

Chairman SHAW. Mr. Cardin? 

Mr. CARDIN. Let me join the Chairman in thanking you for 

coming before our Committee. The SSA tells us there are 40,000 

people who have taken advantage of the Ticket to Work. That is 

a small fraction of the number of people who could benefit from the 

14 

Ticket to Work. A lot of times in Congress, we debate numbers. We 

debate dollars. Your testimony has really put a face on the issue 

to us, that we are dealing with real people and their lives and affecting their lives. So, we very much appreciate your testimony and 

what it means to us when we work for programs that we think can 

make a difference in people’s lives. The two of you come from different backgrounds, but it was the same program that benefited 

both of you. You were able to take advantage of this program, and 

I very much appreciate the manner in which you expressed that. 

Ms. Nelson, it was very courageous of you to get into this program because you knew there were certain risks involved. You gave 

up certain safety nets that were available to you, but the importance of work, the importance of being the head of your household 

and taking care of your family, the Ticket to Work gave you a 

chance to use that and to use those talents and we thank you for 

having the courage to move forward. Ms. Hancock, as you said, 

your case was different. You needed the bridge to bring you back 

to be able to use your talents, and the Ticket to Work worked for 

both. So, I think that is really a testament to the flexibility of this 

program, and exactly what we intended in Congress. We intended 

this program to be a ticket to be used outside the conventional rehabilitation services that were available through the States, that 

you could use it to get the help that you needed to be able to reenter the employment marketplace. 

We wanted to be flexible. We wanted to have a variety of vendors 

out there that were available, and I think you have raised a very 

good point, one that I want to make sure we follow up on, and that 

is there are different types of ENs that are out there. Some are better than others for your particular needs. One of the things we 

have to make sure that we have adequate information so that the 

ticket is used by the recipient in the most effective way in order 

to accomplish the results, and I think your testimony has helped 

us to focus in on that. So, to both of you, we thank you for being 

here. We thank you for your testimony. I can tell you it has a 

major impact on our work. 

Ms. NELSON. Thank you. 

Ms. HANCOCK. Thank you. 

Chairman SHAW. Thank you, Ben. Mr. Hayworth? 

Mr. HAYWORTH. Thank you, Mr. Chairman. Again, let me 

thank the witnesses. Just a couple of questions, and we appreciate 

the testimony. Ms. Nelson, do you have any piece of advice for others who are receiving benefits who are just now thinking about getting back to work? Is there anything that is just really important 

for people to remember as they take a look at this Ticket to Work 

Program? 

Ms. NELSON. I think that it is very important that they look at 

the Ticket to Work Program, also that it will also protect their benefits, their medical. The Ticket to Work is there so that you don’t 

have to worry about your benefits or your medical. So, that is one 

thing that is very important if they decide to use the Ticket to 

Work. They don’t have to worry that their medical will be taken 

away from them. 

Mr. HAYWORTH. So, the real thing is to emphasize the message 

and expand, and that leads me to Ms. Hancock, a fellow broadVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00018 Fmt 6633 Sfmt 6602 E:\HR\OC\23796.XXX 23796
15 

caster. I worked in television and many a television news director 

said I had a face for radio. Maybe that is how I ended up in the 

Congress. 

[Laughter.] 

I think we get into the real challenge we are confronting today 

with these hearings, because as our colleague from Maryland pointed out, we passed this program in 1999. Now, Mr. Chairman and 

my colleagues, witnesses and others gathered here, this is a critical 

time because we have the irony of some really gratifying success 

stories and we appreciate the presence of television cameras here 

today, and yet the ability of folks to take advantage of this seems 

to be the real challenge, to make sure the word gets out. 

Ms. Hancock, I could not help but notice in your testimony your 

willingness, your invitation to the SSA and others to take advantage of your background in broadcasting and of your story to get 

the message out. It is a bit unfair, but we have both been in the 

broadcasting business, and sometimes in Washington, we get involved in—I am not here to castigate, it is just sometimes in the 

order of doing things. We introduce pilot projects to get the word 

out, and sometimes things are very laudable on the surface, but the 

results are projected a year or two down the road, and there may 

be a lag time that is not at all satisfactory. As a fellow broadcaster, 

what is the best way to get the message to the people who are 

qualified for the Ticket to Work? What do you think would be the 

most effective means of communication? 

Ms. HANCOCK. I am so glad you asked that, because I do have 

an answer, and that answer is when people go to apply for their 

disability and you see your counselor there, the Ticket to Work 

needs to be introduced at that juncture because they need to 

know—for example, if you are on short-term disability, we have got 

a program called Ticket to Work. You don’t lose anything. You 

don’t lose your benefits. You get to work. You have got a trial work 

period. If you can’t succeed, you lose nothing. You start over. Disability benefits stay. If you go past the 9 months, then we take the 

Social Security away. You get back into the mainstream of life. It 

is a win-win situation for all. You are helping to stop the deficit 

in terms of all the moneys going out to people that don’t really 

need to be on Social Security. 

Let us face it. We have got people, excuse me, that don’t need 

to be on Social Security. They are there because they are afraid to 

come back into the workforce, or it is just plain easier not to go 

back to work because you are getting that money. You have some 

people that will stay at that safe house because they are lazy. You 

have got other people, such as the two people you have here. We 

want to get back into society. We want to do the right thing. 

If it was simply introduced when you had your review or when 

you had your initial interview, it is an option that is open without 

passing any type of legislative law. It is already there. The counselors can simply do it at that point, and let you know what your 

options are. Many people do not read the mail. I read the mail. She 

reads the mail. Many people don’t open the mail, so the ticket goes 

in the drawer. The Ticket goes in the trash. So, to get it out, you 

have got to have a one-on-one communication with a human being, 

so the person will understand what the ticket is. 

16 

Mr. HAYWORTH. So, job one of the counselor is to bring up 

Ticket to Work? 

Ms. HANCOCK. Absolutely, and the benefits of Ticket to Work. 

Mr. HAYWORTH. Ms. Nelson, you want to make a comment on 

that? 

Ms. NELSON. I just want to make a comment as to what she 

said. She is telling the truth, because when I received the Ticket 

to Work, the first place I put it was in the filing cabinet. At the 

time, my husband was there. I didn’t read it over. I didn’t think 

that I needed it. Nine months later is when I pulled it out, and at 

the time, I wasn’t even sure if it had expired, or if I was still able 

to use it. So, I agree with her. 

Mr. HAYWORTH. Thank you both very much. Thank you, Mr. 

Chairman. 

Chairman SHAW. Thank you. Just to follow up on that, in looking at the Ticket to Work, I don’t know whether the Members have 

it in their back-up material, but it is a pretty cold document. I 

think we can do a better job of making it more consumer-friendly. 

When you read it, you don’t know if you are getting in trouble or 

what. 

[Laughter.] 

Whether to put it in the filling cabinet or in the round filing cabinet. 

[Laughter.] 

I think it is a little intimidating, and I think maybe we can do 

something to help that out. Ms. Tubbs Jones? 

Ms. TUBBS JONES. Thank you, Mr. Chairman. Ms. Nelson, Ms. 

Hancock, on behalf of all of the folks who are receiving SSI across 

this country, I want to thank you for your wonderful commentaries 

and reports. I am interested, even though you are not here for this 

purpose, how, when you made an application for disability, how 

long that took for you. Was it a long process? Was there delay? 

What happened for you? I hate to go to another part, and maybe 

it is not as glorious as your commentary, but I need to know that 

if you could help me out. 

Ms. HANCOCK. Yes. For me, it was short. This is a true story. 

My mother was visiting me in Atlanta, Georgia. We were at a CHU 

facility and a woman saw me, and I was limping. She said to me, 

‘‘Excuse me, are you receiving Social Security,’’ and I really ignored 

her, because I was trying to ignore the condition. In fact, I was a 

little hurt, and I said, ‘‘No, I am not receiving,’’ because it was one 

of those things where you don’t want to be bothered. The injury 

was too new. So, to make a long story short, my mother says, ‘‘Listen to what this woman has to say,’’ and I did. 

Ms. TUBBS JONES. Mothers always say that, don’t they? 

[Laughter.] 

Ms. HANCOCK. So, the woman worked at Social Security and 

she said, ‘‘You need to see me at my office.’’ It was almost like a 

Godsend, like a little blessing. I went in and mine actually didn’t 

take long at all. When people say they are denied, I just went 

through the process fairly quickly. Within 3 months, I was getting 

Social Security. So, I didn’t have a bad time at all. 

Ms. TUBBS JONES. Where are you from, again? 

Ms. HANCOCK. Washington, D.C. 

17 

Ms. TUBBS JONES. Okay. Thank you. I thought they had some 

other State on there. 

Ms. HANCOCK. I live in Newnan, Georgia. 

Ms. TUBBS JONES. That is what I am saying. Okay. I am not 

totally confused. Great. What about you, Ms. Nelson? 

Ms. NELSON. For me, it didn’t take long at all. I was in the hospital for about a month and they weren’t expecting me to live. 

When I did start to recover, to get better, they did it in the hospital 

so when I returned home, I was eligible for Social Security. 

Ms. TUBBS JONES. So, tell me what you are doing right now, 

Ms. Nelson. What type of work are you doing? 

Ms. NELSON. Right now, I work for a marketing company. I invite people to a vacation resort in the Poconos, the Pennsylvania 

and New Jersey area. 

Ms. TUBBS JONES. What about you, Ms. Hancock? 

Ms. HANCOCK. Right now, I am mediating, mostly divorce 

cases. Daily, I teach, and I am a master’s candidate for counseling. 

Ms. TUBBS JONES. If there was one thing, and I am almost 

done, Mr. Chairman, if there was one thing that you would improve in addition to how people are noticed of Ticket to Work, what 

would that proposal be for either one of you? 

Ms. NELSON. I would say a lot of people watch television. Put 

it on television. 

Ms. HANCOCK. Yes, they do. That is good. 

Ms. TUBBS JONES. Ms. Hancock? 

Ms. HANCOCK. For me, again, I would build a campaign, an actual campaign, because when we campaign and we get things done 

through campaigns, we stir up, again, from the broadcasting, we 

stir up interest. 

Ms. TUBBS JONES. If there was an opportunity for either of you 

to serve on an advisory Committee to the Ticket to Work Program, 

would you consider that? 

Ms. HANCOCK. I would be your girl. 

Ms. NELSON. Yes. 

Ms. TUBBS JONES. Okay. 

[Laughter.] 

Thank you very much, Mr. Chairman. 

Chairman SHAW. Thank you. Mr. Hulshof? 

Mr. HULSHOF. Thanks, Mr. Chairman. I promised Mr. 

Hayworth—he had to step out just for a moment, and I promised 

that we would not ask for a recorded roll call vote on whether we 

believe he has a face for radio. 

[Laughter.] 

Chairman SHAW. We are still wondering if he has a face for politics. 

[Laughter.] 

That will teach him to leave the hearing. 

[Laughter.] 

Mr. HULSHOF. I am sure he will be back any minute now. I certainly don’t have the breadth of experience as the Chairman as far 

as the number of hearings, but I do look around the room, and I 

think of the number of hearings that this Subcommittee has had 

regarding this issue, and I see some familiar faces here in the hearing room who have been with us working on this issue, actually 

18 

even back to 1997. I think is when we began under a former Chairman, and now Senator, Jim Bunning of Kentucky, when he chaired 

this Subcommittee. 

We have a very active disability community in Central Missouri. 

I will confess that before they brought this issue to my attention 

about things like the income cliff, and things like losing health insurance, and things like the barriers and obstacles in place to keep 

people who want to return to the workforce and be productive, and 

the self-esteem and all those things, they are the ones who brought 

it to my attention. So, it is great that we can come and talk about 

a successful program, but also then to see what we need to do to 

make sure that this program continues, that we go and recruit others and tell others about this very successful program. 

This was an interesting political lesson for me because this was 

the first time I actually got to be on a Conference Committee, that 

is, to work with Senator Kennedy and Rick Lazio of New York, 

again, a former Member, and we were trying to work the details 

of this out. I know that when the bill, the final version, there were 

folks that were concerned about the final version, but I think we 

had a good product. There is my friend back. 

[Laughter.] 

So, again, whatever suggestions that you have, and I applaud 

each of you and I know, Ms. Hancock, just as a final question, I 

know you are not here for self-promotion, but where can I get your 

book? 

Ms. HANCOCK. I will send you a copy. 

Mr. HULSHOF. Okay. Thank you, Mr. Chairman. 

Chairman SHAW. Thank you. Mr. Becerra? 

Mr. BECERRA. Thank you, Mr. Chairman, and thank you very 

much for what was compelling testimony. I think you bring real life 

to what we try to do sometimes, so it is nice to see that oftentimes 

policy is put in practice, and it is great to see that. I know we are 

going to have an opportunity to talk to the folks from the agencies 

that are equipped and empowered to administer these programs, 

and hopefully what we can do is try to perfect them, because we 

know that there have been some difficulties, whether it is not the 

best providers being out there or just not having the access and to 

beneficiaries not knowing about them. So, we thank you for the testimony and appreciate that you shared your stories. Just so you 

know, my understanding is that there is an opening right now with 

the Ticket to Work Program for the Director, so if any of you are 

interested in applying, you might want to consider submitting your 

resume. 

[Laughter.] 

I think Congresswoman Tubbs Jones asked a question that I 

wanted to ask, which was give us your on-the-ground impressions 

of what we should do, and you mentioned two very good ones, the 

publicity campaign, doing something on television, maybe through 

public service announcements. Any other thoughts about what we 

should know about making the program more user friendly? The 

simplest things, just so we know how you all need to access the 

program. 

Ms. NELSON. I think one thing to make the program more user 

friendly is to emphasize on the medical part of it protecting medVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00022 Fmt 6633 Sfmt 6602 E:\HR\OC\23796.XXX 23796
19 

ical benefits. That was one of my biggest issues of even beginning 

to work and to continuing to work. We are always going to need 

medical help, and me personally, I know that I am going to have 

hip replacements soon. I never know when I am going to need another eye surgery. So, that is always a major concern as far as me 

working at this time. 

I am in training to become supervisor on my job, but at the same 

token, I am afraid to take the position because I know with a certain amount of money, the medical benefits are taken away and 

that is one of my biggest concerns. Even with the medications I 

take, it is really a big concern of mine. So, if there is some way 

that you can assure Social Security beneficiaries that they will be 

protected in that aspect, I am sure that a lot of people will take 

advantage of the Ticket to Work. 

Mr. BECERRA. Ms. Nelson, have you had or do you have a good 

experience that you can tell us about with regard to VR services? 

Has that continued? Now that you have used the Ticket to Work 

Program, are you still accessing the VR services? 

Ms. NELSON. Yes. Goodwill has helped me. Everything that I 

need, I went to GGI, any encouragement, counseling. Regardless as 

to what it was, I have been to GGI. I consult GGI. I always consult 

Ron Rattay, who has answered all of my questions. If he didn’t 

know the answer, he found the answer, and this made me feel confident. 

Mr. BECERRA. So, you had a pretty good experience working 

with the agencies involved? 

Ms. NELSON. Yes. 

Mr. BECERRA. Good. Ms. Hancock, I don’t know if you have 

anything you would like to add. 

Ms. HANCOCK. I think I have probably said enough. I do want 

to say that she is absolutely right. If we could just alleviate the 

fear of, ‘‘Are we going to lose this?’’ People just don’t understand 

that you can benefit in a win-win situation, and that everything is 

not taken away from you at once. They think if they are working 

4 or 5 months, that is 4 or 5 months into their ticket period, not 

understanding that if you start over, the whole process starts over, 

so you are losing nothing. I think that should be made more clear. 

Other than that, I am done. 

[Laughter.] 

Mr. BECERRA. Thank you for coming. Mr. Chairman, thank 

you. 

Chairman SHAW. Thank you. I am going to just read something 

into the record off of an actual Ticket to Work ticket. It has been 

a successful program, I am not knocking it, but I think there are 

many people out there like you two who would avail themselves of 

this instead of being too quick just to throw it away or being intimidated by it. 

I am reading right from the ticket. It says, ‘‘This ticket is issued 

to you by the SSA under the Ticket to Work and Self-Sufficiency 

Program.’’ Now, that has got to mean a lot to people who are on 

disability. ‘‘If you want help in returning to work or going to work 

for the first time, you may offer this ticket to an EN of your choosing or take it to your State VR agency for services. If you choose 

an EN and it agrees to take your ticket, or if you choose your State 

20 

agency and you qualify for services, these providers can offer you 

services to help you go to work. An EN provides the services at no 

cost to you. The SSA will pay the EN if you assign your ticket to 

it, and the EN helps you go to work and complies with the other 

requirements of the program. An EN serving under the program 

has agreed to abide by the rules and regulations of the program 

under the terms of its agreement with the SSA for providing services under the program. Your State agency can tell you about its 

rules for getting services.’’ 

Now, if you are going to be informed about the program after 

reading this, you have got a sense that I think is rather remarkable. I do understand there is a letter accompanying this, but I 

don’t have a copy of it. I am sure it gives us a lot more information, 

but, all of us here on this panel have been involved in advertising 

ourselves in political campaigns and we would never send out 

something like this, because it would never be read. I think that 

we must become a little more imaginative if we are going to get 

more people into the program. You people have demonstrated, Ms. 

Nelson and Ms. Hancock, you have demonstrated what you can do 

for yourself. 

This Subcommittee and the entire Committee on Ways and 

Means has, I think, done some wonderful things, and Ticket to 

Work, I think, is another program in which we show that we have 

faith in the human spirit if we just let it fly. You have certainly 

proven that to us. Ms. Nelson, I am really very proud to have you. 

I think you just live outside of my congressional district. I checked 

you out. I don’t think you live in my district. 

[Laughter.] 

You do live in the West Palm Beach area, which I do represent 

a portion of, and I am very proud to—I will claim you as a constituent, even if you live out of the district. 

Mr. BECERRA. So do we. 

[Laughter.] 

Chairman SHAW. California is a stretch. 

[Laughter.] 

I have heard of gerrymandering—— 

Mr. BECERRA. We stretch a lot of things in Congress. 

Chairman SHAW. I have heard of gerrymandering, but it doesn’t 

go from Palm Beach to Los Angeles. 

[Laughter.] 

Ron, do you have a question? 

Mr. LEWIS. No. 

Chairman SHAW. I want to thank you for being here and sharing your story. Hopefully, it will be an inspiration to many, and 

Mr. Rattay, just keep up what you are doing. You are obviously 

doing the right thing and we very much appreciate your being here 

with us this morning. 

Ms. HANCOCK. Thank you for having us. 

Ms. NELSON. Thank you. 

Mr. RATTAY. Thank you. 

Chairman SHAW. Our next panel is made up of Martin Gerry, 

who is Deputy Commissioner, disability and Income Security Programs, SSA, and Troy Justesen, who is the Acting Deputy Assistant Secretary, Office of Special Education and Rehabilitation ServVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00024 Fmt 6633 Sfmt 6602 E:\HR\OC\23796.XXX 23796
21 

ices at the Department of Education. We welcome both of you back 

to this panel and we look forward to your testimony. As both of you 

know, we have your full testimony and it will be made a part of 

the record. You may proceed as you see fit. Mr. Gerry? 

STATEMENT OF MARTIN H. GERRY, DEPUTY COMMISSIONER, 

DISABILITY AND INCOME SECURITY PROGRAMS, SOCIAL SECURITY ADMINISTRATION 

Mr. GERRY. Thank you, Mr. Chairman. Mr. Chairman and 

Members of the Subcommittee, as you know, Mr. Chairman, the 

SSA administers both the SSDI, and the SSI programs. These programs provide benefits to about 10.5 million Americans with disabilities. The Ticket to Work Program allows these beneficiaries 

greater flexibility and expanded choice in obtaining the rehabilitation, employment, and other support services that they need in 

order to go to work and to attain their employment goals. 

Mr. Chairman, I would like to express my thanks to you, Mr. 

Matsui, and to the other Members of this Subcommittee for all of 

the hard work and support that you have provided in making the 

Ticket to Work Program a reality. I look forward to continuing to 

work together closely with the Subcommittee to strengthen the program in a way that builds on our early experience and significantly 

expands participation in the program by both our beneficiaries and 

by ENs. 

In his New Freedom Initiative, President Bush pledged that his 

Administration will work tirelessly to help Americans with disabilities become fully integrated into the American work force so that 

they may realize their dreams for meaningful and successful careers. The Ticket to Work Program will help us tear down many 

of the barriers that currently prevent Americans with disabilities 

from full participation in the economic mainstream of American society. 

With the Ticket to Work Program, beneficiaries have more opportunities to obtain employment support services to help them reach 

their employment goals. In addition, the program will help us fulfill the promise of the Americans with Disabilities Act. Commissioner Barnhart and I are deeply committed to achieving the goals 

of this very important program. 

Mr. Chairman, I would like to begin by briefly describing how 

the Ticket to Work Program operates and making some comments 

on where we are in implementation of the program. The SSA currently provides benefits under the SSDI and SSI Programs, as I 

said, to approximately 10.5 million Americans with disabilities. 

Under current agency regulations, an SSDI or SSI beneficiary with 

a disability receives a Ticket to Work if he or she is between the 

ages of 18 and 64 and has a medical condition that is not expected 

to improve in the near future. Approximately 9.2 million, or a little 

over 85 percent of the 10.5 million of all our current beneficiaries 

with disabilities meet this standard. 

Under the act, the SSA enters into agreements with ENs, and 

State VRs. The ENs are qualified State, local, or private organizations that offer employment support services. A beneficiary who receives a Ticket to Work can choose to assign it to the State VR 

agency or to any EN that provides services within his or her comVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00025 Fmt 6633 Sfmt 6602 E:\HR\OC\23796.XXX 23796
22 

munity. Together, these agencies serve as ticket providers under 

the program. The act does require that a ticket provider accept a 

measure of risk whenever it agrees to provide services to a beneficiary. The ENs and State VR agencies may only be paid under the 

program based on success in assisting beneficiaries to secure and 

maintain employment and to move off the disability benefit rolls. 

An EN might never be paid if a beneficiary’s cash benefits do not 

stop as a result of work. An EN may decide whether or not to accept the assignment of a ticket. State VR agencies incur less risks 

than ENs do because those agencies are already funded and fully 

capitalized through the Rehabilitation Act (P.L. 93–112). 

Once a ticket is assigned by a beneficiary to a ticket provider, the 

beneficiary and the provider jointly develop and implement a plan 

of employment, vocational, or other support services designed to 

lead to and maintain employment. Providers may offer these services directly or by entering into agreements with other organizations or individuals to provide the appropriate services at no cost 

to the beneficiary. The Ticket to Work Act provides three additional 

incentives to encourage work activity by beneficiaries. First, the 

SSA will not schedule a periodic continuing disability review 

(CDR), for a beneficiary who is receiving services from a ticket provider. Second, work activity by a beneficiary will not trigger a CDR 

if the beneficiary has received benefits for at least 24 months under 

the Disability Insurance program. Finally, an individual whose 

benefits terminated because of work activity can request that benefits start again without having to complete a new application for 

benefits. 

Mr. Chairman, as you know, we have implemented the Ticket to 

Work in three phases and it is currently available in all States and 

U.S. territories. Through February 2004, tickets have been mailed 

to over 6.9 million disabled beneficiaries, and by September of this 

year, the remaining 2.2 million eligible beneficiaries will have received a Ticket to Work. As of the beginning of this month, 40,441 

beneficiaries who had received Tickets to Work had assigned them 

to ticket providers. Of this total, 36,525, or approximately 90 percent, have been assigned to a State VR agency, and 3,916, or 10 

percent, have been assigned to an EN. It is interesting, however, 

to note that 30 percent of the ticket assignments have been made 

in the last 5 months. This suggests to me, Mr. Chairman, that 

there is a significant acceleration going on in the use of tickets and 

the assignment of tickets. 

The first milestone payment was made by Maximus in May of 

2002, and the first outcome payment was paid in July of 2002. We 

now have more than 1,600 payments based on the work of 450 

beneficiaries going to 116 ENs and totaling over $530,000. Over the 

last few months, we have received valuable information from several sources regarding the initial implementation of the Ticket to 

Work Program. The Ticket to Work Act requires the Commissioner 

to submit periodic evaluation reports of the Ticket to Work Program to the Congress. The SSA has contracted with Mathematica 

Policy Research to evaluate the impact of the Ticket to Work Program. 

Mathematica has provided a draft of the first in a series of evaluation reports, and while Mathematica notes in its draft report 

23 

that, overall, the SSA has made great progress in developing a system to assist individuals with disabilities to find work and to remain in the work force, it points out that most beneficiaries who 

use the Ticket to Work have assigned them to traditional State VR 

agencies and the ticket assignments to ENs have been concentrated 

among a few. It reports that ENs as a group feel that the SSA 

needs to move quickly to make the process friendlier to providers, 

and I will be happy, both to provide the Subcommittee with a copy 

of the final version of this report, which we expect to be available 

shortly, and to brief Members and staff as to its findings. 

The Ticket to Work Act also identifies four groups of beneficiaries 

with disabilities as potentially at risk and requires the Commissioner to study the adequacy of incentives for ENs to serve people 

in these populations. To this end, the SSA formed an Adequacy of 

Incentives Advisory Group that has been meeting quarterly and 

will complete its work this spring. I think I have attended all but 

one half-day of their meetings. 

Last fall, the Advisory Group issued an interim report recommending regulatory and administrative changes. The Advisory 

Group will also issue a final report, we believe by the end of next 

month, that proposes projects to evaluate the effectiveness of adjusted incentives and provides recommendations regarding the 

most promising of these incentives. The Ticket to Work Advisory 

Panel has been a valuable partner in studying the Ticket to Work 

Program and making recommendations for improvements. The 

panel has been concerned about the balance between State VR 

agencies and other ENs and about ways in which we can encourage 

more beneficiaries to assign their tickets to ENs. It has also advised us on ways to improve our marketing of the program to both 

beneficiaries and potential ENs, provided specific recommendations 

with respect to establishing a core of work-incentive specialists, 

and offered suggestions on a way to reduce the incidence of overpayments caused by work. 

Commissioner Barnhart and I believe that it is our mission to 

see that the ticket program lives up to its potential, and I think 

it has great potential to return people to work. Based on all of the 

information that we have received, we have already taken a series 

of actions to improve our return to work service. These include 

steps to simplify the payment process for ENs, to increase the pool 

of ENs, and to improve our wage reporting process. We have jointly 

funded with the U.S. Department of Labor new positions in the 

One-Stop Career Centers to help people with disabilities increase 

their employment opportunities and have expanded the pool of SSA 

field employees who are available to answer questions relating to 

return to work, including the employment of 58 full-time employees 

who serve as Area Work Incentive Coordinators. 

I want to thank the Subcommittee for its advice and guidance as 

we work closely with you to develop this approach. In summary, 

Mr. Chairman, our early experience and the preliminary evaluation, analyses, and recommendations that I summarized earlier 

have shown us both that the Ticket to Work Program can provide 

beneficiaries with more opportunities to obtain employment support services to help them reach their employment goals, and also 

24 

that we need to do more to increase program participation and 

build on program success. 

Finally, I want to thank you, Mr. Chairman, Mr. Matsui, and all 

the other Members of the Subcommittee for showing continued 

dedication to the program. Thanks to that commitment, we look 

forward to providing more beneficiaries with additional opportunities and the tools that they need to enter or reenter the workforce. 

In addition, I would also like to thank the Subcommittee for its 

work to pass H.R. 743, the ‘‘Social Security Protection Act’’ (P.L. 

108–203). With the provisions in that bill regarding SSA demonstration projects, we can move forward with our agenda of 

projects designed to provide alternative return to work services. We 

look forward to working with the Subcommittee as we continue our 

efforts to make the Ticket to Work Program a success. I would be 

happy to answer any questions. 

[The prepared statement of Mr. Gerry follows:] 

Statement of Martin H. Gerry, Deputy Commissioner, Disability and 

Income Security Programs, Social Security Administration 

Mr. Chairman and Members of the Subcommittee: 

Thank you for inviting me today to discuss implementation by the Social Security 

Administration (SSA) of the Ticket to Work and Self-Sufficiency Program (the ‘‘Ticket to Work program’’) authorized by The Ticket to Work and Work Incentives Improvement Act of 1999 (the ‘‘Act’’), PL 106–170. 

As you know, Mr. Chairman, SSA administers both the Social Security Disability 

Insurance (SSDI) and Supplemental Security Income (SSI) programs. These programs provide benefits to about 10.5 million Americans with disabilities. The Ticket 

to Work program allows these beneficiaries greater flexibility and expanded choice 

in obtaining the rehabilitation, employment and other support services that they 

need to go to work and attain their employment goals. 

I would like to express my thanks to you, Mr. Chairman, Mr. Matsui, and members of the Subcommittee, for your hard work and support in making the Ticket to 

Work program a reality. I know we will continue to work together closely to 

strengthen the program in a way which will build on our early successful experience 

and expand the participation we have already seen in the program. 

Commissioner Barnhart and I have been fortunate to participate in Ticket to 

Work program activities throughout the nation. I know that she has especially fond 

memories of kicking off the Ticket to Work program in February 2002 alongside the 

late Senator William Roth. Among the other Ticket events she attended that year 

was one in Representative Hayworth’s district. In addition, senior agency staff have 

traveled throughout the country to help introduce this program to the American 

people. Today I would like to provide an update on the implementation of the Ticket 

to Work program, and touch on a few related issues. 

An Overview of the Ticket to Work Program 

First, let me briefly describe how the program works. SSA currently provides benefits under the SSDI and SSI programs to approximately 10.5 million Americans 

with disabilities. Under current agency regulations, an SSDI or SSI beneficiary with 

a disability receives a Ticket to Work if he or she is between the ages of 18 and 

64 and has a medical condition that is not expected to improve in the near future. 

Approximately 9.1 million, or over 85 percent, of all beneficiaries with disabilities 

meet this standard. 

Under the Act, SSA enters into agreements with Employment Networks (ENs) 

and with State Vocational Rehabilitation Agencies (‘‘State VR Agencies’’). ENs are 

qualified State, local, or private organizations that offer employment support services. These organizations include One-Stop Career Centers established under the 

Workforce Investment Act of 1998; single providers of services; or groups of providers organized to combine their resources into a single entity. 

A beneficiary who receives a Ticket to Work can choose to assign it to any EN 

that provides services within the community or to the State VR Agency. Together, 

these organizations are referred to as ‘‘Ticket Providers.’’ An EN may decide whether or not to accept the assignment of a Ticket. The Act requires that an EN accept 

a measure of risk whenever it agrees to provide services to a beneficiary. ENs may 

25 

only be paid based on their success in assisting beneficiaries to secure and maintain 

employment and move off the disability benefit rolls. An EN might never be paid 

if a beneficiary’s cash benefits do not stop as a result of work. State VR Agencies 

are receiving approximately $2.6 billion from the Department of Education for the 

primary purpose of providing employment services to individuals with significant 

disabilities. VR agencies are therefore better capitalized than small or new ENs and 

incur less financial and actuarial risk than ENs serving smaller numbers of individuals. 

Once a Ticket is assigned by a beneficiary to a Ticket Provider, the beneficiary 

and the Provider jointly develop and implement a plan of employment, vocational, 

or other support services designed to lead to and maintain employment. Providers 

may provide these services directly or by entering into agreements with other organizations or individuals to provide the appropriate services at no cost to the beneficiary. 

Ticket Providers may be paid based only on their success in assisting beneficiaries 

to secure and maintain employment and move off the disability benefit rolls. Where 

this occurs, an EN may elect to receive payment under one of two systems. Under 

the Outcome Payment System an EN will be paid for each month, up to sixty 

months, in which a beneficiary it is serving does not receive cash benefits due to 

work or earnings. Under the Outcome-Milestone Payment System, an EN will receive payment when a beneficiary it is serving reaches one or more milestones toward self-supporting employment. Under this second 

payment system, the EN will also receive reduced outcome payments for each 

month, up to sixty months, that a beneficiary does not receive cash benefits due to 

work or earnings. The agency has provided up to four milestones for which an EN 

can be paid. 

The Ticket to Work Act provides three additional incentives to encourage work activity by beneficiaries. First, SSA will not schedule a periodic continuing disability 

review (CDR) for a beneficiary who is receiving services from a Ticket Provider. Second, work activity by an SSDI beneficiary will not trigger a CDR if the beneficiary 

has received benefits for at least 24 months. Finally, an individual whose benefits 

terminated because of work activity can request that benefits start again without 

having to complete a new application for benefits. 

Implementation of the Ticket to Work Program 

SSA is implementing the Ticket to Work program in three phases. During the 

first phase of the program, from February through October 2002, about 2.4 million 

beneficiaries with disabilities in 13 states received Tickets to Work. During the second phase, which ran from November 2002 through September 2003, we mailed 

Tickets to approximately 2.6 million beneficiaries in 20 additional States and the 

District of Columbia. Then beginning in November 2003, we started releasing Tickets to the approximately 4.1 million beneficiaries in the remaining 17 States and 

the U.S. Territories during the third and final implementation phase. 

Through February 2004, Tickets have been mailed to over 6.9 million disabled 

beneficiaries. By September 2004, the remaining 2.2 million eligible beneficiaries 

will have been mailed a Ticket to Work, and any eligible beneficiary who has yet 

to receive a Ticket to Work in the mail can obtain one by asking for it. To date, 

we have certified almost 1,100 ENs to participate in the Ticket program. 

The Act calls for the Commissioner to enter into agreements with Program Managers to assist the Agency in administering the Ticket to Work program. Among the 

duties of our Program Manager, Maximus, Inc., are recruiting, recommending, and 

monitoring the ENs selected by SSA to provide services; facilitating beneficiary access to the ENs; facilitating payment to Ticket Providers; and resolving disputes between beneficiaries and Ticket Providers under the program. 

Ongoing Operation of the Ticket to Work Program 

As of the beginning of this month, 40,441 SSDI and SSI beneficiaries who had 

received Tickets to Work (‘‘Ticket Holders’’) had assigned them to Ticket Providers. 

Of this total, 36,525 (90%) were assigned to a State VR Agencies and 3,916 (10%) 

were assigned to other ENs. Approximately 30 percent of ticket assignments have 

been made in the last 5 months. 

The first milestone payment was made by Maximus during May 2002. The first 

outcome payment was paid in July 2002. Through February 2004 we have made 

more than 1,600 payments to nearly 120 ENs totaling over $530,000 based on the 

work of 450 beneficiaries. 

Our early experience shows us that the Ticket is already proving it can provide 

beneficiaries with more opportunities to obtain employment support services to help 

26 

them reach their employment goals. It is our mission to see that the ticket lives up 

to its potential to return people to work 

Evaluation of the Ticket to Work Program 

Section 101(d) of the Ticket to Work Actrequires the Commissioner to submit periodic evaluation reports of the Ticket to Work program to Congress. SSA has contracted with Mathematica Policy Research, Inc. (‘‘Mathematica ‘‘) to evaluate the impact of the Ticket to Work program. Mathematica has provided a draft of its first 

in a series of evaluation reports. I will be happy to provide the Subcommittee with 

a copy of the final version of this report which we expect to be available shortly, 

and will also be happy to brief you on its findings. 

Mathematica’s preliminary findings are generally consistent with our experience 

with the program. Most beneficiaries who use Tickets to Work have assigned them 

to traditional State VR agencies. Ticket assignments to ENs have been concentrated 

among a few ENs, and the ENs as a group feel that SSA needs to move quickly 

to make the process friendlier to providers. 

As Mathematica notes in the draft report, overall, it is clear that SSA has made 

great progress in developing such a system to assist individuals with disabilities to 

find work and remain in the workforce. This undertaking, which required SSA to 

develop new capabilities to integrate information 

from the SSI and DI programs, so that beneficiaries work could be appropriately 

considered in determining theirs and their service providers eligibility to benefits. 

The Work of the Adequacy of Incentives Advisory Group 

The Ticket to Work and Work Incentives Improvement Act of 1999 identified four 

groups of people with disabilities as potentially ‘‘at risk.’’ These groups are: 1) individuals with a need for ongoing support and services; 2) individuals with a need for 

high-cost accommodations; 3) individuals who earn a sub-minimum wage; and 4) individuals who work and receive partial cash benefits. 

The Act requires the Commissioner to study the adequacy of incentives to Employment Networks in the Ticket to Work program for serving these four groups of 

beneficiaries. SSA formed an Adequacy of Incentives Advisory Group to help determine the best approach for conducting a targeted, in-depth analysis of the ‘‘at risk’’ 

groups. The Advisory Group has been meeting quarterly, and will complete its work 

this spring 2004. Last fall, the group issued an interim report, ‘‘Recommendations 

for Improving Implementation of the Ticket to Work and Self-Sufficiency Program 

(Regulatory and Administrative Changes).’’ The group will also issue a final report, 

which will propose projects to evaluate the effectiveness of adjusted incentives and 

recommendations regarding the most promising adjusted incentives. 

Recommendations of the Ticket to Work Advisory Panel 

The Ticket to Work Advisory Panel has been a valuable partner in studying the 

program and making recommendations for improvements. They too have been concerned about the balance between State VR agencies and other ENs, and about 

ways in which we can encourage more beneficiaries to assign their Tickets to ENs. 

They also advise us on ways to improve our public education of the program and 

how to market the program to both beneficiaries and potential ENs. 

We have carefully considered the recommendations of the Panel with respect to 

establishing a corps of work incentive specialists, who will be available to advise 

beneficiaries on the effects of work on benefit payments, and on ways to reduce the 

incidence of overpayments caused 

by work. They recognize, as do we at SSA, that the fear of creating overpayments 

is a powerful disincentive to returning to work that our beneficiaries face. 

The $1 for $2 Benefit Offset Demonstration 

The Ticket to Work legislation required SSA to test a DI benefit offset similar to 

what is provided in the SSI program. Generally, SSI benefits are reduced $1 for 

every $2 earned over the $65 earned income monthly exclusion. Because there is 

no parallel provision for the DI program, DI beneficiaries are often reluctant to attempt work because of the abrupt loss of all cash benefits faced if they engage in 

substantial gainful activity. 

Therefore, we plan to conduct a national demonstration project to test a $1 reduction in benefits for every $2 in earnings over a certain level in the DI program in 

combination with interventions that offer a range of ongoing employment supports, 

which may include some combination of employment services, health care services, 

transportation assistance, training, and other similar supports. 

In addition, we plan to conduct a small-scale process demonstration of the benefit 

offset in four sites. We expect this project to begin enrolling participants this fall. 

27 

Program Improvements 

I would now like to discuss a number of initiatives we have already put in place 

on a number of fronts to improve our return to work services based on all the information that we have received. They include simplifying the payment process for 

ENs, increasing the pool of ENs, improving our wage reporting process, and jointly 

funding with the Department of Labor a new position to help people with disabilities increase their employment opportunities. I will discuss these in more detail. 

Work Incentive Specialists 

Section 1149 of the Social Security Act, as enacted by Section 121 of the Ticket 

Act requires SSA to establish a corps of specialists devoted to issues related to work 

incentives. We have worked closely with Subcommittee staff to develop and implement this concept. 

Commissioner Barnhart has expanded the pool of field employees who would be 

available to answer questions relating to return to work, while establishing a dedicated number of employees in each area of the region who will serve full time as 

Area Work Incentive Coordinators (AWICs), for a total of 58 employees nationwide. 

I want to thank the Subcommittee for its advice and guidance as we worked closely 

with you to develop this approach. 

AWICs are the focal point of contact for advocates area-wide, and serve as ombudsmen. They monitor the area employment support workloads and work with the 

Area Directors to ensure that we effectively manage work incentive workloads. In 

addition, we have trained all of our public service employees, including staff in all 

local Social Security offices, on SSA employment support programs. AWICs work 

with other staff to develop any area training needs to maintain the level of expertise 

on work incentives for all direct contact employees and they are a ready resource 

for providing accurate information to those employees when questions arise. 

An Improved EN Payment Process 

Because many ENs found the payment process too cumbersome, we have developed a new, simpler process for paying them. Under the new process, SSA will pay 

ENs upon receiving a certification from the EN that a Ticket Holder is still working, 

provided that the EN initially submits return to work evidence. Prior to this change, 

ENs were required to send in evidence of the work, such as pay stubs, monthly. 

Now ENs have several options for requesting payments on either a monthly or quarterly basis without needing to submit pay stubs. 

Expanded Choice of Employment Networks 

In order to attract sufficient providers of employment services and in concert with 

Maximus, we have conducted 90 Employment Network Opportunity Conferences 

across the country. We did this so beneficiaries will enjoy the degree of choice when 

selecting an EN that the Congress envisioned when the Act was passed. These 

events were attended by more than 8,000 individuals, representing 6,100 organizations. To date, 483 conference attendees have applied to become employment networks. In addition, Maximus has made presentations about the Ticket to Work program at nearly 300 events nationwide and delivered the message to 20,000 different 

organizations and 50,000 individuals through 250,000 distinct contacts. We will continue to seek out EN recruitment opportunities and process improvements so we 

may offer more choices for our beneficiaries who want to work. 

Because we learned that the lack of upfront funding was a barrier to EN participation, SSA has developed an EN capitalization initiative that helps ENs locate and 

apply for additional funding to support their efforts. 

Eliminating Barriers and Disincentives 

Overpayments to beneficiaries with disabilities attempting to work are a major 

barrier to participation in the Ticket to Work program. Disability recipients who try 

to return to work deserve to know that their work information will be processed 

right away to prevent large overpayments that are a burden to the recipient as well 

as an important program integrity issue. Accurate and prompt wage report processing is critically important. 

The Social Security Protection Act of 2004 (P.L. 108–203) imposes a requirement 

for a work report receipt, and we expect that our current software, known as the 

Modernized Return to Work, or MRTW, and our PC–CDR processes that field offices 

have been using, should be able to fulfill that requirement. The issue of handling 

work reports is a major priority of Commissioner Barnhart, and we expect several 

new processes to have a positive impact on the problem, reducing both overpayments and the work disincentives caused by the threat of such overpayments. 

28 

In January 2004, we began a phased rollout of our eWork application for controlling and processing disability work activity and work CDR workloads. It replaces 

the stand-alone MRTW and PC–CDR that I have just mentioned. The eWork system 

automates and simplifies the processing of work issues in Title II disability cases; 

its key functional areas are workload management and control, case development, 

adjudication and decision-making, notices and forms, and automated mainframe systems inputs. In summary, eWork connects all of the separate pieces to the whole 

through an electronic interface usable by authorized personnel nationwide and work 

to minimize the occurrence of overpayments due to work.. 

Expansion of Work Opportunities 

Over the last 18 months, SSA has worked closely with the Department of Labor’s 

Employment and Training Administration and its State and local partners to jointly 

fund the establishment of a new position, the Disability Program Navigator. Approximately 110 Navigators have been hired to work in DOL One-Stop Career Centers in 14 states. A key role for Navigators is to help people with disabilities to increase their employment opportunities. Locating of the Navigator in the One-Stop 

Career Centers provides an important link to local employers in fulfilling this role. 

Navigators will also facilitate access to programs and services that impact 

successful entry or reentry into the workforce. This includes access to housing, 

transportation, health care, and assistive technologies as needed to effectively participate in training services or for successful placement in employment. 

SSA is also continuing to use the Employer Assistance Referral Network (EARN) 

managed by the Department of Labor’s Office of Disability Employment Policy and 

the Ticket to Hire, a specialized subunit of EARN that matches employers with job 

ready candidates from the Ticket to Work program. 

Conclusion 

Finally, I thank you, Mr. Chairman, Mr. Matsui, and all the members of the Subcommittee, for showing continued dedication to the Ticket to Work program. Thanks 

to that commitment, we look forward to providing more beneficiaries with the additional opportunities and tools they need to enter or reenter the workforce. 

In addition, I would like to thank you for your work to pass H.R. 743, the Social 

Security Protection Act of 2004(P.L. 108–203). Because of the provisions in the bill 

regarding SSA demonstration projects, including ensuring that projects can continue 

to move beyond this December, we can move forward with our agenda of projects 

designed to provide alternative return to work services. 

I would also like to acknowledge the valuable input we have received from the 

Ticket Advisory Panel and the Social Security Advisory Board. We are committed 

to achieving the goal set by Congress to improve access to jobs for Americans with 

disabilities. I believe, and I am sure you will agree, that the nation benefits greatly 

when all of its citizens have the opportunity to make the most of their talents. We 

look forward to working with you as we continue our efforts to make the Ticket to 

Work program a success. 

f 

Chairman SHAW. Thank you. Mr. Justesen? 

STATEMENT OF TROY R. JUSTESEN, ACTING DEPUTY ASSISTANT SECRETARY, OFFICE OF SPECIAL EDUCATION AND REHABILITATION SERVICES, U.S. DEPARTMENT OF EDUCATION 

Mr. JUSTESEN. Thank you, Mr. Chairman and the Committee 

for having me here today and for having me join my colleague, 

Martin Gerry from SSA, of which we are developing a very strong 

relationship between the SSA and the Department of Education to 

implement the success of the ticket program with the VR Services 

Program. 

The State VR Program is the Nation’s longest-running public employment program serving people with disabilities. In its 80-plusyear history of the program, over 10 million individuals with disabilities have achieved employment through the VR Program. Each 

year, approximately 220,000 individuals go to work with the help 

of the VR Program. Based on a recent study of this program, apVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00032 Fmt 6633 Sfmt 6602 E:\HR\OC\23796.XXX 23796
29 

proximately 85 percent of individuals with disabilities who get jobs 

maintain employment at least 3 years after they have been employed and their hourly wage increase over this same 3-year period 

is over 78 percent. 

Social Security recipients and beneficiaries presently account for 

about one-fourth of the total VR caseload nationwide, but each 

State agency’s caseload varies depending on the unique characteristics of the State, the flexibility of the VR Program, and referral 

sources within the State. For example, in California 43 percent of 

its individuals with disabilities served through the VR Program, 

there are also SSDI and SSI beneficiaries, whereas in Wisconsin, 

only 8.6 percent of individuals whose cases were closed received 

SSI or SSDI benefits. 

Other factors, such as VR’s requirements to serve individuals 

with the most significant disabilities when there are insufficient 

funds to serve all eligible individuals may also have an impact on 

the number of SSI and SSDI beneficiaries served by the VR Program. Further, the 1998 amendments to the Rehabilitation Act requires VR agencies to presume eligibility for individuals who have 

already been determined eligible for SSI and SSDI services. State 

VR agencies are a significant partner in implementing the options 

available in the Ticket to Work Program for many individuals with 

disabilities. As of this March, and you know this, Mr. Chairman, 

you said this earlier, 40,950 tickets have been assigned by SSI and 

SSDI recipients. Over 90 percent of those issued tickets are assigned to VR agencies. 

Since the passage of the Ticket to Work legislation, the Office of 

Special Education and Rehabilitative Services (OSERS), the office 

within the Department of Education charged with working with VR 

State agencies, has held training programs for State VR agency 

staff during SSA’s roll-out phase of the ticket program in order to 

facilitate success of the program. In addition to providing ongoing 

training to State VR agencies, OSERS is committed to continuing 

its work with the SSA to help evaluate the ticket program and the 

role State VR agencies play in this overall program. 

To this end, we at the Department of Education have been working very closely with the SSA to complete a Memorandum of Understanding which will be allow for both agencies to share and link 

valuable data concerning individuals with disabilities who are 

served by both of these programs. We are doing this because we 

can better determine the long-term benefits of the VR Program and 

its relationship to the overall ticket program. We know there are 

several issues that have arisen regarding the program interactions 

between VR Programs and private and public ENs. One complication is that the Rehabilitation Act requires VR agencies to seek 

comparable services and benefits from other providers, which may 

include ENs. The issue of comparable services is discussed in greater length in my written testimony, but let me just say that we recognize the importance of collaboration on this issue and we will 

work with all of our partners to provide guidance on this issue and 

to resolve the concerns. 

Second, many of our private ENs have expressed concern regarding agreements that are required when private ENs refer ticket 

holders to a State VR agency for services. It is our understanding 

30 

at the Department of Education that in the majority of cases, these 

agreements are regarded by both parties as fair and inclusive of 

the principle of shared risk and reward. However, we recognize 

that some agreements may not reflect the principles of true partnerships and fairness. We are committed to continuing our work 

with the SSA to provide guidance to the State agencies and other 

ENs on this issue and are hopeful that we can continue to work 

together to be able to resolve issues regarding these agreements. 

Third, we, and particularly I, Mr. Chairman, want you to know 

that we have heard of many concerns about ENs competing with 

State VR agencies for ticket assignments. It is important to recognize that State VR agencies have a long history that predates the 

ticket program with most ENs operating today. Without the assistance of Community Rehabilitation Programs that are now ENs, the 

success of the program I mentioned earlier would not have been 

possible. I would like to highlight a couple of beneficial aspects of 

our continuing dialog between the advocacy community regarding 

the ticket program. Since its inception, the Ticket Advisory Panel 

continues to be a main conduit of information for us at the Department of Education. From the panel, we have learned what is working and what needs to be improved. 

For example, as a result of our work with the panel, we have 

seen a need to more closely monitor the cooperative agreements between the State agencies and private ENs and we are working with 

the initial 13 States in the program to examine their agreements 

and provide feedback to Social Security and with Social Security 

and with the Members of your Committee. As we are learning more 

about the implementation of the ticket program, we understand 

that there is more that needs to be done to improve the participation of both beneficiaries in the program and private and public 

ENs. This is a vital effort. It is an area particularly important to 

the Department of Education and we hope this information that we 

have provided you today in my extended written comments and our 

continuing work with Social Security will improve the ticket program, and more importantly, improve the lives of people with disabilities. I am happy to be here, and I am also happy to take any 

questions you have. Thank you, Mr. Chairman. 

[The prepared statement of Mr. Justesen follows:] 

Statement of Troy R. Justesen, Ed.D., Acting Deputy Assistant Secretary, 

Office of Special Education and Rehabilitation Services, U.S. Department 

of Education 

Mr. Chairman, members of the Committee, thank you for the opportunity to appear before you today to discuss the Ticket-to-Work program. I am pleased to join 

you and my colleague, Martin Gerry, to discuss the Ticket-to-Work program and its 

relationship to the State Vocational Rehabilitation (VR) Services Program administered by the Department of Education. The Office of Special Education and Rehabilitative Services (OSERS) is committed to working with the Social Security Administration (SSA) to ensure the effective implementation and success of the Ticket-toWork program. 

The State VR Services Program is the nation’s longest-running public employment 

program serving individuals with disabilities. In our 80-plus year history, over ten 

million individuals served by VR have achieved employment. Each year, approximately 220,000 individuals go to work with the help of VR. Based on a recent longitudinal study of the State VR Services Program, approximately 85 percent of the 

individuals who obtain jobs maintain employment for at least three years after leaving the program. The longitudinal study also found that these individuals increased 

31 

their average hourly wage from $7.56 to $13.48 per hour, a 78 percent increase in 

earnings over the same three-year period. 

As you may know, Social Security beneficiaries account for approximately onefourth of the total VR caseload. It should be noted, however, that the Rehabilitation 

Act of 1973, which authorizes the State VR program, provides substantial flexibility 

to States. Because of this flexibility, the referral sources and the characteristics of 

each State agency’s caseload vary. For example, in California, 43 percent of individuals whose cases were closed in Fiscal Year 2002 after receiving VR services were 

Supplemental Security Income recipients and/or Social Security Disability Insurance 

(SSI/DI) beneficiaries, while in Wisconsin, only 8.6 percent of individuals whose 

cases were closed in Fiscal Year 2002 after receiving VR services received SSI and/ 

or SSDI. Other factors, such as the Rehabilitation Act’s requirement that States 

give priority to individuals with the most significant disabilities when there are insufficient funds to serve all eligible individuals, may have an impact on the number 

of SSI recipients and SSDI beneficiaries served. 

The 1998 Amendments to the Rehabilitation Act reflected Congress’ desire to provide seamless access to VR services for SSI recipients and SSDI beneficiaries. The 

Amendments required State VR agencies to presume VR eligibility for individuals 

who receive SSI and/or SSDI. Presumed eligibility allows individuals who have already gone through the arduous Social Security benefit-eligibility process to avoid 

providing similar information to State VR agencies in order to be determined eligible for VR services. 

Since the start of the Ticket program, State VR agencies have been a significant 

partner in implementing options under the Ticket program for individuals with disabilities. As of March 8, 2004, a total of 40,950 tickets have been assigned by SSI 

recipients and SSDI beneficiaries. Just over 90% of those Tickets (36,972) were assigned to VR agencies. It is clear how important the State VR Services Program is 

to the success of the Ticket-to-Work program. 

Since the passage of the Ticket-to-Work and Work Incentives Improvement Act 

(TWWIIA), we have held training programs for State VR agency staff as Social Security conducted its three-phase ‘‘roll-out’’ of the Ticket program. At each training 

session, we brought together SSA staff, SSA’s Ticket Program Manager (Maximus), 

and State VR agency staff to discuss emerging issues and to build long-term relationships designed to facilitate the return to work of individuals with disabilities. 

We have recognized throughout the early implementation phases of the Ticket-toWork program that there is a critical need for on-going discussions across Federal 

programs and we are committed to keeping the dialogue open. We monitor and provide updates via several listservs that are dedicated to the interaction between 

State VR agencies and the Ticket program. We are hopeful that, in the future, joint 

training opportunities for State VR agency staff and private Employment Networks 

(ENs) will be possible. 

In addition to providing ongoing training to State VR agencies, OSERS is committed to working with SSA to conduct research and evaluation of the Ticket program and the involvement of State VR agencies in the program, as well as other 

issues affecting the ability of individuals with disabilities to achieve employment 

outcomes. To this end, we are completing a Memorandum of Understanding, or 

MOU, with SSA, which will allow both agencies to share and link data concerning 

individuals with disabilities served by both the VR program and SSA. By linking 

this data, SSA and OSERS can better determine the long-term outcomes for SSI and 

SSDI beneficiaries who receive services through the VR and Ticket programs. 

The Ticket program unquestionably presents new challenges to OSERS and the 

State VR Services Program, and we have a great deal more work to do as we attempt to redefine our role and those of our State partners. Several issues have arisen regarding program interactions between the VR programs and the private Employment Networks (ENs) and we are working with SSA to address these issues. 

First, many private ENs are concerned about the impact of the ‘‘comparable services and benefits’’ requirement under the Rehabilitation Act when they and the 

State VR agency are jointly serving the same individual. With only a few exceptions, 

section 101(a)(8)(A)(i) of the Act requires the State VR agency to determine whether 

a comparable service or benefit is available from any other program to an eligible 

individual with a disability prior to providing a VR service. The VR Regulations (34 

CFR 361.5(b)(10)) define a ‘‘comparable service or benefit’’ as a service available 

from another public source, health insurance or employee benefit that is (1) available when the individual needs it, and (2) is commensurate with the service that 

the individual otherwise would receive from the VR agency. Therefore, if an individual is served by both the State VR agency and a public-funded EN, then VR can 

consider services provided by the EN that are available and commensurate with the 

services that would be provided by the VR agency to be a ‘‘comparable benefit or 

32 

service.’’ Let me give you an example. An EN that receives public funding may provide general job-placement services. However, if that EN does not have experience 

in providing job-placement services to individuals with severe and persistent mental 

illnesses, then the EN’s job-placement services may not meet the specific needs of 

such an individual. In that circumstance, the State VR agency may not consider the 

EN’s job-placement services to be ‘‘commensurate’’ and, therefore, not a comparable 

benefit or service. So, VR could then provide the job-placement service to the individual. We will continue to work with SSA to provide guidance to State VR agencies 

on this issue. 

A second issue is that many private ENs have expressed concern regarding agreements that are required when a private EN refers a Ticket holder to a State VR 

agency for services. These agreements are called for by TWWIIA. It is our understanding that, in a majority of States, these agreements are regarded by both parties as fair and inclusive of the principle of shared risk and reward. However, we 

also recognize that some agreements may not reflect the principles of true partnership and fairness. We are committed to working with SSA to provide State agencies 

and other ENs with guidance on this issue. Office of Management and Budget Circular A–87 may affect these agreements in regard to proportionality of effort by various parties. However, we are hopeful that together SSA and OSERS will be able 

to resolve issues that arise in this regard. 

Third, some private ENs have made statements that they do not wish to ‘‘compete’’ with State VR agencies for Ticket assignments. It is important to recognize 

that, typically, State VR agencies have long histories that pre-date the Ticket program with most ENs operating today. Without the assistance of community rehabilitation programs that are now ENs, the successes of the VR program that I mentioned earlier would not have been possible. We value our EN partners and recognize the need for their participation, not only for the services they provide, but also 

for the choice of service provision that their participation ensures Ticket holders. 

Now that I have enumerated some of the challenges we face in moving forward 

with the implementation of the Ticket program, I would like to take a moment to 

highlight what I consider to be a truly beneficial byproduct of continued dialogue 

with the advocacy community regarding this new program. Since its inception, the 

TWWIIA Advisory Panel has been a main conduit of information for us. From the 

Panel, we at OSERS have learned about what in the VR/EN relationship is working 

and what needs to be improved. Without the meaningful exchange that occurs regularly between OSERS and the Panel, we would be at a distinct disadvantage in determining areas of concern as well as aspects of the VR/Ticket interface that are 

working well. 

As a result of our interaction with the Panel, we have seen a need to more closely 

monitor the cooperative agreements between State VR agencies and private ENs. 

We have just started that effort. We are working closely with the 13 State VR agencies that were involved in the first-phase roll-out of the Ticket-to-Work Program and 

we are examining their agreements with ENs and providing feedback on those 

agreements. We hope to provide our findings to both SSA and the TWWIIA Advisory 

Panel. 

What we are all learning as we implement the new Ticket program is that more 

needs to be done to improve the participation of both beneficiaries and private ENs 

in this vital effort. I hope that the information I have provided today will assist you 

in your work with the Ticket program. Again, I thank you for the opportunity to 

share our experiences to date. OSERS and our partners in the State VR Services 

Program stand ready to do our part to facilitate the successful employment of Ticket 

holders. 

I will be happy to answer any questions that you may have. 

f 

Chairman SHAW. Thank you very much. Mr. Gerry, you heard 

Ms. Nelson, her testimony, and one of the things that she was emphasizing was making these programs known to other people and 

she mentioned that it would be good to put some of this stuff on 

television. Now, I don’t know what extent you can. People are griping about us talking about Medicare and the drug bill on television. 

Has any thought been given to, in some way, getting more of this 

information out through the media? 

33 

Mr. GERRY. Yes, Mr. Chairman. Perhaps what I might do is explain. We have entered into a contract with Fleischman-Hillard, 

which is a large public relations consulting firm, to design—and 

they are in the process of creating, a strategic plan for this very 

question of how we effectively communicate, not only with beneficiaries, but also potential ENs. 

Over a 2-year period they are conducting telephone interviews 

with beneficiaries and with other stakeholders. They are trying to 

figure out the most effective way, and it goes to your comments 

earlier about the design of the ticket and the kind of language that 

is used. They are really trying to figure out how to get the message 

across in the most effective way. Now, part of that would obviously 

be what medium you would use and part of it would be what you 

would say in terms of the content. They are developing a national 

marketing strategy and materials that we would use. 

We really believe that given the importance of this task and the 

ticket itself, it was important to get people who are really experts 

to help us do this design. So, that is the process that we are involved in. That task order was met on September 30 of last year, 

so we are about 6 months into the process now. My sense of what 

is going on is it has been very positive. I think we are getting some 

insights, and we are continuing to have dialogs with other organizations, which we do believe is very important. On the other hand, 

as you mentioned, without getting people with that kind of expertise to give us advice, television advertising is very expensive and 

it has, at least recently, become somewhat controversial. So, we 

thought it important to do it as quickly as we could, but to do it 

prudently, as well, and so we are trying to balance these two tasks. 

Chairman SHAW. I would say one of the things you have to do 

is to try to make a determination of people with disabilities that 

are not in the work force, how do they spend their day. I would say 

that you will probably find out that a large part of that day is sitting in front of the television set. Then, what are they watching? 

That would be something. So, you can be very selective as to where 

you put it. Of course, cable is always an inexpensive option. I 

think, too, I think one of the most effective ways you can do it is 

to get people like Ms. Nelson and Ms. Hancock to get on the television and say, ‘‘If I can do it, you can do it.’’ It just gets people 

thinking. 

Mr. GERRY. Like everyone else in the room, I was very much 

moved by what they had to say and I certainly would agree with 

that point. We are not going to sit and wait for this period to go 

by. We expect to get feedback throughout the process from 

Fleischman-Hillard and I would certainly be happy to take up that 

specific topic with them. 

Chairman SHAW. I think the ticket—I have been very critical of 

this, and in all fairness, I don’t know what else is in the envelope, 

but just looking at this, it is a document that I think is not very 

understandable in the verbiage and I think it can be jazzed up considerably with some kind of illustration on it, such as somebody 

gainfully employed while sitting in a wheelchair or with crutches 

or showing obvious signs of blindness or another type of disability. 

Mr. GERRY. I have to say, Mr. Chairman. 

34 

Chairman SHAW. I applaud you for getting the advertising agency or public relations agency involved in it because these programs 

have to be sold to people and they are getting courage. I can tell 

you, if you are on disability, probably every time you get something 

from the Social Security office that you know is not a check, you 

probably hold your breath when you open the envelope. It is kind 

of like getting something from the IRS that is unexpected. I think 

we all have experienced having to open that envelope to see what 

is in there. I just think that we can go a long way toward helping 

them. Mr. Collins? 

Mr. COLLINS. Thank you, Mr. Chairman. I just wonder what 

the postage is to mail those. Mr. Gerry, what did you think about 

Ms. Hancock’s idea that when an individual files, that they be 

given the information at that point of contact with Social Security? 

Mr. GERRY. Well, I thought it was an interesting idea. The Ticket to Work Program, of course, applies to beneficiaries so that we 

could explain when someone filed an application, what their options would be if they were to become a beneficiary. Under the statutory language, I think we can only actually make the program 

available to beneficiaries. 

Now, we do have an early intervention demonstration which we 

have been in the process of designing and will actually start in the 

next 3 or 4 months that really focuses on applicants and is designed to try to help people who might not wish to continue even 

to pursue their application because they might be able to go to 

work through a somewhat parallel structure. I think the only problem right now would be, although we could explain the Ticket to 

Work, there is no way that we could offer the ticket itself until 

someone actually became a beneficiary. Although we heard good 

stories about how long it took from the panelists, sometimes, obviously, it takes a much longer period of time. 

I think everything we know about the psychology of people in the 

population that we serve would strongly argue that the earlier we 

can make an offer of assistance in returning to work, probably the 

better in terms of what will happen, but we would be somewhat 

constrained right now by the statutory requirement that only beneficiaries can be served. 

Mr. COLLINS. You don’t have to be a beneficiary to be given the 

information. 

Mr. GERRY. Absolutely not. 

Mr. COLLINS. All right. That is probably too simple. Ms. Hancock also mentioned that she went through three ENs before finally 

finding one in Connecticut, I believe it was, that would actually listen to her. What kind of feedback have you had from others in this 

same area? 

Mr. GERRY. We certainly have had all kinds of feedback. We 

have had people who are very happy with the EN, and that was 

true of obviously one of the panelists who preceded us, and others 

who were dissatisfied and changed. I think it is inherent in the 

choice model. I think what the Congress wanted us to do is to 

maximize the opportunity for people to choose, and as a result of 

that, although we do through Maximus review the applications 

from people who are ENs, there is likely to be a pretty significant 

variation out there in terms of not just the ability of people to reVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00038 Fmt 6633 Sfmt 6602 E:\HR\OC\23796.XXX 23796
35 

late to particular beneficiaries but the kinds of services and strategies that they offer. That seems to me to be kind of inherent in the 

way the program was designed, in that the idea was to get as much 

competition and choice as possible. 

Mr. COLLINS. Do we have any method, are we putting in place 

any method to keep some statistics on these ENs? 

Mr. GERRY. Yes. We do collect information about the ENs and 

we are developing strategies for tracking payments. What we 

haven’t attempted to do, and again, it would be a question of how 

consistent it is with the overall goal of the statute, is to try to do 

any kind of qualitative assessment of ENs. Now, these are riskbearing activities, so when the ENs accept tickets, they do put 

money out to provide services, which, if they are not successful, 

they wouldn’t receive payment. 

Of course, we also have in our regulations rules that say that not 

only do ticket holders have a choice of ENs, but they can discharge 

them, and as the witness testified, can change. So, we have really 

been, frankly, looking at the market as the primary way in which 

ENs who would better serve our beneficiaries would be the ENs 

people choose and keep. We have also assumed that if they are not 

successful in providing those services, they won’t be paid, so that 

their incentive should be for ENs to be as responsive as they can. 

I am not arguing that is always true. 

Mr. COLLINS. You mentioned Ticket Tracker. I was just looking 

at the Georgia statistics here earlier. There have been 285,000-plus 

tickets issued in Georgia. Assigned to State VR agencies, 780; assigned to ENs, 181, for a total of 961, or 0.34 of 1 percent. 

Mr. GERRY. I am looking at the same numbers, Mr. Chairman. 

Mr. COLLINS. The number I don’t see is how much success have 

we had with the 961? 

Mr. GERRY. I don’t have that information—I would be happy to 

provide it for the record—broken down by State. I can talk about. 

Mr. COLLINS. This is broken down by State. 

Mr. GERRY. That is, and I don’t know specifically. 

Mr. COLLINS. Would that be an important statistic, to keep 

track of that? 

Mr. GERRY. I think it sounds to me like it would be an important statistic—— 

Mr. COLLINS. It would be some good information. Is Ms. Hancock the only one in Georgia? 

Mr. GERRY. As I indicated, Mr. Collins, I don’t know. 

Mr. COLLINS. You don’t know, do you? 

Mr. GERRY. No, I don’t. 

Mr. COLLINS. Well. 

Mr. GERRY. I will find out and make it available. 

[The information follows:] 

The following information is through March 29, 2004: 

36 

State Tickets Issued Tickets Assigned to SVRA 

SVRA Payments 

for Work Activ- ity *(Cost 

Reimb.)/# 

Beneficiaries 

Tickets Assigned to ENs 

EN Payment 

for Work Activity/# Beneficiaries 

Alabama 89,065 160 2 22 0 

Alaska 14,770 70 0 2 0 

Arizona 167,662 463 4 272 81 

Arkansas 136,370 97 5 100 0 

California 369,343 968 13 156 1 

Colorado 102,854 385 1 36 5 

Connecticut 94,787 530 2 28 3 

Delaware 26,990 493 5 14 5 

District of Columbia 20,729 61 1 25 0 

Florida 581,072 2,836 58 463 45 

Georgia 287,627 911 22 184 11 

Hawaii 11,016 8 0 4 1 

Idaho 14,851 126 0 7 0 

Illinois 389,456 4,850 65 256 45 

Indiana 191,759 365 0 53 1 

Iowa 86,467 755 13 59 11 

Kansas 71,129 251 1 63 3 

Kentucky 252,598 353 6 45 5 

Louisiana 200,537 1,246 2 67 4 

Maine 24,086 92 0 6 0 

Maryland 51,688 60 8 32 0 

Massachusetts 240,821 694 29 125 16 

Michigan 358,958 3,061 8 154 16 

Minnesota 47,910 102 1 29 0 

Mississippi 160,833 233 0 138 9 

Missouri 213,754 485 1 154 11 

Montana 28,265 156 1 2 0 

Nebraska 17,052 103 0 2 0 

Nevada 57,053 251 0 115 419 

New Hampshire 37,339 33 1 11 1 

New Jersey 219,116 398 1 87 7 

37 

State Tickets Issued Tickets Assigned to SVRA 

SVRA Payments 

for Work Activ- ity *(Cost 

Reimb.)/# 

Beneficiaries 

Tickets Assigned to ENs 

EN Payment 

for Work Activity/# Beneficiaries 

New Mexico 64,345 67 1 19 2 

New York 721,629 7,844 24 426 59 

North Carolina 125,719 244 0 19 0 

North Dakota 15,289 16 0 7 0 

Ohio 148,667 1,594 1 20 0 

Oklahoma 132,799 1,597 7 20 48 

Oregon 108,967 282 0 75 8 

Pennsylvania 173,216 432 0 32 0 

Rhode Island 16,290 12 0 4 0 

South Carolina 185,861 1,461 21 95 8 

South Dakota 20,327 347 0 1 0 

Tennessee 256,261 1,041 6 330 13 

Texas 209,248 186 6 99 0 

Utah 15,321 105 0 0 0 

Vermont 22,643 500 1 4 2 

Virginia 222,186 621 3 154 12 

Washington 68,673 76 0 45 125 

West Virginia 48,671 48 0 5 0 

Wisconsin 162,498 2,044 1 150 33 

Wyoming 4,979 4 0 0 0 

*data for the period 1/01/2002 through 2/29/2004 

f 

Mr. COLLINS. Well, one-third of 1 percent assigned to either one 

the EN or the State VR agency, but that leaves 99 and two-thirds 

percent tickets issued and never followed up on. 

Mr. GERRY. Well, they haven’t been assigned. Let me just suggest that—— 

Mr. COLLINS. They have been issued. 

Mr. GERRY. They have been issued. It is accurate, they haven’t 

been assigned. They may still be assigned. We do note, and one of 

the findings that Mathematica had in its preliminary report is that 

for a variety of reasons, people do wait, and actually, we heard that 

from one of the witnesses, often many months, I think an average 

of 10 or 11 months, before they actually use the ticket. So, it isn’t 

necessarily true that that is going to be all of the tickets that are 

assigned. 

38 

Mr. COLLINS. The whole goal of the whole program is to get 

people back to be active in the workplace if that is their desire to 

do so, but the follow-up oftentimes to something that is in the mail, 

follow-up like I believe it was Ms. Nelson put hers on the dresser 

and found it after the fire. 

Mr. GERRY. We are planning. 

Mr. COLLINS. I think there are a lot of loose ends that you 

learn as you go. You are learning. I appreciate your time. 

Mr. GERRY. Thank you. 

Chairman SHAW. Mr. Gerry, I got a little bit of clarification 

from Kim Hildred while you were answering Mr. Collins’s questions. Obviously, you can’t offer someone a Ticket to Work if they 

are not a beneficiary, because by definition, you have got to be a 

beneficiary before you can get a ticket, and that is certainly a reasonable part of the legislation. However, when somebody is advised 

that they have been approved for disability, are they advised—now, 

I assume they are advised through the mail? 

Mr. GERRY. Yes, they receive a notice. 

Chairman SHAW. At that point, do they receive any information 

on the Ticket to Work? 

Mr. GERRY. I don’t believe so. 

Chairman SHAW. This would be a good time to let them know 

that this doesn’t have to be a permanent part of their life and that 

we do have ways for them to escape the dependency of SSI if they 

feel able to go into the workplace. 

Mr. GERRY. I would like to check on that, Mr. Chairman. I am 

not sure of the answer to that, that is, whether we—— 

Chairman SHAW. I would say when somebody is advised that 

they have been approved, you have got their attention, and they 

are probably going to read very carefully anything you send to 

them and I think that is important. Ms. Tubbs Jones? 

Ms. TUBBS JONES. Mr. Chairman, thank you very much. Mr. 

Gerry, Mr. Justesen, good morning. I wasn’t here at the early part 

of your testimony because I took a few moments to call the Vocational Guidance and Rehabilitation Services Center in Cleveland, 

Ohio, to kind of get a feel for what is going on with them and their 

ability to provide Ticket to Work. They said they were referred 25 

Ticket to Work folks but were only able to take 1 because of the 

situation of the other 24 people that were referred, but a young 

woman by the name of Nora Owens gave me about 7,000 things 

she wanted to tell you, but I told her I didn’t have that much time. 

[Laughter.] 

Before I get to what Nora talked about, I understand how difficult it is sometimes to administer large programs like this particular program. What I might suggest to you, that you find the 

media agency that the Administration used to do prescription drug 

benefits and have them do the work that you need to do to do 

media for the people on disability, because they were able to turn 

it out real quick. I believe that this issue is as important as the 

prescription drug benefit, and the people who are receiving disability across this country would love to hear about Ticket to Work 

as quickly as the others did. I say that tongue-in-cheek, but I really 

am sincere about it. I am confident that the people who are representatives in this audience kind of agree with me, as well. 

39 

From the Cleveland Vocational Guidance and Rehabilitation 

Services, one of the issues raised is that, for example, if they receive a person referred for a particular service, they get a fee-forservice for whatever the referral is. Very seldom will they get a referral like a State agency referral where they have the opportunity 

to get a longer term payment and that the reason that a number 

of the smaller agencies are not ENs is because the payment is so 

long in coming, you deliver a service and it is 9 months, 2 years 

down the line, that they are not able to get the service. I am going 

to just put on two or three of these points and then you can use 

the rest of my 5 minutes to respond. 

The other problem that they seemed to say, for example, the 

need for someone who is ultimately given a Ticket to Work to be 

able to do a Medicaid buy-in. They gave me, for example, a young 

man who was an excellent computer person, but his medical service 

needs far exceeded anything that he would be able to pay or receive 

in their health care program and that he ought to be able to work 

as many hours as he would like to work and they ought to be able 

to employ him as many hours as they can without him being put 

in the position to be removed from the program because there are 

a limited number of hours he can work and a limited amount of 

money that he could pay. They said that if he, in fact, could work 

full-time, he could make $40,000 or $50,000 a year, but he still 

would need the supplemental benefit of a Medicaid buy-in. 

I talked about the small agencies. I talked about the Medicaid. 

The first point they made was that the way it is operated or the 

payment for the services through Ticket to Work makes it exceptionally costly to provide some of the services and that a review of 

how services are provided and how they are paid might make a 

better use of dollars. 

Finally, she said to me that if, in fact, you got, for example, 10 

Ticket to Works, that the referral to a Ticket to Work EN really 

reduces the number of dollars that a State agency actually gets to 

provide VR services so that, in essence, instead of providing additional services for those with disability, we are supplanting some 

of those services with these services instead of extending the service. I asked a lot of questions, put a lot out there, but you are free 

to use the rest of the time to do what you can do to respond to my 

questions. 

Mr. JUSTESEN. Thank you. 

Ms. TUBBS JONES. I used all my time, Mr. Chairman? Doggone 

it. 

[Laughter.] 

Maybe you can write back to me. 

Chairman SHAW. Go ahead. 

Mr. JUSTESEN. First of all, Congresswoman, I counted 15 questions. 

[Laughter.] 

Ms. TUBBS JONES. I am a trial lawyer. 

[Laughter.] 

Mr. JUSTESEN. Well, first of all, the State of Ohio is under an 

order of selection with regard to the VR Services Programs which, 

in a nutshell, means that when the State agency’s funds are not 

sufficient enough to serve all potentially eligible consumers of the 

40 

VR system, the State must prioritize a service to those individuals 

with the most significant disability. In addition, I want to say that. 

Ms. TUBBS JONES. Are any other States like that? 

Mr. JUSTESEN. I think there are—it is in the early twenties. 

We can supply you with those exact facts. 

[The information follows:] 

ORDER OF SELECTION STATUS FOR STATE VR AGENCIES 

2004—FINAL 

TOTAL 

80 agencies 

ORDER OF SELECTION 

42 agencies 

NO ORDER 

38 agencies 

Region I Connecticut G; Maine G & B; Massachusetts G; 

Rhode Island; Vermont G 

Connecticut B; Massachusetts B; New Hampshire; Vermont B 

Region II New Jersey G; Virgin Islands New Jersey B; New York G & B; Puerto Rico 

Region III Delaware B; Maryland; Pennsylvania; Virginia G 

& B; West Virginia 

Delaware G; District of Columbia 

Region IV Georgia; Kentucky G & B; Mississippi; North 

Carolina G; Tennessee 

Alabama; Florida G & B; North Carolina B; 

South Carolina G & B 

Region V Indiana; Illinois; Minnesota G; Ohio; Wisconsin Michigan G & B; Minnesota B 

Region VI Arkansas G & B; Louisiana; New Mexico B; 

Oklahoma 

New Mexico G; Texas G & B 

Region VII Iowa G; Kansas; Missouri G; Nebraska G Iowa B; Missouri B; Nebraska B 

Region VIII Colorado; North Dakota; Wyoming Montana; South Dakota G & B; Utah 

Region IX Arizona; California; Hawaii American Samoa; CNMI; Guam; Nevada 

Region X Oregon B; Washington G Alaska; Idaho G & B; Oregon G; Washington B 

Changes from previous year: Indiana, Virginia G, and Virginia B moved to an order. 

Of the 24 general VR agencies: 14 (58 percent) were on an order 

Of the 24 agencies serving blind individuals: 7 (31 percent) were on an order 

Of the 32 combined VR agencies: 21 (66 percent) were on an order 

Revised Dec 2004 

f 

Ms. TUBBS JONES. Thank you. 

Mr. JUSTESEN. John Connelly is the State VR Director for the 

State of Ohio and is a very good resource with us at the Federal 

level and with Social Security in working through some of these 

challenges that are unique to the State of Ohio. Let me also say 

before Martin answers more of the technical questions, since I am 

2 months on the job from moving over from the White House that 

individuals with disabilities who receive SSI—who are recipients of 

SSI or SSDI beneficiaries are presumed eligible for VR services. 

That is regardless of their choosing to use their ticket for other 

public or private EN providers. In other words, individuals in Ohio 

with significant disabilities, or the most significant disabilities, are 

entitled to the services that the State ER agencies provide and 

make available regardless of their use or choice to use the ticket 

options that they have available to them. I will turn it over to Martin to be more specific on your questions. 

Mr. GERRY. Thanks, Troy. The first point that I wrote down was 

that agencies don’t become ENs because it takes too long to get 

41 

paid, and that is a serious problem. That is to say that there is risk 

involved in this program and there is a need, of course, for agencies 

that are providing services who accept a ticket to finance the initial 

provision of those services in hopes that they will be paid later 

when an individual achieves SGA, then goes off benefits and then 

for a period of time payments are made. So, it is, in fact, fairly 

common to hear from smaller agencies that might be interested in 

becoming ENs that the period of time and the way in which payments are set, the amount of those payments, is a disincentive. 

The issue of capitalization, obviously, what the VR agencies have 

is an advantage in that they have money. They have a flow of 

money under the Rehabilitation Act that allows them to, in effect, 

front the cost of some of these services in the hopes that they will 

collect under the program. So, I think one of the things that we 

have been looking at and one of the things we have been getting 

advice on from several of the organizations that I mentioned, the 

Advisory Panel and others, is the need to really look carefully at 

the payments, the way we have set the payments, the amounts of 

the payments, things that we could do that would make it at least 

more attractive for ENs, where they could be paid at least earlier. 

The capitalization problem is a much tougher one for us in that 

we want to help, we want to see if we can provide as many inducements to others to provide initial capital, but it is not something 

that we are really able to do under the statute as it is drafted. I 

do think it is a significant problem, and I think that what you 

heard on the telephone, which was probably something we could 

have heard in several other States—— 

Ms. TUBBS JONES. Mr. Chairman, Mr. Gerry, thank you very 

much. In deference to my colleagues, you have been very generous 

with time. I would be willing to accept my answers in writing at 

a subsequent time, Mr. Chairman. Thank you, Mr. Gerry. 

[The information follows:] 

Ms. Tubbs Jones: And that the reason that a number of the smaller agencies are not ENs is because the payment is so long in coming. You deliver 

a service, and it’s 9 months, 2 years down the line, that they’re not able to 

get the service. 

The SSA has taken aggressive steps to address the need to get timely payments 

to ENs by establishing a Certification Payment Request Process. The Certification 

Payment Request Process allows ENs to submit a signed written statement that the 

ticket holder’s work and earnings are sufficient to warrant outcome payments, in 

lieu of having to provide proof of the ticket holder’s earnings, ENs can request payments under the Certification Payment Request Process after a ticket holder meets 

specific work requirements and has achieved a level of earnings from employment 

to qualify an EN for outcome payments. This new process can be used either on a 

monthly or quarterly basis. The SSA will pay outcome payments based on the EN’s 

certification, unless our records indicate that the Ticket holder is receiving cash disability benefits. 

In addition, the SSA launched the Employment Network Capitalization Initiative 

in September 2002. Through this initiative, our Program Manager, MAXIMUS, has 

been training ENs on how to identify and secure alternative funding sources. Such 

funding can be used by ENs to cover the costs of services to beneficiaries under the 

ticket program until such time as the EN receives payments based on the employment outcomes achieved. In addition to offering training online, MAXIMUS has conducted a series of regional seminars (with five completed, and 3 more planed for 

2004) and distributed an Employment Network Capitalization Resource Directory to 

all ENs. 

Ms. Tubbs Jones: The other problems that they seem to say—for example, 

the need for someone who is ultimately given a Ticket to Work to be able 

to do a Medicaid buy-in. 

42 

An SSI beneficiary may keep Medicaid benefits while he/she is working if his/her 

earnings e insufficient to replace SSI cash benefits, Medicaid benefits, and publicly 

funded healthcare that would be lost due to those earnings. We use a formula that 

includes the SSI Federal benefit rate (FBR) plus the average per capita Medicaid 

expenditures for each state to calculate the amount of earnings that is considered 

sufficient to replace all benefits that could be lost, The resultant figure is called the 

threshold amount and is different for each State. As long as a person earns under 

their state’s threshold amount, he/she will keep Medicaid eligibility. In some states, 

a person could earn $40,000 and still be under the threshold amount. 

If a person’s earnings are higher than the threshold amount for his/her State, we 

can calculate individualized threshold amount if he/she has medical expenses that 

are higher than the State’s average per capita Medicaid expenditures. In calculating 

an individualized threshold, we use the person’s actual medical expenses instead of 

the state’s per capita Medical expenditures to determine the amount of earnings 

that are sufficient to replace all benefits. If that person’s earnings are below his/ 

her individualized threshold amount, he/she will keep Medicaid benefits. 

States have the option of providing Medicaid coverage to people with disabilities 

whose earnings are too high to qualify under other rules (such as under the SSI 

threshold amount). A state may extend Medicaid coverage to working people with 

disabilities between ages 16 and 65 who have income limits to allow a working person with a disability to buy into Medicaid. At least 27 states have a Medicaid buyin program. 

Ms. Tubbs Jones: the way it’s operated, or the payment for the services 

through Ticket to Work, makes it exceptionally costly to provide some of 

the services and that a review of how services are provided and how 

they’re paid might make it better—a better use of dollars. 

Section 1148(h) of the Social Security Act provides that ENs will be paid under 

the Ticket to Work Program on the basis of outcomes and/or milestones achieved 

by beneficiaries using their tickets in going to work and achieving self-sufficiency. 

The total payment available to an EN is limited to the amount of outcome payments 

available over 60 months, in addition tomilestone payments (and reduced outcome 

payments) if the EN elects the outcome-milestone payment system. 

Section 1148(c) of the Act provides a State VR agency witha choice of receiving 

payment for serving beneficiaries using their tickets either on the same basis as an 

EN, or on the basis of reimbursement for the cost of services provided to beneficiaries by the State VR agency. e total reimbursement payable to a State VR agency under the cost reimbursement system is limited to the estimated savings to the 

trust funds and general revenues which will result in the rehabilitated beneficiary 

leaving the beneficiary rolls. This choice is not available under the Act to ENs. 

Ms. Tubbs Jones: the referral to a Ticket to Work EN really reduces the 

number of dollars that a State agency actually gets to provide VR services. 

So that, in essence, instead of providing additional services or those with 

disability, we’re supplanting some of those services with these services instead of extending the service. 

The Ticket to Work and Work Incentives Advisory Panel and other observers of 

the Ticket to Work Program have noted that services and supports provided by 

other programs should. be combined with, rather than offset by, services and supports provided by the Ticket to Work Program. 

We are working with the Office of Special Education and Rehabilitation Services 

in the Department of Education, as well as other agencies including the Center for 

Medicare and Medicaid Services, to ensure that the Ticket to Work, State VR programs, and other programs work together to ensure that our beneficiaries are provided with the services and supports they need to return to work and attain selfsufficiency. 

f 

Chairman SHAW. Thank you. Mr. Hayworth? 

Mr. HAYWORTH. Thank you, Mr. Chairman. Deputy Commissioner Gerry, Mr. Justesen, thank you both for being here. Deputy 

Commissioner Gerry, please extend my good wishes to Commissioner Barnhart. It was great, because she came to Arizona. We 

had the first Tickets to Work in Arizona. If could just say, and we 

all lived happily ever after, that would be delightful, but we are in, 

as we documented earlier, really the challenging phase, from the 

notion of drafting a bill, seeing the good work of folks, and on conVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00046 Fmt 6633 Sfmt 6602 E:\HR\OC\23796.XXX 23796
43 

ference Committees, having it voted out of both Houses, having it 

signed into law, and now implementation. 

We heard from the previous panel the challenges of letting people know the word and emphasizing what has happened here. You 

touched on in answering the question, Deputy Commissioner 

Gerry, about the marketing firm or the firm that is developing a 

marketing strategy, but I have heard from representatives of ENs 

on our next panel, there is a real concern that even with this contract, it will take at least 2 years for the SSA to implement a fullblown marketing campaign. 

Now, here is the problem we have in Arizona. We have already 

seen the number of ENs accepting tickets drop from 27 to just a 

handful, in part because there seems to be no demand. The ENs 

need help now. I appreciate the professionalism that a marketing 

firm can bring, but is there not an interim step that could be 

taken? What can be done now to get the word out to the folks about 

Ticket to Work? 

Mr. GERRY. Thank you, Mr. Hayworth. There are things that 

we are doing now. I think it is a combination of both you mentioned the ENs that are dropping out and it is a concern that we 

have. Part of it is the whole question of what beneficiaries now— 

the whole question of providing information and prompting beneficiaries. 

I think we also have to look at the other problem I was just talking about with Ms. Tubbs Jones, which is that one of the things 

we have envisioned, of course, was ENs coming in who had contacts with beneficiaries because they were organizations that routinely served those beneficiaries. So, the more we could bring ENs 

that had those kinds of contacts, the more likely we would be able 

to get beneficiaries. So, I think it is both of those issues together. 

The other thing I would have to say, having worked with the 

populations of people for many years who are being served by the 

program, is that there is a trust factor that we have to overcome. 

The history of the relationship between the SSA and some of our 

beneficiary groups has not necessarily engendered trust in the likelihood of what is going to happen and we have to sell the reality 

of the ticket, as we know it really is to people who have had reasons to be concerned about what will happen. So, we have to overcome that. 

I think word of mouth is probably something that is going to 

have to go a long way in doing that. I think what really happens 

when you have those kinds of problems often is you need successes 

and then you need people talking to other people about the successes. So, I think it is all three of those things. I didn’t mean to 

suggest that we were going to wait 2 years to do anything about 

it. What I really wanted to suggest is that we are 6 months into 

a 2-year activity to really come up with a national marketing plan. 

Now, we have been doing a lot of conferences around the country. 

We have been doing a lot of talking to organizations. I won’t read 

the numbers. I would be happy to provide them for the record. 

[The information follows:] 

• The SSA has been working on outreach and marketing activities to raise the 

public’s awareness about the Ticket to Work Program through; 

44 

• Partnering with the Department of Labor’s Office of Disability Employment Policy to use their Employer Assistance Referral Network (EARN) and a specialized subunit of EARN, named Ticket to Hire, which specializes in matching employers with job ready candidates from the Ticket to Work Program. Ticket to 

Hire links employers to Employment Networks in their community that have 

job-ready candidates. 

• Partnering with other agencies to expand awareness and understanding of the 

Ticket legislation, Ticket to Hire, and other employment supports, including the 

Office of Personnel Management, the U.S. Chamber of Commerce, and the Department of Education. 

• Publishing Ticket to Work success stories in newsletters, electronic publications 

and on websites such as the Office of Employment Support Program’s ‘‘Work 

Site’’ and MAXIMUS’ Web site. We also share success stories with numerous 

disability organizations for use in their publications and websites. 

• Participating in conferences, meetings and forums that promote the hiring of 

people with disabilities. 

• Maintaining the Internet ‘‘Work Site’’, http://www.socialsecuritv.aov/work, that 

educates and provides resources to people interested in the Ticket to Work and 

other employment supports for people with disabilities. The ‘‘Work Site’’ has an 

entire section dedicated to Ticket to Work information for beneficiaries, advocates and service providers. This includes Frequently Asked Questions, statistics on Ticket assignments and directories of ENs, Benefits Planning, Assistance, and Outreach organizations and Protection and Advocacy organizations. 

• Contracting with The Arc of the United States to provide an analysis and evaluation of beneficiary data to determine how to segment markets and target 

beneficiaries with marketing efforts to maximize participation in the Ticket to 

Work Program. 

In addition, MAXIMUS, the SSA’s Program Manager for the Ticket to Work Program, is Marketing the ticket program to prospective employment networks. Their primary marketing vehicle has been the Employment Network Recruitment Fair. Through December 00.3, MAXIMUS had held 90 of 

these events, at least one in every State and Puerto Rico, employment Network Recruitment Fairs allowed MAXIMUS to reach more than 8,000 individuals representing nearly 6,400 different organizations. In addition, by invitation 

MAXIMUS made presentations at more than 200 other events. The combination 

of onsite marketing with direct mail and telephone outreach has resulted in 

MAXIMUS delivering the ticket program message to about 50,000 individuals, representing approximately 20,000 different organizations. In total, MAXIMUS has 

made over 250,000 distinct contacts. This presents a ratio of about 200 direct outreach contacts to each Employment Network proposal received. 

f 

Maximus has made a lot of presentations, and we are significantly working on our field offices. That is a place where we can 

have right now some significant impact—it has come up two or 

three times already. As we talk to our beneficiaries, we could be 

saying more about the ticket. We could be giving out more information. 

I mentioned in both my written and oral testimony that we have 

hired 58 Area Work Incentive Coordinators. Those are in our areas 

within the 10 regions that we have, and one of their major tasks 

is to train our staff in the field offices who come into daily contact 

with our beneficiaries to talk about the ticket and to answer questions about the program. That is pretty important, and probably ultimately one of the crucial things we need to do, which is to change 

the culture of our field offices so that these capabilities are there. 

Is it going to happen overnight? I wish I could say yes. I think 

where we have these people in place, we see significant differences. 

I think that is an important strategy, as well. I would be very interested in any other specific things that we can do as we get this 

marketing plan. It is not that we don’t have an interest in it or 

45 

that we aren’t willing to devote resources to it, but it is not clear 

to me precisely how we should do it. 

Mr. HAYWORTH. I thank you for that, and as I was listening 

to you talk, I thought about a marketing slogan for a certain sports 

attire firm that is three words that I think is really important here. 

‘‘Just do it.’’ 

[Laughter.] 

Just do it. The most basic things are here, and I have to admit 

we understand Congress is a deliberative body. You talked about 

the trust factor. One of the problems we have is if Congress is a 

deliberative body, I don’t know how we describe the pace of the bureaucracy. It is glacial. Despite the best of intentions, we have a 

glacial pace here. So, to the extent that we bring, I like to think, 

light and maybe a little heat from Arizona, we appreciate the efforts, but my friend Susan Webb will be on the following panel. For 

purposes of full disclosure, she is my friend from Arizona and obviously part of ENs and part of the EN Association in the State of 

Arizona, but she made this point to me earlier this morning. 

If Binder and Binder and other Social Security attorneys can advertise on television day in, day out, over and over about getting 

people onto benefits, why can’t the SSA advertise at least as often 

to get people off benefits and back into the world of work? A comment, a thought on that from either of you gentlemen? 

Mr. GERRY. I tried to address earlier the question of television 

advertising, which is not without controversy and also not without 

expense. I don’t mean that in some penny-pinching sense, but as 

a practical matter. One of the things I hope that we will get is a 

recommendation on how to do that. It would not be difficult to 

spend $50 or $100 million to do ineffective television advertising. 

Mr. HAYWORTH. Maybe I will just talk to the Arizona Association of Broadcasters saying, hey, if you are receiving Social Security disability and need to go back to work, why not find out about 

the Ticket to Work Program? You can keep your medical benefits 

and go back to work. Contact your counselor for more information. 

Ta-dah. There it is, and it didn’t take me 2 years to explain that, 

and I can get that right to the Arizona Broadcasters Association. 

I appreciate the good efforts, and I am not here to beat you up. I 

really do. I just believe we have got to get moving to get the word 

to folks, and I thank you. 

Chairman SHAW. We are going to have to move on to Mr. Becerra. 

Mr. BECERRA. Thank you, Mr. Chairman. Commissioner Gerry, 

Mr. Justesen, thank you very much for your testimony. Let me ask 

a quick question. How much did the Fleischman and Hilliard contract cost the SSA and the taxpayers? 

Mr. GERRY. It is about $900,000 for 2 years. 

Mr. BECERRA. You might want to explore paying Fleischman 

and Hilliard the way you pay the ENs. Maybe they will act a little 

faster and give us more outcome if they know that they don’t get 

paid until they have some outcome. 

Mr. GERRY. If we can get it consistent with the statute, I am 

sure we will do that. 

Mr. BECERRA. It might be tough. I know that you receive no resources to administer this Ticket to Work Program. First, I want 

46 

to mention something that I mentioned to the Commissioner when 

she was last here. You all do yeoman’s work. You have what is a 

large agency, but you deal with tens of millions of people and beneficiaries, so first and foremost, to all the people who work very 

hard at the SSA, we want to say thank you very much. 

In that hearing that we had last week with the Commissioner, 

she mentioned that her budget request was half-a-billion dollars 

higher than what the Bush Administration allocated in its budget. 

Obviously, tough times. We are in deficit so everyone is having to 

tighten the belt, but given that the SSA is receiving less money 

than it asked for from the Administration and given that you never 

received any new resources to try to administer the Ticket to Work 

Program, how can you tell us that you will be able to deal with 

some of the bureaucratic delays that have been raised by my colleagues and others and that you have identified with fewer resources? 

Mr. GERRY. First, let me just say for the record, although I 

wasn’t present during the Commissioner’s testimony, actually, had 

the agency received what the President requested from the Congress, this budget problem that you are talking about wouldn’t 

have existed. The problem was not what we received from the Administration or from the Office of Management and Budget but, 

frankly, what we received from the Congress. 

Mr. BECERRA. So, we need to do. 

Mr. GERRY. The President’s budget request for 2004 was significantly higher than that approved by Congress. 

Mr. BECERRA. So, a clear message, then. I hope all of us then 

in Congress will hear that. 

Mr. GERRY. I just wanted to clarify where the shortfall came 

from. 

Mr. BECERRA. Clarion call. Make sure we are clear. 

Mr. GERRY. We appreciate very much the efforts of this Subcommittee. 

Mr. BECERRA. I want to make sure there is no doubt. Let the 

buck stop where it should. If you are not getting the resources that 

you should have, then Congress has to do more to allocate resources so you can have the personnel to administer the programs 

properly. 

Mr. GERRY. Well, I certainly would agree with that. I think the 

Commissioner has also testified that she is very pleased with the 

2005 budget as proposed by the President, which is a substantial 

increase, 6.5 percent—— 

Mr. BECERRA. Well, remember, she also said that she is going 

to have to put off implementing some of her programs to try to reduce the backlog in disability determinations because she is not 

getting what she asked for. So, while she may be pleased, I suspect 

if we had a chance to give her a couple of drinks in private times, 

she would probably tell us something a little differently, as well. 

[Laughter.] 

Mr. GERRY. I think if she is displeased, it may be with the outcome of the appropriations process in the Congress, not with the 

President’s request. 

Mr. BECERRA. The whip has to be used both ways. 

47 

Mr. GERRY. As far as your question about our ability to do the 

work, I think we have the resources. I would not want to leave the 

impression with the Subcommittee that the problems that we are 

encountering in the ticket program that we need to overcome are 

resource-driven. I don’t think that is the situation. 

Mr. BECERRA. I want to make sure, then. You are not going to 

come back to us later on and say, we just didn’t have the personnel. So, let me get to another question. Is it correct to say that 

for the last 7 months, the Ticket to Work Program has been without a Director? 

Mr. GERRY. No. It would be incorrect to say that. There has 

been an acting Associate Commissioner throughout that entire period. 

Mr. BECERRA. Not a permanent Director. 

Mr. GERRY. That is right, and we are. 

Mr. BECERRA. How long have we had an Acting Director? 

Mr. GERRY. We have had an Acting Director since, I believe, 

September. 

Mr. BECERRA. When do you think we will have someone? 

Mr. GERRY. Actually, it is an acting Associate Commissioner, to 

be accurate. 

Mr. BECERRA. When do you think, Commissioner, that we will 

have a permanent individual in that position? 

Mr. GERRY. We have permanent people there, Mr. Becerra, but 

the position will be filled, I think as a result of the posting we have 

right now. The position is being posted. I think it was alluded to 

earlier in the hearing. I am not sure whether it closes tomorrow 

or a week from tomorrow, but that is roughly the timeframe. 

Mr. BECERRA. Okay. Do you think? 

Mr. GERRY. I would anticipate we would have an Associate 

Commissioner who would be selected within the next month. 

Mr. BECERRA. That is good to know. The ENs, a question for 

you. Of the 1,100 that have participated, how many of them are 

nonprofits? 

Mr. GERRY. I don’t know that. I would have to provide that for 

the record. 

[The information follows:] 

Approximately 75% of the 1,137 Employment Networks currently available to assist beneficiaries are not-for-profit. 

f 

Mr. BECERRA. Could you get that for me, because it seems that 

one of the difficulties that we are having, and I am not sure if 

there is an easy way to resolve it, is that the ENs don’t get paid 

until after they have a positive outcome, and for a lot of folks, it 

is tough to go that long before you get some dollars in for the services you have been providing. 

Now, I don’t want to put a further burden on a nonprofit, but 

nonprofits tend to run under very tight budgets and often they get 

their funding from various sources in lump sums, so they sometimes have to go periods without a regular source of income flowing 

in. Since they are nonprofits, their status depends on their abiding 

by Federal laws. 

48 

I am wondering with a nonprofit as opposed to a for-profit, which 

has to generate the moneys to continue to pay employees and stay 

in business, that maybe there is an opportunity to work with nonprofits where you can come up with a creative system of payment 

where you might not be able to do it with a for-profit, because if 

a for-profit ultimately goes under, we all lose because they can 

claim bankruptcy and we will never get the money, but a nonprofit, 

if it goes under, chances are it is going to have a tough time ever 

reenergizing itself and asking for nonprofit status from the Federal 

Government again. 

So, I am wondering if there may be some work that we can do. 

Obviously, Goodwill Industries does tremendous work in so many 

different areas, and I bet you they could use 10 times the budget 

they do all the work on. Again, not to impose something on Goodwill or any of these other noble nonprofits, but maybe there is a 

way to address the payment problems you have with the EN by 

working with the nonprofits that aren’t trying to make the buck to 

make a living but are doing this because of the charitable and 

noble purpose behind it and work out a creative way to find a way 

to fund these ENs in a way that keeps them going and adds more 

of these ENs to the system, because it seems like if you are only 

going to live with 1,100 of them, it is always going to be tough nationwide to let the beneficiaries have that full sense of who is out 

there, who can help them. I put that out there. Maybe if you can 

let us know later on how many of these nonprofits are out there, 

that would be very helpful. 

Mr. GERRY. If I can just make one comment. 

Mr. BECERRA. Yes, sir. 

Mr. GERRY. You mentioned in passing about living with the 

1,100, and I am not satisfied that we have adequately recruited 

ENs. I think that the number is perhaps less crucial than the reality of what is actually available to our beneficiaries. There are 

still significant areas of this country where there isn’t a good competitive market available. The 1,100 are not evenly distributed 

around the country and they don’t serve all of the beneficiary 

groups. 

So, I just didn’t want to pass by the idea that that is enough or 

that I would imply that it is enough. I think we have to really do 

a better job of reaching out to ENs. The other observation I make 

is that I don’t believe anywhere in the statute Congress differentiated within the category of ENs, and that could create some difficulty in trying to come up with separate payment schemes, but 

I am perfectly willing to look at the options. 

Mr. BECERRA. Just to look at it. I don’t know, either, but I am 

just wondering if because they operate under different scenarios, 

that maybe we can do that. Mr. Chairman, if I can ask one last 

question, I will make it very quick. The notice to beneficiaries, I 

thought Ms. Hancock made a great suggestion of providing the information upon first point of contact, which is when the then-applicant for benefits first reaches the SSA, no telling whether the person will actually qualify for the benefits. It seems to make perfect 

sense to just give the notice up front and say, by the way, should 

you end up qualifying for these benefits, we hope that you will consider the possibility of returning to work at some point soon and 

49 

here is your Ticket to Work. Maybe you don’t have the authority 

right now, but is there any reason why the SSA would not want 

to consider that? 

Mr. GERRY. I don’t think it is a question of authority. I think 

it is an interesting idea and I would be happy to look into it. I 

think we have the legal authority to do it. I would be happy to pursue it and give you a more complete answer. 

[The information follows:] 

While we cannot issue a ticket to an individual who is not yet a beneficiary, we 

believe that providing information about the program as early as possible to applicants who might later become eligible for the Ticket program is an excellent idea 

and are considering various ways to ensure that accurate information is offered to 

individuals so that they can make sound decisions about 

f 

work activity. 

Mr. BECERRA. Mr. Chairman, thank you very much. 

Mr. HULSHOF [presiding]. Let me announce there are votes upcoming and there are some Members on the next panel that actually have flights to catch, so, if Members could try to confine their 

remarks to the time allotted, I would appreciate it. I am going to 

make a quick comment and a question, taking my time. I appreciate, Mr. Justesen, in your testimony you recognize—you are absolutely correct that State VR agencies do have long histories that 

predate the ticket program and most of the ENs today, but I also 

appreciate that you in that same paragraph on page 6 of your testimony state unequivocally that you value the EN partners and recognize the need for their participation, not only for the services 

that they provide, but for the choice of service provisions that they 

offer. 

If you mention in Columbia, Missouri, the name Advent Enterprises, everybody immediately understands that this is a private 

VR service that has a good relationship with the State VR, and so 

I appreciate that. Mr. Gerry, I know that we have beaten you up 

a bit about the fact that 90 percent of the tickets are being assigned to the State VR agencies, only 10 percent to the ENs. The 

only comment I would have, and you set out a number of reasons 

why that is the case, what I wanted to just reiterate in anticipation 

of the next panel, there are those that are expressing the burdens 

of the payment process. One referred to it as, I think, quote, ‘‘administrative drag,’’ and I enlisted that term from the next panel, 

which forces these ENs to spend time and their resources dealing 

with Maximus, and/or the agency rather than helping the beneficiaries, and a couple of examples that seemed to be a bit egregious, let me ask if you agree. 

Twenty-thousand dollars due from the agency 3 to 12 months or 

longer. I recognize what you said earlier about capitalization and 

some of the smaller networks, and yet waiting for that amount of 

funds for any private agency seems to be a pretty substantial burden, or some citing the fact that they spend more money and staff 

time to collect the payment than the payment amount. I know, 

again, you have talked about Maximus briefly. What can you do or 

the SSA do to address their concerns on administrative drag? 

Mr. GERRY. We actually have been doing several things, and in 

my written testimony, I provide a little more detail about this. On 

50 

the payment collection issue, I think we have done some things 

that make it much easier, much less time consuming, and, frankly, 

less expensive for ENs. We have changed our administrative procedures. We used to require a much more rigorous verification of ongoing employment. In other words, we had the issue of pay stubs. 

We had expectations that beneficiaries would continue to provide 

evidence on a monthly or quarterly basis that they were continuing 

to be employed. Now, many beneficiaries, once they are employed, 

don’t particularly want to go back and forth to the EN and that 

makes perfectly good sense. So, we have actually changed our administrative procedures to allow some of the good faith verification 

that the EN is not aware of any change in the employment status 

rather than requiring the collection of pay stubs. 

Now, that is a big change in terms of the amount of work that 

has to go on. So, the first time that a payment is claimed, we want 

some proof that the individual went to work, but we are not requiring that kind of documentation for all of the payments, and we 

have also created three or four different ways in which payments 

can be made, either quarterly or monthly, and we have given 

choices to the ENs of how to basically manage the payment process. 

So, those are efforts to try to make it easier, and I think on the 

pay stub collection of information front, we have done a pretty good 

job of eliminating a lot of the problems. The staggering and the 

timing of payments, the amounts of the payments, those are problems that we are actively reviewing. I think Congress intended in 

the legislation that the Commissioner look at that, and we are 

doing that right now. 

Mr. HULSHOF. A last comment and then I will yield briefly to 

Mr. Pomeroy, then Mr. Brady. Even before the ticket program was 

signed into law, this Subcommittee has actually been concerned 

about overpayments. We have had hearings on this issue. Each 

time, overpayments has been one of the serious concerns, and so 

I also wanted to, at least on the record, express that matter. Mr. 

Pomeroy? 

Mr. GERRY. If I can just comment, and I will do it briefly. 

Mr. HULSHOF. Okay. 

Mr. GERRY. I have a lot of detail about what we are doing right 

now in terms of some of the systems changes, but I want to say 

for the record that this is a matter of the highest priority to the 

Commissioner and to me personally. I think we have to move and 

we have to move extremely quickly on the overpayment problem. 

I think it is one of the most serious barriers to getting people to 

work and I think that even though it has been accelerated, it is 

something that we cannot just leave to the routine changes of our 

systems, and wait for that. I think we are looking at as many different ways as we can right now to make that problem disappear 

because I think it is a serious problem. 

Mr. HULSHOF. There are those in the audience nodding their 

heads in assent to that statement. Mr. Pomeroy? 

Mr. POMEROY. Thank you, Mr. Chairman. Years ago, I spoke 

to the North Dakota Mental Health Association and a young 

woman followed me out and explained to me her situation. She was 

a nurse who no longer could work because of a bipolar disorder and 

51 

she desperately needed an SSA disability determination for the 

medicine that she required, but when she didn’t work, her condition got worse and she was just desperate to get to work. So, when 

we passed this Ticket to Work, I thought of her and I thought of 

that situation and I was thrilled about the potential. 

I look at the chart. North Dakota has got 22 people that have 

actually been able to access this, and needless to say, that is so far 

short of what my hope and expectation was for this program. I 

don’t recall a program where I have been as excited about the 

launch of it and disappointed about the mid-term implementation 

of it. 

So, from both sides of the dais here, we have given one message, 

and that is we can do a better job of getting this program available 

to people whose lives will turn around if they have access to it and 

can fully implement it. I couldn’t have been more impressed by the 

initial panel this morning as an indication of what can happen to 

people when they can get back to work. I am looking at the Advisory Committee’s recommendations to you and among their recommendations, they call for congressional action to make it clear 

that Congress did not intend to make beneficiaries ineligible for the 

full range of services from VR, Medicaid, or other Federal and 

State programs. To me, that ought not take an additional act of 

Congress. Isn’t it pretty clear from Ticket to Work legislation that 

this is to be additive, not a zero-sum game in terms of these benefits? 

Mr. GERRY. I am a recovering lawyer, Mr. Pomeroy, and I don’t 

want to give you a legal opinion about it, particularly because I 

think it applies probably partly to the Rehabilitation Act. In other 

words, I think when Troy was talking earlier about provisions of 

the Rehabilitation Act, which we don’t administer, the Department 

of Education administers, there are provisions there about comparable benefits that have been interpreted in different ways. It is 

up to the Department of Education, of course, to interpret that 

statute, but it is, of course, up to the Congress what the content 

of that statute is and what that means. 

So, the question which you are raising involves partly the SSA 

and Ticket to Work, but it also involves the question of what acceptable practice under the Rehabilitation Act would be, and that 

is really a question that I am not prepared to answer. I think it 

is an important question, and Troy, I don’t know if you want to try 

to respond, or—— 

Mr. JUSTESEN. You asked a complex question, Congressman, 

and one which is very important to the Rehabilitation Services Administration that is under my office and its interaction between 

that statute, the Rehabilitation Act, and the Ticket to Work and 

Work Incentives Improvement Act, and that is one in which we 

would be happy to supply for the record a more—— 

Mr. POMEROY. I actually will want from both agencies a clear 

explanation of where Congress needs to clarify, if clarification is 

needed. Just specifically on this one, Mr. Justesen, to follow up, if 

I can get this straight. If a beneficiary assigns a ticket to an EN, 

is he or she still entitled to VR services under the Rehabilitation 

Act if the EN’s services are not comparable to what was being provided by VR? 

52 

Mr. JUSTESEN. As I understand your question, the answer is 

yes. 

Mr. POMEROY. They are still entitled to compensation, because 

the education. 

Mr. JUSTESEN. They are entitled to services and benefits under 

VR. 

Mr. POMEROY. Services, right. I am sorry, wrong word. Services 

and benefits. Are you monitoring States to make certain that they 

are implementing the VR Act (P.L. 105–220) in that fashion? 

Mr. JUSTESEN. Yes, and it is important for us, as I said in my 

comments earlier, that we are valuing the input from the Advisory 

Board, the Ticket Advisory Board, and our collaboration with Social 

Security. Anecdotally, we have received in the Department of Education communications, concerns expressed by advocates and others 

throughout the country that this is an issue in which we in the Rehabilitation Services Administration under the Department of Education need to pay particular attention to. We are doing that. 

Mr. POMEROY. Great. 

Mr. JUSTESEN. It is important for us to make sure that each 

of the three phases, and we are beginning with the first 13, of review of the agreements between the State VR agencies and other 

public and private ENs, to make sure that individuals with disabilities are protected under the Rehabilitation Act as well as the opportunity for them to benefit under the ticket program. 

Mr. POMEROY. That is terrific, because what this is about is an 

additional level of support to get people back to work, not just another source of funding to then have other funding withdrawn. 

Mr. JUSTESEN. As I said, I will be happy to submit for the 

record a clear explanation of this issue. Individuals with disabilities, regardless of their option of exercising the ticket, if they are 

individuals who receive SSI benefits or SSDI benefits, those individuals are presumed eligible for VR services without the need in 

the past to have completed a great deal of extra paperwork to be 

eligible for both programs. 

Mr. POMEROY. As you do supply that information, I would like 

you to reference the Advisory Committee’s recommendation. I am 

not trying to at all point fingers at anybody. If Congress has more 

clarification to do, let us go ahead and do it. I am not, frankly, at 

all certain that we do. I believe that it is relatively clear on what 

has been enacted already. 

Mr. JUSTESEN. Perhaps. I would be happy to submit it for the 

record. 

Mr. POMEROY. All right. 

[The information was not received at the time of printing.] 

Mr. JUSTESEN. Let me tell you, I don’t think, and we don’t take 

in any way your questions to be those of criticism. These are areas 

of partnership building for us at all of the Federal agency levels 

and one of the efforts we need to do at the Federal agency levels 

is model interaction and interagency implementation of the ticket 

program even better than we have done in the past, and I think 

we are making efforts to do that. 

Mr. POMEROY. The only final question—I asked a lot of questions, comments—this business of getting this marketed in an effective way so that people that might avail themselves of these 

53 

services know that they can is just terribly important. I right now 

extend an invitation to SSA to have a meeting with me in North 

Dakota. Hopefully, with media coverage, we will be able to get the 

word out on it. We have about the lowest rate of participation in 

the entire country, and I know that does not reflect the work ethic 

of North Dakotans on disability payments. They want to get off. We 

have got a program to get them off. I will personally work with you 

to do that. 

Mr. JUSTESEN. I would be happy to accept your invitation right 

now. I have actually worked in North Dakota on the Special Education Program and know a little bit about the population. I certainly would be happy to do that. I am sure Commissioner 

Barnhart would. 

Mr. POMEROY. Terrific. We look forward to it, and we are coming into springtime, so it is not even that bad of a draw. 

[Laughter.] 

Thank you very much. I yield back. 

Mr. BRADY [presiding]. Thank you, Congressman. Commissioner, Secretary, the Ticket to Work Program is a great concept. 

It is real important that it succeed and it is appropriate at this 

hearing that we focused a lot because of the roll-out on process, but 

let us conclude the panel with this question. We are at different 

phases in different areas. For our customers, for our clients, for the 

ones we really want to serve, what are the results so far for those 

especially choosing ENs? Are the disabled getting services more tailored to their individual needs? Are they getting them better or 

faster or in a way that helps them get to the workplace sooner? For 

those, we are really concerned. They happen to be our employers, 

as well. What are the results for them so far? 

Mr. GERRY. Let me see if I can set the stage to answer that 

question by going back to where we were before the ticket and 

where we had consistently two-tenths of 1 percent of our beneficiaries leave our rolls for reasons other than death. I can’t testify 

they all went to work, but some significant number of the twotenths of 1 percent. That is where we were. That is where we have 

been for 20 years. That was the status quo that the ticket changed. 

I think it is important to remember that that is where we were 

because the ticket has, I think, had significant effects on that as 

demonstrated. Specifically, we have about 670 people that we are 

paying, that have generated EN payments. So, it is people who are 

working, that have been working for some time, that are off cash 

benefits. While that doesn’t sound like a huge number of people, 

even out of the 40,000, we have to remember where we are in the 

process, because in order to be paid, you have to have worked for 

a significant period of time—in the case of VR, it is 9 months, and 

in the case of the ENs, it is an even longer period of time. So, I 

expect that number to expand fairly significantly over the next 

year or two. 

Now, I think that is impressive compared to where we started. 

Is it what Congress looked for as the outcome or the final effect? 

No. I think we have to work on a lot more things in order to make 

this program work. I think in reading the statute, as I read it anyway, and looking at the legislative history, I think Congress knew 

that we were going to learn a lot as we implemented the statute, 

54 

and what the Commissioner is dedicated to, and I am, too, is to 

make changes as soon as we learn, not to wait, not to hesitate, but 

to do it and to do it with this Subcommittee. There may be things 

that ultimately have to come back to the Subcommittee and say, 

these are statutory issues. 

We are, at this point, trying to do everything we can within the 

Commissioner’s regulatory authority, and in some cases, I mentioned even changing administrative procedures. So, I think, yes, 

there are real people who are getting real benefits and I think that 

there is real promise and that the vision that this Subcommittee 

had when it passed the ticket is the right vision and one that we 

can reach. I just think we are, as you say, we are at a critical point 

in time and I think that we have to do—and I can pledge to you 

on the behalf of the agency what we are doing is trying to think 

about all the changes we can make or recommend to the Congress 

that would really make this program work more successfully. 

I think the one concern I have is that we have to keep going back 

to who the program is supposed to work for, and that is the beneficiaries. The fundamental issue is the choice of beneficiaries of different kinds of services that will allow them to achieve their employment goals, and that is what I keep reminding myself of, because we can get drawn off on other interests. 

Now, to have a vibrant and an active set of ENs and to have VR 

agencies become competitive. What we really want is not to repeat 

the two-tenths of 1 percent experience that we had before, but 

through competition to see good things happening. So, instead of 

seeing VR agencies as associated with a program that hasn’t produced much in the past, they would become part of a new program 

where they actively compete and cooperate. I think that is what we 

want and what we want to achieve, but I am very optimistic that 

we are going to get there. I just don’t want to over-promise or overcommit. At the same time, we couldn’t be more dedicated to getting 

there. 

Mr. BRADY. Thank you, Commissioner. I appreciate it. Mr. Secretary? 

Mr. JUSTESEN. It is important for the Committee to understand, and I know that you do, but I want to reemphasize this, that 

the success of the Ticket to Work Program is not solely on the 

shoulders of the SSA. They are the lead. We at the Department of 

Education look to the SSA to provide us with guidance on how to 

best implement the Ticket to Work Program. The VR Services Program administered at the Department of Education is a very important partner, together with the Department of Labor’s efforts, 

that are new in terms of our understanding how this evolution has 

evolved for us to all begin to work together at the Federal level. 

The VR Program has an important component and access in the 

advocacy community that may well be the primary access for entry 

into the world of employment. The Social Security may not always 

be in all cases. We have a large Independent Living Advocacy Program in which we partner that with the VR Services Program that 

is a vital first entry point for many individuals who may later become recipients of SSI or SSDI in which we are looking to build on 

that partnership and, frankly, we haven’t done as well as we could, 

but the Secretary of Education, Secretary Paige, is very interested 

55 

in our efforts to increase the employment opportunities for people 

with disabilities and we look forward to doing that. 

Mr. BRADY. Thank you. I think this is important because my experience is everything looks perfect on paper in Washington, D.C. 

How it works in life is usually a whole different matter. Staying 

on top of it to make it work the right way is our job, so, thank you, 

panelists. We appreciate it. 

Mr. BRADY. The next panel, I would like to invite up at this 

point. Thank you for being here today. We have with us Sarah 

Wiggins Mitchell, who is Chair of the Ticket to Work and Work Incentives Advisory Panel; Tom Golden, who is a member of the same 

panel; Paul Seifert, Social Security Task Force, Consortium for 

Citizens with Disabilities (CCD); Tom Foran, Vice President of Integrated Disability Resources (IDR); Quintin Mitchell, who is Director of VR Services in Richmond; Susan Webb with the Arizona Employment Network Association; and John Coburn, Staff Attorney 

for Health and Disability Advocates in Chicago, Illinois. In that 

order, why don’t we begin with Sarah Wiggins Mitchell for her 5- 

minute statement. 

STATEMENT OF SARAH WIGGINS MITCHELL, CHAIR, TICKET 

TO WORK AND WORK INCENTIVES ADVISORY PANEL; AND 

THOMAS P. GOLDEN, MEMBER, TICKET TO WORK AND WORK 

INCENTIVES ADVISORY PANEL 

Ms. WIGGINS MITCHELL. Thank you, Mr. Chairman, and good 

afternoon. On behalf of the Advisory Panel, we would like to thank 

you for this opportunity to speak to you today. The panel appreciates the support this Committee demonstrates for people with 

disabilities and the SSA disability programs. We have submitted 

written testimony for the record and now will simply be highlighting some of the points we made in that testimony. 

The panel believes that the ticket program has much unrealized 

potential. Beneficiaries are showing interest in the program in two 

ways. Forty thousand people have assigned their tickets to receive 

VR and employment support services. In addition, the program 

manager, Maximus, received over 23,000 calls about the ticket in 

the month of February alone and over 10 million hits were made 

to their Ticket to Work website in the calendar year 2003. 

The support programs established by the Ticket Act are also 

proving to be very successful. Almost 100,000 beneficiaries have 

sought information and assistance from the Benefits Planning and 

Assistance and Outreach Program (BPA&O). The SSA’s customer 

satisfaction survey supports what the panel has been hearing from 

beneficiaries across the country. The BPA&O services are excellent 

and essential to people with disabilities who want to work. The 

panel was pleased that the BPA&O and PABS Programs were reauthorized in H.R. 743 and thanks this Committee for their hard 

work in passing that legislation. 

The establishment of the Area Work Incentive Coordinator 

(AWIC) position within the SSA is a very positive development. 

The panel was very pleased that SSA decided to create a position 

that is permanent and devoted full-time to work incentive duties 

as part of their internal core of work incentive specialists. The 

panel has heard positive testimony and comments regarding the 

56 

AWIC positions and hopes that SSA will expand the number of 

AWIC positions to meet the enormous demand for their services. 

Mr. GOLDEN. While the SSA is making some progress in a number of areas, the panel has serious concerns in three key areas 

which threaten the success of the ticket program. Of most concern 

to the panel is the current low participation of ENs. As you are 

aware, the panel issued a report last month entitled, ‘‘The Crisis 

in EN Participation: A Blueprint for Change.’’ Central to this report is the assumption that recruiting and retaining a large number of ENs is crucial to accomplishing the primary Stated goal of 

the ticket program, giving people with disabilities a real choice in 

rehabilitation and employment. 

Our report identified a number of issues that are causing providers not to participate or to drop out of the program altogether. 

These are the need for Congress to clarify that the ticket program 

should be used as a supplemental, rather than a substitute, funding source; the design of the EN payment system; the inadequacy 

of provider incentives, the administration of claims for payment; 

marketing; EN training; and the treatment of American Indian VR 

Programs. While all of these issues are important, I will briefly discuss only two. 

The design of the payment system for the ticket program and the 

administration of claims for payment by ENs pose immediate 

threats to the success of the program, placing too much financial 

risk on ENs, who must make large investments up front and wait 

a long time for payments. The panel has recommended moving 

more of the payment into the first 12 months of employment, increasing the payment to greater than 40 percent of the average 

benefit amount, reducing the difference between milestone and outcome payments, and increasing the sum of payments for SSI to 

equal that of the payments for SSDI. 

Second, the requirements SSA places on ENs to make a claim for 

and receive payment are burdensome and costly. SSA not only does 

not make payments to ENs in a timely manner, sometimes taking 

up to 120 days, but also has established a quarterly payment 

schedule. Finally, the panel is concerned that SSA has yet to undertake a demonstration project addressing any of these issues. 

These administrative problems must be addressed without delay. 

The second major area hindering the success of the program is 

the lack of marketing and public education about the program 

itself. Over the past 3 years, the panel has repeatedly recommended that SSA undertake a national coordinated marketing 

and public education campaign to increase awareness of and interest in the program. While the panel is pleased that SSA has awarded a contract for the design of a strategic marketing plan, no actual 

marketing plan will have been implemented until the plan is completed. The panel urges SSA to move forward quickly with other interim marketing activities such as possibly sending a reminder letter to beneficiaries who have received a ticket in the past and not 

used them, or other suggestions that were made by our esteemed 

panel earlier today. 

Finally, the panel is concerned about the insufficient training 

SSA field staff receive about SSA work incentives and the ticket 

program. The panel continues to hear stories of beneficiaries who 

57 

received inaccurate information about work incentives from SSA 

field staff. Receiving bad information can cause a person not to 

make a job attempt, to receive an overpayment, or to be forced to 

stop working altogether. It also increases mistrust and fear. This 

situation is unacceptable to the panel and Americans with disabilities. 

The Ticket Act requires the SSA to have staff available and accessible that possess a thorough understanding of the work incentives and are able to provide this information to beneficiaries who 

want to work. As Stated earlier, AWICs represent the best type of 

customer service. However, the training received by AWICs does 

not seem to filter down to the Work Incentive Liasons and other 

field staff. We urge SSA to expand the training available to all SSA 

field staff and put in place quality assurance measures. 

Ms. WIGGINS MITCHELL. In conclusion, the panel believes the 

ticket program has great potential to help many people with disabilities improve their lives by going to work. While it is still early 

in the implementation process, the failure of SSA to take steps to 

immediately address the concerns outlined in this statement could 

have a dire effect on the success of the program. Thank you again 

for your opportunity to speak with you today. Normally, I would 

say we would be happy to stay and answer questions, but my colleague and I need to be in other areas of the country and are going 

to have to leave. 

Mr. BRADY. That is fine. 

Ms. WIGGINS MITCHELL. We would be glad to answer in writing any questions that you would have for the panel. 

Mr. BRADY. Thank you. Have a safe trip. 

Ms. WIGGINS MITCHELL. Thank you. 

Mr. BRADY. I noticed that I don’t think either of you took a 

breath during your—— 

[Laughter.] 

I thought, man, things are speeding up in this room now. 

[Laughter.] 

So, anyway, we appreciate you being here. Thank you. 

Ms. WIGGINS MITCHELL. Thank you very much again. 

[The prepared statement of Ms. Wiggins Mitchell follows:] 

[The prepared statement of Mr. Golden follows:] 

Statement of Sarah Wiggins Mitchell, Chair, Ticket to Work and Work 

Incentives Advisory Panel 

Introduction 

The Ticket to Work and Work Incentives Advisory Panel (the Panel) would like 

to thank Chairman Shaw for holding this hearing. The Panel appreciates the Committee’s high level of interest in ongoing oversight regarding the Ticket Program 

and the other important programs and policies of the Ticket to Work and Work Incentives Improvement Act. The Panel would also like to take the time to recognize 

the support this committee demonstrates for people with disabilities and the Social 

Security Administration Disability programs. 

Good News 

The Panel believes that the Ticket Program is a very popular program with still 

much unrealized potential. Advocates for people with disabilities at the national and 

grassroots levels are very supportive of this program and are working with their 

Federal partners to make the program succeed. 

58 

Positive Sign: Consumer Interest 

Consumers are also showing great interest in the program. Forty thousand people 

have assigned their tickets to receive vocational rehabilitation and employment support services. While only about 4000 of those are with Employment Network providers, or what we call ENs, that is a big number for the short time that the Ticket 

Program has been around. This is especially true given the fact that the roll out 

of the Ticket program was delayed and is not yet completed. The rest of the Tickets 

have been assigned to State Vocational Rehabilitation agencies. 

Even beneficiaries who have not assigned a Ticket are very interested in finding 

out about the program. The Program Manager, Maximus, received over 23,000 calls 

in the month of February alone. Almost 20,000 of those were inquiries made by or 

on behalf on beneficiaries with interest in the Ticket program. In addition, 

MAXIMUS reports that during calendar year 2003, over 10 million hits were made 

to the Ticket to Work website. 

TWWIIA Support Programs are Excellent 

The support programs established by the Ticket to Work and Work Incentives Improvement Act are also proving to be very successful. Almost 100,000 beneficiaries 

have sought information and assistance from the benefits planning assistance and 

outreach program, or BPAO. The results of the customer satisfaction survey that 

were just released by the Social Security Administration supports what the Panel 

has been hearing from beneficiaries across the country: BPAO services are excellent 

and essential to people with disabilities who want to work. Eighty nine percent of 

those surveyed rated the service they received as excellent, very good, or good. And, 

the percent of the people who reported they were working jumped by 19 % subsequent to their contact with the BPAO. The Panel is pleased that the BPAO program 

was reauthorized in HR743 and thanks this Committee for their hard work in passing that legislation. 

Positive Implementation Step: Area Work Incentive Coordinator 

The establishment of the Area Work Incentive Coordinator, or AWIC, position 

within SSA is a very positive development in implementation of the Ticket program, 

as well as in the overall administration of work incentives. The Panel is very 

pleased that SSA decided to create a position that is permanent and devoted full 

time to work incentive duties as part of their internal corps of work incentives specialists. The Panel has repeatedly heard very positive testimony and comments regarding the dedicated and skilled SSA employees that fill the AWIC positions. As 

we all know, the provision of accurate and timely information on work incentives 

is a critical factor in making people feel secure in their attempt to go to work. 

AWICs help to make that happen for SSA beneficiaries. The Panel hopes that SSA 

will expand the number of AWIC positions to meet the enormous demand for their 

services. 

Three Areas of Concern 

While the Agency is making good progress, the Panel has serious concerns in 

three key implementation areas that threaten the success of the Ticket Program. 

Of most concern to the Panel is the current low participation of ENs. Second, we 

are concerned about the lack of public education and marketing of the Ticket Program to beneficiaries, their families, and ENs. A third major area of concern is the 

inadequate training provided to SSA field staff about work incentives in general, 

and the Ticket Program specifically. 

Concern One: EN Participation 

As you probably know, the Panel issued a report last month on the crisis in EN 

participation and its potential impact on the Ticket Program. The Executive Summary of that report is included at the end of this statement (beginning on page 8). 

Central to this report is the assumption that recruiting and retaining a large 

number of active ENs is a critical factor in accomplishing the primary stated goal 

of Ticket Program—giving people with disabilities a real choice in rehabilitation and 

employment services. Our report identified a number of issues related to the structure of the Ticket Program that are causing providers not to participate as ENs or 

to drop out altogether. These are: the need for Congress to clarify that the Ticket 

Program should be used as a supplemental, rather than a substitute, funding 

source; the design of the EN payment system; the inadequacy of provider incentives; 

the administration of claims for payment; marketing; EN training; and the treatment of American Indian VR programs. 

Finally, the Panel is concerned and puzzled that in the fourth year of the Ticket 

Program, SSA has yet to undertake a demonstration or pilot project addressing 

some of these issues especially the payment issue. The problems outlined below in 

59 

the Executive Summary must be addressed without delay to make the Ticket Program more attractive to current and potential ENs and to ensure that current ENs 

to remain in the program. 

Concern Two: Marketing and Public Education 

The second major area the Panel believes maybe hindering the success of the program is the lack of marketing and public education being conducted by SSA in support of the program. The Panel has repeatedly recommended that SSA undertake 

a national coordinated marketing and public education campaign in order to increase awareness of and interest in the Ticket program. Currently, beneficiaries are 

informed only once about the Ticket Program and they may not be informed at all 

about other TWWIIA provisions and work incentives. The only marketing material 

most beneficiaries receive on the Ticket Program is a letter describing the program 

when the Ticket is being rolled out, or when they first become eligible for benefits. 

The Panel is pleased that SSA has awarded a contract for the design of a strategic 

marketing plan for the program that will be completed this year. However, in the 

meantime, many ENs report having trouble finding people willing to assign their 

Tickets and many beneficiaries and local advocates remain completely in the dark 

about the Ticket program and the other work incentives. Although these SSA contracting efforts are very positive steps, the Panel is concerned that the next year 

or two will be devoted to planning marketing efforts rather than actual marketing 

of the Ticket Program. Extensive planning activities may delay implementation of 

a national marketing plan even further. The Panel believes it is reasonable to expect that marketing would occur prior to, or during, the rollout of a new program, 

not after. 

The Panel urges SSA to move forward quickly with other marketing activities, 

such as sending reminder letters to all people who have received but not yet used 

their ticket. 

Concern Three: Training 

The final area that is of most concern to the Panel is the insufficient training SSA 

field staff receive about work incentives and the Ticket Program. The Panel has 

heard in public testimony across the country, stories of beneficiaries who have received inaccurate information about work incentives from SSA staff in the field office. Receiving bad information can cause a person not to make a job attempt, to 

receive an overpayment, or to be forced to stop working. It also increases mistrust 

and fear. This situation is unacceptable to the Panel and Americans with disabilities. Every SSA field office should have accessible and available staff that possess 

a thorough understanding of the work incentives and be able to provide accurate 

basic information to SSA beneficiaries with disabilities who want to work. 

On that note, the Panel wants to again recognize the very positive step the Agency took in the creation of the AWIC position as part of their internal corps of work 

incentive experts. This represents the best type of customer service. The AWICs received good basic training (two full weeks) and many of them were former Employment Support Representatives (with six weeks of training). AWICS are reported to 

be very knowledgeable and highly regarded in the field and by beneficiaries. 

There are not nearly enough AWICs to be available to answer every question 

beneficiaries have but the training that AWICs have received on SSA work incentives and the Ticket Program is exemplary. SSA cannot, however, rely on AWICs 

to provide all information and advice to beneficiaries on work incentives and the 

Ticket Program. SSA created a filter down, train the trainer approach to build their 

corps of internal work incentive specialists. AWIC’s train Work Incentives Liaisons 

(or WILs), the people who provide information on work incentives on top of their 

regular duties in the field office. WILs receive their limited training from the 

AWICs and then are expected to train the remainder of the field office staff. SSA 

work incentives and their interaction with the Ticket Program are very complicated 

and technical topics. The problem with SSA’s current strategy is that the necessary 

knowledge does not seem to filter down to the claims representatives and service 

representatives who are answering beneficiary questions about work incentives on 

a day-to-day basis. We trust that SSA will make more intensive training, along the 

lines of what AWICs receive, available to all SSA field staff. 

Conclusion 

The Panel believes the Ticket Program has great potential to help many people 

with disabilities improve their lives by going to work. This statement outlines a 

number of concerns the Panel has about SSA’s administration of the Ticket Program. While it is still early in the implementation process of this new program, the 

failure of SSA to take steps immediately to address these concerns may have a dire 

effect on the success of the program. 

60 

The Crisis in EN Participation: A Blueprint for Action (February 2004) 

Executive Summary 

Thousands of people with disabilities and their advocates shared a dream that the 

Ticket to Work and Work Incentives Improvement Act of 1999 (the Act) would greatly expand employment opportunities for people on the Social Security Administration (SSA) disability rolls. Three years after enactment of the law, it is clear that 

their dream is faltering. The Ticket to Work and Self-Sufficiency Program (Ticket 

Program) is failing to recruit the anticipated numbers of new employment service 

providers, called Employment Networks (ENs). In addition, those enrolled as ENs 

are serving only a fraction of the beneficiaries thought to be interested in participating in the Ticket Program. Nearly 1,000 providers have enrolled in the program, 

but only about one-third of those operating have accepted any tickets. The Panel believes that without immediate attention to the very real problems affecting EN participation, the Ticket Program will fail. The Panel urges Congress and the Commissioner to act quickly on the following recommendations. 

Issues and Recommendations 

Ticket Program as a Supplemental Funding Source—ENs are uncertain 

about whether and how they can use funds from other public sources to serve ticket 

holders and have chosen not to actively participate in the Ticket Program because 

of fear of losing other stable funding sources. 

Recommendations 

• Congress should develop statutory language that clearly articulates its original 

intent that the Ticket Program’s outcome and milestone payments should provide additional resources to assist beneficiaries in attaining and retaining employment. In general, the Panel believes that Congress did not intend to make 

beneficiaries ineligible for the full range of services from vocational rehabilitation (VR) programs, Medicaid, or other Federal and State programs by making 

them eligible for the Ticket Program. 

• Congress should direct the Commissioner to implement the Ticket Program as 

a complement to the traditional SSA VR Reimbursement Program, paying State 

VR agencies for up-front services and paying ENs for long-term employment 

outcomes. 

• As part of the mandated evaluation of the Ticket Program, the Commissioner 

should conduct an assessment of the Ticket Program and the SSA VR Reimbursement Program, running in combination, to determine whether that approach produces better long-term, cost-effective outcomes than the historical VR 

Reimbursement Program alone, and to ensure the financial viability of running 

the two programs in combination. 

The EN Payment System—Two problems in the EN payment system discourage 

the active participation of many providers: (1) the payment system places too much 

financial risk on ENs and (2) the payment system provides significantly lower reimbursements to ENs for serving Supplemental Security Income (SSI) recipients than 

for serving Social Security Disability Income (SSDI) beneficiaries. 

Recommendations 

• The Commissioner should immediately modify the EN payment system to move 

more of the payment into the first 12 months of employment and reduce the 

difference between the milestone and outcome payments. 

• The Commissioner should test two or three creative approaches that place more 

up-front financial risk on SSA but, if successful, could significantly increase 

Ticket Program participation by both ENs and beneficiaries, thereby increasing 

long-term savings to SSA. 

• Congress should amend the statute to permit payments to ENs to be set at a 

level greater than 40 percent of average benefits for both SSDI and SSI beneficiaries and after the statutory change the Commissioner should implement an 

increase in EN payments for beneficiaries of both programs. 

• Congress should amend the statute to permit the Ticket Program to increase 

the sum of payments available for serving SSI recipients to a level equal to the 

sum of payments available for serving SSDI beneficiaries. 

• The changes to the EN payment system should be implemented as quickly as 

possible. 

Adequacy of Provider Incentives—Because little is known about outcome payments for providers, the Act authorizes the Commissioner to review, refine, and alter 

the payment system to ensure that it provides adequate incentives for ENs to serve 

61 

beneficiaries and produce savings to the program. Despite major problems with the 

payment model, no alterations have been made to the original program payment system. The Commissioner has established an advisory group on Adequacy of Incentives 

(AOI) to assist SSA with the design of a workable payment system, including financial incentives to serve four groups of beneficiaries with special needs that were referenced in the Act. 

Recommendations 

• The Commissioner should implement a modified EN payment system that generally incorporates the principles outlined in the AOI Advisory Group’s interim 

report. (The Panel supports the principles in the report but has not endorsed 

a specific model.) • For any new payment system to be successful, the Commissioner must first implement the Panel’s recommendations relating to the EN payment system and 

EN claims administration. • The Commissioner and Congress should make clear in statute and in program 

regulations that payments to ENs must supplement funding from other public 

programs (such as State VR, Mental Health, Medicaid, Housing and Urban Development, Department of Labor) and should not pay for services for which 

beneficiaries are already eligible. 

EN Payment Claims Administration—Two factors compound the financial risk 

and working capital problems of Employment Networks: (1) long-term tracking 

of beneficiary earnings is labor intensive and administratively burdensome for 

ENs and (2) there are often long delays in processing EN claims for payment. 

Recommendations 

• Once a beneficiary has been certified as employed above the substantial gainful 

activity (SGA) level or leaves cash benefit status, the Commissioner should continue to pay the EN on a monthly basis as long as the beneficiary remains in 

zero benefit status and the EN has not yet received 60 months of outcome payments, or until the beneficiary requests a new EN. 

• The Commissioner should refine the EN payment claims processing system to 

ensure timely payments to ENs within businesslike timeframes. A widely accepted business standard for turnaround time on receivables is 30 days. 

Marketing to ENs and to Beneficiaries—To date, there is no national marketing plan for the Ticket Program and the Program is not well understood by the 

vast majority of beneficiaries or by those who influence a beneficiary’s decision to attempt work. Further, ENs spend considerable time explaining the Program and dispelling misconceptions. Also, the lack of marketing contributes to the insufficient demand for EN services. However, SSA has recently awarded contracts to support development of a strategic marketing plan and EN marketing and recruitment efforts. 

The Panel has made numerous recommendations to the Commissioner on this issue 

in past reports. 

Recommendation 

The Commissioner should create opportunities for the Panel to (1) review the 

work plans and proposed activities under the strategic marketing plan contract and 

the project designed to improve EN participation and (2) engage in a dialogue with 

the contractors and relevant SSA staff so that the Panel can provide timely and substantive input on these marketing activities. 

EN Training and Communication—There is inadequate training, technical assistance (TA), and timely information available to ENs. Existing TA and training resources are inadequate, nonuniform, piecemeal, uncoordinated, and of varying quality, with no coordinated means for ENs to identify and share best practices. 

Recommendations 

• The Panel, in partnership with the Commissioner, should convene a meeting of 

key stakeholders to develop a national training and communications conference 

for all ENs. 

• The Commissioner should appoint a working committee to develop the plan for 

this training conference and to develop the overall strategy for bringing together a broad-based coalition of stakeholders to oversee and sponsor the event. 

Panel members should be active participants. 

American Indian VR Program Eligibility for the SSA VR Reimbursement 

Program—Despite having to meet the same service standards as State VR agencies, 

American Indian Vocational Rehabilitation (AIVR) programs operated by Tribal NaVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00065 Fmt 6633 Sfmt 6621 E:\HR\OC\23796.XXX 23796
62 

tions programs are not exempt from the Ticket Program EN application process and 

are excluded from the traditional SSA Reimbursement Program for State VR agencies. 

Recommendation 

Congress should amend the statute to permit AIVR programs operating under section 121 of the Rehabilitation Act to participate in Ticket to Work in a manner 

equivalent to State VR agencies; that is, they should be exempt from the EN application process and be subject to the same reimbursement rules. 

f 

Statement of Thomas P. Golden, Member, Ticket to Work and Work 

Incentives Advisory Panel 

Introduction 

The Ticket to Work and Work Incentives Advisory Panel (the Panel) would like 

to thank Chairman Shaw for holding this hearing. The Panel appreciates the Committee’s high level of interest in ongoing oversight regarding the Ticket Program 

and the other important programs and policies of the Ticket to Work and Work Incentives Improvement Act. The Panel would also like to take the time to recognize 

the support this committee demonstrates for people with disabilities and the Social 

Security Administration Disability programs. 

Good News 

The Panel believes that the Ticket Program is a very popular program with still 

much unrealized potential. Advocates for people with disabilities at the national and 

grassroots levels are very supportive of this program and are working with their 

Federal partners to make the program succeed. 

Positive Sign: Consumer Interest 

Consumers are also showing great interest in the program. Forty thousand people 

have assigned their tickets to receive vocational rehabilitation and employment support services. While only about 4000 of those are with Employment Network providers, or what we call ENs, that is a big number for the short time that the Ticket 

Program has been around. This is especially true given the fact that the roll out 

of the Ticket program was delayed and is not yet completed. The rest of the Tickets 

have been assigned to State Vocational Rehabilitation agencies. 

Even beneficiaries who have not assigned a Ticket are very interested in finding 

out about the program. The Program Manager, Maximus, received over 23,000 calls 

in the month of February alone. Almost 20,000 of those were inquiries made by or 

on behalf on beneficiaries with interest in the Ticket program. In addition, 

MAXIMUS reports that during calendar year 2003, over 10 million hits were made 

to the Ticket to Work website. 

TWWIIA Support Programs are Excellent 

The support programs established by the Ticket to Work and Work Incentives Improvement Act are also proving to be very successful. Almost 100,000 beneficiaries 

have sought information and assistance from the benefits planning assistance and 

outreach program, or BPAO. The results of the customer satisfaction survey that 

were just released by the Social Security Administration supports what the Panel 

has been hearing from beneficiaries across the country: BPAO services are excellent 

and essential to people with disabilities who want to work. Eighty nine percent of 

those surveyed rated the service they received as excellent, very good, or good. And, 

the percent of the people who reported they were working jumped by 19% subsequent to their contact with the BPAO. The Panel is pleased that the BPAO program 

was reauthorized in HR743 and thanks this Committee for their hard work in passing that legislation. 

Positive Implementation Step: Area Work Incentive Coordinator 

The establishment of the Area Work Incentive Coordinator, or AWIC, position 

within SSA is a very positive development in implementation of the Ticket program, 

as well as in the overall administration of work incentives. The Panel is very 

pleased that SSA decided to create a position that is permanent and devoted full 

time to work incentive duties as part of their internal corps of work incentives specialists. The Panel has repeatedly heard very positive testimony and comments regarding the dedicated and skilled SSA employees that fill the AWIC positions. As 

we all know, the provision of accurate and timely information on work incentives 

63 

is a critical factor in making people feel secure in their attempt to go to work. 

AWICs help to make that happen for SSA beneficiaries. The Panel hopes that SSA 

will expand the number of AWIC positions to meet the enormous demand for their 

services. 

Three Areas of Concern 

While the Agency is making good progress, the Panel has serious concerns in 

three key implementation areas that threaten the success of the Ticket Program. 

Of most concern to the Panel is the current low participation of ENs. Second, we 

are concerned about the lack of public education and marketing of the Ticket Program to beneficiaries, their families, and ENs. A third major area of concern is the 

inadequate training provided to SSA field staff about work incentives in general, 

and the Ticket Program specifically. 

Concern One: EN Participation 

As you probably know, the Panel issued a report last month on the crisis in EN 

participation and its potential impact on the Ticket Program. The Executive Summary of that report is included at the end of this statement (beginning on page 8). 

Central to this report is the assumption that recruiting and retaining a large 

number of active ENs is a critical factor in accomplishing the primary stated goal 

of Ticket Program—giving people with disabilities a real choice in rehabilitation and 

employment services. Our report identified a number of issues related to the structure of the Ticket Program that are causing providers not to participate as ENs or 

to drop out altogether. These are: the need for Congress to clarify that the Ticket 

Program should be used as a supplemental, rather than a substitute, funding 

source; the design of the EN payment system; the inadequacy of provider incentives; 

the administration of claims for payment; marketing; EN training; and the treatment of American Indian VR programs. 

Finally, the Panel is concerned and puzzled that in the fourth year of the Ticket 

Program, SSA has yet to undertake a demonstration or pilot project addressing 

some of these issues especially the payment issue. The problems outlined below in 

the Executive Summary must be addressed without delay to make the Ticket Program more attractive to current and potential ENs and to ensure that current ENs 

to remain in the program. 

Concern Two: Marketing and Public Education 

The second major area the Panel believes maybe hindering the success of the program is the lack of marketing and public education being conducted by SSA in support of the program. The Panel has repeatedly recommended that SSA undertake 

a national coordinated marketing and public education campaign in order to increase awareness of and interest in the Ticket program. Currently, beneficiaries are 

informed only once about the Ticket Program and they may not be informed at all 

about other TWWIIA provisions and work incentives. The only marketing material 

most beneficiaries receive on the Ticket Program is a letter describing the program 

when the Ticket is being rolled out, or when they first become eligible for benefits. 

The Panel is pleased that SSA has awarded a contract for the design of a strategic 

marketing plan for the program that will be completed this year. However, in the 

meantime, many ENs report having trouble finding people willing to assign their 

Tickets and many beneficiaries and local advocates remain completely in the dark 

about the Ticket program and the other work incentives. Although these SSA contracting efforts are very positive steps, the Panel is concerned that the next year 

or two will be devoted to planning marketing efforts rather than actual marketing 

of the Ticket Program. Extensive planning activities may delay implementation of 

a national marketing plan even further. The Panel believes it is reasonable to expect that marketing would occur prior to, or during, the rollout of a new program, 

not after. 

The Panel urges SSA to move forward quickly with other marketing activities, 

such as sending reminder letters to all people who have received but not yet used 

their ticket. 

Concern Three: Training 

The final area that is of most concern to the Panel is the insufficient training SSA 

field staff receive about work incentives and the Ticket Program. The Panel has 

heard in public testimony across the country, stories of beneficiaries who have received inaccurate information about work incentives from SSA staff in the field office. Receiving bad information can cause a person not to make a job attempt, to 

receive an overpayment, or to be forced to stop working. It also increases mistrust 

and fear. This situation is unacceptable to the Panel and Americans with disabilities. Every SSA field office should have accessible and available staff that possess 

64 

a thorough understanding of the work incentives and be able to provide accurate 

basic information to SSA beneficiaries with disabilities who want to work. 

On that note, the Panel wants to again recognize the very positive step the Agency took in the creation of the AWIC position as part of their internal corps of work 

incentive experts. This represents the best type of customer service. The AWICs received good basic training (two full weeks) and many of them were former Employment Support Representatives (with six weeks of training). AWICS are reported to 

be very knowledgeable and highly regarded in the field and by beneficiaries. 

There are not nearly enough AWICs to be available to answer every question 

beneficiaries have but the training that AWICs have received on SSA work incentives and the Ticket Program is exemplary. SSA cannot, however, rely on AWICs 

to provide all information and advice to beneficiaries on work incentives and the 

Ticket Program. SSA created a filter down, train the trainer approach to build their 

corps of internal work incentive specialists. AWIC’s train Work Incentives Liaisons 

(or WILs), the people who provide information on work incentives on top of their 

regular duties in the field office. WILs receive their limited training from the 

AWICs and then are expected to train the remainder of the field office staff. SSA 

work incentives and their interaction with the Ticket Program are very complicated 

and technical topics. The problem with SSA’s current strategy is that the necessary 

knowledge does not seem to filter down to the claims representatives and service 

representatives who are answering beneficiary questions about work incentives on 

a day-to-day basis. We trust that SSA will make more intensive training, along the 

lines of what AWICs receive, available to all SSA field staff. 

Conclusion 

The Panel believes the Ticket Program has great potential to help many people 

with disabilities improve their lives by going to work. This statement outlines a 

number of concerns the Panel has about SSA’s administration of the Ticket Program. While it is still early in the implementation process of this new program, the 

failure of SSA to take steps immediately to address these concerns may have a dire 

effect on the success of the program. 

The Crisis in EN Participation: A Blueprint for Action (February 2004) 

Executive Summary 

Thousands of people with disabilities and their advocates shared a dream that the 

Ticket to Work and Work Incentives Improvement Act of 1999 (the Act) would greatly expand employment opportunities for people on the Social Security Administration (SSA) disability rolls. Three years after enactment of the law, it is clear that 

their dream is faltering. The Ticket to Work and Self-Sufficiency Program (Ticket 

Program) is failing to recruit the anticipated numbers of new employment service 

providers, called Employment Networks (ENs). In addition, those enrolled as ENs 

are serving only a fraction of the beneficiaries thought to be interested in participating in the Ticket Program. Nearly 1,000 providers have enrolled in the program, 

but only about one-third of those operating have accepted any tickets. The Panel believes that without immediate attention to the very real problems affecting EN participation, the Ticket Program will fail. The Panel urges Congress and the Commissioner to act quickly on the following recommendations. 

Issues and Recommendations 

Ticket Program as a Supplemental Funding Source—ENs are uncertain about 

whether and how they can use funds from other public sources to serve ticket 

holders and have chosen not to actively participate in the Ticket Program because of fear of losing other stable funding sources. 

Recommendations 

• Congress should develop statutory language that clearly articulates its original 

intent that the Ticket Program’s outcome and milestone payments should provide additional resources to assist beneficiaries in attaining and retaining employment. In general, the Panel believes that Congress did not intend to make 

beneficiaries ineligible for the full range of services from vocational rehabilitation (VR) programs, Medicaid, or other Federal and State programs by making 

them eligible for the Ticket Program. 

• Congress should direct the Commissioner to implement the Ticket Program as 

a complement to the traditional SSA VR Reimbursement Program, paying State 

VR agencies for up-front services and paying ENs for long-term employment 

outcomes. 

• As part of the mandated evaluation of the Ticket Program, the Commissioner 

should conduct an assessment of the Ticket Program and the SSA VR ReimVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00068 Fmt 6633 Sfmt 6621 E:\HR\OC\23796.XXX 23796
65 

bursement Program, running in combination, to determine whether that approach produces better long-term, cost-effective outcomes than the historical VR 

Reimbursement Program alone, and to ensure the financial viability of running 

the two programs in combination. 

The EN Payment System—Two problems in the EN payment system discourage the 

active participation of many providers: (1) the payment system places too much 

financial risk on ENs and (2) the payment system provides significantly lower 

reimbursements to ENs for serving Supplemental Security Income (SSI) recipients than for serving Social Security Disability Income (SSDI) beneficiaries. 

Recommendations 

• The Commissioner should immediately modify the EN payment system to move 

more of the payment into the first 12 months of employment and reduce the 

difference between the milestone and outcome payments. 

• The Commissioner should test two or three creative approaches that place more 

up-front financial risk on SSA but, if successful, could significantly increase 

Ticket Program participation by both ENs and beneficiaries, thereby increasing 

long-term savings to SSA. 

• Congress should amend the statute to permit payments to ENs to be set at a 

level greater than 40 percent of average benefits for both SSDI and SSI beneficiaries and after the statutory change the Commissioner should implement an 

increase in EN payments for beneficiaries of both programs. 

• Congress should amend the statute to permit the Ticket Program to increase 

the sum of payments available for serving SSI recipients to a level equal to the 

sum of payments available for serving SSDI beneficiaries. 

• The changes to the EN payment system should be implemented as quickly as 

possible. 

Adequacy of Provider Incentives—Because little is known about outcome payments for providers, the Act authorizes the Commissioner to review, refine, and 

alter the payment system to ensure that it provides adequate incentives for ENs 

to serve beneficiaries and produce savings to the program. Despite major problems with the payment model, no alterations have been made to the original program payment system. The Commissioner has established an advisory group on 

Adequacy of Incentives (AOI) to assist SSA with the design of a workable payment system, including financial incentives to serve four groups of beneficiaries 

with special needs that were referenced in the Act. 

Recommendations 

• The Commissioner should implement a modified EN payment system that generally incorporates the principles outlined in the AOI Advisory Group’s interim 

report. (The Panel supports the principles in the report but has not endorsed 

a specific model.) 

• For any new payment system to be successful, the Commissioner must first implement the Panel’s recommendations relating to the EN payment system and 

EN claims administration. 

• The Commissioner and Congress should make clear in statute and in program 

regulations that payments to ENs must supplement funding from other public 

programs (such as State VR, Mental Health, Medicaid, Housing and Urban Development, Department of Labor) and should not pay for services for which 

beneficiaries are already eligible. 

EN Payment Claims Administration—Two factors compound the financial risk 

and working capital problems of Employment Networks: (1) long-term tracking 

of beneficiary earnings is labor intensive and administratively burdensome for 

ENs and (2) there are often long delays in processing EN claims for payment. 

Recommendations 

• Once a beneficiary has been certified as employed above the substantial gainful 

activity (SGA) level or leaves cash benefit status, the Commissioner should continue to pay the EN on a monthly basis as long as the beneficiary remains in 

zero benefit status and the EN has not yet received 60 months of outcome payments, or until the beneficiary requests a new EN. 

• The Commissioner should refine the EN payment claims processing system to 

ensure timely payments to ENs within businesslike timeframes. A widely accepted business standard for turnaround time on receivables is 30 days. 

66 

Marketing to ENs and to Beneficiaries—To date, there is no national marketing 

plan for the Ticket Program and the Program is not well understood by the vast 

majority of beneficiaries or by those who influence a beneficiary’s decision to attempt work. Further, ENs spend considerable time explaining the Program and 

dispelling misconceptions. Also, the lack of marketing contributes to the insufficient demand for EN services. However, SSA has recently awarded contracts to 

support development of a strategic marketing plan and EN marketing and recruitment efforts. The Panel has made numerous recommendations to the Commissioner on this issue in past reports. 

Recommendation 

The Commissioner should create opportunities for the Panel to (1) review the 

work plans and proposed activities under the strategic marketing plan contract and 

the project designed to improve EN participation and (2) engage in a dialogue with 

the contractors and relevant SSA staff so that the Panel can provide timely and substantive input on these marketing activities. 

EN Training and Communication—There is inadequate training, technical assistance (TA), and timely information available to ENs. Existing TA and training resources are inadequate, nonuniform, piecemeal, uncoordinated, and of 

varying quality, with no coordinated means for ENs to identify and share best 

practices. 

Recommendations 

• The Panel, in partnership with the Commissioner, should convene a meeting of 

key stakeholders to develop a national training and communications conference 

for all ENs. • The Commissioner should appoint a working committee to develop the plan for 

this training conference and to develop the overall strategy for bringing together a broad-based coalition of stakeholders to oversee and sponsor the event. 

Panel members should be active participants. 

American Indian VR Program Eligibility for the SSA VR Reimbursement 

Program—Despite having to meet the same service standards as State VR agencies, American Indian Vocational Rehabilitation (AIVR) programs operated by 

Tribal Nations programs are not exempt from the Ticket Program EN application process and are excluded from the traditional SSA Reimbursement Program 

for State VR agencies. 

Recommendation 

Congress should amend the statute to permit AIVR programs operating under section 121 of the Rehabilitation Act to participate in Ticket to Work in a manner 

equivalent to State VR agencies; that is, they should be exempt from the EN application process and be subject to the same reimbursement rules. 

f 

Mr. BRADY. Mr. Seifert? 

STATEMENT OF PAUL J. SEIFERT, SOCIAL SECURITY TASK 

FORCE, CONSORTIUM FOR CITIZENS WITH DISABILITIES 

Mr. SEIFERT. Thank you, Mr. Chairman. I am testifying today 

on behalf of the CCD and Work Incentives Task Forces. The CCD 

is a national organization representing over 100 disability organizations, membership organizations of people with disabilities, provider organizations, a good many people who are participating in 

the ticket program and a good many organizations providing those 

services as ENs. It was with a great deal of support from the disability community and, of course, bipartisan support from Congress 

that the ticket legislation passed in 1999. However, an array of factors, we believe, have kept the ticket program from meeting its full 

potential and we have four areas of concern that we would like to 

mention today. 

As previously mentioned, the reimbursement schedule for ENs is 

wholly inadequate, and is creating a major barrier to ENs who 

67 

want to participate in the program. There are issues between State 

VR agencies, ENs, and beneficiaries that have resulted in many potential ENs not participating in the program and beneficiaries unknowingly assigning their tickets to VR, overly burdensome reporting requirements on EN and State VR agencies in order to receive 

reimbursement, and as I think has been gone over in great detail, 

poor marketing to ENs in terms of recruitment and a lack of 

awareness about the ticket among SSA beneficiaries, not to mention the other work incentives. 

I want to talk about the reimbursement scheme, and just skip 

right to our proposals. First of all, we think Congress should eliminate the statutory requirement that the milestone outcome payment system pay less than the outcome payment only system. Congress should clarify that a partial reduction of benefits under the 

SSI Program for working SSI beneficiaries is, in fact, an outcome, 

deserving a payment to an EN, maybe not the full amount, but certainly that is something we want to reward and not penalize. 

Congress should shorten the period in which outcome payments 

are made and should raise the percentage of the average monthly 

benefit used to determine payments to ENs. Waiting 60 months for 

the full repayment is just too long for most small nonprofits to capitalize expenses over that period of time. Fourth, the SSA should 

increase the value of the milestone payments and allow the partial 

payment for some work that is under the SGA level. Again, we endorse the recommendations of the Employment Network Work 

Group that the panel put together and also the Adequacy of Incentives Work Group report which will be coming out shortly. 

The interplay between State VR agencies and beneficiaries and 

ENs is another area of concern to us and has been a concern ever 

since this legislation was developed. Quite frankly, we believe Congress needs to repeal the language that requires agreements between ENs and VR agencies. Second, we think that the legislative 

language should be enacted that prohibits VR agencies from collecting ticket payments from ENs who refer beneficiaries to State 

VR agencies. We think that Social Security ought to pay VR its cost 

reimbursement under its current situation, and keep the ticket intact so ENs can regain or at least get reimbursed for the payments 

and services that they provide over the 60-month period for which 

a beneficiary has deposited that ticket. 

The marketing issue is one that we discussed with Social Security in the early rollout of the ticket, and one that we had several 

concerns with. First of all, we were worried that the tickets would 

roll out before enough ENs were signed up, and part of the reason 

why so few tickets are being deposited or so many are being deposited with VR agencies is we rolled it out so fast that there aren’t 

enough ENs to potentially provide enough services to all the people 

who may want them. 

Number two, mailing the ticket to beneficiaries was probably not 

the best marketing device. Beneficiaries get essentially two things 

from Social Security, a check and bad news, and probably since this 

was not a check, at best it was probably kept in a drawer or on 

top of a dresser somewhere where it might be gotten later or forgotten. So, that was probably not the best technique. In addition, 

the cost of mailing out millions of these tickets was probably proVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00071 Fmt 6633 Sfmt 6602 E:\HR\OC\23796.XXX 23796
68 

hibitive and not the best use of the agency’s resources. We believe 

that use of the advocacy community to advertise the ticket as well 

as the other work incentives, the use of television and radio public 

service announcements would do a lot to promote the use of the 

ticket among beneficiaries, and a more aggressive strategy for signing up ENs plus a modification of the payment and reimbursement 

schedule will convince more smaller nonprofits to get involved in 

the program. 

It was touched on briefly by Mr. Hulshof, but the issue of overpayments is a staggeringly frightening phenomena for anyone who 

has ever experienced it and it has got to be dealt with. It not only 

affects ENs in the sense that when an overpayment is made, a payment to an EN is not being made when it should be, but perhaps 

most significantly, beneficiaries are stuck having to repay at times 

tens of thousands of dollars of benefits they were not supposed to 

get even when they have reported their earnings to Social Security 

in accordance with the statute. Worse than that, beneficiaries have 

to pay taxes on the overpayment that they get and they can’t pay 

it out of the benefits they get. So, we have imposed an additional 

tax burden on a working beneficiary for getting an overpayment 

they are not supposed to get. Now, they can always file for reimbursement in a later tax year, but do we really have to do this to 

people who are trying to work? 

In conclusion, we believe the ticket has a great deal of potential. 

We think these modifications will go a long way to help the ticket 

realize that potential. We applaud the agency for its rapid and extraordinary rollout and we hope that some adjustments are forthcoming. Thank you. 

[The prepared statement of Mr. Seifert follows:] 

Statement of Paul J. Seifert, Social Security Task Force, Consortium for 

Citizens with Disabilities 

Mr. Chairman, Mr. Matsui, members of the Subcommittee, my name is Paul J. 

Seifert. I am the Director of Government Affairs for the International Association 

of Psychosocial Rehabilitation Services (IAPSRS) and today I am testifying on behalf 

of the Consortium for Citizens With Disabilities (CCD) Work Incentives and Social 

Security Task Forces. CCD is a coalition of nearly 100 national organizations advocating on behalf of people with physical, mental, and sensory disabilities. On behalf 

of CCD I thank you for this hearing to examine the Social Security Administration’s 

management of the Ticket to Work program. 

With a great deal of support from the disability community and near unanimous, 

bi-partisan support in both the House and Senate, Congress enacted and President 

Clinton signed into law the Ticket to Work & Work Incentives Improvement Act 

(TWWIIA) in December 1999. This legislation was designed to expand the rehabilitation services and health care coverage for Social Security beneficiaries who want 

to go back to work. A key component of the TWWIIA legislation is the Ticket-toWork Program. 

There are high expectations in both the disability community and among members of Congress for the Ticket to Work program. And though those expectations 

have not been fully realized, a couple of key positive points should be mentioned. 

First, SSA should be recognized for their rapid regulatory development and rollout 

of the Ticket program. The first tickets were issued to beneficiaries a little over two 

years after passage of the legislation, and today just four years after the final regulations were approved, beneficiaries in every state, the District of Columbia and the 

territories are able get a Ticket to Work. This is an extraordinary accomplishment 

given that the Ticket to Work is a brand new program that required the creation 

of a new Office of Employment Support Programs within SSA and the hiring or reassignment of many SSA staff. 

Second, while much criticism has been leveled at the Ticket Program for its real 

or perceived failures the fact is, when compared to the old SSA Alternate Provider 

69 

(AP) Program, more people are using the Ticket and SSA is making payments to 

more Employment Networks for serving more beneficiaries than they did under the 

old AP program. The numbers speak for themselves. Under the AP Program only 

428 private agencies participated. Today 1,100 Employment Networks are participating in the Ticket. Under the old AP program only about 15 successful outcomes 

were achieved resulting less than $50,000 in payments to providers. As of March 

17, 2004, the Ticket has paid $583,000 in payments have been made to 160 ENs 

for serving 473 beneficiaries. 

However, the standard for success was not merely to do better than the AP program, but rather to significantly expand the array of employment services for people 

with disabilities and increase the resources available to provide those services. Unfortunately, an array of factors has kept the Ticket from reaching its full potential. 

Those factors are 1) a wholly inadequate EN reimbursement schedule that is keeping potential ENs from participating and keeping most of those who do participate 

from taking Tickets, 2) issues between State Vocational Rehabilitation Agencies and 

ENs and beneficiaries have resulted in many potential ENs deciding to not participate and has beneficiaries unknowingly assigning their Tickets to State VR, 3) overly burdensome reporting requirements on ENs seeking reimbursement, and 4) poor 

marketing to ENs and a lack of awareness about the Ticket among SSA beneficiaries. 

REIMBURSEMENT IS INADEQUATE 

Reimbursement under the Ticket to an EN occurs when a beneficiary who has assigned their Ticket goes to work and no longer receives cash benefits. Small milestone payments are available to the EN and paid when the beneficiary’s work effort 

reaches Substantial Gainful Activity for a certain period of months. The outcome 

payments are spread out over 60 months, payable for a month whenever the beneficiary is not receiving cash benefits. The payments are calculated as forty percent 

of the average monthly SSI and SSDI benefit. 

SSA’s payment methodology has several flaws. ENs who choose to receive milestone payments (all but a couple have chosen milestones) have their total payment 

cut by fifteen percent compared to the outcome-only payment scheme. No upfront 

funding means ENs must capitalize all the costs until the person is working above 

SGA and then completely off cash benefits and the milestone payments are too 

small to be attractive to ENs. The policy of requiring SSI beneficiaries to go completely off cash benefits ignores that many SSI beneficiaries who offset much of 

their SSI benefit through work generate much savings that ENs get no credit for 

under the current payment scheme developed by SSA. 

Participation by ENs will continue to be weak unless they can foresee a more reasonable level of payment made in a more timely fashion. 

We propose several improvements: 1) Congress should eliminate the statutory requirement that the milestone-outcome payment system pay less than the outcomeonly payment system, 2) Congress should clarify that a partial reduction of benefits 

under the SSI program is an ‘‘outcome’’ deserving of some reward to ENs, 3) Congress should shorten the period in which outcome payments are made and raise the 

percent of average monthly benefit used to determine payments to ENs, and 4) SSA 

should increase the value of the milestone payments and allow partial payment for 

some work that is under the SGA level. 

STATE VR AGENCIES, ENs and BENEFICIARIES 

The interplay between State VR agencies, ENs and beneficiaries was a concern 

from the day the first Ticket legislation was developed. State VR agencies have developed stand alone, take it or leave it, one size fits all agreements for ENs in their 

states. These agreements all contain one common provision—the full and total repayment of all of VR’s costs out of the ENs ticket payment by an EN who refers 

a beneficiary to VR. In two states we found the VR agency demanded a percentage 

of the ENs ticket reimbursement ABOVE the state VR agencies actual costs. In two 

other states the VR agency has required ENs to join the state VR agency’s ‘‘Employment Network.’’ It was hoped by advocates that the Ticket would supplement existing VR funds for employment services, not supplant those funds. 

In addition, in one state we found examples of state VR counselors who had failed 

to file the beneficiaries Ticket when the beneficiaries went to VR for services. As 

a result, the beneficiary was not eligible the Continuing Disability Review (CDR) 

protections Congress incorporated into the Ticket and the person was denied that 

protection. Fortunately the action taken by local Protection and Advocacy program 

was able to stop the CDR and restore the protection afforded under the Ticket. 

Finally, in an SSA document known as ‘‘Transmittal 17,’’ SSA has essentially allowed state VR agencies to involuntarily assign a beneficiary’s ticket apparently 

70 

without their knowledge or signed consent. Furthermore, we just discovered that the 

Florida state VR agency is going back through their case files and retroactively assigning the Tickets of every person who had received VR’s services after February 

2002 without notice to the beneficiary and regardless of whether the beneficiary had 

intended to assign that Ticket to VR or not. 

It is abundantly clear that, after more than two years of Ticket roll out, no resolution of the issues between state VR agencies and ENs and beneficiaries is in sight. 

Further, the Rehabilitation Services Administration (RSA) and SSA have been unable to resolve matters at the federal level. However, we want to also be clear that 

it would be unfair to vilify VR agencies. The Federal-State VR Program remains 

woefully under funded given its broad mission and the number of people who seek 

VR services. One example of the strain on the system is the number of cases VR 

counselors must handle. It is not uncommon for a state VR counselor to be assigned 

150 to 200 cases. This strain is unlikely to ease as state budgets tighten. Consequently, we hope the recommendations below will both make the Ticket more successful and help State VR agencies play a more significant part. 

We urge Congress to amend the Ticket program by eliminating the requirement 

that there be agreements between ENs and state VR agencies when the EN refers 

a beneficiary to VR. Congress should adopt language prohibiting state VR agencies 

from requiring ENs who refer clients to state VR from demanding repayment from 

the EN. Most significantly, a recommendation of the Adequacy of Incentives Work 

Group that was created under the TWWIIA law would allow cost reimbursement for 

state VR agencies separately from the Ticket program, and would thus keep intact 

the Ticket for the beneficiary’s use. 

EN REPORTING REQUIREMENTS and OVERPAYMENTS 

Payment under the Ticket program occurs when the beneficiary is no longer receiving benefits. Because SSA is unable to verify in a timely way the wages and 

income of working beneficiaries or former beneficiaries, SSA is requiring ENs to 

produce the beneficiary’s wage verification for each month the EN is requesting a 

payment. The EN payment request system leaves major difficulties for the vast majority of ENs. Those ENs who are using the Milestone/Outcomes payment system 

still must turn in copies of pay stubs until the beneficiaries reach zero cash benefit. 

This means that they may be faced with one to two years or more of collecting pay 

stubs. Current ENs and potential ENs need to know that a reliable system exists 

to provide payments for their successful efforts. 

In addition, because SSA does not stop checks to working beneficiaries in a timely 

fashion, many beneficiaries continue to receive benefits that SSA should have 

stopped, even when the beneficiary has reported their income to SSA. The few people who figure out this problem just put the money in the bank and wait for SSA 

to ask for it back, a request that may come years later. The vast majority of beneficiaries simply believe the money is theirs and spend it, then don’t have it when 

SSA demands repayment. Often times calls to SSA offices are of little help or the 

wrong information is given. These overpayments often go one for months and sometimes years and total tens of thousands of dollars. More astounding is the fact that 

beneficiaries must pay taxes on the overpayments they receive. An adjustment can 

be made in later tax years, but must we really put beneficiaries though this? 

Public Law 108–203, which President Bush recently signed on March 2nd, calls 

on SSA to issue ‘‘receipts’’ whenever a beneficiary reports earnings to SSA. This receipt may well help a beneficiary waive an overpayment, but it does not solve the 

tax problems facing beneficiaries or the payment issues facing ENs. Worse, overpayments reinforce the fears that many beneficiaries have about returning to work. 

We call on Congress to allocate resources to SSA to put an end to their inability 

to process earnings reports. With overpayments causing massive problems for beneficiaries and ENs, it is time to act decisively on this issue. 

PROMOTING THE TICKET and RECRUITING ENs 

SSA’s plan to mail Tickets to beneficiaries was viewed skeptically by advocates. 

The cost was high and we know that beneficiaries would be apt to ignore the mailings without knowing more about the work incentives, vocational services and employment options. Also, to date while the TWWIIA legislation has provided over seventy-five million to states to start their Medicaid Buy-in programs, all ENs received 

was a burdensome application form, a fight with their state VR agency, and a stingy 

reimbursement scheme. The wonder isn’t that too few ENs have signed up or that 

they are taking too few Tickets, the real wonder is that any signed up at all and 

that they take any Tickets. 

To do better SSA must make real changes in the program. SSA should make use 

of the networks of advocacy groups and PSAs on radio and TV to advertise the TickVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00074 Fmt 6633 Sfmt 6621 E:\HR\OC\23796.XXX 23796
71 

et to beneficiaries and non-traditional potential ENs. Most of all, more must be done 

to explain the Ticket and the work incentives to beneficiaries. Early results show 

that the Benefits Planning Outreach and Assistance program, as well as the Protection and Advocacy program, are a success. It is time for Congress to dramatically 

increase funding for these effective programs. Finally, Congress unintentionally excluded Vocational Rehabilitation Programs for American Indians from participating 

in the Ticket program. 

Disabled Adult Child Benefits 

KWe want to thank this Subcommittee and Congress for resolving a problem in 

the way the Title II work incentives, including the Ticket program, affect people 

who receive Disabled Adult Child (DAC) benefits. P.L. 108–203, has a provision to 

extend indefinitely the time-frame for a DAC beneficiary to re-enter the Title II program with DAC benefits if the individual is still disabled and the termination was 

due to work over the SGA level. When this provision becomes effective in October 

2004, people receiving DAC benefits will no longer be faced with the potential permanent loss of DAC benefits if they are at first successful in leaving the rolls due 

to work but later need to return to the Title II program. 

We urge the Subcommittee to consider addressing the situation of people who are 

on the SSI program who are likely to receive DAC benefits in the future when their 

parents retire, die, or become disabled. If the individual with disabilities earns income above the SGA level before applying for DAC benefits, access to DAC benefits 

may be permanently barred. This is a substantial work disincentive for people who 

are severely disabled during childhood and who may need the benefits earned for 

them by their parents. But for the fact that their parents have not yet retired, died, 

or become disabled, they stand in the same position as those for whom the provision 

was included in P.L. 108–203. We would be happy to work with the Subcommittee 

to explore possible solutions to this problem. 

There is one remaining work disincentive for people who qualify for DAC benefits 

that could be resolved through regulatory change. We understand that SSA’s interpretation regarding the value to be placed on a worker’s work effort (regarding 

whether it exceeds SGA or not) is different for people in supported employment depending upon whether the individual is supported directly by an employer or whether the individual is supported by services from an outside source, such as a statefunded supported employment agency. As a result, an individual’s work effort could 

be found to exceed SGA when the support is from a third party while that same 

work effort could be found not to exceed SGA when the support is from the employer. From the perspective of the individual, this is an arbitrary distinction. Further, there may be additional complications in that the nature and scope of the support provided to the individual may be misunderstood when making the valuation 

of work effort. For instance, while the individual may be performing the actual task 

(bagging groceries, assembling a package, etc.), it may be that the individual would 

be unable to perform the task without the help of the job coach in ensuring that 

the individual arrives at work on time properly attired, that he/she interacts appropriately with customers and co-workers, and that he/she remains focused on the assigned job tasks, among other things. We believe that this is an area that needs 

further examination if work incentives are to work as intended by TTWWIIA. We 

urge the Subcommittee to collaborate with SSA to ensure resolution of this problem. 

In conclusion, the Ticket program is full of potential, but that potential can only 

be realized with action by Congress and SSA to make the necessary changes. We 

knew that it would take time to shape this program into a successful effort and that 

changes large and small would be needed. We are on the right track but it is time 

make those changes as mentioned earlier. 

Again thank you Mr. Chairman, and members of the Committee, for the opportunity to testify on this important issue. 

f 

Mr. BRADY. Thanks for racing through that and giving us a lot 

of good information. Tom? 

STATEMENT OF TOM FORAN, VICE PRESIDENT, INTEGRATED 

DISABILITY RESOURCES, INC., BLOOMFIELD, CONNECTICUT 

Mr. FORAN. Thank you. I represent IDR. We are the EN that 

Ms. Hancock worked with. I would like to share with you some of 

our experiences with the ticket program to date which is a bit of 

72 

a good news/bad news scenario. Currently, we have about 162 active tickets from 30 different States. We are negotiating ticket assignments with an additional 400 beneficiaries. We have 65 people 

currently employed, 35 of them over SGA. We are on target to return an additional 120 beneficiaries back to work by the end of 

2004. We have received over 5,000 inquiries from beneficiaries interested in returning to work and we have invested over $1.3 million into the ticket to Work Program structure to allow us to handle a large number of beneficiaries. 

On the bad news side, we have earned about $50,000 in payments to date. We have only been paid about $22,000. We have 

several outstanding payments due from November of 2002. We 

spend in many instances as much in time and energy to collect our 

first payment as the first payment amount. Administrative drag 

can be mind-numbing at times. Due to the negative cash flow and 

the administrative burden that we experience on a day-to-day 

basis, we have had to turn away over 4,000 beneficiaries who wanted to return to work that we just could not afford to provide services to. 

Without some change in the payment structure and the administration of the program, we may be forced to shut down in the near 

future, at least for beneficiaries who our only source of revenue is 

from the Ticket to Work Program. However, given all that, we do 

think this program has tremendous potential. You heard this morning from individuals who have been served already. We are regularly serving folks. This is an exciting program. It really hurts my 

staff personally to have to turn people away. They get very, very 

upset with me when I tell them we can’t work with certain folks. 

We fully support the recommendations that were laid out in the 

Ticket to Work and Work Incentives Advisory Panel report, ‘‘The 

Crisis in EN Participation: A Blueprint for Action.’’ We would actually suggest taking the recommendations a step further by implementing the payment structure that was outlined from the Adequacy of Incentives Group in the interim report from September of 

2003, basically moving about 25 percent of the payments into the 

first year of service, which is when the majority of expenses are incurred. 

We feel the key to success of this program is really basically a 

demand and supply issue. The first piece, obviously, is creating demand amongst beneficiaries for return to work services, and Susan 

Webb will be talking a bit more about that. So, I am not going to 

touch on that right now. On the supply side, we currently have 

over 1,000 ENs. However, only about a third of them are actively 

taking tickets and I would like to know what the definition of actively taking tickets is. If it is one or two tickets, I would not call 

that being an active EN. 

Two critical issues that we have already heard today are, one, 

the amount and the duration of the negative cash flow that is created. As I said before, we have invested over $1.3 million and we 

have only earned about $50,000. If we shut down today and only 

served the people that we would be working with and they were 

successful in returning to work or remaining at work for the full 

60 months, we probably would be almost close to break even, but 

73 

trying to convince an investor to wait 60 months is a pretty hard 

thing to do. They get very impatient. 

The other issue is the lack of access to capital for ENs. Typically, 

an EN has no collateral to take to a bank and get a loan. Additionally, the risk is too great, the negative cash flow too high, and 

there is no history to the program to show demonstrated success 

to attract venture capital. Our suggestion would be, one, to adopt 

the changes in the payment structure. Two, create some type of 

loan guarantee program or tax credit program whereby investors 

who take the risk in this program are rewarded down the road 

with tax credits. 

There are many other improvements that can be made to this 

program. However, without addressing these two critical issues for 

ENs, which is really the supply side of the whole equation, addressing those issues is tantamount to fixing or setting an individual’s 

broken leg after an accident when they are actually in cardiac arrest. The ENs will not be here 6 months from now. I know I won’t 

be. I don’t think Susan Webb will be if some changes aren’t made 

soon. I think this would be a tremendous loss to the program, to 

have the experienced ENs who have already gone through the process drop out of the programs because they can no longer fund it. 

Some of the other suggestions we have are, again, increasing the 

administrative efficiency. Help Maximus change their focus from 

purely recruiting new ENs, that ultimately don’t become active, 

into the system, to making the existing ENs successful. I think 

that is a critical thing. Reducing the administrative drag, increasing the efficiencies, increasing the supports to them. Educating 

beneficiaries on the quality active status of ENs. Right now, a beneficiary gets a list of about 20 to 30 ENs that are serving their area 

with no idea whether those ENs are actually taking tickets or what 

their track record is. I don’t look at that as choice. I look at that 

as a bunch of phone calls that a beneficiary has to make and just 

get disappointed over and over again. 

So, in conclusion, if we can provide more information to the beneficiaries about what is out there and provide them with successful 

ENs, I think you will start seeing a significant amount of momentum being generated, and again, success always breeds success. 

Thank you very much. 

[The prepared statement of Mr. Foran follows:] 

Statement of Tom Foran, Vice President, Integrated Disability Resources, 

Inc., Bloomfield, Connecticut 

Thank you for the opportunity to provide testimony today. Integrated Disability 

Resources (IDR) is one of the largest national Employment Networks (EN). IDR’s 

experience with the Ticket to Work program to date is a good news/bad news story. 

The good news is, we: 

• Have 161 active tickets assigned from beneficiaries in 30 different states 

• Are negotiating ticket assignment with over 400 additional beneficiaries 

• Have returned 65 beneficiaries (40% of active tickets) to work with 35 of them 

already over SGA 

• Are on target to return an additional 120 beneficiaries to work by 12/31/2004 

• Have invested over $1,300,000 in the TTW program to date 

• Have received over 5,000 inquiries from beneficiaries interested in returning to 

work 

On the surface, this appears to be a very successful program. However, without 

some significant changes in the program’s design and administration we will be 

74 

forced to stop accepting tickets resulting from new inquiries, which of course is the 

bad news side of our story. Given our success rate in helping individuals return to 

work, this would also be bad news for the SSA. To date, we: 

• Have earned only $50,000 compared to the $1,300,000 investment mentioned 

above. Of this $50,000 

• $7,000 is on beneficiaries who will not provide us with their pay stubs • $21,000 has been received from Social Security • $20,000 is due from Social Security much of this has been outstanding for 

three to twelve months or longer (as of our last EN payment report from 

Maximus we have 2 open requests for payment that are with the SSA field 

office from November of 2002) • .Often have had to spend more money in staff wages to physically collect the 

first payment than the amount of the payment itself. • Have spent an enormous amount of time managing unrealistic beneficiary expectations (e.g. ‘‘buy me a $100,000 tractor trailer’’ or ‘‘pay for my college education’’) • Have experienced an incredible amount of ‘‘administrative drag’’ that requires 

us to spend valuable resources dealing with Maximus and or the SSA, instead 

of helping beneficiaries execute their individual work plans. We suggest implementing: 

• On-line access to information from Maximus for: 

• Status of a ticket regarding its ability to be assigned 

• Past history of a beneficiary’s ticket to determine if multiple ENs will 

need to share payments 

• Status of payment requests 

• Automated reimbursement processes 

• Currently, each EN must create its own billing and ticket tracking system instead of having Maximus maintain one online system. 

• Follow-ups with SSA field offices are sporadic and not automated 

• The milestone portion of the payment process still requires pay stubs 

as documentation. 

• Have had to ‘‘screen out’’ over 4,000 interested beneficiaries. Initially, we 

were willing to work with a much higher percentage of interested beneficiaries but have determined that due to capital restraints caused by the 

reimbursement structure and process, we need to limit the scope of our program. 

• Will soon have to stop working with beneficiaries for whom our only source 

of revenue is the Ticket to Work program. This represents about 90% of our 

active tickets. 

While our situation and current level of participation is tenuous, it is important 

to note that we feel with some relatively moderate changes, the TTW program can 

be a tremendous success for both the SSA and its beneficiaries. 

We strongly support the changes suggested in the Ticket to Work and Work Incentives Advisory Panel’s February, 2004, Advice Report to Congress and the Commissioner of the Social Security Administration The Crisis in EN Participation—A 

Blueprint for Action. In fact we recommend taking it one step further, and suggest 

adopting the payment system outlined in the Adequacy of Incentives (AOI) Advisory 

Group’s September, 2003 Interim Report. 

The AOI Advisory Group suggested moving a significantly greater portion of the 

TTW payments into the first 12 months and decreasing the threshold of success for 

milestone payments to a $600 earnings level. 

Modeling the AOI suggested payment structure revealed that our earned revenue 

to date would have been closer to $80,000. While this is still nowhere near our overall investment in the program, it dramatically reduces our negative cash flow on 

any one beneficiary allowing us to reinvest in serving more beneficiaries sooner. 

What follows is IDR’s perception of the issues diminishing the success of the program and our suggestions for change. It is our belief that the success of the Ticket 

to Work program comes down to its ability to create both demand and supply. 

Demand for return to work services must be created within the beneficiary population. Once created, there needs to be an adequate supply of return to work services from quality employment networks. 

Demand 

Experience has shown us that the mailing of tickets to beneficiaries creates a significant amount of interest and demand for return to work services. We regularly 

see a dramatic spike in inquiries for services from beneficiaries seven to fourteen 

days after each batch of ticket mailings. 

75 

For states in which the mailings are completed (phase one and two states) we see 

a drop in the volume of inquiries that correlates closely with the amount of time 

since the last mailing. 

Given the success of the mailings to date, we suggest regular re-mailings to beneficiaries encouraging them to consider returning to work. These mailings could be 

as simple as a postcard including success stories and reminding them of the incentives in place to help them in the return to work process. 

For EN’s that are limited to serving phase one and two states, the time to execute 

these re-mailings is now. Without them, the few successful ‘‘local’’ EN’s may go out 

of business. 

Supply 

While the demand for return to work services appears to be relatively easy to create, the supply is critically low. In general, beneficiaries tend to identify the list of 

EN’s serving their area and begin contacting EN’s at the top of the list (typically 

an alphabetical listing) to see what is available. 

IDR is typically mid-way through an alphabetical listing of 30 to 50 EN’s serving 

a beneficiary’s area. By the time they get to us, 75% of the beneficiaries are completely frustrated by the process. With 2/3 of EN’s listed not actively taking tickets, 

a beneficiary has typically received no response from 12 to 30 EN’s before reaching 

IDR! 

Supply Issues 

The overwhelming issues driving EN’s to either stop or never begin serving beneficiaries are: 

• The negative cash flow created by the current program design; and • The lack of access to working capital. 

Most EN’s do not have the collateral to qualify for a loan and the payback time, 

lack of historical results and overall risks are too great to attack venture capital. 

The Solution 

To ensure an adequate and effective supply of return to work services for motivated beneficiaries the negative cash flow and overall risk to EN’s needs to be dramatically reduced, while increasing access to working capital. Implementing the 

AOI Advisory Group’s suggested payment structure, or something similar, will go 

along way in reducing the negative cash flow issue. 

Access to capital can be accomplished through the use of loan guarantees and or 

tax credits for qualified investments in the TTW program. For example, the State 

of Connecticut has a program in place that provides a dollar for dollar tax credit 

to investors that invest in new businesses that create insurance jobs within the 

state. 

Other Suggested Improvements 

• Providing more information and/or education to beneficiaries would facilitate 

greater participation in the program and help improve its overall effectiveness. 

Areas of concern are: 

• Each EN’s status in regard to its ability to accept new tickets and its track 

record in serving beneficiaries • What a beneficiary can expect from an EN • Clarity regarding the types of return to work services to expect from and 

EN. We have found that many individuals request unrealistic programs, 

such as funding a four-year college education or the purchase of a $100,000 

tractor-trailer, and feel that managing expectations would improve the success of the program and save time on the part of the EN. • Change Maximus’ focus from recruiting more EN’s to making the existing EN’s 

more successful, which will in turn make recruiting EN’s easier. Areas to consider are: 

• Improve the administrative efficiency of the program with more on-line reports and processes • Provide training by successful EN’s to inactive EN’s improving their likelihood of success • Establish and support regional EN associations to foster communication 

and the sharing of best practices • Congress should set a clearly defined target for reducing the Social Security 

roles and identify the entities that are accountable for attaining this goal. We 

suggest setting the goal for job placements at a minimum range of 5 to 10% 

of the current beneficiary population with incentives in place for success above 

this level. 

76 

Thank you again for the opportunity to testify today. 

f 

Mr. BRADY. Thank you, sir. Quintin, welcome. The microphone 

is yours, sir. 

STATEMENT OF QUINTIN M. MITCHELL, DIRECTOR, VR 

SERVICES, RICHMOND AREA ARC, RICHMOND, VIRGINIA 

Mr. MITCHELL. Thank you. I am Quintin Mitchell. Thank you 

for the opportunity, Mr. Chairman. I am Director of Rehabilitation 

Services for Richmond Area ARC in Richmond, Virginia. Our agency became a—upon reviewing the Ticket to Work incentive, one of 

the motivating factors of ARC to become an EN was having the opportunity to provide employment services to individuals who want 

to work and become self-sufficient, additionally, provide a non-traditional referral base to ticket holders or individuals who have the 

appropriate skill set to filing the positions we have open and other 

jobs in the community. 

Our agency has traditionally serviced the Mentally Retarded population. However, other areas of service provision includes individuals with diagnoses of mental illness, autism, developmental delay, 

brain trauma, and individuals with physical disability. Our agency’s NISH contracts have provided the opportunity to service a vast 

array of individuals. Individuals’ backgrounds include undergraduate and graduate degrees as well as persons who are Ph.D. 

candidates. When positions become available within our organization, individual ticket holders are encouraged to apply when their 

skill set matches the advertised position. 

Since ticket participants don’t have to use their tickets, we have 

found that those who elected to do so really have the incentive to 

work because they aren’t forced to. There are many participants 

who want to get off the benefit rolls and this desire benefits not 

only participants, but also other sources, as well. Employees who 

are in need of skilled, reliable employees, ENs who have the resources to provide employment and other related services, and the 

reduction of benefits being paid out by SSA are all win-win situations. 

Richmond ARC’s initial experience with the Ticket to Work Program was that of being bombarded by ticket holders wanting employment services. We began providing services in March of 2003. 

To date, we have screened over 340 calls from individuals who 

wanted us to provide employment services. While this may not be 

an astronomical number by comparison with other ENs, however, 

in Virginia, we have billed for the most milestones, which is 15, 

which Tina Chang, Financial Director for Maximus, provided me 

with the information the day before yesterday. 

We have accepted and have been assigned so far, 90 ticket holders. Holding orientation twice per month at two locations has resulted in meeting the needs of individuals who don’t have the 

means to come to our facility. As of this date, the need to conduct 

intakes more frequently has resulted in weekly one-on-one consultations as well as screenings. In order to meet the various needs 

of the ticket holders, we have elected to implement features in the 

orientation to expedite the process. Initially, as tickets began to roll 

77 

out in Virginia, calls jammed the switchboard. Now all inquiries 

are routed either to the employment specialist or me with an extension just for ticket holders. ARC makes it a policy to return calls 

promptly. 

Additionally, recruitment is not limited to just call ins. We also 

are viewing the monthly disk of ticket holders that Maximus supplies and send letters of introduction to a random sampling of the 

unassigned ticket holders, specifying what services we provide and 

inviting them to an orientation. Employment specialists also post 

flyers at the local SSA office or to the Metro Richmond networking 

meeting, participates in focus groups and job fairs, and have been 

fortunate enough to be the recipient of marketing expertise by the 

leadership of Metro Richmond organization. Additionally, an advertisement is placed in the Employment Guide publication by our 

agency at our expense. 

It should also be noted that no additional staff was hired in order 

to meet the undertaking. Even though no additional staff was 

hired, the ARC still meets the presenting needs of all inquiries and 

works toward effectively and efficiently addressing areas of concern 

that most have about their benefits and how they may be affected. 

Maximus has provided much support and endless help in maneuvering through the maze of red tape we have encountered in many 

instances. 

While there are many positives in the Ticket to Work and SelfSufficiency Program, there are also obstacles that impede and deter 

ticket holders from participating in this program. Unfortunately, 

some ticket holders have elected, after having gone through the 

screening, the interviewing, counseling, placement on the job, to 

leave their jobs in some cases, decide against being employed at all 

because of the lack of critical information having been provided to 

them by SSA. 

It has been our experience that most ticket holders are unaware 

of the most basic information concerning their benefits and how 

they can be affected and/or knowledge of work incentives. This information now has become part of our orientation process when we 

meet with the ticket holder. 

Some of the problems that impede and interrupt the provisions 

of services for our agency to the ticket holders revolve around the 

lack of information provided to them by the SSA. A few examples 

that we have encountered and continue to encounter are SSA has 

provided inaccurate and sometimes inconsistent information to the 

ticket holders. An example is a ticket holder was told that there 

was an application for the 1619(b) by an SSA individual but they 

couldn’t find it, while another person told the ticket holder there 

was no such application. 

Inconsistency of providing EN payment processing report so as 

not to know the status of receiving payment for services already 

rendered. ticket holders who have been working before contracting 

services with our agency have not been informed that they were required to turn in their pay stubs. This lack of information causes 

the individual to be in overpayment and the EN doesn’t receive 

payment. Not notifying beneficiaries that they are not eligible for 

benefits, but a check is still mailed and/or deposited in the beneficiary in overpayment. The lack of advertising or marketing in the 

78 

SSA office about the Ticket to Work Program. Our agency has 

taken initiatives to go down to the SSA buildings and place flyers 

and posters at our own expense. 

The Ticket to Work Self-Sufficiency Program is a viable entity to 

beneficiaries who want to work. However, identifying and rectifying 

the problems that impede a successful placement of individuals in 

jobs has to be addressed. The potential for other agencies becoming 

an EN is sometimes thwarted by the lack of manpower, resources, 

and investment coupled with the slow turnaround time and being 

paid for the services that they provide. Having had the opportunity 

to provide services to wide range of individuals who have the desire 

and initiative to be gainfully employed and the continuation of inquiries regarding our employment services are all indicators that 

the ticket program can be a success. In order to facilitate this success, it is absolutely essential that all stakeholders work collaboratively and consistently. 

In closing, I thank you for this opportunity to share our agency’s 

experiences with the Ticket to Work Self-Sufficiency Program. It is 

my hope that after identifying these areas of concerns that impact 

the ticket holder in an adverse manner, we can move forward toward a resolution. 

[The statement of Mr. Mitchell follows:] 

Statement of Quintin M. Mitchell, Director, Vocational Rehabilitation 

Services, Richmond Area Arc, Richmond, Virginia 

Mr. Chairman, Members of the Committee, my name is Quintin M. Mitchell and 

I am Director of Rehabilitative Services for the Richmond Area Arc in Richmond, 

Virginia. Thank you for the invitation for me to comment on Social Security Administration’s management of the Ticket to Work and Self-Sufficiency Program. 

I would like to take a brief moment to provide some background information on 

how our agency elected to become a participating Employment Network (EN). 

Upon reviewing the Ticket to Work initiative, one of the motivating factors of 

Richmond Area Arc to become an EN was having an opportunity to provide Employment Services to individuals who want to work and become self-sufficient. Additionally, it provides a non-traditional referral base and the Ticket-holders are individuals who have the appropriate skill set for filling positions that we have open, and 

other jobs in the community. Our agency has traditionally serviced the M.R. population. However, other areas of service provision includes individuals with diagnosis 

of M.I., autism, developmentally delayed, brain trauma and individuals with physical disabilities. 

Our agency’s NISH contracts have provided the opportunity to service a vast 

array of individuals. Individual’s backgrounds include undergraduate and graduate 

degreed persons as well as Phd. Graduates. 

When positions become available within our organization individual Ticket-holders are encouraged to apply when their skill set matches the advertised position. 

Since Ticket participants don’t have to use their Ticket we have found that those 

who have elected to do so really have the incentive to work because they aren’t 

forced to. There are many participants who want to get off the benefit rolls and this 

desire benefits not only the participants but other sources as well. Employers who 

are in need of skilled, reliable employees, ENs who have the resources to provide 

Employment and other related services and the reduction of benefits being paid out 

by the Social Security Administration (SSA) are all win-win situations. 

Richmond Area Arc’s initial experience with the Ticket to Work Program was that 

of being bombarded by Ticket-holders wanting Employment Services. We began providing services in March of 2003. To date we have screened over three (340) hundred forty calls from individuals wanting us to provide Employment Services. While 

this may not be seen as an astronomical number by comparison with other ENs, 

however, in Virginia, we have billed for the most Milestones, fifteen (15). (Tina 

Chang, Financial Director for Maximus). We have accepted and have been assigned, 

so far, ninety (90) Ticket-holders. Holding Orientation twice per month at two (2) 

locations has resulted in meeting the needs of individuals who do not have the 

79 

means to come to our facility. As of this date the need to conduct Intakes more frequently has resulted in weekly one-on-one consultations/screenings. 

In order to meet the various needs of the Ticket-holders we have elected to implement features in the orientation to expedite the process. Initially, as Tickets began 

to rollout in Virginia, calls jammed the switchboards. Now all inquiries are routed 

either to the Employment Specialist or me with an extension just for Ticket-holders. 

ARC makes it a policy to return all calls promptly. Additionally, recruitment is not 

limited to call-ins of inquiries. We also, after viewing of the monthly disk of Ticketholders, that Maximus supplies, sends letters of introduction to a random sampling 

of the unassigned Ticket-holders, specifying what services we provide and inviting 

them to an orientation. Employment Specialists also post flyers at the local SSA office, attend the Metro Richmond networking meetings, participates in focus groups 

and job fairs and have been the fortunate recipient of marketing expertise by the 

Leadership Metro Richmond organization. Additionally, an advertisement is placed 

in the Employment Guide publication. 

It should also be noted that no additional staff was hired in order to meet this 

undertaking. Even though no additional staff was hired, the ARC still meets the 

presenting needs of all inquiries and works towards effectively and efficiently addressing areas of concerns that most have about their benefits and how they will 

be affected. 

Maximus has provided much support and endless help in maneuvering through 

the maze of red tape we have encountered in many instances. 

While there are many positives in the Ticket to Work and Self Sufficiency Program there are also obstacles that impede and deter Ticket-holders from participating in the program. Unfortunately, some Ticket-holders have elected, after having gone through screening, interviewing, counseling and placement on the job, to 

leave their jobs and in some cases, decide against being employed at all because of 

the lack of critical information having been provided to them by S.S.A. 

It has been our experience that most Ticket holders are unaware of the most basic 

information concerning their benefits and how they can be affected and/or knowledge of Work Incentives. This information, now, has become a part of the orientation process when we meet with the Ticket-holder. 

Some of the problems that impede and interrupt the provision of services, for our 

agency, to Ticket-holders, revolve around the lack of information provided to them 

by the Social Security Administration. A few examples that we have encountered, 

and continue to encounter are: 

1. S.S.A. has provided inaccurate and sometimes inconsistent information to Ticket-holders. Ex.: Ticket-holder was told there was an application for 1619b by 

S.S.A. but they couldn’t find it while another person told the Ticket-holder 

there was no application. 

2. Inconsistency of providing EN Payment Processing Report so as not to know 

the status of receiving payment for services rendered. 

3. Ticket-holders, who have been working before contracting services with our 

agency, have not been informed that they were required to turn in their pay 

stubs. This lack of information causes the individual to be in overpayment and 

the EN doesn’t receive payment. 

4. Not notifying beneficiary that they are not eligible for benefits, but check is 

mailed/deposited and beneficiary is in overpayment. 

5. The lack of advertisement/marketing in the S.S.A. office building about the 

Ticket to Work Program. 

The Ticket to Work Self Sufficiency Program is a viable entity to beneficiaries who 

want to work. However, identifying and rectifying the problems that impede the successful placement of individuals in jobs has to be addressed. 

The potential for other agencies becoming an E.N. is sometimes thwarted by the 

lack of manpower, resources, and investment coupled with the slow turnaround time 

of being paid for the services they provided. 

Having had the opportunity to provide services to a wide range of individuals, 

who have the desire and initiative to be gainfully employed, and the continuation 

of inquiries regarding our Employment Services are all indicators that the Ticket 

Program can be a success. In order to facilitate this success it is absolutely essential 

that all stakeholders work collaboratively and consistently. 

In closing, I thank you for this opportunity to share our agency’s experiences with 

the Ticket to Work Self Sufficiency Program. It is my hope that after identifying 

80 

areas of concerns, that impact the Ticket-holder in an adverse manner, we can move 

towards resolution. 

Ticket to Work can be a beneficiary’s best option. 

f 

Mr. HAYWORTH [presiding]. Thank you, Mr. Mitchell, for your 

testimony from someone from Virginia. I turn to a fellow Arizonan, 

Susan Webb. Welcome. 

STATEMENT OF SUSAN WEBB, ARIZONA EMPLOYMENT 

NETWORK ASSOCIATION, PHOENIX, ARIZONA 

Ms. WEBB. Mr. Chairman from the great State of Arizona, it is 

always good to see you. My name is Susan Webb and I am the Director of Arizona Bridge to Independent Living (ABIL) Employment 

Services in Phoenix, Arizona, and I am here today on behalf of the 

Arizona EN Association. I want to thank you for the opportunity 

to testify today on behalf of the association. In general, our association agrees with the outcomes and recommendations of the EN 

Summit that was sponsored last May by the Ticket to Work Advisory Panel. We believe that several issues that were identified during that summit contribute to the current lack of participation 

among ENs nationwide. 

Those issues are, first, high capitalization costs and risks; second, inadequate payment structure and pay stub processing burdens; third, the need for comprehensive training and technical assistance for EN staff; and fourth, the need for a national marketing 

campaign conducted by SSA to motivate beneficiaries to contact 

ENs about the program. We believe that all of these issues are 

equally important and their solutions must be implemented concurrently for the ticket program to sustain itself and achieve the goals 

that you, Mr. Chairman, were very, very adamant about when this 

legislation first passed. However, my testimony today is designed 

to focus solely on the marketing issues. 

I, however, would remind you, as some of my colleagues have 

been testifying, I feel the need to say that some of the information 

that has come forward, for example, there has been $523,000 paid 

out in payments to ENs nationally, there are 1,100 existing ENs. 

We understand about a third are accepting tickets in some form. 

I want to make the point that our little agency, 1 EN out of 1,100, 

has received $71,000 of that $523,000 and we have about another 

$20,000 pending. For one EN to be representing that much of the 

outcome is very disturbing. There is something wrong. Even though 

I feel very fortunate to be here to give my opinion, I think that 

somehow we are in the trenches here and I think we need to be 

heard in terms of what we are saying about these four major areas, 

and they need to be solved concurrently and right now. So, I just 

wanted to make that point very strongly. 

Arizona is one of the first 13 States to implement the Ticket to 

Work Program. It is now more than 2 years since the tickets were 

first distributed in our State. I would disagree with some of the 

comments made about—I think Martin Gerry may have made this 

comment, actually. During the initial phases of the ticket rollout, 

there were approximately 27 ENs signed up in our State. Today, 

81 

there are only a handful left that are accepting tickets. I talked to 

one of my colleagues in Tucson just before coming here and he told 

me he accepted one ticket last month. Is that an active EN out of 

the handful? That is certainly not going to get those 150,000 ticket 

holders in Arizona off the rolls and back to work. 

We believe the reasons for this statewide rescission are several. 

However, many have simply stopped taking tickets due to the lack 

of sufficient demand by beneficiaries to justify maintaining the 

qualified staff they need to do this work. Since the initial ticket 

mailing, beneficiary inquiries to ENs have dropped to just a trickle. 

They are just not even on the radar screen with this anymore. 

I guess this is where I probably want to take issue with Martin 

Gerry, and that is that we are seeing in the trenches, honest-togoodness ENs out there doing this work. As a Center for Independent Living, our center since 1981 has served primarily people 

with significant disabilities. Those are not the people coming forward in the ticket program. It is the people that have job skills and 

experience and much to offer an employer. They are coming forward. They are not the ones that go to organizations like ours. 

They don’t go to disability-related stuff. They don’t hang out at the 

field offices, as I believe one of the—in fact, I believe it was Clay 

Shaw who said that, in fact, these people are sitting in their living 

rooms and that is where we need to get to them, hence the reason 

for my testimony today. 

The members of our EN association recognized this problem 

more than a year ago and we decided to pool our resources to market the program. We began by making cold calls from the compact 

disk we receive monthly from Maximus. Unfortunately, this yielded 

very, very little return on our investment. Beneficiaries refused to 

talk to us because they thought we were telemarketers and they 

wanted us to take them off our call list. Then, those who did talk 

to us were totally unfamiliar with the program and required an average of 15 minutes per call, which is very, very expensive for any 

EN to be able to undertake that kind of activity. Even though there 

is benefit to that, it is not a solid return on investment because 

very few of those people end up being actual ticket users. 

We then decided to approach the SSA about a piggyback approach. We knew that the SSA was going to be doing something 

and we were very, very pleased that they were very willing to work 

with us and to talk with us, and we have been doing that systematically. As a result of those teleconferences we have had, we conducted some focus groups and I would have to again disagree with 

my colleague, Paul Seifert, that, in fact, from the focus group what 

came out loudly and clearly was that if they get a letter from the 

SSA, they do read it, even if it is only because they fear bad news. 

So, our association recommends the following: that the SSA be 

allocated the resources to send reminder letters or postcards about 

the Ticket to Work Program at least once annually and to stagger 

those in one-twelfths, so, that it doesn’t create this up front demand and then nothing toward the end of the year. 

Second, we believe the notices should direct ticket holders to contact their local BPA&O Program and should be specific about that 

BPA&O Program in their area. The reason for that is because our 

local BPA&Os contact which ENs are currently accepting tickets 

82 

and so that beneficiaries are not forced to call from a long list of 

ENs just to be told, ‘‘I am sorry, we are not participating anymore.’’ 

Thirdly, we believe that the SSA should begin distributing the interim reminders to beneficiaries in the year one rollout States no 

later than June this year. Year two States could begin in June of 

next year, and year three States in 2006 if SSA hasn’t begun a national campaign by that time. 

I want to make one final comment, and that is that we have read 

the statement of work for the 2-year marketing contract to 

Fleischman-Hillard. We believe it is excellent. The problem is, 2 

years will mean 3 and a half years into this program and we will 

only have a pilot done by then. We will be dead in the water. We 

will not be an EN by that time without something done in the interim. 

Although I applaud the response from the SSA, I applaud the 

statement of work in that contract, we are a rollout State in year 

one; and last month, I received 24 inquiries from 150,000 tickets, 

and we are the number one EN in the country. Something has got 

to be done, and I encourage SSA and this body to work together 

to find the money to do that. Thank you, Mr. Chairman. 

[The prepared statement of Ms. Webb follows:] 

Statement of Susan Webb, Arizona Employment Network Association, 

Phoenix, Arizona 

Thank you for the opportunity to provide testimony on behalf of the Arizona Employment Network (EN) Association. In general, our association agrees with the outcomes and recommendations of the Employment Network Summit sponsored last 

May by the TWWIIA Advisory Panel. We believe that several issues identified during that Summit contribute to the current lack of participation by ENs nationwide. 

Those issues are 1) high capitalization costs and risks; 2) inadequate payment structure and pay stub processing burdens; 3) the need for comprehensive training and 

technical assistance for EN staff; 4) the need for a national marketing campaign 

conducted by SSA to motivate beneficiaries to contact ENs about the Ticket to Work 

Program. 

We believe all of these issues are equally important and their solutions must be 

implemented concurrently for the TTW Program to sustain itself and achieve the 

goals Congress intended when it overwhelmingly passed the TWWIIA legislation. 

However, my testimony today will focus solely on the marketing issues. 

Arizona is one of the first 13 states to implement the TTW Program. It is now 

more than two years since tickets were first distributed in our state. During the initial phases of ticket rollout there were approximately 27 ENs on the approved list. 

Today there are only a handful left who are accepting tickets. There is only one ENs 

in the Tucson metropolitan area accepting only a small number of tickets any 

longer. Tucson is the second largest metro area in our state with more than 850,000 

residents and 16% of our state’s population. We believe the reasons for this statewide rescission are several; however, many have stopped taking tickets due to the 

lack of sufficient demand by beneficiaries to justify maintaining the necessary qualified staff to do so. Since the initial ticket mailing beneficiary inquiries to ENs have 

dwindled to a trickle. 

The members of our EN Association recognized this problem more than a year 

ago. We decided to pool our resources to market the program. We began by making 

cold calls from the CD we receive monthly from MAXIMUS. Unfortunately, this 

yielded very little return on our investment. Beneficiaries refused to talk to us and 

asked us to take them off our ‘‘call lists’’ as they thought we were telemarketers. 

Those who did talk with us were not familiar with the ticket program and required 

an average of 15 minutes per call. While there is value in such calling as it certainly 

gives beneficiaries good information, it does not result in solid return on investment 

for the EN in terms of signed-on, qualified ticket users. 

We then decided to approach SSA about a ‘‘piggyback’’ approach; that is, if SSA 

did some sort of marketing, our ENs could follow up with the necessary contacts. 

That approach would strengthen SSA’s marketing efforts and be less resource-intensive for ENs. We are pleased that SSA staff has been very responsive to us in this 

83 

regard and we have participated in several teleconferences with them to pursue the 

idea. From those teleconferences our association’s marketing committee agreed to 

conduct focus groups among our existing ticket users to determine what marketing 

activities caused or would cause them to respond to the program. We completed 

those focus groups, and our final report of the outcomes is attached to this testimony. 

Last September SSA awarded a two-year contract to a marketing firm to design 

a marketing plan. We have reviewed the statement of work and believe the end result will be a good one. However, at the end of the two-years of that contract, only 

a pilot program will have been completed. There is no time frame stipulated as to 

when an actual full-blown national campaign will be implemented. Arizona and the 

other first-year rollout states will have been implementing the ticket program for 

31⁄2 years when the pilot is completed. Without an effective, interim marketing campaign we fear the TTW program will be dead by then. 

Our Association recommends the following: 

1. SSA should be allocated the resources to send reminder letters or post cards 

about the TTW Program at least once annually to all current ticket holders. 

1⁄12 of the notices should be distributed monthly to even out the demand upon 

MAXIMUS, ENs, BPAOs, PABBS and SSA Field Offices. This will ensure better service to beneficiaries. 

2. The notices should direct ticket holders to contact their local BPAO program 

and should include the specific BPAO contact information for their area/state. 

The BPAOs will track which ENs in their communities are currently accepting 

tickets and will give contact information to beneficiaries only for those ENs 

who have indicated that they are currently accepting tickets. The BPAOs 

should be allocated appropriate resources to accommodate this additional demand. 

3. SSA should begin distributing the interim reminders to beneficiaries in the 

year-one rollout states no later than June of this year. Year two states could 

begin in June of next year and year three states in June of 2006 if there is 

no comprehensive, national marketing campaign developed and implemented 

by that time. 

We believe an interim plan as outlined above will have the following benefits: 

1. Rekindle beneficiary demand and interest in the Program. The initial mailing 

generated significant inquiries from beneficiaries. We believe periodic reminders will generate at least as much response and will capture potential participants who might not have been ready to work during the initial rollout. 

2. Increased beneficiary demand could create interest by ENs to accept tickets 

again, thus improving the choice among providers as originally envisioned by 

Congress. 

3. Periodic reminders will help beneficiaries accept the ‘‘new’’ SSA culture that 

Social Security Disability programs are not early retirement, but are in fact offering ways for individuals and their families to become self-supporting. 

4. Provide TTW Program information in beneficiaries’ living rooms rather than 

requiring them to go to disability-related or public service-related locations to 

get the information. Our focus group respondents stressed the fact that they 

always read mail they get from SSA, even if it is only because they fear bad 

news. 

5. Having local BPAOs be the initial point of contact will relieve that burden from 

MAXIMUS and will take advantage of the excellent training and skills that 

have been demonstrated by the BPAOs across the country. 

In conclusion, I am posing a question to the Social Security Subcommittee that 

I have asked many times and have yet to receive an answer: 

If Binder and Binder and other social security attorneys can advertise on TV day 

in, day out, over and over about getting people ONTO benefits, why can’t SSA advertise at least as often to get people OFF benefits? This is especially puzzling since 

the money that pays for those attorneys’ ads comes directly from the SSA Trust 

Fund. 

Once again, on behalf of the Arizona Employment Network Association we thank 

you for the opportunity to comment. 

f 

Mr. HAYWORTH. I thank you very much for your testimony, 

Susan. Now we turn to Mr. Coburn. 

84 

STATEMENT OF JOHN V. COBURN, STAFF ATTORNEY, HEALTH 

AND DISABILITY ADVOCATES, CHICAGO, ILLINOIS 

Mr. COBURN. Thank you, Mr. Chairman. Thank you for the opportunity to share our organization’s recommendations on how to 

improve the Ticket to Work Program. I actually as I got up here 

realized going last, I get to tie up some of the loose ends and get 

us going so that we can continue on. 

The Health and Disability Advocates is my employer and they 

are the convener of the Midwest Employment and Training Partnership. The Partnership currently has roughly 80 active members 

and is comprised of employment and training service providers participating in the Ticket to Work Program in Region V, which includes Illinois, Indiana, Michigan, Minnesota, Ohio, and Wisconsin. 

Also participating in the Partnership are the SSA-funded BPA&O 

projects and the Protection and Advocacy for Beneficiaries of Social 

Security projects. 

As you might suspect, our first policy recommendation is to enhance the payment system for ENs. This is key to the viability of 

this program, and you heard on the panel today that recommendation. The Partnership fully endorses the recommendations of the 

Adequacy of Incentives Advisory Group and the EN Summit which 

is mentioned in the panel report you received. Second, the Partnership strongly recommends that SSA abandon its sub-regulatory 

Transmittal 17 and completely disconnect cost reimbursement to 

State VR agencies from ticket assignment. This is a clear point 

that I want to make today. We believe that this policy is directly 

contrary to the intent of Congress and the authorizing statute. 

State VR agencies rely on a projected amount of SSA reimbursement as a base for their annual budgets. As a result of Transmittal 

17 and SSA policy, many State VR agencies have been put into the 

position of having to aggressively seek tickets from beneficiaries 

just to meet their annual budget. 

I think this explains the enormous differential, with 90 percent 

VR ticket assignment and 10 percent private EN, along with the 

payment system. I think it also, I suspect, may account for the increase recently in ticket participation. I think that the State VR 

agencies have been assigning more tickets and I would submit that 

we need to look into that to see, is it that there are more ticket 

participants coming forward to participate in this program, or has 

the State VR agency under Transmittal 17 submitted the tickets 

for assignment, and that is accounting for the increase. 

The problem with not separating cost reimbursement from the 

ticket assignment is that you have a system right now as it stands 

with these statistics that 10 percent of the beneficiaries are participating in, which is the system Congress intended to create, a system that is designed to assist beneficiaries in leaving the Social Security rolls. The other 90 percent are potentially—we don’t know— 

participating in the pre-Ticket Act cost reimbursement system, 

which does not have as its ultimate goal the leaving of the beneficiary rolls. Cost reimbursement has a different standard for payment. If this continues, the Ticket Act will never come close to 

reaching its goal of doubling the number of beneficiaries leaving 

the Social Security rolls because of employment. 

85 

Another recommendation from our Partnership which was mentioned today is that SSA has to immediately address this problem 

with overpayments. We heard testimony today about how long it is 

taking on claims administration. I think that Maximus and SSA 

have been doing a good job on their part in claims administration 

by passing some new policies that deal with quarterly reporting. 

However, in order to get paid, that still has to go through the SSA 

reporting system at the local offices, which still is not modernized 

and still is not up to date in all circumstances. 

The Partnership recognizes that SSA is working toward modernizing the current worker reporting system and that this will take 

time. In the interim, SSA can make minor operation changes to 

speed up this process. We heard mention today about the recently 

retooled Work Incentive Liaison in the local SSA offices. The Partnership believes that it should become a specific job duty of each 

of these Work Incentive Liaisons to take the ticket participant 

work histories and work on those cases. The Partnership also recommends that SSA set up a system for itself where claims with 

proper documentation have a 30-day turnaround in order to keep 

them viable. 

Since launching the Midwest Employment and Training Partnership in June of 2003, Health and Disability Advocates has received 

an overwhelming number of requests for training or technical support from employment service providers on topics ranging from 

what is the ticket program, what are these regulations, how does 

this work, to requests for assistance in building a service model 

that ensures successful and financially feasible participation in the 

Ticket to Work Program. Fortunately, we do have some private 

foundation funding to do some of this, but our limited funding will 

not meet this need. Based on this experience, the Partnership recommends that a technical assistance and training system built off 

of the current existing SSA-funded technical assistance and training systems be created. 

Finally, I want to briefly mention the Chicago Ticket to Work 

Pilot Program that we are going to be starting here in a few 

months. We created this pilot and secured funding for it from the 

City of Chicago and the Illinois Division of Rehabilitation Services. 

The pilot is designed to demonstrate to you as a committee, SSA, 

and others how an adequate payment system with up front funding 

can result in the positive outcomes that the Ticket to Work legislation intended. The project’s payment system is based upon and resembles the up front payment system recommended by the AOI Advisory Group and the EN Summit. We have created this project to 

put into action what everybody has been saying about the payment 

system, and we hope that SSA will follow our lead. Thank you. 

[The prepared statement of Mr. Coburn follows:] 

Statement of John Coburn, Staff Attorney, Health and Disability Advocates, 

Chicago, Illinois 

Chairman Shaw and Members of the Committee— 

I thank you for the opportunity to share our organization’s recommendations on 

how to improve the Ticket to Work program. I work for the Health & Disability Advocates, a national policy and advocacy group headquartered in Chicago, Illinois. 

The Health & Disability Advocates (HDA) is the convener of the Midwest Employment and Training Partnership (Partnership). The Partnership currently has roughly 80 active members and is comprised of employment and training providers and 

86 

state Vocational Rehabilitation agencies (VR) that are participating as Employment 

Networks (ENs) in the Social Security Administration’s (SSA) Region V, which includes Illinois, Indiana, Michigan, Minnesota, Ohio and Wisconsin. Also participating in the Partnership are the SSA-funded Benefits Planning Assistance & Outreach (BPAO) and Protection & Advocacy for Beneficiaries of Social Security 

(PABSS). 

Today I am going to share with you policy recommendations developed by the 

Partnership. I will also talk to you about the Chicago Ticket to Work Pilot, a project 

that our organization has developed to demonstrate a more integrated and responsive payment model for Employment Networks. 

As you might suspect, our first policy recommendation is to enhance the payment 

system for Employment Networks. You will hear from many today about the need 

to change the payment structure, so I will not dwell on this in my testimony. The 

Partnership fully endorses the recommendations of the Adequacy of Incentives Advisory Group for structuring the payment system on gross wages, with some payment 

upon job placement, and allowing payment for partial self-sufficiency. It is our belief 

that you will never get adequate participation from employment and training providers outside of the traditional state vocational rehabilitation model without changing the current payment system. The current payment structure provides no financial incentives for providers to become active ENs. Until the Ticket Work Program 

payment structure is on par with how state vocational rehabilitation services are 

funded and how services under the Workforce Investment Act are funded, the Ticket 

to Work Program will always be subpar. 

As our second policy recommendation, the Partnership strongly recommends that 

SSA change how it compensates state VR under the Ticket to Work Program. The 

current SSA policy—explained in SSA Transmittal 17—often only allows cost reimbursement to state VR agencies on those cases in which individuals have assigned 

their Ticket to that state VR agency. We believe that this policy is directly contrary 

to the intent of Congress and the authorizing statute. 

State VR agencies rely on a projected amount of SSA reimbursements as a base 

for their annual budgets. As a result of Transmittal 17, many state VR agencies 

have been put into the position of having to aggressively seek Tickets from beneficiaries just to meet their annual budget. This creates an employment and training 

services environment where state VR is given little or no encouragement, nor reward, for creating innovative partnerships with other employment training service 

providers or the private sector. 

The numbers bear this out—there are 3,978 (10%) beneficiaries participating in 

a system that Congress intended to create, a system that is designed to assist beneficiaries in leaving the Social Security roles. The other 36,972 (90%) beneficiaries 

are potentially (and most likely) participating in the pre-TTWWIIA cost reimbursement system, a system that does not base payment upon assisting a beneficiary in 

leaving the roles. If this continues, TWWIIA will never come close to reaching its 

goal of doubling the number of beneficiaries leaving the Social Security roles because of employment. 

Our next policy recommendation is that the SSA immediately address the inadequacy of its work reporting system to eliminate problems with overpayments. The 

work reporting system must be drastically improved to assure the maintenance of 

up-to-date records on work history. If it does not improve, Employment Networks 

can face significant payment delays. It only takes a few experiences with payment 

delays and complications for a service provider to decide continued participation in 

the Ticket to Work Program is not worth it. In addition, problems with this work 

reporting system continue to discourage beneficiaries from seeking employment, 

which diminishes interest in seeking services from the Ticket to Work Program. 

The Partnership recognizes that SSA is working toward modernizing the current 

work reporting system and that this will take time. Prior to achieving full modernization, the Partnership believes SSA can make minor operation changes to improve EN claims administration. We suggest that SSA give the recently re-tooled 

Work Incentives Liaisons in the local SSA offices the specific job duty of maintaining ticket participant’s work activity. Upon assignment of a ticket, the EN should 

be notified of the name and contact information of the local Work Incentive Liaison 

assigned to that ticket holder’s case. With this information, the EN could follow up 

with the local Work Incentive Liaison if payment is not made in a timely manner. 

The Partnership also recommends that SSA provide payment on EN claims with 

proper documentation within 30 days of submission. 

The last recommendation I will share with you today deals with the lack of technical assistance and support available to those Employment Networks currently trying to make a success of the Ticket to Work program. Since launching the Midwest 

Employment and Training Partnership in June of 2003, HDA has received an overVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00090 Fmt 6633 Sfmt 6621 E:\HR\OC\23796.XXX 23796
87 

whelming number of requests for training or technical support from employment 

service providers on topics ranging from the Ticket to Work Program regulations to 

building a service model that ensures successful and financially feasible participation in the Ticket to Work Program. Fortunately, we have private foundation funding to do some of this, but our limited funding will not meet the need. Based on 

this experience, the Partnership recommends that a technical assistance and training system built off of the existing SSA-funded technical assistance and training 

system be created. The system must be built on a regional and local level so that 

employment service providers can receive services without extensive travel costs and 

lost staff time. Such a model will also foster information sharing and replication of 

promising practices among ENs. 

Chicago Ticket to Work Pilot 

I will use the balance of my time to talk the Chicago Ticket to Work Pilot Project 

designed to demonstrate to you, SSA, and others how an adequate payment system 

can result in the positive outcomes that the TWWIIA legislation intended. Health 

& Disability Advocates and other members of the Partnership have successfully engaged the Chicago Mayor’s Office for People with Disabilities, Chicago Mayor’s Office of Workforce Development, and the Illinois Department of Human Services— 

Division of Rehabilitation Services to pilot an up-front payment system for ENs in 

the city of Chicago. 

The Chicago Ticket to Work pilot is slated to begin in April or May of 2004, and 

will be the only project of its kind in the country that combines municipal and state 

dollars. The purpose of this pilot is to demonstrate a payment system that provides 

ENs with guaranteed payment within the first year of placement, encourages active 

participation by ENs and, more importantly, results in successful transitions to selfsufficiency. The Pilot Project will be implemented as follows. Through a neutral application process, three ENs serving residents of Chicago will be chosen to participate in the Project. These three ENs will be eligible to receive payment on 8 to 10 

of their assigned tickets. Upon placing one of these ticket holders in competitive employment, the EN will receive $2000. After 6 months of successful placement, the 

EN will receive another $2000. Upon completion of one year of successful employment, the EN will receive $1000. After this, the Employment Network will continue 

to be paid by the Social Security Administration through the current payment system. 

Each EN will be assigned to work closely with one of the Department of Labor/ 

Social Security Administration-funded Disability Program Navigators (DPN) and/or 

the Department of Labor-funded Work Information Navigator (WIN). The DPN and/ 

or WIN will provide recruitment and referral services to the EN. The EN will only 

be paid under the Pilot Project for tickets assigned as a result of a referral from 

the DPN and/or WIN. Through this requirement, the Project hopes to build new and 

lasting relationships between the Employment Network and the One-Stop Center 

system. 

Many stakeholders and experts have stated that the payment structure needs to 

change for TWWIIA to meet its goals. We have created this Project to put into action what so many have said and hope that SSA will follow our lead. 

Mr. Chairman, and members of the committee, I thank you for your time and welcome any questions you may have. 

f 

Mr. HAYWORTH. Thank you, Mr. Coburn. I appreciate that you 

appreciate the importance of going last and the advantage of tying 

everything up. All of you on this third panel should know, and I 

think you do after listening to the discussion today, your testimony, 

all of your testimony, is very important to us and was used to inform us as we brought your issues to Mr. Gerry and Mr. Justesen. 

As we continue to move through this process to the implementation 

and to ensure the effectiveness of Ticket to Work, we will be continuing to monitor and be calling on you again in the future, because we are at a critical juncture in this program. Your testimony 

today is very much appreciated and we thank you for it. With that, 

this hearing of the Subcommittee on Social Security is adjourned. 

[Whereupon, at 12:52 p.m., the hearing was adjourned.] 

88 

[Questions submitted from Chairman Shaw to Mr. Gerry, Mr. 

Justesen, Mr. Foran, Mr. Mitchell, and Mr. Coburn, and their responses follow:] 

Questions from Chairman E. Clay Shaw, Jr. to Mr. Martin H. Gerry 

Question: Why are 90 percent of tickets being assigned to State VR (VR) 

agencies and only 10 percent to Employment Networks (ENs)? The Subcommittee has heard concerns about the payment system for ENs since the 

SSA first proposed it over 2 years ago. When will the SSA address this and 

how? 

Answer: Section 1148(h)(5) of the Social Security Act requires the Commissioner 

to review the EN payment systems and alter them to better provide incentives for 

ENs to assist beneficiaries to enter the workforce, while providing for appropriate 

economies. Based on this authority, we are considering changes in the payment system. 

The SSA also h as taken aggressive steps to address the need to get timely payments to ENs by establishing a Certification Payment Request Process. The Certification Payment Request Process allows ENs to submit a signed written statement 

that the ticket holder’s work and earnings are sufficient to warrant outcome payments, in lieu of having to provide proof of the ticket holder’s earnings. ENs can 

request payments under the Certification Payment Request Process after a ticket 

holder meets specific work requirements and has achieved a level of earnings from 

employment to qualify an EN for outcome payments. This new process can be used 

either on a monthly or quarterly basis. SSA will pay outcome payments based on 

the EN’s certification, unless our records indicate that the ticket holder is receiving 

cash disability benefits. 

Question: A procedural directive, known as ‘‘Transmittal 17’’ from the 

SSA requires VR agencies to be assigned a ticket before they can receive 

any reimbursement for costs from the SSA. Many argue that this requirement denies ticket holders the right to make an informed choice. Also, 

since the budgets of VR agencies often rely on income from the SSA, many 

believe that VRs are aggressively seeking ticket assignments, rather than 

creating partnerships with ENs so that beneficiaries can receive services 

from both a State VR provider and an EN. What is the SSA doing to resolve 

this issue? 

Answer: The operating guidelines issued to the State VR agencies in Transmittal 

Number 17 are based on the policies in the Social Security Regulations. The Social 

Security Regulations require that each State VR agency must participate in the 

Ticket to Work Program by accepting ticket assignments if it wishes to receive payments from SSA for serving beneficiaries who are issued tickets. (A State VR agency 

can receive payment under the cost reimbursement system for the cost of reasonable 

and necessary services provided to a beneficiary who has not been issued a ticket.) 

This ensures that all beneficiaries with tickets receiving services from State VR 

agencies will receive the same protection from continuing disability reviews based 

on their employment that are provided to beneficiaries receiving services from ENs. 

The pamphlet that we provide to beneficiaries with their tickets allows them to 

make an informed choice by explaining that they will be assigning their tickets 

when they sign a plan. Beneficiaries also receive a letter after they assign their ticket. This letter tells them their ticket has been assigned and includes a fact sheet 

with information about continuing disability review protection. In addition, a beneficiary whose ticket has been assigned to a State VR agency retains the opportunity 

under the Social Security Regulations to choose to unassign the ticket and reassign 

it to receive services from an EN. 

We are working with the Rehabilitation Services Administration to foster better 

partnerships between the State VR agencies and ENs when they provide services 

to beneficiaries with tickets. 

Question: Given that less than 1 percent of disabled beneficiaries return 

to work, it is easy to understand why field office staff in 1,800 offices across 

the country, buried in other work, can’t stay current with their understanding of how work and work incentives affect benefits. Given advances 

in technology, why doesn’t the agency centralize expertise in a cadre of experts to ensure beneficiaries get the right answer the first time? Couldn’t 

these individuals also help address work reports to avoid overpayments? 

Answer: Since the Ticket to Work and Work Incentives Improvement Act was implemented, SSA has worked to establish a corps of trained, accessible, and responsive specialists within the agency who specialize in disability work incentives. At 

89 

the Regional level, the Plan for Achieving Self Support (PASS) cadre members have 

been participating in this effort, along with Public Affairs Specialists and other field 

personnel. 

In May 2003, the Area Work Incentives Coordinator (AWIC) position was established. The AWIC position is a full-time permanent position and is part of SSA’s 

approach to assist beneficiaries with disabilities to obtain accurate and timely information regarding work, and to expeditiously process work reports and other disability work-issue workloads. 

Work Incentives Liaison (WIL), located directly in local offices, train all directservice personnel on SSA’s disability employment support programs. WILs have the 

technical background to provide improved service and information related to SSA’s 

employment support programs to SSA beneficiaries, applicants, advocates and service providers. 

The SSA has ongoing automation enhancements directed to improving work incentive workloads. SSA is currently in the process of implementing an application 

called eWork, which will enable SSA to provide better, more timely service by consolidating work reporting and documentation on one, universally available system. 

eWork will also generate a work report receipt and provide improved management 

information, workload controls and processing tools for work incentive. Our automation enhancements c ombined with our establishment of a network of experts will 

help ensure work reports will be addressed timely, thereby avoiding overpayments. 

Question: The Ticket Advisory Panel recommends that Congress clarify 

in law that the ticket program should be used as a supplemental, rather 

than a substitute-funding source. In other words, that Congress did not intend to make beneficiaries ineligible for the full range of services from VR 

programs, Medicaid, or other Federal and State programs by making them 

eligible for the ticket program. Can you provide more details about the 

genesis of this recommendation and your reactions to it? 

Answer: The Ticket to Work and Work Incentives Advisory Panel has noted that 

services and supports provided under other programs should be combined with, 

rather than offset by, services and supports provided by the Ticket to Work Program. They also reported that some ENs have chosen not to participate in the Ticket to Work Program because they are uncertain about whether and how they can 

use funds from these other sources to service ticket holders. We are working with 

other agencies, including the Rehabilitation Services Administration and the Centers for Medicare and Medicaid Services, to ensure that the guidance they provide 

is clear and does not unnecessarily restrict the use of their program funds when the 

Ticket to Work Program offers additional assistance to a beneficiary. 

Questions from Chairman E. Clay Shaw, Jr. to Dr. Troy R. Justesen 

Question: A procedural directive, known as ‘‘Transmittal 17’’ from the 

SSA requires State VR (VR) agencies to be assigned a ticket before they can 

receive any reimbursement for costs from the SSA. Many argue that this 

requirement denies ticket holders the right to make an informed choice. 

Also, since the budgets of State VR agencies often rely on income from the 

SSA, many believe that State VR agencies are aggressively seeking ticket 

assignments, rather than creating partnerships with employment networks 

(ENs) that allow a beneficiary to receive services from both a State VR provider and an EN. What is the Department of Education doing to resolve 

this issue and encourage partnerships between State VRs and private ENs? 

Answer: For purposes of this question, SSA’s ‘‘Transmittal 17’’ requires two 

things: 1) VR can assign an individual’s ‘‘ticket’’ to itself if the individual has been 

determined eligible for the VR program, has signed an agreed-upon Individualized 

Plan for Employment (IPE) with the VR agency, and has not yet assigned the ticket 

to another Employment Network (EN); and 2) VR (or any EN) must have an assigned ‘‘ticket’’ before VR can receive payment, including the traditional cost-reimbursement payment method, for VR services rendered under the Ticket-to-Work program. My answer to your question is lengthy and technical because the issues you 

have raised involve complicated interrelationships between two complex programs. 

I would like to assure you that ‘‘Transmittal 17’’ and its various implications and 

effects as they are now understood are under close joint review by the Department 

and SSA. Above all, we must remain focused on the larger purpose of enabling and 

assisting consumers with disabilities to achieve the dignity, sense of self-worth and 

capacity for social and economic contributions to society. Good policies will lead to 

good jobs. 

The Ticket to Work and Work Incentives Improvement Act (TWWIIA) is designed 

to give consumers more options when seeking employment-related services. To this 

90 

end, TWWIIA gives consumers the right to assign the ticket to the EN of their 

choice. This means that the individual can assign the ticket to the VR agency or 

to an EN that will accept it. However, Transmittal 17 removes this choice in certain 

circumstances, namely when the individual has a ticket that he/she has not yet assigned and seeks services from the VR agency. Transmittal 17 advises the VR agencies that individual consent is not required to make the assignment in this scenario. 

To accomplish the assignment of the ticket in this case, Transmittal 17 advises VR 

agencies to submit the signature page of the IPE to Maximus, the contractual program manager for the Ticket-to-Work program. Maximus then treats the assignment as voluntary on the basis of the signed IPE. This situation has caused some 

advocates to argue that individuals are being denied the ability to choose an EN 

as required by TWWIIA. 

The principle of informed choice is a central theme throughout the State VR services program. section 102(d)(4) of the Rehabilitation Act 1973, as amended (Rehabilitation Act), requires that a State VR agency’s written policies and procedures must 

‘‘provide or assist eligible individuals in acquiring information that enables those individuals to exercise informed choice under this title in the selection of—(A) the employment outcome; (B) the specific VR services needed to achieve the employment 

outcome; (C) the entity that will provide the services; (D) the employment setting 

and the settings in which the services will be provided; and (E) the methods available for procuring the services.’’ Because of these requirements of the Rehabilitation 

Act and an individual’s right to choose an EN under TWWIIA, we have advised 

State VR agencies to discuss openly the options available to the individual with regard to choosing an EN. We have advised State VR agencies to inform SSI recipients and SSDI beneficiaries holding unassigned tickets that the IPE signature can 

be interpreted as the individual’s willingness to assign his or her ticket to the State 

VR agency. In doing this, we believe the State VR agencies are operating within the 

requirements of both the Rehabilitation Act and TWWIIA in ensuring that the individual has the opportunity to exercise informed choice. 

The issue of payment is interrelated to the issue of ticket assignment because 

TWWIIA authorizes payment for services rendered to the EN holding the assigned 

ticket. The payments are incentives for ENs and VR agencies to assist SSI recipients and SSDI beneficiaries to become employed. ENs can choose to receive payments under the Outcome system or the Milestone/Outcome system. VR agencies 

have a third payment option; that of receiving payment pursuant to the traditional 

cost-reimbursement method authorized by the Social Security Act. However, Transmittal 17 appears not to distinguish among these three payment methods. It requires that the EN or VR agency have the assigned ticket before being able to seek 

any payment (including cost-reimbursement) from SSA. For this reason, ENs and 

VR agencies are anxious to get a ticket assigned as soon as possible. 

Certainly some State VR agencies have come to rely on income from the traditional cost reimbursement payment system, as you mention. VR agencies use this 

income to supplement the formula grant funds received from the Department of 

Education. The amount of SSA cost reimbursements, as a percentage of the overall 

VR agency budget is relatively small, however, the level of such reimbursements 

varies widely among VR agencies as a percentage of the total agency budget. A few 

agencies, particularly active and successful in SSA rehabilitations, receive higher 

levels of reimbursement. Because Transmittal 17 seems to have subsumed the traditional cost reimbursement option under the Ticket-to-Work program, VR agencies 

are on an equal footing with the other ENs with regard to needing an assigned ticket in order to be eligible for payment at a later date. Thus, VR agencies and other 

ENs need to make concerted efforts to inform individuals about the ticket assignment process. 

Question: The Ticket to Work Advisory Panel has found that some State 

VR agencies have determined that the ‘‘comparable services and benefits’’ 

requirement under the Rehabilitation Act prevents them from providing 

services to Social Security Disability Insurance and Supplemental Security 

Income recipients who assign their ticket to a private EN. Can you explain 

how the Department of Education will work with State VR agencies to provide the maximum amount of services available under the law? Do you believe that any legislative changes are needed to the Rehabilitation Act to 

allow for ENs and State VR agencies to coexist and complement each other 

as envisioned under the Ticket to Work Act, or can needed change be accomplished through regulation? 

Answer: We are not aware of any State VR agency that has refused as a general 

practice to provide services to an SSI recipient or SSDI beneficiary who has assigned his/her ticket to a private EN. However, we are aware that State VR agenVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00094 Fmt 6633 Sfmt 6621 E:\HR\OC\23796.XXX 23796
91 

cies in certain circumstances are asking that the private ENs holding the ticket provide some of the necessary services as a ‘‘comparable service and benefit.’’ 

Section 101(a)(8)(A)(i) of the Rehabilitation Act requires the VR agency, except in 

very limited circumstances, to determine whether comparable services and benefits 

exist prior to providing services to an eligible individual. The VR regulations define 

‘‘comparable services and benefits,’’ in pertinent part, as those services and benefits 

‘‘that are—(A) provided or paid for, in whole or in part, by other Federal, State, or 

local public agencies. . . .; (B) available to the individual at the time needed to ensure the progress of the individual toward achieving the employment outcome. . . .; 

and (C) commensurate to the services that the individual would otherwise receive’’ 

from the State VR agency (34 CFR 361.5(b)(10)). This means that VR must determine whether another appropriate source can provide the services that VR otherwise would provide in accordance with the individual’s IPE in a timely manner. As 

you know, the intent behind this requirement was to ensure that VR funds could 

be maximized in order to meet the needs of more eligible individuals, especially 

those with the most significant disabilities. 

We do not view a ticket by itself as representing a comparable service and benefit. 

Nor do we consider the fact that an individual has assigned his/her ticket to a private EN by itself as constituting a comparable service and benefit under the Rehabilitation Act. However, we do consider the ticket as being a comparable service and 

benefit under the Rehabilitation Act when: 1) the individual has assigned the ticket 

to an EN; 2) the EN has listed the service in its own individualized work plan (developed between the EN and the individual) pursuant to TWWIIA requirements; 3) 

the EN is capable of providing a service that is listed on the individual’s IPE; 4) 

the service offered by the EN is commensurate to the service that otherwise would 

be provided by the State VR agency; and 5) the EN is capable of providing the service when it is needed by the individual. If any of the above factors are not met, the 

ticket does not constitute a comparable service and benefit for purposes of the VR 

program. In that instance, assuming comparable services and benefits do not exist 

from another source, the State VR agency should provide the services pursuant to 

the IPE. 

Our interpretation encourages a cooperative effort between both the VR agencies 

and the ENs to serve individuals as effectively as possible while maximizing funds 

from each program. We will continue to provide technical assistance to the State VR 

agencies to ensure that the search for comparable services and benefits does not result in a delay in services to individuals. We also will continue to remind State VR 

agencies that the requirement for seeking comparable services and benefits should 

be done in such a manner to ensure cooperation among programs serving individuals with disabilities. 

As a policy matter we recognize that the intent of the Ticket program is to establish a cadre of rehabilitation service providers, in addition to the traditional VR 

services program present in every State that can provide multiple opportunities and 

pathways for SSI recipients and SSDI beneficiaries to obtain the services necessary 

for gainful employment. For decades, the VR program has been essentially the sole 

public program assisting individuals with disabilities to achieve gainful employment. The current situation in which the potential for competition between VR 

agencies and ENs for both clients and payments from SSA is new and the implications are not fully understood. 

The Department has not taken a position on the need for a legislative change. 

However, we are aware the current Senate Bill (S. 1627) reauthorizing the Work 

force Investment Act 1998 (which includes the Rehabilitation Act in Title IV) proposes clarifying language on comparable benefits. 

We must defer to SSA concerning regulatory changes governing the Ticket program, but we will of course work with SSA if changes are proposed. 

Question: It has been reported that private providers perceive that if 

they sign up to be an EN, their current relationship with their State VR 

agency may be jeopardized. It has also been reported that some current VR 

clients were threatened with termination from VR if they did not assign 

their ticket to the VR agency, or worse, weren’t informed that they could 

be better served by taking their ticket to elsewhere versus staying on a 

waiting list at the VR agency. This is deeply disappointing and completely 

opposed to the goals of the ticket program. Have you heard similar allegations? Are they true? If so, what are you doing to address the situation? 

Answer: I am not aware of any individual threats concerning termination of clients or willful ‘‘noninformation’’ about ticket options being provided to VR clients. 

However, if complaints are brought to our attention we will certainly respond to 

them. 

92 

State VR agencies have typically had longstanding cooperative or purchaser-vendor relationships with many, if not most ENs. Thus, it is understandable that some 

providers could be concerned about the potential for jeopardizing their relationship 

with the VR agency. However, perceptions that a relationship ‘‘may be jeopardized’’ 

provide little basis for investigation in the absence of specific complaints. I have 

heard anecdotal references similar to the allegations you have mentioned. However, 

no documented and specific examples have been brought to my attention. However, 

we will work with our colleagues at SSA to address any specific complaints that 

may be presented. 

Question: As you mention in your testimony, many EN perceive that negotiated agreements they have entered into with the State VR agencies do 

not reflect the principles of true partnership and fairness. This is especially a concern given the low percentage of tickets assigned to ENs. When 

do you plan to complete your review of all agreements between the State 

VR agencies and ENs? 

Answer: TWWIIA authorizes ENs and VR agencies, when serving mutual consumers, to share payments received from SSA when the two entities have developed 

an agreement that outlines how services will be provided and income shared. ENs 

and VR agencies may, of course, enter into a wide range of agreements for various 

purposes for their mutual benefit. 

We are aware that some ENs, including some VR agencies, believe the agreements they have developed do not reflect the principles of true partnership and fairness. This has prompted OSERS to begin reviewing these agreements. Although 

there is no legal requirement for us to conduct this review or for the VR agencies 

to submit these agreements to us, we believed such a review would be helpful in 

order to get a better understanding of the actual working relationships between 

State VR agencies and ENs. 

We are currently reviewing agreements that were developed by ENs and VR agencies in the 13 first-phase States. We hope to review all available agreements within 

the next 6 months. We will provide the Subcommittee with a report of our findings 

once our review and analysis are completed. 

Questions from Chairman E. Clay Shaw, Jr. to Mr. Tom Foran 

Question: Can you share with me on average, what are the costs of returning an individual to employment? Even with adjustments to the milestone payments, can employment networks cover their costs and still make 

a reasonable profit, given the potential total payment of $16,740 for Social 

Security beneficiaries and $10,620 for Supplemental Security Income beneficiaries? 

Answer: Because of the tremendous variation in costs, at the individual level, giving an average cost may be less meaningful than focusing on the second part of this 

question. We’ve seen beneficiaries that are able to return to work with an outlay 

of only several hundred dollars. We’ve also seen others that would require more 

than $50,000 and even at that level the success is not guaranteed. 

When looking at the second part of your question it is important to understand 

the effects of: 

• The time value of money on payments, 

• The cost of Maximus and SSA imposed administrative costs (drag), 

• Success rate in returning beneficiaries to work, 

• Once at work the effect of beneficiaries dropping out of the work force due to 

death, economy related work force reductions, choice and worsening of their 

physical state. 

Additionally, we need to define ‘‘reasonable profit’’ which is directly tied to the 

source and cost of capital. 

Once all of these parameters are determined a present value of future cash flows 

can be created to determine the amount of resources that can be provided to any 

one individual in the return to work process. An employment networkthen looks for 

beneficiaries that can be returned to work with that level of resources. 

Taking into account the above items, IDR has estimated the present value of future payments per successful ticket as follows: 

• SSDI current milestone structure = $2,800 

• SSI current milestone structure = $1,420 

• SSDI with AOI workgroup suggested changes $3,800 

• SSI with AOI suggestions (diff. Reflects lower success rate) $3,000 

93 

With the current dramatically lower payments for SSI beneficiaries, we feel the 

risk/reward is too great and therefore do not work with SSI only beneficiaries. 

Under the current milestone structure only 1 in 25 beneficiaries that contact us 

meet our screen of being a SSDI beneficiary with a 75% likelihood of successful fulltime return to work for $2,800 in time and services. 

We believe it is dangerous to use a cost figure that represents an average per individual placement, however. We fear that policy makers will use such a number 

to reduce payouts for the program without realizing the actual costs to operate the 

program include far more than just the cost of an individual placement. The aggregate program costs for screening all the people who never actually deposit their ticket as well as the people we are never actually able to place represents the majority 

of the costs incurred to operate a successful employment network. 

Additionally, for the reasons mentioned above, a significant percentage of those 

who are placed for whom we are eligible for a milestone/outcome payment will never 

actually achieve 60–72 months of employment. It is also impossible to compute the 

total cost of any placement at this time since the ticket program is so new. For example, we do not know the cost or amount of future services that will be required 

to help those ticket users who are working now stay at work. Consequently, the 

total possible payout for any one beneficiary (i.e. $16,750 for SSDI and $10,620 for 

SSI) not only has to cover our costs and generate a reasonable profit for those we 

actually place but also must cover the aggregate costs incurred for all the people 

we do not place. 

We believe placement rates could be increased by restructuring the payment system. By changing to the AOI workgroup recommended payment structure we estimate we would be able to work with 1 in 10 to 1 in 15 beneficiaries. By removing 

much of the administrative drag we would likely be in 1 in 8 to 1 in 12 ranges. 

Improving access to capital (reducing cost) would also allow us to work with more 

beneficiaries. 

So, yes it is possible for an employment network to earn a fair profit at the $16,740 (or current $17,170) total payment for SSDI beneficiaries. The question is 

how many beneficiaries is an employment network able to serve? 

When IDR decided to become an employment network, we planned to do so on 

a significant scale. Our initial plans were to serve 2,000 plus beneficiaries per year. 

Our infrastructure was built to handle at least that amount. 

Unfortunately, given the level of screening we have to do to deal with unexpected 

issues like administrative drag and lack of appropriate education given to beneficiaries on the Ticket to Work Program it is unlikely we will come anywhere near 

our goal without improvements in the program. 

Question: What has been your experience in working with the State VR 

agencies? What suggestions do you have for improvements? 

Answer: Our main office is in Connecticut and we have had a very positive experience in dealing with Connecticut’s Bureau of Rehabilitation Services. The problem 

we face in dealing with other State VR agencies is that each state takes a different 

approach with different agreements in dealing with EN’s. To be honest, we made 

the decision early on that it was not worth the time and expense to enter into negotiations with each state and simply refer beneficiaries to their State VR agency if 

we can’t help them. 

We would be much more likely to work on a collaborative basis with other State 

VR agencies if there was a uniform agreement applicable to all states. 

It is important to note the comments we get from beneficiaries about their experiences with State VR agencies. In general, they revolve around frustrations the beneficiaries have with not being served by State VR for the following reasons: 

• Lack of funding 

• The beneficiary not having a disability ‘‘severe’’ enough to be assisted 

• The waiting list for services is ‘‘years’’ long 

• Rehab Counselors don’t get back to the beneficiary for months on end 

Another suggestion would be to more strongly encourage State VR to focus their 

limited resources on providing services designed to get beneficiaries ‘‘job ready’’ 

under the existing cost reimbursement program and to rely on EN’s to provide the 

placement services under the ticket program. 

Although some more traditional ENs have recommended operating the ticket program payment system similarly to the cost-reimbursement scheme currently in use 

with State VR, we believe that such a plan would create more administrative burden ‘‘proving’’ to SSA that the costs for which we are requesting reimbursement are 

legitimate. Further, it would designate a bureaucratic approach to the types of services provided rather than the ‘‘whatever it takes’’ approach we are free to use under 

the current Ticket structure. This has been demonstrated clearly by the Projects 

94 

with Industry programs that exist today. Originally, they were intended to be more 

community and employer-focused. However, because of the manner in which PWIs 

are funded and monitored their programs today are so restricted that they, too, are 

not able to place as many people as they could if their program contained more flexibility. 

Question: What can be done to assist recipients who want to use their 

Ticket in selecting one employment network from the often long list of employment networks available to recipients? 

Answer: Provide adequate and timely information on each employment network 

servicing their area. Examples of information/services to provide include items currently tracked by Maximus such as: 

• Tickets assigned to date • Tickets unassigned by ENs • Tickets unassigned by beneficiary • Number of successful placements to date 

Regularly updated (at least monthly) list of what EN’s are still active 

Offer workshops via the BPAOs on how to choose an EN and what an EN and 

a consumer can offer each other. 

I want to emphasis that the information provided needs to be readily available 

information that Maxims is ALREADY collecting. Asking EN’s report and track additional statistics will only add to the administrative drag and reduce resources 

available to provide services to beneficiaries. 

Questions from Chairman E. Clay Shaw, Jr. to Mr. Quintin M. Mitchell 

Question: Can you share with me on average, what are the costs of returning an individual to employment? Even with adjustments to the milestone payments, can employment networks cover their costs and still make 

a reasonable profit, given the potential total payment of $16,740 for Social 

Security beneficiaries and $10,620 for Supplemental Security Income beneficiaries? 

Answer: On average the costs of returning an individual to employment, for our agency, is $15,819.00. This figure is at the low end. Even with adjustments to the 

milestone payments, it is a very slim margin for our agency to cover cost and still 

make a profit.The profit is really not a reasonable one. 

Question: What has been your experience in working with the State VR 

agencies?What suggestions do you have for improvements? 

Answer: Our agency has opted not to work with the State VR agencies in our 

area. From the start of this initiative we decided that working with the State Voc 

Rehab would not be in our best interest, economically or providing the Ticket participants with expedient service delivery. 

Question: What can be done to assist recipients who want to use their 

Ticket in selecting one employment network from the often long list of employment networks available to recipients? 

Answer: One approach to assist recipients who want to use their Ticket in selecting one employment network from the often long list of EN.s available is to narrow 

the list to their service area within 30 miles. We are finding that more and more 

Ticket holders are contacting our agency, which is outside of our service delivery 

area. To accommodate these individuals we have set up satellite meeting space in 

that area and travel to meet them on an as needed basis. Because of fewer E.N. 

participation and more Ticket participants, slim margin of profit and already 

stretched staff it is becoming increasingly more challenging to ensure that the program is successful. 

Questions from Chairman E. Clay Shaw, Jr. to Mr. John V. Coburn 

Question: Can you share with me on average, what are the costs of returning an individual to employment? Even with adjustments to the milestone payments, can employment networks cover their costs and still make 

a reasonable profit, given the potential total payment of $16,740 for Social 

Security beneficiaries and $10,620 for Supplemental Security Income beneficiaries? 

Answer: The cost of returning an individual to employment can vary greatly depending on many factors, including but not limited to, the nature of the individual’s 

disability, the individual’s employment history, and the individual’s education and 

experience. In addition to the costs expended to assist a particular individual in returning to work, there are general overhead costs associated with actively participating as a provider in the Ticket to Work Program. These costs may include staff 

95 

costs associated with performing intake, staff costs associated with assessing an individual’s service needs prior to accepting their ticket, marketing of the Ticket to 

Work Program, and so forth. These costs are incurred on all individuals who contact 

the agency, including individuals who the agency may ultimately decide not to serve 

under the Ticket to Work Program. 

In order to develop response to your questions, I polled members of the Midwest 

Employment and Training Partnership (Partnership). I have received several different responses with a range of costs for employment and training services One 

Employment Network, which serves exclusively blind individuals, stated that the 

average cost per individual to train, educate, and place the individual in competitive 

employment ranged from $35,000 to $40,000. This was the highest amount reported. 

On the lower end, another agency that works with a cross-disability population reported that it was currently costing about $2000 per individual to place a person 

in competitive employment through the Ticket to Work Program. This figure does 

not include what it may or may not cost to keep the person in competitive employment throughout the Ticket to Work payment timeline, nor does it include some of 

the overhead costs mentioned previously. A third agency that works with younger 

adults reported an average cost of between $5000 and $6000 to obtain employment, 

with follow-up services costing approximately $3000 per year. Finally, another agency, which works with a cross-disability population, reported a range of $5200 to 

$12,000 to assist an individual in returning to work with 3 months of intensive follow-up services. 

So, our experience has been that there is a great variance in expenditures needed 

to assist a person in securing and maintaining employment. However, in almost all 

cases, the greatest percentage of these expenditures are incurred by agencies prior 

to and upon placement in competitive employment. Therefore, adjustments in the 

milestone payments to further increase the funds available during the beginning of 

the employment services process will increase the ability of Employment Networks 

to accept more Tickets. 

The current total payment system under the Ticket to Work Program will not 

make it possible to serve all beneficiaries. For some beneficiaries, payments of 

$16,740 or $10, 620 will never cover the expenditures required in order to return 

them to employment. However, these amounts, if paid out in a greater percentage 

during the first year, would make it financially feasible for Employment Networks 

to accept more Tickets and increase their participation over time. 

Question: What are the one or two most significant benefits of the upcoming City of Chicago Pilot that represent an improvement over the current 

Ticket to Work payment systems for employment networks? 

Answer: In the Midwest, we have learned that Employment Networks have been 

hesitant to meaningfully participate in the Ticket to Work Program because the 

agency must bear all the costs associated with the placement of the individual in 

employment. And, even after incurring these costs, the Employment Network may 

never receive payment if it is not successful, or the EN receives payments over a 

significant period of time at very low rates. Quite simply, the current system of payment requires agencies to incur costs that it cannot carry for the period of time it 

must wait in order to be reimbursed. To be frank, the current Ticket to Work milestone and outcome payment model is not a strong business model that will bring 

new players into the system much less attract many of the experienced employment 

and training providers to this new program. 

First and foremost, the City of Chicago Pilot (CCP) provides the Employment Networks with a significant income to cover their cost of service within the first year 

of a ticket participant’s employment. The Employment Networks can be assured of 

reimbursement of at least some of their costs at placement ($2000), when the greatest costs have been incurred. In addition, subsequent payments of $2000 at 6 

months and $1000 at 1 year allow the Employment Networks to recoup a larger 

amount of their overall costs within a short period of time. This is done without discouraging the Employment Networks from continuing to work with the individual 

over the next 5 years as Employment Networks will continue to receive payments 

from the SSA system after the first year if the individual maintains employment. 

Second, the CCP allows for payment to the Employment Network within the first 

year without requiring the individual to earn Substantial Gainful Activity (SGA) or 

greater within that first year. Employment Networks believe that the process of returning an individual to full-time employment at or above SGA can often be accomplished over time. For some individuals, particularly those receiving SSI benefits 

with no work history, securing employment at or above SGA can best be accomplished by first gaining some work experience, sometimes at a part-time level. For 

other individuals, the best way to return them to work at or above the SGA level 

is to first allow them to work at any level, gain confidence in their ability to mainVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00099 Fmt 6633 Sfmt 6621 E:\HR\OC\23796.XXX 23796
96 

tain employment, and address their fears about returning to work and losing their 

cash benefits. Once this is done, the transition to full-time, self-sustaining employment is the next natural step and the Employment Networks can realistically assist 

them in getting there. 

The current payment system will not pay the Employment Networks during the 

time in which they are gradually assisting the individual in gaining full-time employment. Therefore, it is not financially feasible for the Employment Networks to 

work with the large group of beneficiaries described above. On the other hand, the 

CCP makes payments to Employment Networks when they assist the individual in 

gaining competitive employment, regardless of that person’s employment income. 

This is done without losing sight of the ultimate goal—-self-sustaining employment. 

The Employment Networks must still create a plan for returning the individual to 

self-sufficiency, as required by current SSA regulations, and will receive payments 

through the SSA system when they do so. 

[Questions submitted from Mr. Matsui to Dr. Justesen, and his 

responses follow:] 

Question: If a Social Security beneficiary assigns a ticket to an Employment Network, is he or she still entitled to services and benefits under title 

I of the Rehabilitation Act? Please describe the interpretation of ‘‘comparable benefits and services’’ as it relates to the ticket program. Are state 

agencies complying with this requirement of the Rehabilitation Act with 

respect to Social Security beneficiaries who have been assigned tickets? Is 

your agency monitoring state’s compliance with this requirement? 

Answer: VR is an eligibility program rather than an entitlement program but Social Security beneficiaries are deemed presumptively eligible. Assignment of a ticket 

to an employment network does not limit an individual’s potential eligibility for VR 

services. That eligibility is governed by the Rehabilitation Act. 

Section 101(a)(8)(A)(i) of the Rehabilitation Act requires the VR agency, except in 

very limited circumstances, to determine whether comparable services and benefits 

exist prior to providing services to an eligible individual. State VR agencies must 

comply with this requirement as a matter of law, and it is to the advantage of the 

agencies to do so because use of third-party resources allows the agencies to serve 

more clients or provide enhanced services. The Rehabilitation Services Administration is currently reviewing agreements that were developed by ENs and VR agencies 

in the 13 first-phase States and hopes to review all available agreements within the 

next six months. The reviews will necessarily involve consideration of the use of 

comparable benefits. 

The VR regulations define ‘‘comparable services and benefits,’’ in pertinent part, 

as those services and benefits ‘‘that are—(A) provided or paid for, in whole or in 

part, by other Federal, State, or local public agencies. . . .; (B) available to the individual at the time needed to ensure the progress of the individual toward achieving 

the employment outcome. . . .; and (C) commensurate to the services that the individual would otherwise receive’’ from the State VR agency (34 CFR 361.5(b)(10)). 

This means that VR must determine whether another appropriate source can provide the services that VR otherwise would provide in accordance with the individual’s IPE in a timely manner. As you know, the intent behind this requirement was 

to ensure that VR funds could be maximized in order to meet the needs of more 

eligible individuals, especially those with the most significant disabilities. 

We do not view a ticket by itself as representing a comparable service and benefit. 

Nor do we consider the fact that an individual has assigned his/her ticket to a private EN by itself as constituting a comparable service and benefit under the Rehabilitation Act. However, we do consider the ticket as being a comparable service and 

benefit under the Rehabilitation Act when: 1) the individual has assigned the ticket 

to an EN; 2) the EN has listed the service in its own individualized work plan (developed between the EN and the individual) pursuant to TWWIIA requirements; 3) 

the EN is capable of providing a service that is listed on the individual’s IPE; 4) 

the service offered by the EN is commensurate to the service that otherwise would 

be provided by the State VR agency; and 5) the EN is capable of providing the service when it is needed by the individual. If any of the above factors are not met, the 

ticket does not constitute a comparable service and benefit for purposes of the VR 

program. In that instance, assuming comparable services and benefits do not exist 

from another source, the State VR agency should provide the services pursuant to 

the IPE. 

97 

Question: A number of concerns have been raised about whether the ticket 

program may be replacing, rather than supplementing, other pre-existing publicly funded services such as VR services provided under Title 

I of the Rehabilitation Act. The intent of Congress in enacting the ticket program was not to deny access to these other services. Does Congress need to clarify the law? If so, where? 

Answer: State VR agencies are serving the great majority of persons holding tickets and seeking services. Experience to date with implementation does not support 

concerns about the ticket program replacing services such as VR. This is 

unsurprising because the VR agencies are well-established entities with operating 

capital provided by their formula grants from the Department. The Department has 

not taken a position on the need for any legislative change. We would in any event 

expect to work closely with but defer to SSA as the administering agency if legislative recommendations are to be developed. 

f 

[Submissions for the record follow:] 

California Department of Rehabilitation 

Sacramento, California 95815 

March 30, 2004 

Chairman E. Clay Shaw, Jr. 

Subcommittee on Social Security 

1102 LHOB 

Washington, DC 20515 

Dear Congressman Shaw: 

As the Director of the California Department of Rehabilitation (DOR) I want to 

take this opportunity to provide written testimony for the official record of the above 

referenced hearing. This testimony will provide some information on DOR’s activities relevant to the implementation of the Ticket to Work Program specifically as 

they relate to Transmittal 17 of the SSA VR Provider Handbook and the development of agreements between DOR and Employment Networks (EN). 

Several months prior to Ticket rollout in California, DOR convened a Ticket to 

Work Workgroup that consisted of field and management staff, community partner 

agencies and several constituency groups representing a unified approach to DOR’s 

role in the Ticket to Work Program. The workgroup was charged with the task of 

extensively reviewing Social Security Administration’s Ticket to Work (TTW) regulations and policies related to TTW including the Transmittal 17 document. In addition, the workgroup carefully researched, studied and compared policies implemented by first and second round ticket states. As a result, the workgroup developed guidance and procedures consistent with the TTW regulations and Title I of 

the Rehabilitation Act of 1973, as amended. 

Transmittal 17 of Social Security Administration’s (SSA’s) Vocation Rehabilitation 

(VR) Provider Handbook allows for the ‘‘automatic’’ assignment of a Ticket to State 

VR agencies when a consumer signs the Individualized Plan for Employment (IPE). 

The SSA’s position has been that if a beneficiary receives a Ticket and then enters 

into an IPE they have decided to use their Ticket. California DOR does not practice 

this ‘‘automatic’’ ticket assignment. A statement has been added to our IPE template to emphasize the voluntary nature of the Ticket and consumer informed 

choice. All consumers eligible or potentially eligible for a Ticket are provided verbal 

and written information on TTW program including a fact sheet that emphasizes 

that TTW is a voluntary program. Finally, guidance has been developed so that 

DOR counselors review and revisit TTW with each consumer at the time of progress 

and annual reviews. 

Concern has been raised about the various EN/VR agreements requiring full repayment of the entire VR costs out of the EN ticket payments and the reported ‘‘one 

size fits all agreements.’’ State Vocational Rehabilitation (VR) agencies have been 

working with SSA beneficiaries under a reimbursement program legislatively authorized by the Social Security Act since 1981. Under this reimbursement program 

SSA reimburses State VR agencies for reasonable and necessary service costs incurred in assisting consumers who engage in employment with earnings equal to or 

above SSA’s standard for substantial gainful activities (SGA) for at least 9 months. 

Indirect and tracking costs are also reimbursed. The annual SSA Reimbursement 

report for Federal Fiscal Year 2003 indicates SSA realizes savings from this proVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00101 Fmt 6633 Sfmt 6621 E:\HR\OC\23796.XXX 23796
98 

gram. In FY 2003 $84.6 million dollars were reimbursed to VR agencies nationwide. 

SSA projected the savings in benefits to be $458.7 million dollars. 

As is true for many state VR agencies, DOR has come to rely on these reimbursements to maintain ongoing programming. The TTW program has introduced a new 

way of doing business. With an estimated 1,000,000 Tickets scheduled to be released 

in California by September 2004, DOR certainly supports increased consumer choice 

and the addition of EN’s to provide services. California’s EN Agreement only requires the EN to reimburse DOR at the rate of 50% of each payment received from 

SSA until DOR’s direct costs (not indirect and tracking costs) are reimbursed or 

until DOR has received 50% of all payments, whichever is first. Furthermore, DOR 

does not ask for more than 50% of the total payments the EN receives. 

Finally, California DOR supports the proposals that have been made by others to 

this hearing and the Ticket to Work Advisory Panel for SSA to create a dual payment system in which state VR agencies continue to be reimbursed for services provided to assist beneficiaries in preparing for and entering the labor market. EN’s 

then will be paid for the long-term follow up and support for beneficiaries to maintain their employment and freedom from reliance on cash benefits. 

California DOR appreciates this opportunity to provide testimony. We look forward to future collaboration in improving the TTW program and support your ongoing efforts to help make this program a success for beneficiaries with disabilities. 

Sincerely, 

Catherine Campisi 

f 

Director 

Statement of Robert Kilbury and Louis Hamer, Council of State 

Administrators of Vocational Rehabilitation, Chicago, Illinois 

In Illinois there are 60 ENs with 32 ENs having an active agreement with State 

VR. Since the Ticket program started two years ago in Illinois we have gone from 

73 ENs to 60 ENs now. Many ENs have stopped taking the Ticket assignment from 

customers. Most community based providers have attributed the lack of Tickets accepted due to the payment system. In Illinois we do have an agreement that was 

developed with cooperation with community providers. The EN agreement calls for 

State VR to pay for services and to eventually receive payment back for its cost once 

the EN receives payment from SSA. The EN will keep any monies received over 

State VR’s cost. In most cases it could be a large sum. Illinois does not ask for any 

cost reimbursement above what it pays out. 

′′Transmittal 17′′ allows State VR to submit the Ticket Registration Form 

(TRF1365) along with a copy of the signed IPE signature page for assignment when 

the customer does not sign the TRF1365. The customer is informed by State VR 

that by signing the IPE (Plan) they are assigning their Ticket to VR. In Illinois we 

only submit in this manner with the customer’s approval. This is no different than 

when a customer goes to an EN and signs a Individual Work Plan (IWP), they are 

in essence assigning their Ticket to that EN. This happens and not all customers 

are informed they have assigned their Ticket to that EN. In Illinois over 98% of all 

Tickets to date have been submitted with customer signature on the TRF1365. 

It is very unfair to vilify State VR agencies over the Ticket program. In Illinois 

not every customer that comes through the door is a SSA recipient. The funds captured from SSA reimbursement goes back into the pool to pay the cost for all it’s 

customers, including SSA recipients. State VR does indeed continue to be woefully 

under-funded. The amount of reimbursement has been steadily shrinking over the 

last two years with a large reduction expected again this year. 

We disagree with the recommendation of eliminating the requirement that there 

be agreements between ENs and State VR agencies when the EN refers a beneficiary to VR unless SSA allows cost reimbursement for State VR agencies separately from the Ticket program. 

Illinois State VR spent significant resources the first year training staff, hiring 

Ticket operators, setting-up a Ticket Cost Center and meeting with ENs in development of the EN agreement. We continue to spend large amounts training staff on 

SSA revisions and communicating with Maximus and customers who have no intent 

to return to work. This program would be most effective if there were unlimited 

funding for State VR with some additional funds for ENs. Since there is no endless 

trail of money, SSA should not consider changing the system to reward ENs that 

are able to cherry-pick it’s customers. We must remember that State VR must work 

with every customer that comes through the door. 

99 

Making further changes to provide more incentives to return to work would benefit customers more. Give the customer to try to work for a year if they assign there 

ticket and allow them to keep all their benefits would open the door to more customers making a real attempt to get off benefits, not making ENs rich on the backs 

of the customer. 

f 

Statement of Mike Hedden, Indiana Vocational Rehabilitation Services, 

Indianapolis, Indiana 

In regard to the Hearing on March 18, 2004, the testimony given does not accurately reflect the situation in Indiana. Indiana has invested significant resources in 

its training of Vocational Rehabilitation Counselors. We have held several training 

seminars explaining the Ticket program as well as developing detailed intake procedures, flow charts and updating our computer system. We do not use a ‘‘stand alone, 

take it or leave it, one size fits all agreement’’ with the ENs with whom we have 

Memorandums of Understanding. Our agreement with ENs states that ‘‘both the 

IWP and the IPE will be written by the respective party in a manner, consistent 

with law, to reinforce common goals, policies and procedures for Ticket customers 

referred by the EN to VRS.’’ Our agreements do not necessarily require full and 

total repayment of all of VR’s costs. Our reimbursement agreement states that VRS 

will be reimbursed by the EN for all actual service costs provided through VRS at 

the rate of 50% of all outcome or milestone payments to the EN until VRS is reimbursed for all actual service costs (these costs do not include the costs associated 

with VR Counselor time or in support of the VR Counselor). In other words, once 

an EN begins to receive payments, VR is entitled to 50% of each payment received 

until service costs are paid in full or until no further payments are made to the EN. 

The EN, in other words, will always receive 50% of the total payments and may 

receive more than 50% once VR’s costs are reimbursed. If payments to the EN stop 

prior to full service costs being reimbursed to VR, VR expects no further reimbursement from the EN. 

f 

Statement of James Wallace, Louisiana Rehabilitation Services, 

Department of Social Services, Baton Rouge, Louisiana 

Louisiana Rehabilitation Services (LRS) has taken a very active role in promoting 

Ticket to Work (TTW) in the state of Louisiana. Our agency, which is located in a 

second phase Ticket rollout state, began training our personnel statewide in 2001. 

The agency has done follow-up training in 2002. Louisiana Rehabilitation Services 

(LRS) personnel also participated in providing training to beneficiaries, potential 

Employment Networks (ENs), and other entities in 2002 in conjunction with the 

Medicaid Buy In (MBI) program. The MBI training was repeated in 2003 with LRS 

participation. Furthermore, the agency was involved in statewide teleconference 

training in 2003. 

In our agency training, beneficiary options with special emphasis on informed 

choice to the consumers was stressed. Additionally, the training stressed that Rehab 

Act guidelines preclude denying services to any eligible consumer even if a Ticket 

is assigned to another entity. 

The LRS does have EN agreements with four Employment Networks throughout 

the state. The agreements do call for Ticket assignment to LRS and payment to the 

EN on typically a fee-for-service basis. LRS would be reimbursed under the traditional cost method. Any excess payments from Social Security would be split on a 

50/50 basis. 

The LRS has neither solicited ENs nor coerced them into partnerships to ‘‘control 

competition.’’ ENs in the state appear to be reluctant to accept Ticket assignments 

because of the uncertainty and duration in payment and tracking. ENs and LRS negotiated so that in instances where the EN can independently serve the recipient, 

that recipient will not be referred to LRS. That said, current TTW procedures do 

allow appeals to Maximus and Social Security when Ticket assignment and payment 

is in question. 

The LRS, as a whole, is as well trained or in many cases better trained on Ticket 

issues, including informed choice, as any other entity in the state. In our state, as 

in many others, LRS has over 90% of the Ticket assignments. It is our viewpoint 

that Ticket indifference is due to the payment system for ENs and the burdensome 

100 

administrative and tracking system. Further the lack of marketing to recipients by 

ENs contributes to the very low number of cases handled through them. 

Thank you for the opportunity to respond to this very topical subject. 

f 

Maryland Division of Rehabilitation Services 

Baltimore, Maryland 21201 

March 31, 2004 

The Honorable Benjamin L. Cardin 

Member of Congress 

2207 Rayburn HOB 

Washington, DC 20515 

I want to respond to testimony that was provided by the Consortium of Citizens 

with Disabilities (CCD) at the March 18th hearing convened by the House Social 

Security Subcommittee on SSA’s Ticket-to-Work program. The comments of Paul 

Seifert stating ‘‘State VR agencies have developed stand alone, take it or leave it, 

one size fits all agreements for ENs in their states’’, comes as a shock to this administrator of the Maryland VR program. Let me assure you that Mr. Seifert’s statement could not be further from the reality of what has occurred in our state. 

First, Maryland Division of Rehabilitation Services (DORS) implementation planning was guided by the following principles: 

• Persons with disabilities in Maryland are entitled to the opportunities, rights 

and remedies afforded under Title I of the Rehabilitation Act regardless of ticket status or assignment. 

• Maryland DORS implementation will foster the goals of the Ticket-to-Work legislation: to expand service delivery capacities; and provide greater choice to ticket-holders to prepare for and obtain employment. 

• Implementation will occur in a manner that is fiscally responsible and fair to 

ticket-holders, our community partner agencies and DORS. 

We have steadfastly adhered to those principles throughout the process. 

Second, Maryland DORS initiated an interagency implementation team to ensure 

that our roll-out strategies were consistent with our principles. Representatives 

from a number of community rehabilitation programs participated on the state team 

in addition to representatives from Maryland’s benefits planning assistance and outreach (BPAO) organizations; the Client Assistance Program; and the state’s protection and advocacy program. 

Third, Maryland does not have a ‘‘one size’’ agreement with ENs but rather varies 

the agreement based on which entity will provide the Ticket-to-Work administrative 

functions. We also tailor specific elements of the agreements to the unique relationship we have with each provider. 

While disagreeing categorically with Mr. Seifert’s comments regarding implementation of the Ticket-to-Work for Maryland, I agree with his support of a recommendation of the Adequacy of Incentives Work Group. The current design of 

Ticket-to-Work by the Social Security Administration is seriously flawed. I strongly 

support the Work Group recommendation to reestablish cost reimbursement for state VR agencies separate from the Ticket-to-Work program and 

thereby keep intact the Ticket option for the consumer. 

I appreciate your consideration of these comments, and would ask that this letter 

be submitted as part of the official record of the hearing. Please do not hesitate to 

call me if you need additional information. Thank you. 

Sincerely, 

Robert A. Burns 

Assistant State Superintendent in Rehabilitation Services 

f 

Statement of Elmer C. Bartels, Massachusetts Rehabilitation Commission, 

Boston, Massachusetts Introduction 

The Massachusetts Rehabilitation Commission (MRC) thanks Chairman Shaw for 

the opportunity to provide the Committee with its comments concerning the implementation of the programs of the Ticket to Work and Work Incentives Improvement 

Act, with particular attention focused upon the Ticket Program. Massachusetts was 

among the first states to roll out the Ticket Program and the MRC has actively 

101 

worked to fashion a collaborative system of specialized training, support, and placement services with the state’s community rehabilitation program providers, working 

as Employment Networks, in an effort to maximize choice and value for its consumers. 

BPAO Program Success 

The Benefits Planning Assistance and Outreach Program (BPAO) has been an unqualified success in Massachusetts. The MRC operates its ‘‘Project IMPACT’’ BPAO 

program in partnership with state independent living programs, non-profit community based organizations, and One-Stop Career Centers. The collaboration has resulted in referrals exceeding expectations and the development and implementation 

of over 1600 benefits plans. Reauthorization of the Program in HR 743 will have 

a direct and positive impact on the employment efforts of hundreds of individuals 

with significant disabilities in the Commonwealth. 

Traditional Cost Reimbursement and the Ticket Program 

A tension has existed in the Ticket program since the issuance of the first SSA 

instructions concerning State Vocational Rehabilitation Program participation in the 

Ticket Program and the continued relevance of the SSA/VR cost reimbursement program. That tension has continued to grow during the first several years of program 

implementation and it threatens to undermine the Ticket Program’s potential for 

success. 

From the time the idea of the Ticket Program was first discussed in Congress, 

the CSAVR and interested state programs have emphasized the need to preserve 

the successful and vitally important SSA/VR cost reimbursement program. We believe that the SSA has promulgated policy regarding the administration of the Ticket Program, through its regulations and Transmittal 17 that is contrary to the intent of Congress, the language of TWWIIA, and the law as it relates to the administration of the VR cost reimbursement program. The Ticket Program has great potential to stimulate creative collaboration among community rehabilitation providers 

and state VR agencies. That collaboration could result in increased choice, quality, 

and funding for SSI/DI recipients interested in obtaining and retaining employment. 

However, as others have stated in their testimony, the programs working to assist 

individuals with disabilities to obtain real and meaningful work are woefully underfunded. A Ticket Program designed to redistribute rather than supplement existing 

funds is destined to fail. The work that State VR agencies and community rehabilitation providers perform is difficult, it is important, and it has real value to people 

with disabilities. It can be improved upon but what is good must be maintained. The 

threat of a new program diverting scarce funding from a collaborative system of 

proven effectiveness causes apprehension and at times conflict rather than promoting enthusiastic and creative participation. 

It is in the interest of the Social Security Administration, ENs, State Vocational 

Rehabilitation Programs and most importantly people with significant disabilities 

hoping to work, that this tension be relieved. Congress and the SSA should make 

it clear that the Ticket Program and the VR cost reimbursement program complement one another; supplement one another, and together work to creatively address the needs of individuals with disabilities seeking to maximize their economic 

independence. 

How the Ticket Program and VR Cost Reimbursement Program Could Together Improve the Prospect of Long Term Employment for Individuals With Disabilities 

The State VR Program is mandated to provide an eligible individual with any 

service described in an individualized plan of employment necessary to assist them 

in preparing for, securing, retaining, or regaining an employment outcome that is 

consistent with the strengths, resources, priorities, concerns, abilities, capabilities, 

interests, and informed choices of the individual. It is neither uncommon nor unrealistic for many individuals with significant disabilities to seek and obtain costly vehicle modifications or payments for the costs of college degrees from the State VR Program. Yet, such expectations are justifiably viewed as unrealistic or beyond the 

scope of the capacity of ENs to address. 

Many individuals with disabilities require long-term ongoing supportive services 

to enable them to successfully obtain and retain employment. Long-term supports 

to employment are often beyond the scope of services available to consumers from 

the State VR agency. Community rehabilitation providers, serving as ENs, have the 

expertise and staff to provide this necessary and relatively low cost on the job service to individuals with disabilities. All that is needed is a funding mechanism. In 

Massachusetts, we have developed some means by which we are able to support 

these activities. However, the need is only partially met. 

102 

A Ticket payment mechanism that supports EN efforts to provide the services 

necessary to ensure that individuals with disabilities are able to retain employment, 

complimented by a VR reimbursement system funding the up front costs associated 

with all aspects of individuals preparing for and obtaining employment, will undoubtedly result in increased, long-term, quality employment for SSI/DI recipients 

who desire increased social and economic autonomy. 

In Conclusion 

The TWWIIA BPAO Program has been a tremendous success. There has been 

positive cooperation among state and community based partners that has resulted 

in an impressive number of consumer referrals with a very high level of consumer 

satisfaction. The reauthorization of the BPOA Program is a very positive development. 

It is not the belief of the MRC that a lack of interested and qualified Employment 

Networks is threatening the success of the Ticket Program. 1,100 ENs is a sizeable 

network of service providers. It is our belief that ENs make business decisions based 

upon their assessment of what is in their and their consumers’ best interests. A 

Ticket Program that secures the funding base of ENs, through the preservation of 

the VR cost reimbursement program, and provides ENs an opportunity to expand 

existing services and resources, through a Ticket payment system that funds the 

provision of long term support services, will go a long way toward assuring the success of the Ticket Program. 

Thank you again for providing the Massachusetts Rehabilitation Commission with 

the opportunity to share with you some of its concerns regarding the operation and 

improvement of the Ticket to Work Program. 

f 

Statement of Dan O’Brien, Oklahoma Department of Rehabilitation 

Services, Oklahoma City, Oklahoma 

Chairman Shaw, Ranking Member Matsui and Members of the Subcommittee, 

thank you for holding this Hearing to evaluate the state of Ticket to Work implementation. The Oklahoma Department of Rehabilitation Services was one of the 13 

initial rollout states for the Ticket to Work in 2002. 

The reality of the Ticket from the street level perspective is that the system is 

broken and if not fixed will go the way of the failed Alternate Participant (AP) Program. Most of the problems have been predictable and the Adequacy of Incentives 

(AOI) Interim Report and the Ticket Panel’s Employment Network (EN) Summit report summarize both the problems and make workable recommendations for solutions. We would encourage Congress and SSA to adopt their recommendations forthwith before any more potential energy is squandered. As they say in Oklahoma, 

beneficiaries are beginning to wonder if they have been sold a ‘‘pig in a poke’’, at 

this point the Ticket seems long on promise and short on delivery. 

It is our position that there is a substantial consensus among experts and EN’s 

alike that the Ticket can be salvaged if quick and decisive action is taken soon. The 

market based competitive model envisioned for the Ticket was undone by the lack 

of funding of the Ticket payment structure. Baring a huge influx of new funding, 

a blended funding approach, using existing resources to complement the Ticket, is 

the only logical solution. The AOI Committee recommendations (report link below), 

which operationalize this approach, should be implemented rapidly and to the fullest extent possible. 

http://www.dri.uiuc.edu/research/p03-08h/interim_report_03-08h.pdf 

Oklahoma DRS has made every effort to ensure the Ticket’s success in Oklahoma. 

To that end we conducted the following activities: 

Recrkuitment of EN’s: When the Ticket legislation passed the DRS agency assumed that it would be structured as complementary to the traditional VR reimbursement program, much like the AOI study group has recently recommended. We 

recruited our traditional partners in delivering Supported Employment, a total of 

26 Community Rehabilitation Programs, to be Alternate Providers under the previous SSA return to work program. It was our understanding that these organizations would be grand fathered into the Ticket EN system, thus ensuring Oklahomans a health EN network once the Ticket rolled out. However, SSA decided not 

to grandfather in the AP providers and required them to resubmit an application. 

The combination of this paperwork burden with the low rates of payment resulted 

in few of our CRP recruits becoming EN’s. Those that did complete the paperwork 

103 

have not been active. The primary problem is the low payment rates, the Ticket 

milestone payments represent a small fraction of what it costs for CRP/EN’s to provide Supported Employment services. Implementation of the AOI Interim Report 

recommendations #1, to increase Milestone payments and allow payment for partial 

self-sufficiency, and #3 known as the Partnership Plus, would address the EN 

underfunding/undercapitalization problems that are restricting the Ticket’s EN provider systems growth. 

Ticket Outreach Pilot: Under an SSA state partnership grant, Oklahoma DRS 

piloted an assertive outreach/marketing effort combined with Work Incentive education and choice of vendor using a vocational voucher, similar to the Ticket but better funded. Beginning in 1999 and ending in 2003 the ODRS developed systems for 

recruiting, educating on work incentives and providing Job Coaching services to 

beneficiaries with a Mental Health diagnosis. The techniques developed under this 

grant were used to develop the procedures described in #3 through #7 below. 

Required Benefits Planning: Supported Employment Contractors are required 

to provide benefits planning assistance to all beneficiaries who are placed in a job. 

Active Recruitment of Ticket holders: Oklahoma DRS created a Ticket Unit 

that works with the Workforce system to actively recruit Ticket holders. Since February 2002 the Ticket staff have invited all callers to the agency toll free Ticket hotline to Ticket Orientation meetings held at the Workforce One Stop Centers. Thousands of Ticket holders received basic work incentive training at a One Stop to enable them to make use of their Ticket and plan their return to work. 

Expected Eligibility Process: Oklahoma DRS developed an expedited eligibility 

process for Ticket holders that resulted in determination of eligibility and assignment to a VR/VS counselor within 3–5 days after application. This is significantly 

faster than the normal paperwork processing time prior to the Ticket rollout. 

Training of DRS Staff: All DRS staff including front line staff received training 

on the Ticket to Work and the agencies assertive collaboration with Workforce on 

Ticket rollout. 

Direct Marketing of the Ticket with the Disability Program Navigators: 

The DRS and Workforce system have recently collaborated on a pilot direct Marketing campaign designed to reinvigorate the Ticket. Beginning in February and 

ending in April 2004 a pilot is being conducted where every Ticket holder in a suburban county near Oklahoma City is being invited to attend a Ticket Orientation 

meeting at the Local Workforce One Stop conducted by the Disability Program Navigator. In addition the SSA funded Benefits Planner, SSA’s Area Work Incentive Coordinator and local VR staff are present to answer questions about available work 

incentives. This effort has received excellent feedback from those involved and will 

be evaluated for it’s expansion potential. 

We share the CCD’s concern, expressed in Paul Siefert’s written testimony, about 

SSA’s rule on automatic assignment of the Ticket. As one of our staff has said, ‘‘We 

don’t make the rules, we just abide by them.’’ SSA considers the signature on the 

IPE to be an indication that an individual decided to use the ticket to obtain services from the State VR Agency. SSA memos state ‘‘. . . the Ticket is assigned when 

the IPE (VR Individualized Plan for Employment) is signed.’’ The separation of the 

Ticket and Reimbursement systems, as recommended by the AOI study group, 

would resolve this problem. 

SSA reimbursement funds, over $100 million per year nationally, provide services 

to thousands of additional beneficiaries each year. Loss of reimbursement funds, as 

is happening this year across the country, primarily due to the slow economy, reduces our ability to serve beneficiaries. The VR system is the only part of the Ticket 

system that is providing a significant level of services. SSA seems to be in the process of dismantling the Reimbursement program without having a working system 

to replace it. The logical step is to cross breed the two systems, as the AOI group 

has recommended, which will correct the deficiencies in both systems. 

Our agency has collaboratively developed an EN agreement with our EN/CRP 

partners, which both parties consider fair. Any funds recouped under these agreements, strictly a theoretical case as to date there are none, would allow the agency 

to serve additional SSA beneficiaries. Our VR–EN agreement only requires EN’s to 

pay VR 50% of payments received from SSA under the Ticket up to the amount actually expended by VR on direct client services. Theoretically, as no shared cases 

have been developed, this is only necessary in the small minority of cases where 

beneficiaries actually leave the SSA rolls. It is our understanding that only one out 

of 14 beneficiaries who have work activity ever leave the rolls, so most likely DRS 

will only receive any reimbursement in less than 7% of the cases where we expend 

money. And most beneficiaries do not work the entire 60 months of the outcome period. Therefore DRS, hypothetically, would expend an average of $10,000 per case 

and on 93% of the cases get nothing back from the EN and on 7% of the cases would 

104 

get back considerably less than the cost of services. One would not be far wrong if 

you said this argument is much ado about nothing. 

f 

Pennsylvania Office of Vocational Rehabilitation 

Harrisburg, Pennsylvania 17102 

November 24, 2004 

Kim Hildred 

Majority Staff Director 

1025 Connecticut Avenue NW 

Suite 205 

Washington, DC 20036 

Dear Kim: 

The Pennsylvania Office of Vocational Rehabilitation (OVR) takes exception to the 

testimony provided by Paul Seifert on March 18, 2004 to the House Social Security 

Subcommittee on Social Security’s Management of the Ticket to Work Program. 

OVR has invested a lot of time, energy and resources into the Ticket to Work program in order to maintain and continue the partnerships we have established over 

the past years with other employment programs, schools, agencies and facilities. 

Employment Network Referral Agreements 

A committee composed of representatives from the Pennsylvania Association of 

Rehabilitation Facilities (PARF) and OVR staff spent considerable time developing 

an agreement that met with the approval of the committee. The federal guidelines 

established for Social Security reimbursement were followed when determining reimbursement for services provided. OVR’s agreement does require repayment of 

services provided whereby OVR receives fifty percent of each payment that the Employment Network (EN) collects from Social Security until repaid. However, OVR 

does not require repayment from the EN if the EN takes a loss on a Ticket customer. OVR only receives payment from the EN if the EN receives a payment. 

Training and Outreach 

OVR has invested significant resources to provide outreach and training to the 

community and OVR staff about the Ticket to Work Program. Individual training 

programs were designed and directed specifically to OVR staff. In addition to training staff, the OVR Ticket to Work Coordinator has presented to special interest 

groups, advisory councils, schools, parents and Career Link staff. Many of these 

presentations have been co-presented with members from the Benefits Program Assistance and Outreach Programs, Social Security and Employment Networks. 

A letter has or will be sent to all OVR Pipeline cases as Tickets are distributed 

informing them of the program. Included in the mailing is a Fact Sheet that explains the Ticket program and the choices available. 

Transmittal #17 

OVR does not involuntarily assign a beneficiary’s Ticket without his/her knowledge. OVR is following the guidelines established by Social Security in Transmittal 

#17. 

OVR counselors have been instructed to discuss the assignment of the Ticket per 

Social Security regulations. In addition, a form has been developed for counselors 

to give the beneficiary that specifically addresses the assignment of the Ticket when 

the Individual Plan of Employment is signed. 

Employment Networks 

OVR staff has reported that there are beneficiaries coming to OVR with their 

Ticket, as other ENs have not accepted them for services. Some of the reasons for 

refusal include: 

• Ticket holders only want to work part time 

• The EN doesn’t have the resources to provide the services needed 

• Lack of EN providers 

• EN can receive direct payment for services from OVR faster than through Social 

Security 

• If customer isn’t employment ready, they are referred to OVR 

OVR strives to facilitate and maintain viable working relationships with agencies, 

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105 

viding services to people with disabilities. Partnering with others is an intricate link 

in providing quality services to those we serve. 

Sincerely, 

Stephen R. Nasuti 

f 

Executive Director 

Statement of Larry C. Bryant, South Carolina Vocational Rehabilitation 

Department, West Columbia, South Carolina 

Based on the hearing that took place on March 18, 2004 regarding the Social Security Administration’s (SSA’s) Management of the Ticket to Work Program, it is 

evident that the concerns regarding the Ticket to Work program continue to escalate. The South Carolina Vocational Rehabilitation Department believes that the 

successful services that the state vocational rehabilitation departments are providing to social security beneficiaries are being over looked due to the unresolved 

issued that have resulted from the 1999 Ticket to Work and Self-sufficiency legislation. Therefore, we feel that it is necessary to provide written documentation regarding the positive services to social security beneficiaries that take place in South 

Carolina. 

Since the program’s inception in 1999, the South Carolina Vocational Rehabilitation Department has actively supported the program. Our agency has invested a significant number of resources to train our staff regarding the ticket program and the 

impact that this program has on social security beneficiaries who desire to obtain 

independence through employment. Not only do we feel that our staff members 

should be educated about the ticket program, we feel strongly that our clients 

should have a full understanding of the program and work incentives that go along 

with it. Therefore, we request that ALL of our applicants and existing clients in the 

VR program who are receiving SSI and/or SSDI meet with a Benefit Specialist to 

discuss these issues. We encourage this regardless of ticket ‘‘assignability.’’ 

Our agency is especially proud of the relationship that we have developed with 

our local Social Security offices. During the roll out phase of the ticket program in 

our state, we invited Social Security staff to attend and present at our ticket to 

work training sessions. Currently, we are working closely with the Work Incentive 

Coordinator in our state to provide additional ticket training in our 22 local offices 

located through the state. We feel that this relationship with SSA exemplifies the 

importance that South Carolina Vocational Rehabilitation Department places on 

providing services to the social security beneficiaries of South Carolina. 

We are also in the process of fostering a positive working relationship with the 

Employment Networks that serve South Carolina. We feel that it is necessary to develop an Employment Network (EN)/Vocational Rehabilitation (VR) agreement that 

caters to the needs of the client not to the needs of ‘‘reimbursement.’’ It is our intention to provide the best services to social security beneficiaries as possible. Therefore, as we establish agreements with Employment Networks, not only will they outline an agreed method of payment, but most importantly shared service provisions. 

We do not agree with a ‘‘take it our leave it, one size fits all’’ attitude toward EN/ 

VR agreements. Service provision is our number one priority. The reimbursement 

that we receive is to supplement our services to social security beneficiary, not to 

supplant these services. Again, our client’s needs and employment objectives drive 

the services provided to them. We encourage input from employment networks and 

other agencies regarding service provision for our clients. I will say, however, that 

the negative attitude displayed by other entities regarding Vocational Rehabilitation 

and Ticket to Work activities has been discouraging. 

As the Ticket to Work program continues to evolve, we feel that it is imperative 

to continue obtaining input from all parties who have been affected by this legislation. Resolutions to the issues surrounding the ticket program need to occur quickly 

in order to maintain the highest quality of service to social security beneficiaries. 

f 

106 

Tennessee Division of Rehabilitation Services 

1Nashville, Tennessee 37248 

April 1, 2004 

The Honorable E. Clay Shaw, Jr. 

Chairman 

Subcommittee on Social Security 

U.S. House of Representatives 

1102 Longworth House Office Building 

Washington, DC 20515 

Dear Chairman Shaw: 

On March 18, 2004, the Subcommittee on Social Security held a hearing on the 

Social Security Administration’s Management of the Ticket to Work Program. The 

Division of Rehabilitation Services (DRS), with Tennessee Department of Human 

Services, would like to submit written comments for the hearing record in rebuttal 

to testimony presented by Mr. Paul J. Seifert, with the Social Security Task Force, 

Consortium for Citizens with Disabilities. 

Staff Training on the Ticket Program 

Tennessee DRS State Office staff has traveled the state training its field counselors on the Ticket to Work Program. The agency also trains all new Vocational 

Rehabilitation (VR) Counselors on the Ticket to Work Program as part of its New 

Counselor’s Training. Additionally, the agency often and regularly communicates to 

its staff updated and important information on this subject. 

Informing SSA Beneficiaries of the Ticket Program 

A couple of months before the Ticket to Work Program was to be implemented 

in Tennessee, the agency sent out thousands of letters to its SSI/SSDI clients informing them of the forthcoming Ticket Program. The letter explained the program 

and pointed out that this new program was soon to start up in Tennessee. Clients 

were told that they may be getting a ‘‘ticket’’ to use to help enable them to get employment. Clients were told about the options they would have in choosing service 

providers, as well about the CDR benefit in using the Ticket. 

The Agreement with Employment Networks 

The agency has a standard Employment Network agreement that is applicable to 

all those ENs who wish to partner with the agency. There are currently five such 

agreements in place in Tennessee. No EN has voiced any concern to the State Office 

about the contents of this Agreement. 

According to the Ticket to Work regulations, if an EN holds a ticket on an individual that they want to refer to a state VR agency, they must first have an agreement in place with that agency. The agency’s agreement with ENs allows these referrals to be made under the ticket rules. 

As partners under the agreement, the Ticket Program lets the EN and the state 

VR agencies decide how they wish to share the Ticket payments from SSA. 

Tennessee’s agreement with their EN partners lets the state VR agency recover 

monies it spends in serving the EN referrals. The money comes through a percentage of the periodic payments the EN gets from SSA via the EN payment system. 

This way, the EN always gets a portion of the SSA payment and the state VR agency gets a portion up until the state VR agency recovers its actual costs in serving 

the individual. The state VR agency receives no monies above its actual costs. 

A Possible Solution 

Most state VR agencies across the nation would possibly welcome the recommendation of the Adequacy of Incentives Work Group—i.e., that cost reimbursement be made to state VR agencies separately from the Ticket Program, with the 

Ticket money going to ENs serving the beneficiary. In his testimony, Mr. Seifert 

seems to support this recommendation. This solution lets state VR agencies recover 

their costs and lets ENs receive money via the Ticket Program. 

Sincerely, 

Carl Brown 

f 

Assistant Commissioner 

107 

Statement of Terrell I. Murphy, Texas Department of Assistive and 

Rehabilitative Services, Austin, Texas 

I would like to take a moment to comment on the March 18, 2004 

Hearing on the Social Security Administration’s Management of 

the Ticket to Work Program. 

The Department of Assistive and Rehabilitative Services (DARS) 

administers the public vocational rehabilitation program in Texas. 

DARS has invested a significant amount of time and other resources in order to train VR counselors about the Ticket program. 

We have responded to numerous calls from consumers inquiring 

about the program, and do our best to explain not only the program 

but also the options available to them. We routinely refer consumers to the Benefits Planning Assistance and Outreach programs around the State, and encourage consumers to contact other 

Employment Networks (EN) in Texas so they can make informed 

decisions regarding the service provider that can best meet their 

individual needs. 

We originally developed a template for an EN agreement based 

on models from other States. This template basically required full 

repayment of VR’s costs. For example, when VR expends less than 

$10,000 on a beneficiary referred by an EN that holds the beneficiary’s ticket assignment, VR may ask for 50 percent of the EN’s 

outcome payments until VR has received full reimbursement for 

the services purchased for that beneficiary. For cases where VR expends more than $10,000, VR may seek a greater percentage of the 

EN’s outcome payments. Our rationale was that it was in the best 

interest of our consumers for us to reclaim as much money as possible in order to be able to serve additional consumers. Our experience has been that Employment Networks have demonstrated little 

interest in entering into this type of agreement. As a result, we 

have initiated a process to meet with representatives from Employment Networks to discuss creating an agreement that would be 

more suitable. 

Our goal is to work cooperatively with Employment Networks 

and all other interested individuals and organizations in order to 

best meet the employment needs of individuals with disabilities. 

f 

Utah State Office of Rehabilitation 

Salt Lake City, Utah 84114 

April 1, 2004 

Committee on Ways and Means 

U.S. House of Representatives 

1102 Longworth House Office Building 

Washington D.C. 20515 

Dear Honorable Congressmen E. Clay Shaw Jr. and Members of the Subcommittee, 

In regard to the March 18th Hearing on the Social Security Administrations management of the Ticket to Work program, we respectfully provide the following input. 

We applaud the efforts of Congress and Social Security to create work incentives 

for individuals with disabilities. These new provisions have created countless opportunities for individuals who otherwise would not have engaged in work activity. We 

respect an individual’s right to choose how and whether rehabilitation services will 

be provided. Furthermore, we support the efforts of Congress, the Social Security 

Administration and the Ticket to Work Advisory Panel to make improvements to 

the Ticket to Work program. It is due to our interest in helping make this program 

a viable and affable program for beneficiaries and Employment Networks (EN’s) (inVerDate Aug 31 2005 13:39 Apr 28, 2006 Jkt 023796 PO 00000 Frm 00111 Fmt 6633 Sfmt 6621 E:\HR\OC\23796.XXX 23796
108 

cluding State Vocational Rehabilitation Agencies), that we want to ensure Congress 

have access to accurate information regarding states implementation of the Ticket 

to Work program. 

Many of the concerns regarding the Ticket to Work program have been well documented over the past two years. Others have not. The Utah State Office of Rehabilitation (USOR) agrees with the recommendations made recently by the Ticket to 

Work Advisory Panel. The problems associated with low EN participation have been 

attributed to the high amount of risk involved in assigning tickets with little or no 

hope for claiming any payment from Social Security. However USOR feels that EN 

participation has not been affected in the manner espoused by Mr. Seifert. In Paul 

Seifert’s testimony, he asserts that ‘‘State VR agencies have developed stand alone, 

take it or leave it one size fits all agreements for EN’s in their states’’. He further 

asserts that these agreements ‘‘require full and total repayment of all of VR’s costs’’. 

In the state of Utah, we have conducted focus groups with our EN’s to explore the 

fairness of our draft agreement. The Employment Networks were given a draft copy 

of the agreement and encouraged to make comments. We have maintained the position that EN’s in our state are not obligated to sign any agreement, and we have 

encouraged them to draft their own agreements for our consideration. Furthermore, 

we have conducted countless focused training sessions in conjunction with our Area 

Work Incentive Coordinator to ensure that EN’s were up to date on the provisions 

of the Ticket to Work legislation and to empower them to draft their own agreements. We held our own ‘‘EN recruitment’’ symposium and dedicated almost 1⁄2 day 

to discuss creative partnerships. Despite our outreach efforts and openness to creative partnerships, none of the EN’s have submitted an EN agreement for our consideration and have unanimously agreed to sign the agreement posed by our agency. 

The reasons cited by the EN’s remain consistent with earlier and well documented 

implementation issues with the Ticket to Work program. The EN’s in Utah are 

afraid of the financial risk involved in accepting tickets, with or without VR as a 

partner. The EN’s in Utah including USOR meet periodically to discuss ticket issues 

and to provide general support to each other. At all times, this has been done in 

a spirit of cooperation and collaboration, not just between USOR, but also among 

all seven of the Utah EN’s. On one occasion, one of the EN’s called the Ticket to 

Work coordinator at USOR to ask her technical assistance in assigning a ticket to 

his EN. She walked him through the process of how he could assign a ticket to his 

company. In the end, the EN made the decision not to accept the ticket, and referred the individual to VR because he felt that the administrative work associated 

with the ticket was burdensome. Our state has worked hard to create a healthy 

working relationship with Employment Networks, and to emphasize the importance 

of those relationships in our own staff training. 

Frankly, we are offended by Mr. Seifert’s testimony to the contrary. 

In further testimony, Paul Seifert criticizes the state VR agencies who failed to 

register tickets in a timely fashion, with the unfortunate circumstance of benefits 

being reduced (and later restored) for a beneficiary. We would just like to assure 

Congress as well as Mr. Seifert that our state database system allows us to track 

where all our tickets are during the entire assignment process. We have created an 

electronic system of completing the SSA1365 form and recording when the ticket is 

actually assigned by Maximus thereby hoping to alleviate any of the potential problems mentioned in testimony. 

Finally, Mr. Seifert addresses transmittal 17. The Utah State Office of Rehabilitation shares concern over this policy decision made by the Social Security Administration. Informed Consent has been a guiding force in our daily operations prior to 

Ticket to Work, and remains integral to our Ticket policy and procedure today. 

During the first two years of the Ticket Implementation process I chaired the 

Council of State Administrations of Vocational Rehabilitation (CSAVR) Committee 

on Social Security Relationships. The committee had numerous meetings with SSA, 

RSA and others to identify issues and seek solutions regarding implementation 

problems associated with the Ticket to Work and Work Incentives Act. Quarterly 

teleconferences were held between the states currently implementing the ticket, 

CSAVR, RSA, and SSA to determine how the ticket was being implemented and to 

provide technical assistance. In addition CSAVR, SSA and RSA sponsored national 

training conferences prior to each group of states that were implementing the Ticket 

program. Even before the ticket program began, CSAVR was providing input to SSA 

and Congress regarding these issues. In the last four years, upper management 

from SSA and Maximus have participated in every CSAVR conference. 

Contrary to Mr. Seifert’s testimony, it has been my observation that State VR 

agencies have bent over backwards to assist in the development of the ticket program. Yes, a few states have made some mistakes which have been corrected. In 

109 

the final analysis the Ticket program would be dead in the water without the State 

VR agencies. 

The State of Utah is still in early implementation phase. There have only been 

11,698 tickets mailed thus far, with 72 tickets assigned. Utah, like other states has 

made great preparations for this program. We are hopeful that measures will be 

taken to ensure the success of this program. We support the recommendations made 

by the Adequacy of Incentives Advisory Committee and as well, the Ticket to Work 

Advisory Panel recommendations. We urge Congress to seek input from all states 

regarding Ticket to Work Implementation. The Ticket to Work and Work Incentive 

Improvement Act holds much potential for job seekers with disabilities, but to realize the potential of this program we must work together to overcome the barriers 

rather than pointing fingers. The Utah State Office of Rehabilitation is committed 

to working with Congress and the Social Security Administration in realizing the 

potential of this important program. 

Respectfully, 

Blaine Petersen 

f 

Executive Director 

Statement of Michael O’Brien, Washington Department of Social and 

Health Services, Division of Vocational Rehabilitation, Lacey, Washington 

Mr. Chairman, Mr. Matsui, and members of the House Social Security Subcommittee, I am writing on behalf of Washington State Division of Vocational Rehabilitation (DVR) in order to provide written testimony in connection with the hearing on the Social Security Administration’s implementation of the Ticket to Work 

and Self-Sufficiency Program, authorized under the Ticket to Work and Work Incentives Improvement Act of 1999. 

I am writing in response to the comments made in Mr. Seifert’s testimony under 

the heading ‘‘State VR Agencies, Employment Networks (ENs) and Beneficiaries.’’ 

Mr. Seifert’s written testimony states: ‘‘State VR agencies have developed standalone, take-it-or-leave-it, one-size-fits-all agreements for ENs in their states. These 

agreements all contain one common provision—the full and total repayment of all 

of VR’s costs out of the EN’s ticket payment by an EN who refers a beneficiary to 

VR.’’ 

This is not our practice in Washington State. The fact is, we want and need ENs. 

Washington State has a capacity issue and we believe ENs can assist in addressing 

this issue. Our agreements with ENs do not require more than a forty percent reimbursement to DVR on a shared Ticket. We have provided technical support to the 

local Workforce Development Councils to assist them in becoming Employment Networks. We are in the process of providing training on Ticket and work incentives 

to One-Stop staff. We will be holding focus groups this spring with ENs to figure 

out what else can be done to assist them. 

Washington State DVR took an active role a year prior to the phase three rollout in order to ensure that Ticket was successful in our State. We formed an interagency Ticket Advisory Group whose purpose was to prepare the state for Ticket, 

to encourage and support the development of Employment Networks, and to ensure 

that work incentives were understood throughout the system so that customers 

would take advantage of the incentives. Sixteen of DVR’s staff have gone through 

the SSA certification to become benefits planners. Washington State DVR developed 

its own training modeled after the SSA training and has trained one third of its 

staff in benefits planning. 

The Ticket Advisory members also have coordinated numerous joint and solo presentations on Ticket to Work, SSA work incentives, and the Medicare Buy-In program. Washington State DVR sponsored and coordinated two spring conferences on 

Ticket to Work to encourage EN development. Those conferences were attended by 

over 400 people. Washington State DVR paid for national experts on Ticket to 

speak. 

Under the leadership of Washington State DVR, this committee developed a Ticket brochure with basic information on Ticket that could be used system wide, as well 

as a Ticket brochure for transition students. We compiled a list of frequently asked 

questions which is posted on all partners’ websites. We currently are planning six 

one-day conferences statewide that will enable customers to better understand Ticket and the related work incentives. 

Washington State DVR set up a toll-free line that anyone with a Ticket question 

can call. What we are finding is that, as a state, there is a serious problem of Ticket 

110 

holders having nowhere to use their Ticket. Few ENs in our state are accepting 

Tickets and many Ticket holders are very frustrated. Unfortunately, DVR cannot be 

the answer because we are in ‘‘order of selection’’ and have a long waiting list. 

Mr. Seifert, in his testimony, faults VR agencies for delaying or failing to assign 

a beneficiary’s Ticket, resulting in the beneficiary being subjected to a Continuing 

Disability Review (CDR). I would like to state that this does not occur in Washington State. We have made it very clear to Ticket holders and DVR staff that a 

Ticket is assigned only when the 1365 form and the Individualized Plan for Employment (IPE) is signed. We have held four statewide trainings on the Ticket program, 

and 31 additional trainings at every DVR office in the state to insure our staff understands when and how a ticket is assigned. 

However, there is a problem. Transmittal 17 states that a beneficiary’s 

signature on the IPE indicates that the beneficiary has decided to use the 

ticket to obtain services from the State VR agency, if the ticket is assignable. This effectively takes away any choice from the individual. If ticket 

holders sign the IPE—which must occur in order to receive services—then 

according to TM 17 they have assigned their ticket. 

Washington State has chosen to submit only Tickets that the beneficiary 

has deliberately assigned to us. I would suggest that the problem is with 

TM 17, not with public rehabilitation. 

Thank you for the opportunity to share information about Ticket implementation 

and issues in Washington State. 

f 

Statement of West Virginia Division of Rehabilitation Services, Charleston, 

West Virginia 

Reference Hearing on SSA Management of the Ticket to Work program 

held on M arch 18, 2004 

The West Virginia Division of Rehabilitation Services (WV DRS) provides the following comments as it relates to the above referenced hearing: 

1. WV DRS has invested significant resources to train all VR Counselors and administrative staff in the Ticket to Work program, developed a brochure to educate beneficiaries about the program and updated the Electronic Case Management system to collect additional data needed for the program. 

2. WV DRS has provided training to our Consumer Advisory Committee, State 

Rehabilitation Council and Statewide Independent Living Council on the ticket 

program, as well as, facilitated training provided to the Community Rehabilitation Programs in our state. 

3. WV DRS has worked with Social Security Administration and asked for their 

input into developing our processes and procedures for implementing the Ticket to Work program. 

4. WV DRS refers all Social Security recipients to the Benefits Planning Assistance and Outreach program specialist to discuss how working will effect their 

benefits and any incentives they can take advantage of when entering or reentering the workforce. 

5. Our interpretation of the SSA Transmittal 17—If an individual applies for VR 

services, is determined eligible, meets our order of selection of having a most 

significant disability and works with the Rehabilitation Counselor to develop 

their Individual Plan of Employment and would not agree to assign their ticket 

to the agency; then DRS would send MAXIMUS the front and back page that 

includes signatures of the IPE and the unsigned SSA 1365. This effectively establishes that DRS is working with the individual and gives MAXIMUS the 

data it needs to determine ticket assignment and/or sharing of reimbursements. 

Since West Virginia is a third round state, we do not yet have any agreements 

with Employment Networks in our state but we are not experiencing negative relationships with other Employment Networks. 

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