Report to Congressional Committees

United States Government Accountability Office

GAO

March 2005 SOCIAL SECURITY 

ADMINISTRATION 

Better Planning Could 

Make the Ticket 

Program More 

Effective 

GAO-05-248 
Page i GAO-05-248 SSA's Ticket Program 

Letter 1

Appendix I Briefing Slides 6 

Appendix II Comments from the Social Security Administration 38 

Appendix III GAO Contacts and Staff Acknowledgments 44 

GAO Contacts 44 

Staff Acknowledgments 44 

Abbreviations 

DI Disability Insurance 

EN Employment Network 

SSA Social Security Administration 

SSI Supplemental Security Income 

VR Vocational Rehabilitation 

Contents 

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Page 1 GAO-05-248 SSA's Ticket Program 

March 2, 2005 

The Honorable Charles E. Grassley 

Chairman 

The Honorable Max Baucus 

Ranking Minority Member 

Committee on Finance 

United States Senate 

The Honorable William M. Thomas 

Chairman 

The Honorable Charles B. Rangel 

Ranking Minority Member 

Committee on Ways and Means 

House of Representatives 

The Social Security Administration (SSA) manages the two largest federal 

disability benefit programs and made approximately $75 billion in 

payments to about 8 million beneficiaries (ages 18 through 64) in 2003. 

Given the size of its programs, even small improvements in SSA’s ability to 

return beneficiaries to work offer the potential for significant savings. 

Until recently, Social Security beneficiaries who needed help returning to 

work generally had to seek services from state vocational rehabilitation 

(VR) agencies. Few beneficiaries used these services or successfully 

returned to work. Therefore, Congress passed the Ticket to Work and 

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

create a Ticket to Work and Self-Sufficiency Program (the Ticket 

program). The program’s goals are to expand the availability of service 

providers and to help enable beneficiaries to return to work, become selfsufficient, and stop receiving disability benefit payments. Eligible 

beneficiaries can use their tickets as vouchers to request vocational 

rehabilitation, employment, or other support services from the traditional 

state VR agencies or from new SSA-approved public or private providers, 

which are referred to as employment networks (EN). 

The act required SSA to implement the Ticket program and make tickets 

available to all eligible beneficiaries. SSA decided to use three phases to 

make tickets available: (1) beginning with 13 states in February 2002, 

(2) expanding to 20 more states and the District of Columbia in November 

2002, and (3) expanding to the final 17 states and 5 territories in November 

2003. The act also required SSA to perform several periodic and 

United States Government Accountability Office

Washington, DC 20548 
Page 2 GAO-05-248 SSA's Ticket Program 

independent evaluations of the program. For example, SSA was mandated 

to periodically review the systems used to make payments to the providers 

and was also given authority to make needed changes. The act also 

required SSA to provide Congress with three independent evaluations of 

the effectiveness of program activities. Finally, the act created the Ticket 

to Work and Work Incentives Advisory Panel (the Advisory Panel) to 

include experts on employment and related services and representatives 

of individuals with disabilities to provide advice and reports on the 

program to SSA, the Congress, and the President. 

The Congress also mandated in the Social Security Protection Act of 2004 

that GAO evaluate the Ticket program and provide a report to Congress by 

March 2, 2005. The statute requires that GAO (1) examine the annual and 

interim reports issued by the Commissioner of Social Security and the 

Advisory Panel,1

 (2) assess the effectiveness of the activities carried out 

under the program, and (3) recommend legislative or administrative 

changes, if appropriate. To meet these requirements, our report examines: 

(1) the progress SSA has made in implementing and evaluating the Ticket 

program and achieving its goals, (2) the problems that have limited the 

program’s ability to achieve its goals, (3) the recommendations to better 

achieve the goals of the program made by the Advisory Panel, researchers, 

and service providers, and (4) the challenges SSA faces in implementing 

changes to achieve the program’s goals. On February 25, 2005 we briefed 

your staff on the results of our analysis. This report formally conveys the 

information provided during the briefing (see app. I). 

To assess the Ticket program, we reviewed and evaluated the quality of 

key studies conducted for SSA on the implementation and effectiveness of 

the program. We also reviewed reports by the Advisory Panel and other 

related documents. To supplement information in these reports, we 

interviewed key stakeholders involved in implementing or evaluating the 

program, such as SSA officials, state VR officials, and Advisory Panel 

members. We also interviewed representatives of selected disability 

organizations to obtain their views on the Ticket program. However, our 

ability to evaluate the effectiveness of the Ticket program was limited by 

SSA’s lack of information on beneficiaries’ work efforts prior to the 

implementation of the Ticket program. We conducted our work between 

 1

While the mandate also required GAO to examine states’ annual and interim reports on the 

Ticket program, we were unable to undertake this effort because states have not been 

required to, nor have they evaluated, the implementation and effectiveness of the Ticket 

program. 
Page 3 GAO-05-248 SSA's Ticket Program 

August 2004 and January 2005 in accordance with generally accepted 

government auditing standards. 

In summary, we found: 

• SSA has made progress implementing and evaluating the Ticket program, 

but the agency has had limited success in achieving the program’s goals of 

expanding beneficiaries’ choice of service providers and increasing 

beneficiaries’ efforts to work and become self-sufficient. Although SSA 

experienced delays with the initial distribution of tickets, the agency 

finished distributing tickets to eligible beneficiaries throughout the nation 

in September 2004.2

 As part of implementation, SSA has also contracted 

for extensive assessments of its program’s performance. Despite SSA’s 

completion of key implementation activities, it has had limited success 

achieving its goal to encourage service providers to join the program and 

provide services to beneficiaries. As of August 2004, although SSA had 

contacted more than 50,000 potential new service providers, only 1,164 

had become ENs and, as of May 2004, just 386 had accepted tickets and 

agreed to provide services to beneficiaries. Furthermore, early results 

indicate that the program has made little progress in achieving its goal of 

increasing beneficiaries’ efforts to work and to discontinue receiving SSA’s 

disability benefits. Of the 9.5 million beneficiaries receiving tickets, less 

than 1 percent (62,901) have assigned their tickets to an EN or state VR 

agency, as of August 2004. Lastly, about 160 beneficiaries have had 

sufficient earnings to result in the discontinuance of their disability benefit 

payments and payments to ENs, as of March 2004.3

• The Ticket program’s ability to achieve its goals has been hindered by 

several factors, according to the Advisory Panel, researchers, and service 

providers. First, service providers believe that the program’s payment 

system does not provide adequate compensation for the administrative 

costs of participating. Second, participation of eligible beneficiaries has 

been limited by the lack of ENs, the lack of outreach to provide 

information about the program, and the lack of incentives to encourage 

beneficiaries to participate. Beneficiary participation was also reduced by 

SSA’s rules that exclude from the Ticket program some potential 

participants, such as adult beneficiaries who are expected to experience 

medical improvement. Finally, external factors, such as a decline in the 

 2

SSA continues to distribute tickets to additional beneficiaries as they become eligible for 

the Ticket program. 

3

SSA was unable to provide us with more current data. 
Page 4 GAO-05-248 SSA's Ticket Program 

availability of jobs in the economy, may have discouraged program 

participation or reduced the success of beneficiaries’ work activities. 

• The Advisory Panel and others have suggested numerous changes to 

improve the Ticket program. The Advisory Panel and others believe that 

reforming the payment system is critical to expanding participation. In 

addition, they suggested numerous changes to reduce the administrative 

burden for service providers, such as having SSA provide additional 

services, guidance, and information to providers. To address limited 

beneficiary participation, the Advisory Panel and others have a number of 

suggestions, such as using a national campaign to market the program. 

The Advisory Panel also suggested that SSA include in the Ticket program 

beneficiaries it had previously excluded. 

• SSA faces several challenges as it tries to improve the Ticket program’s 

ability to achieve its goals. Although SSA has made some administrative 

changes to the program, the agency recognizes that additional changes are 

needed. However, SSA has deferred other reforms until it has performed 

additional assessments on changes that it believes could be costly. For 

example, SSA officials explained that reforms to the EN payment structure 

could increase Ticket program costs, but may not provide a commensurate 

decrease in benefit payments. In addition, some proposed changes go 

beyond the substantial authority provided to the agency in the Ticket Act 

and may require legislative actions or coordination with other agencies. To 

determine the most effective reforms, SSA officials told us they needed 

more time to collect and evaluate information on the program’s 

performance, reasons for limited beneficiary participation, and the 

potential impact of reforms. However, the agency lacks a plan that defines 

when and how it will assess proposed changes and identify cost-effective 

reforms. 

In conclusion, we believe rigorous planning is needed to provide sufficient 

and reliable information to adequately assess the numerous proposed 

reforms put forth by the Advisory Panel and others. Thorough and reliable 

analysis is particularly important because of the complexity and potential 

costs of this nationwide program, as well as the opportunities that it could 

provide to beneficiaries who want to become self-sufficient. Without a 

well-defined plan to assess proposed changes, SSA may not be able to 

provide stakeholders with cost-effective and timely solutions to increase 

program participation and the number of beneficiaries who become selfsufficient and move off the disability rolls. 

GAO is making one recommendation to the Commissioner of Social 

Security. We recommend that SSA’s Commissioner provide to Congress a 
Page 5 GAO-05-248 SSA's Ticket Program 

plan that defines how and when the agency will assess proposed changes 

so that it may provide timely and cost-effective solutions to increase 

program participation and the number of beneficiaries who become selfsufficient and move off the disability rolls. 

In commenting on the draft of this report, SSA said that, although more 

could be done, it already had a plan to improve the effectiveness of the 

Ticket program. SSA pointed to its evaluation plan and other related 

efforts as its plan for improving the program. In our draft report, we 

recognized that SSA does have an extensive plan for evaluating the 

performance of the Ticket program. But, the agency’s current plan does 

not specifically incorporate efforts to assess the potential costs and 

benefits of implementing changes proposed by the Advisory Panel and 

other stakeholders. As such, we continue to see a need for SSA to better 

delineate how and when the agency will assess the numerous 

recommendations put forth by the Advisory Panel and other stakeholders. 

We have revised our recommendation to clarify this point and, as needed, 

have made changes to address comments from the agency regarding 

appendix I. The agency’s comments are provided in appendix II. 

Copies of this report are being sent to the Commissioner of SSA, 

appropriate congressional committees, and other interested parties. This 

report is also available at no charge on GAO’s Web site at 

http://www.gao.gov. If you have any questions about this report, please 

contact me or Carol Dawn Petersen at (202) 512-7215. Other contacts and 

staff acknowledgments are listed in appendix III. 

Robert E. Robertson 

Director, Education, Workforce, 

 and Income Security Issues 
Appendix I: Briefing Slides 

Page 6 GAO-05-248 SSA's Ticket Program 

Appendix I: Briefing Slides 

1

Congressional Briefing

SOCIAL SECURITY 

ADMINISTRATION: 

Better Planning Could Make the

Ticket Program More Effective
Appendix I: Briefing Slides 

Page 7 GAO-05-248 SSA's Ticket Program 

2

Background

• The Social Security Administration (SSA) manages the nation’s two largest disability programs: Disability Insurance (DI) and 

Supplemental Security Income (SSI).

• Approximately $75 billion was paid to about 8 million DI and SSI beneficiaries (aged 18 to 64) in 2003.

• Until recently, beneficiaries who needed help returning to work generally had to seek services from state vocational rehabilitation 

(VR) agencies. Few beneficiaries used these services or returned

to work.

• Even small improvements in SSA’s ability to return beneficiaries to work offer the potential for significant savings.
Appendix I: Briefing Slides 

Page 8 GAO-05-248 SSA's Ticket Program 

3

The Ticket Act

• Congress passed the Ticket to Work and Work Incentives Improvement Act 

of 1999 (the Ticket Act) to

• create a program to expand the availability of service providers

• help enable beneficiaries

• return to work, 

• become self-sufficient, and 

• stop receiving disability benefit payments. 

• Eligible beneficiaries can use their tickets as vouchers to request vocational 

rehabilitation, employment, or other support services.

• Tickets can be used at VR agencies or at new SSA-approved public or 

private providers, known as employment networks (EN). 
Appendix I: Briefing Slides 

Page 9 GAO-05-248 SSA's Ticket Program 

4

The Ticket Act (continued)

• The Ticket Act 

• required SSA to take specific steps to implement and evaluate the program,

• gave SSA considerable authority to make changes to the program, and 

• created the Ticket to Work and Work Incentives Advisory Panel (the Advisory Panel).

• SSA made tickets available to eligible beneficiaries in three 

phases:

(1) beginning with 13 states in February 2002, 

(2) expanding to 20 more states and the District of Columbia in 

November 2002, and

(3) expanding to the final 17 states and 5 territories in November 

2003.
Appendix I: Briefing Slides 

Page 10 GAO-05-248 SSA's Ticket Program 

5

Congressional mandate and objectives

• Congress mandated in the Social Security Protection Act of 2004 

that GAO assess the Ticket program and make recommendations, 

as appropriate, to Congress by March 2, 2005. 

• To address the mandate, we reviewed the

(1) progress SSA has made in implementing and evaluating the 

Ticket program and achieving its goals,

(2) problems that have limited the program's ability to achieve its 

goals,

(3) recommendations that the Advisory Panel and others have 

made to achieve the program’s goals, and 

(4) challenges that SSA faces in implementing changes to 

achieve the program’s goals.
Appendix I: Briefing Slides 

Page 11 GAO-05-248 SSA's Ticket Program 

6

Scope and methods

• To assess the Ticket program, we

• reviewed and assessed the quality of key studies conducted for SSA,

• reviewed reports by the Advisory Panel and other related documents,

• interviewed key stakeholders, such as SSA officials, state VR officials, and Advisory Panel members, and

• interviewed representatives of selected disability organizations to obtain their views on the Ticket program.

• We conducted our work between August 2004 and January 2005 in accordance with generally accepted government auditing 

standards.
Appendix I: Briefing Slides 

Page 12 GAO-05-248 SSA's Ticket Program 

7

Key findings

• SSA has made progress implementing and evaluating the Ticket 

program, but has had limited success achieving the program’s 

goals

• Inadequate incentives for service providers and beneficiaries to

participate, limited marketing, and other factors have hindered the 

program’s success

• The Advisory Panel, researchers, and service providers have 

suggested improvements to the payment structure and program 

design 

• SSA faces several challenges implementing changes to meet 

program goals
Appendix I: Briefing Slides 

Page 13 GAO-05-248 SSA's Ticket Program 

8

SSA has made progress implementing the program, 

but has had limited success achieving program goals

• SSA implemented the Ticket program after delays establishing 

regulations

• SSA continues to evaluate the program’s ability to meet its goals

• SSA has had limited success achieving its goal of expanding the 

number of ENs 

• SSA has had limited success achieving its goal of increasing 

beneficiaries’ efforts to work and leave SSA’s disability rolls
Appendix I: Briefing Slides 

Page 14 GAO-05-248 SSA's Ticket Program 

9

After experiencing delays, SSA has 

implemented the Ticket program 

• The Ticket Act required SSA to issue final program 

regulations by December 2000, but it did not do so until 

December 2001.

• Difficulties establishing the regulations and other 

administrative problems delayed ticket distribution:

• SSA was required to start making tickets available in 

December 2000, but did not do so until February 2002. 

• As of September 2004, SSA had distributed tickets to all 

eligible beneficiaries. 
Appendix I: Briefing Slides 

Page 15 GAO-05-248 SSA's Ticket Program 

10

SSA continues to evaluate the program

• As part of implementation, SSA has contracted for extensive assessments of the program. 

• Contractors have 

• provided SSA with reports on the early implementation of the program and 

• developed extensive plans to 

• perform additional evaluations, 

• provide annual reports, and

• report on the program’s cost-effectiveness and its impact on 

beneficiaries’ work outcomes in 2006, 2007, and 2008.
Appendix I: Briefing Slides 

Page 16 GAO-05-248 SSA's Ticket Program 

11

SSA has had limited success

expanding the number of ENs

Despite contacting over 50,000 organizations, as of August 2004:

• A total of 1,164 ENs (or about 2 percent of the organizations 

contacted) were enrolled.

• On average, there is 1 EN for every 8,167 ticket holders.

• ENs held 5,603 tickets, or 9 percent of the tickets being used by 

beneficiaries.

• State VR agencies held 56,488 tickets, or 91 percent of the tickets 

being used by beneficiaries.
Appendix I: Briefing Slides 

Page 17 GAO-05-248 SSA's Ticket Program 

12

SSA has had limited success

increasing beneficiaries’ efforts to work

As of August 2004:

• 9.5 million beneficiaries have received tickets.

• 62,901 of them (or less than 1 percent) have used their tickets.

• 687 ticket holders had earnings that resulted in an outcome or 

milestone payment to a service provider.

As of March 2004:

• About 160 ticket holders have had sufficient earnings to result in 

discontinuance of their disability benefits and payments to ENs.
Appendix I: Briefing Slides 

Page 18 GAO-05-248 SSA's Ticket Program 

13

Numerous problems have limited the 

program’s ability to achieve its goals

• The Advisory Panel, researchers, and/or service providers have 

identified the following key problems:

• Various features of the EN payment system

• Some EN administrative requirements

• Insufficient incentives and safeguards for beneficiaries

• Insufficient marketing to beneficiaries

• Exclusion of some beneficiaries from the program

• A weak economy and other external factors
Appendix I: Briefing Slides 

Page 19 GAO-05-248 SSA's Ticket Program 

14

Key problems with the payment system

• ENs receive no up-front funding to cover costs and assume 

significant financial risk for assisting beneficiaries.

• EN payments are small and contingent on a beneficiary’s achieving 

sufficient earnings.

• Earnings must be maintained for 60 months or more to ensure ENs 

receive the maximum payment. 

• Of the two EN payment options, most ENs have selected the 

milestone-outcome option because it can provide earlier payments, 

but total payments can be 15 percent less than the outcome-only 

option. 
Appendix I: Briefing Slides 

Page 20 GAO-05-248 SSA's Ticket Program 

15

Key problems with the payment system 

(continued) 

• The payment system creates

• a disincentive for ENs to serve certain beneficiaries, such as 

those who need extensive services or cannot work full-time 

jobs,

• confusion among ENs about whether funding from other federal and state programs can be used to assist beneficiaries with 

tickets, and

• competition between ENs and state VR agencies that has

• kept some service providers from participating because they did not want to change their ongoing relationships with VR 

agencies and 

• led to some financial and service agreements between VR agencies and ENs that may put ENs at a financial 

disadvantage. 
Appendix I: Briefing Slides 

Page 21 GAO-05-248 SSA's Ticket Program 

16

Key problems with EN administrative 

requirements

• Screening beneficiaries: ENs can receive only contact information 

for beneficiaries and would like more information and guidance to 

help screen them.

• Educating beneficiaries: Beneficiaries receive little information from 

SSA on the program, so ENs report being inundated with inquiries.

• Tracking beneficiaries’ earnings: While SSA has reduced some 

reporting requirements, ENs report continued difficulty obtaining 

earnings information and determining the level of earnings needed 

to qualify for payments.
Appendix I: Briefing Slides 

Page 22 GAO-05-248 SSA's Ticket Program 

17

Key problems with incentives and safeguards

for beneficiaries

• According to the Advisory Panel and researchers, some 

beneficiaries may have little incentive to participate because they 

continue to

• have limited choice in service providers and 

• fear that working could result in 

• the inability to retain or easily reinstate benefits when their 

efforts to work are unsuccessful and

• overpayments from SSA that may cause a financial strain 

during repayment.

• SSA is currently surveying beneficiaries to determine what factors 

influence their participation.
Appendix I: Briefing Slides 

Page 23 GAO-05-248 SSA's Ticket Program 

18

Key problems with incentives and safeguards

for beneficiaries (continued)

• Program safeguards may not protect benefits in some cases and 

may increase beneficiaries’ fears about working because 

• reinstatement of benefits can be expedited only when a 

beneficiary’s job loss is caused by his or her disability and

• SSA can reevaluate a beneficiary’s eligibility for disability 

benefits if it determines that the beneficiary’s progress in the

Ticket program is insufficient.
Appendix I: Briefing Slides 

Page 24 GAO-05-248 SSA's Ticket Program 

19

Key problems with marketing

• As of September 2004, SSA’s information to all eligible beneficiaries about the program has been limited to a brief cover 

letter and a pamphlet mailed with the ticket.

• Although SSA employed its field staff and contracted with community organizations to provide outreach, the Advisory Panel 

reports that these efforts have been insufficient to meet the needs 

of beneficiaries.

• SSA has also contracted for a national marketing campaign and recently taken actions to implement new marketing activities; 

however, the Advisory Panel and others believe that SSA should 

have moved more quickly to increase beneficiaries’ awareness and

interest in the program. 
Appendix I: Briefing Slides 

Page 25 GAO-05-248 SSA's Ticket Program 

20

Key problem with exclusion of certain 

beneficiaries

• SSA excludes from the Ticket program:

• adult beneficiaries who are expected to improve medically,

• SSI beneficiaries under 18 years of age, and

• SSI beneficiaries 18 years of age and older awaiting 

reevaluation of disability status using adult standards.

• Researchers believe that

• adult beneficiaries who are expected to improve medically 

would likely benefit from vocational services and return to work, 

and

• SSI beneficiaries who may be preparing to transition from 

school to work would also benefit from the program.
Appendix I: Briefing Slides 

Page 26 GAO-05-248 SSA's Ticket Program 

21

External factors may also hinder the 

program’s success

The Advisory Panel and researchers have noted the following external 

factors may have hindered the program’s success:

• a weak economy and reduced job availability,

• possible employer discrimination against people with disabilities, 

and

• states’ limited participation in Medicaid buy-in programs to make 

health care more affordable for beneficiaries who want to work.
Appendix I: Briefing Slides 

Page 27 GAO-05-248 SSA's Ticket Program 

22

Suggested reforms to address key problems

• The Advisory Panel, researchers, and/or service providers 

have suggested making reforms to:

• EN payment system

• EN administrative requirements

• incentives and safeguards for beneficiaries

• marketing to beneficiaries

• eligibility policies for beneficiaries
Appendix I: Briefing Slides 

Page 28 GAO-05-248 SSA's Ticket Program 

23

Suggested reforms to the payment system

According to the Advisory Panel, researchers, and/or service 

providers, the Ticket program should

• assist ENs with obtaining up-front funding

• provide larger and earlier payments

• shorten the payment period from 5 years to 3 years

• reduce the difference between the maximum payments for the two 

EN payment options
Appendix I: Briefing Slides 

Page 29 GAO-05-248 SSA's Ticket Program 

24

Suggested reforms to the payment system 

(continued)

According to the Advisory Panel and/or others, the Ticket program 

should

• Enhance the potential for beneficiaries to receive needed services 

and reduce service provider competition by

• allowing a VR agency and an EN to receive payments when serving a beneficiary with both short- and long-term needs

• reducing the minimum earnings needed to trigger EN payments for beneficiaries who cannot work full-time jobs 

• clarifying that EN payments should not disqualify a beneficiary from receiving funds or services from other federal and state 

programs

• creating guidance for developing VR-EN agreements and a model agreement to equitably share the benefits and risks of 

participating
Appendix I: Briefing Slides 

Page 30 GAO-05-248 SSA's Ticket Program 

25

Suggested reforms to reduce EN 

administrative burdens

According to the Advisory Panel and/or others, the Ticket program 

should

• provide more information about beneficiaries to ENs to enable them 

to screen beneficiaries more effectively

• provide more information to beneficiaries to reduce the demand for 

information from ENs

• track earnings for ENs or provide case tracking software to ENs

• establish national technical assistance and training for ENs to 

provide best practices for program administration
Appendix I: Briefing Slides 

Page 31 GAO-05-248 SSA's Ticket Program 

26

Suggested reforms to strengthen

incentives and safeguards for beneficiaries

According to the Advisory Panel and/or others, the Ticket program should

• provide incentive payments to beneficiaries who complete a work plan to become self-sufficient

• create Individual Development Accounts so working beneficiaries can retain earnings to support their work efforts

• not require beneficiaries to reimburse SSA for any overpayments made more than 6 months after the beneficiaries have reported their earnings

• expedite reinstatement of benefits for reasons other than job loss caused by the beneficiary's disability

• have the service provider determine that the beneficiary’s progress is insufficient before SSA can reevaluate the beneficiary’s eligibility for disability benefits
Appendix I: Briefing Slides 

Page 32 GAO-05-248 SSA's Ticket Program 

27

Suggested marketing reforms

According to the Advisory Panel and/or others, the Ticket program should

• Inform eligible beneficiaries about the Ticket program at least once a year

• Increase marketing by

• immediately developing and implementing a nationwide marketing 

campaign to beneficiaries and other potential participants, and/or

• targeting marketing efforts to beneficiaries who are most likely to 

pursue employment

• Expand community planning and outreach efforts to inform beneficiaries of 

work incentives and to clarify program rules
Appendix I: Briefing Slides 

Page 33 GAO-05-248 SSA's Ticket Program 

28

Suggested reforms to beneficiary eligibility 

policies

• The Advisory Panel and/or others have suggested that SSA expand 

eligibility to these additional groups of beneficiaries:

• adult beneficiaries who are expected to improve medically,

• SSI beneficiaries under 18 years of age, and

• SSI beneficiaries 18 years of age and older awaiting 

reevaluation of disability status using adult standards.
Appendix I: Briefing Slides 

Page 34 GAO-05-248 SSA's Ticket Program 

29

SSA faces challenges in achieving program 

goals

• SSA has made some administrative changes, but recognizes 

additional changes are needed to meet program goals.

• SSA has deferred making other reforms until it has performed 

additional assessments on changes that it believes could be 

costly.

• For example, a SSA official explained that reforms to the EN 

payment system could increase program costs without 

providing a commensurate decrease in benefit payments.
Appendix I: Briefing Slides 

Page 35 GAO-05-248 SSA's Ticket Program 

30

SSA faces challenges in achieving program 

goals (continued)

• Some proposed changes may require congressional action or SSA’s coordination with other agencies. 

• To assess potential reforms, SSA wants to gather more 

information on the program’s performance, reasons for 

limited beneficiary participation, and the potential impact of 

reforms.

• As part of this effort, the agency has an extensive and longterm plan to evaluate the program; however, it does not have 

a plan that clearly outlines when and how it will assess 

proposed changes and identify cost-effective reforms.
Appendix I: Briefing Slides 

Page 36 GAO-05-248 SSA's Ticket Program 

31

Conclusions

• Given the complexity and size of the Ticket program, rigorous 

planning is needed to ensure that SSA has sufficient and reliable 

information to assess the numerous changes put forth by the 

Advisory Panel and other stakeholders.

• Without a plan that specifies how and when it will assess the 

proposed changes, SSA may not be able to provide stakeholders 

with cost-effective and timely solutions to increase program 

participation and the number of beneficiaries who become selfsufficient and move off the disability rolls. 
Appendix I: Briefing Slides 

Page 37 GAO-05-248 SSA's Ticket Program 

32

Agency recommendation 

• SSA should provide Congress with a plan that defines how and 

when the agency will assess proposed changes so that it may 

provide timely and cost-effective solutions to increase program 

participation and the number of beneficiaries who become selfsufficient and move off the disability rolls. 
Appendix II: Comments from the Social 

Security Administration 

Page 38 GAO-05-248 SSA's Ticket Program 

Appendix II: Comments from the Social 

Security Administration 
Appendix II: Comments from the Social 

Security Administration 

Page 39 GAO-05-248 SSA's Ticket Program 
Appendix II: Comments from the Social 

Security Administration 

Page 40 GAO-05-248 SSA's Ticket Program 
Appendix II: Comments from the Social 

Security Administration 

Page 41 GAO-05-248 SSA's Ticket Program 
Appendix II: Comments from the Social 

Security Administration 

Page 42 GAO-05-248 SSA's Ticket Program 
Appendix II: Comments from the Social 

Security Administration 

Page 43 GAO-05-248 SSA's Ticket Program 
Appendix III: GAO Contacts and Staff 

Acknowledgments 

Page 44 GAO-05-248 SSA's Ticket Program 

Carol Dawn Petersen, Assistant Director (202) 512-7215 

Julie DeVault, Analyst in Charge (415) 904-2269 

In addition to the individuals mentioned above, the following staff 

members made major contributions to this report: Gretta L. Goodwin, 

Theresa Lo, Cady S. Panetta, Tovah Rom, Daniel Schwimer, and 

Dianne Whitman-Miner. 

Appendix III: GAO Contacts and Staff 

Acknowledgments 

GAO Contacts 

Staff 

Acknowledgments 

(130376) 
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