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75–187 2012

WORK INCENTIVES IN 

SOCIAL SECURITY DISABILITY PROGRAMS 

JOINT HEARING 

BEFORE THE

SUBCOMMITTEE ON SOCIAL SECURITY 

AND

SUBCOMMITTEE ON HUMAN RESOURCES 

OF THE

COMMITTEE ON WAYS AND MEANS 

U.S. HOUSE OF REPRESENTATIVES 

ONE HUNDRED TWELFTH CONGRESS 

FIRST SESSION 

SEPTEMBER 23, 2011 

Serial No. 112–SS10 & 112–HR08 

Printed for the use of the Committee on Ways and Means 

( 


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COMMITTEE ON WAYS AND MEANS 

DAVE CAMP, Michigan, Chairman 

WALLY HERGER, California 

SAM JOHNSON, Texas 

KEVIN BRADY, Texas 

PAUL RYAN, Wisconsin 

DEVIN NUNES, California 

PATRICK J. TIBERI, Ohio 

GEOFF DAVIS, Kentucky 

DAVID G. REICHERT, Washington 

CHARLES W. BOUSTANY, JR., Louisiana 

PETER J. ROSKAM, Illinois 

JIM GERLACH, Pennsylvania 

TOM PRICE, Georgia 

VERN BUCHANAN, Florida 

ADRIAN SMITH, Nebraska 

AARON SCHOCK, Illinois 

LYNN JENKINS, Kansas 

ERIK PAULSEN, Minnesota 

KENNY MARCHANT, Texas 

RICK BERG, North Dakota 

DIANE BLACK, Tennessee 

TOM REED, New York 

SANDER M. LEVIN, Michigan 

CHARLES B. RANGEL, New York 

FORTNEY PETE STARK, California 

JIM MCDERMOTT, Washington 

JOHN LEWIS, Georgia 

RICHARD E. NEAL, Massachusetts 

XAVIER BECERRA, California 

LLOYD DOGGETT, Texas 

MIKE THOMPSON, California 

JOHN B. LARSON, Connecticut 

EARL BLUMENAUER, Oregon 

RON KIND, Wisconsin 

BILL PASCRELL, JR., New Jersey 

SHELLEY BERKLEY, Nevada 

JOSEPH CROWLEY, New York 

Jon Traub, Staff Director 

Janice Mays, Minority Staff Director 

SUBCOMMITTEE ON SOCIAL SECURITY

SAM JOHNSON, Texas, Chairman 

KEVIN BRADY, Texas 

PATRICK J. TIBERI, Ohio 

AARON SCHOCK, Illinois 

RICK BERG, North Dakota 

ADRIAN SMITH, Nebraska 

KENNY MARCHANT, Texas 

XAVIER BECERRA, California, Ranking 

LLOYD DOGGETT, Texas 

SHELLEY BERKLEY, Nevada 

FORTNEY PETE STARK, California 

SUBCOMMITTEE ON HUMAN RESOURCES

GEOFF DAVIS, Kentucky, Chairman 

ERIK PAULSEN, Minnesota 

RICK BERG, North Dakota 

TOM REED, New York 

TOM PRICE, Georgia 

DIANE BLACK, Tennessee 

CHARLES W. BOUSTANY, JR., Louisiana 

LLOYD DOGGETT, Texas, Ranking 

JIM MCDERMOTT, Washington 

JOHN LEWIS, Georgia 

JOSEPH CROWLEY, New York 

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. 


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C O N T E N T S 

Page 

Advisory of September 23, 2011, announcing the hearing ................................... 2 

WITNESSES 

Robert W. Williams, Associate Commissioner, Office of Employment Support 

Programs, accompanied by Dr. Robert R. Weathers II, Deputy Associate 

Commissioner, Office of Program Development and Research, Social Security Administration .............................................................................................. 10 

Daniel Bertoni, Director, Education, Workforce, and Income Security Issues, 

U.S. Government Accountability Office .............................................................. 23 

Deb Russell, Manager, Outreach and Employee Services, Walgreen Company, 

Deerfield, Illinois .................................................................................................. 44 

James Hanophy, Assistant Commissioner, Texas Department of Assistive and 

Rehabilitative Services, Austin, Texas, on behalf of the Council of State 

Administrators of Vocational Rehabilitation ..................................................... 55 

Cheryl Bates-Harris, Senior Disability Advocacy Specialist, National Disability Rights Network, on behalf of the Consortium for Citizens with 

Disabilities Employment and Training Task Force .......................................... 70 

John Kregel, Professor, Special Education and Disability Policy, Virginia 

Commonwealth University, Richmond, Virginia ............................................... 88 

SUBMISSIONS FOR THE RECORD 

Arizona Bridge to Independent Living, statement ................................................ 270 

Corporation for Enterprise Development, statement ............................................ 278 

Linda Landry, statement ........................................................................................ 281 

Health and Disability Advocates, statement ......................................................... 283 

National Association of Benefits and Work Incentives Specialists, statement .. 294 

National Disability Rights Network, statement .................................................... 297 

Oregon Department of Human Services Office of Vocational Rehabilitation 

Services, statement .............................................................................................. 300 

Steve Kofahl, statement .......................................................................................... 301 

APSE, statement ...................................................................................................... 304 


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WORK INCENTIVES IN 

SOCIAL SECURITY DISABILITY PROGRAMS 

FRIDAY, SEPTEMBER 23, 2011 

U.S. HOUSE OF REPRESENTATIVES, 

COMMITTEE ON WAYS AND MEANS, 

SUBCOMMITTEE ON SOCIAL SECURITY, 

SUBCOMMITTEE ON HUMAN RESOURCES, 

Washington, DC. 

The Subcommittee met, pursuant to notice, at 9:05 a.m., in room 

1100, Longworth House Office Building, Hon. Sam Johnson (Chairman of the Subcommittee on Social Security), presiding. 

[The advisory announcing the hearing follows:] 


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ADVISORY 

FROM THE COMMITTEE ON WAYS AND MEANS 

SUBCOMMITTEE ON SOCIAL SECURITY AND 

SUBCOMMITTEE ON HUMAN RESOURCES 

FOR IMMEDIATE RELEASE CONTACT: (202) 225–1721 

September 23, 2011 

SS–10 & HR–08 

Chairman Johnson and Chairman Davis 

Announce a Joint Hearing on Work Incentives in 

Social Security Disability Programs 

U.S. Congressman Sam Johnson (R–TX), Chairman of the House Committee on 

Ways and Means Subcommittee on Social Security, and U.S. Congressman Geoff 

Davis (R–KY), Chairman of the House Committee on Ways and Means Subcommittee on Human Resources, announced today that the Subcommittees will hold 

a joint oversight hearing on work incentives in Social Security disability programs. 

The hearing will take place on Friday, September 23, 2011, in room 1100, 

Longworth House Office Building, beginning at 9 a.m. 

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

hearing will be from invited witnesses only. However, any individual or organization 

not scheduled for an oral appearance may submit a written statement for consideration by the Committee and for inclusion in the printed record of the hearing. A 

list of invited witnesses will follow. 

BACKGROUND: 

The Social Security Administration (SSA) administers two programs, Social Security Disability Insurance (SSDI) and Supplemental Security Income (SSI), which together provide benefits each year to nearly 14 million beneficiaries unable to work 

because of severe disabling conditions. The SSDI program pays benefits to those 

who have sufficient past employment covered by Social Security to qualify. The SSI 

program pays benefits to those who currently have limited income and assets, regardless of prior work history. 

After being awarded benefits based on an inability to work, individuals may attempt to return to work and are offered a variety of programs and supports provided 

by the SSA. In the most recent beneficiary survey, 40 percent of beneficiaries were 

interested in working, yet in 2009, only one half of 1 percent left the rolls to return 

to work. The experience of a cohort of new SSDI beneficiaries tracked over 10 years 

showed that nearly 30 percent worked at some time, and 6.5 percent were able to 

sustain earnings sufficient to have their benefits suspended. 

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

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 SSDI 

and SSI recipients to receive assistance to help them return to work. 

Services are furnished through the current system of State Vocational Rehabilitation (VR) agencies or a ticket holder’s choice of an approved public or private sector, 

program-specific Employment Network (EN) to assist them in entering or re-entering the workforce. When the ticket program was implemented, the SSA automatically issued tickets to most adult beneficiaries on the rolls, and has continued to 

issue them to new beneficiaries. Through June of this year, according to the SSA, 


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of the approximately 12.7 million tickets that have been issued since the program’s 

inception, 290,189 or approximately 2.3 percent have been assigned to an EN or VR 

agency. 

In July 2008, the SSA made major regulatory changes to the Ticket to Work program in an effort to increase participation by ENs and beneficiaries. These changes, 

however, have not been in place long enough for an accurate assessment of their 

impact. However, a May 2011 Government Accountability Office (GAO) assessment 

concluded ‘‘at this time, the agency [SSA] still lacks critical management and oversight mechanisms to assess whether the program is achieving its original purpose, 

and ultimately, whether the program is viable.’’ 

The Ticket to Work Act also authorized two programs now known as the Work 

Incentive Planning and Assistance (WIPA) program and the Protection and Advocacy for Beneficiaries of Social Security (PABSS) program. Under the WIPA program, SSA funds community-based organizations to assist beneficiaries in understanding and utilizing SSA’s complex work incentives policies. Under the PABSS 

program, SSA funds protection and advocacy systems to provide assistance to help 

beneficiaries secure, maintain, or regain employment. The authorization for both 

programs will expire on September 30, 2011, but existing funding permits WIPAs 

to continue providing services until June 30, 2012 and PABSS programs to continue 

serving their clients until February 29, 2012. 

SSA is also developing or conducting several demonstration projects to test new 

work incentive policies for Social Security disability beneficiaries, including a sliding 

scale benefit reduction. However, because SSA’s demonstration authority for disability insurance beneficiaries expired in December 2005, SSA can continue demonstrations already initiated, but cannot begin new projects. Reports issued by the 

GAO in 2004 and 2008 raised concerns about SSA’s management of its demonstration projects. The President’s FY 2012 budget included a proposal to reauthorize for 

5 years SSA’s demonstration authority for the DI program and require the Commissioner to conduct a demonstration project testing alternative methods of treating 

work activity by DI beneficiaries. 

Last, past testimony before the Subcommittees has reported that former beneficiaries have been overpaid tens of thousands of dollars due to SSA’s delays in terminating benefits, even if beneficiaries have informed the agency that they are 

working. The threat of receiving large overpayments, which must later be repaid, 

can be a significant work disincentive for disability beneficiaries. 

In announcing the hearing, Chairman Sam Johnson (R–TX) stated, ‘‘Those receiving disability benefits who want to work are looking for a hand up, not 

a hand out, to help them achieve a better life for themselves and their families. Now, more than ever, how every taxpayer dollar is spent matters. Programs that don’t achieve results must be changed or must end. This hearing will help us determine whether the work incentive programs are getting those who can back to work and a life of self sufficiency.’’ 

Chairman Geoff Davis (R–KY) went on to add, ‘‘Work lets individuals build a 

better life for themselves and their families. We should help individuals 

with disabilities who want to work to achieve that better life. That starts 

with reviewing what we are doing now to assist individuals with disabilities who want to work, and then holding SSA and its work incentive programs more accountable for improving on and achieving that critical goal.’’ 

FOCUS OF THE HEARING: 

The hearing will focus on the current work incentives in the SSDI and SSI programs, their impact on the number of individuals exiting the benefit roles, including 

the data and reports documenting such impact. The Subcommittees will also examine recommended performance standards to guide future evaluations of work incentives programs, with particular focus on Ticket to Work, WIPA, PABSS, and Vocational Rehabilitation Services. In addition, ongoing and proposed SSDI demonstration projects will also be reviewed. 


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DETAILS FOR SUBMISSION OF WRITTEN COMMENTS: 

Please Note: Any person(s) and/or organization(s) wishing to submit for the hearing record must follow the appropriate link on the hearing page of the Committee 

website and complete the informational forms. From the Committee homepage, 

http://waysandmeans.house.gov, select ‘‘Hearings.’’ Select the hearing for which you 

would like to submit, and click on the link entitled, ‘‘Click here to provide a submission for the record.’’ Once you have followed the online instructions, submit all requested information. ATTACH your submission as a Word or WordPerfect document, in compliance with the formatting requirements listed below, by the close 

of business on Friday, October 7, 2011. Finally, please note that due to the 

change in House mail policy, the U.S. Capitol Police will refuse sealed-package deliveries to all House Office Buildings. For questions, or if you encounter technical 

problems, please call (202) 225–1721 or (202) 225–3625. 

FORMATTING REQUIREMENTS: 

The Committee relies on electronic submissions for printing the official hearing record. As always, submissions will be included in the record according to the discretion of the Committee. 

The Committee will not alter the content of your submission, but we reserve the right to format 

it according to our guidelines. Any submission provided to the Committee by a witness, any supplementary materials submitted for the printed record, and any written comments in response 

to a request for written comments must conform to the guidelines listed below. Any submission 

or supplementary item 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 submissions and supplementary materials must be provided in Word or WordPerfect 

format and MUST NOT exceed a total of 10 pages, including attachments. Witnesses and submitters are advised that the Committee relies 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 submissions must include a list of all clients, persons, and/or organizations on whose 

behalf the witness appears. A supplemental sheet must accompany each submission 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://www.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 TDD/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 

Chairman JOHNSON. Good morning. We had a late night last 

night, and some of our guys haven’t woken up yet. 

But this hearing will come to order. I welcome and thank Chairman Davis and Ranking Member Doggett and the Members of the 

Subcommittee on Human Resources for joining us in this joint 

hearing. 

Our Nation’s most vulnerable citizens are at the center of a perfect storm. Record deficits, a still struggling economy, and an 

unsustainable future spending path, driven by the aging of Americans, all threaten the essential programs those with disabilities 

count on. We have been warned by the Social Security trustees 

that the disability insurance program will soon be unable to pay 

full benefits beginning just 7 years from now, in 2018. Those who 


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depend on these critical benefits are counting on us to act, and we 

will. 

This Committee will soon hold hearings on the many challenges 

facing Social Security disability. Today we turn to the issue of helping those already receiving benefits who want to work. To achieve 

that end, Social Security administers a number of work-incentive 

programs. Congress established the current State Vocational Rehabilitation Reimbursement program—that is a mouthful, isn’t it—in 

1981 to encourage State vocational rehabilitation agencies to provide services that would result in work by disability beneficiaries. 

Last year, Social Security paid over $100 million for these services. 

In 1999, Congress passed the Ticket to Work and Work Incentives Improvement Act to make it easier for beneficiaries to return 

to work. The Ticket program allows beneficiaries to choose a publicor private-sector service provider, known as an employment network, to get the training and support they need to find jobs, which, 

in turn, leads to benefit savings because they leave the benefit 

rolls, theoretically. 

Two grant programs were also created as part of the Ticket legislation. One helps beneficiaries understand Social Security’s complex rules, and the other assists in the resolution of potential disputes with employers. The authorization for these two programs 

expires September 30, though their funding continues until the 

next year. 

So where are we today? As we will soon hear, while there is some 

progress to report, the results are disappointing, and problems remain. A recent report by the GAO found Social Security’s oversight 

and management of the Ticket to Work program isn’t where it 

needs to be. For example, certain employment networks were telling ticket holders how they could work and keep their full benefits. 

This is simply unacceptable. Other employment networks are increasingly splitting the Ticket payment with beneficiaries while 

providing no direct services. 

At the same time, I have seen for myself how beneficiaries and 

employers benefit when the system works. While back home this 

August, I visited the Walgreens distribution center in Waxahachie, 

Texas. There, with the help of the Texas Department of Assistive 

and Rehabilitative Services, those with disabilities, including 

former beneficiaries, work side by side with other workers doing 

the same job for the same pay with the same performance. I look 

forward to hearing more of their inspiring stories today. 

Despite these and other work incentives, the fact is less than half 

of 1 percent of those receiving disability has left the benefit rolls 

to work. Now more than ever, how every taxpayer dollar is spent 

matters. Programs that don’t achieve results must be fixed, or they 

must end. The question we must answer today is how work incentives can achieve the results Congress and the taxpayers expect 

and those with disabilities deserve. 

I now recognize Mr. Doggett, the Ranking Member of the Subcommittee on Human Resources, for his opening statement. 

Mr. DOGGETT. Well, thank you very much, Chairman Johnson, 

Chairman Davis. And to all of our witnesses this morning, we look 

forward to hearing from you. 


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I think we all want a system here where any American who 

wants to work can work, and recognize that our workforce needs 

to provide a range of services or of functional levels so that we can 

make reasonable accommodation, where necessary, to allow those 

who have limitations and disabilities to participate to the full extent of their disability. We must also recognize that there are some 

people who have a disabling condition that is so severe that they 

cannot participate in the workforce. Those who are unable to work 

must have the guarantee of a safety net that is more net than hole 

and that helps them live in dignity. 

As the recent U.S. census data indicates, we have an increasing 

number of individuals with disabilities who are poor. Nearly 30 

percent of people who suffer from a disability live in poverty today 

in the United States. And to some extent, with reference to the 

Supplemental Security Income program, that is because the payment is not overly generous. Last year, the monthly benefit was a 

little less than $500 on the average, which would carry you to just 

a little over half of the poverty measure, according to the Congressional Research Service. The majority of those who receive SSI 

have a disability that is expected to last at least a year or result 

in death, and renders them incapable of performing a substantial 

level of work. So it is not surprising that those who are on SSI, receiving those limited benefits, may have difficulty or it may be impossible for them to move back into the workforce. 

At the same time, when you look at the way the law is written 

and the way it has been in effect since 1974, when someone who 

relies on SSI does see improvement in their condition, they want 

to begin to provide some type of employment service, they face the 

limitation that after the first $20 of income, their SSI benefit is reduced by $1 for every $2 of earned income exceeding $65 a month 

until the benefit level reaches zero. This income disregard used to 

determine program eligibility of benefit levels, and it has not been 

replaced since originally set up in 1974. 

As Chairman Johnson mentioned, we have made some progress 

through the Ticket to Work Act, but it is important to analyze how 

that has worked here and what we can do to make it more effective. 

In my home State of Texas, which I share with Chairman Johnson, one of the organizations working in this area is Disability 

Rights Texas. They helped a 41-year-old Austinite with spina bifida 

who receives SSI and had always assumed that he wouldn’t be able 

to work because he was afraid he would lose his benefits. Although 

he had acknowledged that his disability is very severe, and he had 

no work experience or training, he nonetheless decided he would 

try to work. Disability Rights Texas referred him to rehabilitative 

services and a customized employment program that ultimately 

helped him receive a job placement where he is experiencing some 

success and taking pride in the value of his work. 

Another example is a gentleman who lives in Maynard, Texas, 

outside of Austin, who experiences a combination of both physical 

and mental problems that severely affect him. The administrative 

law judge who decided his case noted that he was living in a car 

in the woods and would just sit there most of the day and talk to 

himself and the animals. By the time he had his disability deterVerDate Mar 15 2010 07:02 Aug 23, 2012 Jkt 075187 PO 00000 Frm 00010 Fmt 6633 Sfmt 6602 I:\WAYS\OUT\75187.XXX 75187

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mination hearing, he had been living in the nonrunning vehicle for 

over 4 years and had undergone five psychiatric hospitalizations. 

Now that he receives SSI benefits, he has access to housing and 

regular medical and psychiatric care. 

A contrasting set of examples about why we need to continue to 

strive to improve SSI, but why it will be necessary for some individuals who are not able to become productive members of our 

workforce. 

Mr. Chairman, thank you for holding today’s hearing, and we 

look forward to cooperating with you in seeking improvements in 

the program while maintaining this vital safety net. Thank you. 

Chairman JOHNSON. Thank you. 

I will now recognize the chairman of the Subcommittee on 

Human Resources, Chairman Davis, for his opening statement. 

Chairman DAVIS. Thank you, Chairman Johnson. 

As my colleagues have discussed, today’s hearing examines the 

effectiveness of work incentives administered by the Social Security 

Administration designed to help people with disabilities go to work. 

Chairman Johnson and Ranking Member Doggett focused on the 

effects, especially on individuals who receive disability checks from 

the Social Security Disability Insurance program. 

As Chairman of the Human Resources Subcommittee, I want to 

discuss the implications for people on the Supplemental Security 

Income, or SSI program, which falls under our Subcommittee’s jurisdiction. This is our first hearing this year specifically on the SSI 

Program, and I can’t think of a more appropriate topic than how 

we help people go back to work, and whether those efforts are succeeding. 

Since SSI first started paying benefits in 1974, this means-tested 

cash assistance program has always encouraged work and earnings 

by reducing benefits by only $1 for every $2 in earnings. In other 

words, SSI, by design, tries to overcome disincentives to work inherent in a benefit program for disabled people with very low income. Even though SSI recipients have less work experience than 

SSDI recipients, an average of 5 percent leave the SSI rolls each 

year due to income from work or other sources—this is 10 times 

the rate for SSDI recipients. Still, 5 percent is a very low rate. 

The key questions we have today are, do current programs and 

policies actually promote work? And if not, what else should we be 

doing? Our focus is on working-age, disabled individuals, nearly 40 

percent of whom have expressed an interest in working. Disability 

applicants spend months and, in most cases, years proving they are 

disabled enough to merit benefit payments. Once they successfully 

prove they are too disabled to work, we encourage them to try to 

work with the goal of leaving the benefit rolls again. If it sounds 

complicated and contradictory, that is because it is. 

SSA manages a complex system of work incentives that include 

various exemptions and exceptions and disregards that are both 

difficult for beneficiaries to understand and for SSA to efficiently 

administer. This confusing diagram up on the screen in front of you 

displays just the SSI work incentives, and it says it all. A similarly 

confusing chart exists for the SSDI program. What this all suggests 

is we need more balance. Balance for the beneficiary when it comes 

to easing the transition to work while reducing complexity that has 


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become an obstacle to work. And balance for the Social Security 

Administration in administering complex work incentives efficiently and effectively. Ultimately, this involves a balance of taxpayer dollars, too. 

What is the right balance of incentives for individuals who are 

unable to work due to disability and who receive cash benefits, 

health coverage, and support for a range of assistance and other 

programs? Is there more assistance that would better help them 

work, or would more assistance make it even harder for them to 

work if the benefits of not working increasingly outweigh the benefits of working? The question is, what is the right balance? This 

discussion is why today’s hearing is so important. 

Encouraging work and self-sufficiency improves the well-being of 

individuals and families regardless of their disability status. We 

need to look deeper into these programs to hold SSA, current work 

incentives, and ourselves accountable for achieving this goal in a 

fiscally responsible manner. We can’t continue to just ‘‘do more’’ 

and ‘‘spend more’’ and hope that it helps. We need to start by reviewing whether what we are already doing is working to help 

beneficiaries so we can ensure taxpayer resources are properly targeted. 

We have an excellent panel of witnesses with us today to discuss 

these complicated issues and more. We look forward to all of their 

testimonies. 

With that, I yield back. 

Chairman JOHNSON. Thank you. I appreciate your comments. 

I will now recognize the Ranking Member on the Subcommittee 

on Social Security Mr. Becerra for his comments. 

Mr. BECERRA. Thank you, Mr. Chairman, to both chairmen, for 

holding this hearing today. 

We are examining today some of the tools SSA has to assist disabled Americans who receive benefits, but want to try to return to 

work. I hope that this will be the starting point for moving legislation to continue the Social Security services that have allowed disabled Americans to live and work with dignity. 

Let us put things into perspective. Social Security’s disability 

programs; the Social Security Disability Insurance, DI, program; 

and the Supplemental Security Income program, SSI, are designed 

for people with severe work disabilities. In order to qualify, Americans must suffer from a medical condition so severe that, according 

to medical and vocational experts, it essentially prevents them 

from doing any work at all. 

Most Americans receiving DI or SSI benefits are quite sick. 

About 1 out of every 5 men awarded DI benefits dies within 5 years 

of starting benefits, and about 1 in every 10 Americans awarded 

DI benefits suffers from cancer. Yet only the very sickest cancer patients qualify for benefits. In 2010, 1.6 million Americans were diagnosed with cancer, but fewer than 10 percent of them were 

awarded DI benefits because they had cancer. 

New beneficiaries are also likely to be older. Almost 6 of every 

10 Americans who are awarded benefits are 50 years or older. Nevertheless, a small number of severely disabled Americans courageously manage to work despite very serious challenges, and many 

others want to try. We should encourage work whenever possible, 


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such as by providing support to workers and employers without 

punishing those who are truly unable to work. 

This year’s budget cuts imposed on the Social Security Administration, nearly $1 billion below what Social Security needs to do its 

job, will make it difficult for SSA to support Americans with disabilities who are trying to return to work. Americans who are attempting to work often need specialized help that SSA can’t provide. Congress has authorized some small grants paid out of SSA’s 

regular operating budget to help these Americans secure the specialized support they need. We should do all we can to ensure that 

these services continue their successful record of helping disabled 

Americans return to work. 

Counselors funded through the Work Incentives Planning and 

Assistance program, or WIPA, help Americans understand and 

properly use the incentives offered by SSA that encourage the transition back to work. The Protection and Advocacy for Beneficiaries 

of Social Security program, or PABSS, supports the efforts of disabled Americans to stay on the job; for example, by helping them 

obtain necessary accommodations like assistive technology or adjusted work hours. 

Mr. Chairman, I hope that we move quickly to extend and reauthorize these two important programs that result in more disabled 

Americans working with dignity. At the same time, we must be 

careful that we do not do anything that puts Americans with severe disabilities and illnesses in danger of losing benefits they paid 

for with their contributions and tax dollars. 

Mr. Chairman, I look forward to hearing the witnesses today, 

and I am also hoping that at some point we are able to try to move 

on a bipartisan basis in reauthorizing many of these important programs, making the improvements where possible. 

With that, I yield back the balance of my time. 

Chairman JOHNSON. It can only be bipartisan if you stay on 

the committee. 

Mr. BECERRA. That is a super idea. 

Chairman JOHNSON. Before we move on, I want to remind witnesses to please limit their oral statements to 5 minutes, if possible. However, without objection, all the written testimony will be 

made a part of the hearing record. 

We have one panel today, and our witnesses who are seated at 

the table are from the Social Security Administration. Robert W. 

Williams, Associate Commissioner, Office of Employment Support 

Programs, who is accompanied by Robert R. Weathers II, Deputy 

Associate Commissioner, Office of Program Development and Research; Dan Bertoni, Director of Education, Workforce, and Income 

Security Issues, U.S. Government Accountability Office; Deb Russell, Manager, Outreach and Employee Services, Walgreens Company, Deerfield, Illinois; James Hanophy, Assistant Commissioner, 

Texas Department of Assistive and Rehabilitative Services, Austin, 

Texas, on behalf of the Council of State Administrators of Vocational Rehabilitation; Cheryl Bates-Harris, Senior Disability Advocacy Specialist, National Disability Rights Network, on behalf of 

the Consortium for Citizens with Disabilities Employment and 

Training Task Force; John Kregel, Professor, Special Education 


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and Disability Policy, Virginia Commonwealth University, Richmond, Virginia. 

Mr. Williams, I understand you will be making a statement on 

behalf of the Social Security Administration, and Mr. Weathers is 

accompanying you to also answer questions. I welcome you all, and 

thank you for being here. You may proceed, Mr. Williams. You are 

recognized. 

STATEMENT OF ROBERT W. WILLIAMS, ASSOCIATE COMMISSIONER, OFFICE OF EMPLOYMENT SUPPORT PROGRAMS, 

ACCOMPANIED BY ROBERT R. WEATHERS II, DEPUTY ASSOCIATE COMMISSIONER, OFFICE OF PROGRAM DEVELOPMENT AND RESEARCH, SOCIAL SECURITY ADMINISTRATION 

Mr. WILLIAMS. Good morning, Chairman Johnson, Chairman 

Davis, Ranking Members, and Members of the Subcommittees. I 

am pleased to have this opportunity to discuss the Social Security 

Administration’s employment support and self-sufficiency efforts. I 

want to start by offering you an overview of my view of where we 

need to take our programs. 

I took this job a few months ago for two reasons. The first is that 

my own life and career convince me that many more Americans 

with significant disabilities can work and become fully self-supporting if provided with the right opportunities and support. Second, I think we have an opportunity to ‘‘right-size’’ our expectations 

around the Ticket to Work program and our other employment support programs. 

We need to be realistic and strategic about the number of beneficiaries who will become financially independent due to work and 

earnings, even in the best of economies. We must also ensure that 

the Ticket program and our other work incentives provide a path 

to good jobs, good careers, and better self-supporting futures. 

Frankly, it is the only way we can create a tipping point that will 

enable more beneficiaries to actually earn their way off of the disability rolls and to create better, more secure lives for themselves 

and their families. 

It is time to change our ‘‘any job will do’’ mentality of job placement, where we focused on getting beneficiaries into low-wage jobs 

that offer little in the way of either career security or a better life. 

We need to focus less on the numbers of beneficiaries who work 

just above the substantial gainful activity level and focus instead 

on the quality of support services we provide and, most importantly, the outcomes we successfully support those beneficiaries to 

achieve and sustain over time. If we truly want to produce positive 

outcomes for the Vocational Rehabilitation, the Ticket, and Work 

Incentives Planning Assistance programs, the best way of doing so 

is by recognizing, supporting, reinforcing, and, yes, rewarding the 

initiative and hard-won financial independence of these American 

workers. 

The Ticket program is not where we want it to be or where I believe it can be in the future. Despite an unfavorable job market, 

though, we are making progress, the Ticket regulations we published in 2008 have significantly increased beneficiary and employment network participation in the program. Building on this momentum, we are improving the data we collect on working beneVerDate Mar 15 2010 07:02 Aug 23, 2012 Jkt 075187 PO 00000 Frm 00014 Fmt 6633 Sfmt 6602 I:\WAYS\OUT\75187.XXX 75187

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ficiaries. This is enabling us to focus on those most likely to use 

the Ticket program and to support more beneficiaries to become 

and remain self-sufficient. I believe taking these steps will help 

make work truly work for more Americans with significant disabilities and, thus, advance the basic aims Congress set when it passed 

the Ticket to Work and the Work Incentives Improvement Act of 

1999. 

As you know, last year the Congress extended funding for the 

WIPA and PABSS programs through the end of this month. Unless 

those programs are reauthorized, the money for the WIPA and 

PABSS programs will effectively run out on June 30, 2012, and 

September 29, 2012, respectively. 

Disseminating accurate information to beneficiaries with disabilities about work-incentive programs in support of their efforts to 

work and become self-supporting is critical, and we will work with 

Congress to improve the effectiveness of the program. 

We are aware of a few concerns regarding the current structure 

of WIPA grants. Findings from the most recent evaluation of WIPA 

will be available shortly, and we look forward to reviewing these 

new findings and working with Congress to ensure the best approach going forward. 

The Ticket Act also granted Social Security authority to conduct 

demonstration projects to test how certain changes in the program 

would affect beneficiary work and we have initiated several 

projects. My colleague Bob Weathers will answer any questions you 

may have about these projects. 

In closing, we are firmly committed to assisting beneficiaries 

with disabilities who want to work and become self-supporting. To 

increase our success, we need to refocus our efforts and promote 

real pathways that more beneficiaries can pursue to gain and sustain financial independence. 

Thank you for your interest in this matter. I am happy to answer 

any questions you may have. 

Chairman JOHNSON. Thank you. I appreciate your comments. 

[The prepared statement of Mr. Williams follows:] 


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Chairman JOHNSON. Mr. Bertoni, welcome. Please go ahead. 

STATEMENT OF DANIEL BERTONI, DIRECTOR, EDUCATION, 

WORKFORCE, AND INCOME SECURITY ISSUES, U.S. GOVERNMENT ACCOUNTABILITY OFFICE 

Mr. BERTONI. Mr. Chairmen, Ranking Members, Members of 

the Subcommittee, good morning. I am pleased to discuss work incentives for disability program beneficiaries; in particular, SSA’s 

Ticket to Work program. The Ticket program has been under way 

for more than a decade and utilizes approved providers to assist 

beneficiaries, known as ticket holders, in obtaining employment 

and ultimately reducing their dependence on benefits. 

Our prior work and the work of others has questioned the viability of the program due to low participation and costs that are not 

offset by beneficiaries returning to work. In an effort to attract 

more ticket holders and employment network providers, SSA revised its regulations in 2008 to include additional incentives for 

both groups. My testimony this morning summarizes our May 2011 

report and discusses trends in ticket holder and employment network participation over time, services provided by the various employment networks in SSA’s management and oversight of the 

Ticket program. 

In summary, we found that beneficiaries assigning their tickets 

to employment network providers have more than doubled since 

2008 to about 49,000; however, that number is relatively small 

compared to 12 million eligible beneficiaries. And despite increased 

enrollments, the extent to which beneficiaries are returning to 

work and leaving the rolls is unknown because SSA has not yet 

evaluated program outcomes as required by law. Because such an 

evaluation is key to assessing a program’s effectiveness and longterm viability, we have recommended that SSA prioritize and carry 

through with its plans to study ticket holder exits from disability 

rolls. 

Since 2008, employment network participation has also increased 

to about 1,600 providers; however, the bulk of activity in more than 

70 percent of the $13 million SSA paid out last year went to only 

20 providers, and just 3 received nearly a third of all payments. 

Our analysis show that employment networks offer a range of services including assistance with job search, retention, and transportation; however, since 2008, an increasing number of providers are 

specifically targeting beneficiaries who are already working or don’t 

need help finding work, and the largest are simply passing a portion of the Ticket payment back to the ticket holder, taking a substantial percentage for themselves and providing no direct services. 

Such transactions essentially result in a benefit subsidy to the ticket holder and fairly easy money for providers. 

We have recommended that SSA compile data and assess trends 

in employment network service provisions to determine whether 

they are consistent with the program’s goal of helping individuals 

find and retain sustainable employment and reduce dependence on 

benefits. 

Finally, we found that SSA lacks management tools for evaluating providers and beneficiaries to ensure program integrity and 

effectiveness. For example, SSA had not developed clear guidance 


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and performance measures or providers, which can lead to confusion about program goals and cause them to send mixed messages 

to beneficiaries about expected outcomes. In fact, despite the program’s stated purpose to reduce benefit dependence, our investigator, posing as a brother of a fictitious ticket holder, documented 

multiple providers promoting indefinite part-time work and keeping ticket holders below certain income thresholds so as not to jeopardize their disability benefits. Similar information was conveyed 

on other providers’ Web sites and recorded phone messages. 

We also found weaknesses in SSA’s oversight of ticket holders’ 

timely progress toward employment due to the agency’s suspension 

of required progress reviews between 2005 and November 2010. As 

a result, thousands of ticket holders have been exempt, per program rules, from undergoing medical continuing disability reviews, 

or CDRs, for many years, regardless of whether they are actually 

moving toward self-sustaining employment, intentionally resulting 

in improper payments to individuals who are no longer medically 

eligible. 

We have recommended that SSA develop program performance 

measures consistent with the Ticket law and a strategy for completing the backlog of required progress reviews, which SSA estimates to be between 13,000 and 22,000 cases per month, over the 

next year. Moreover, we have recommended that SSA independently verify the information reported by beneficiaries to more accurately assess timely progress toward sustained employment. 

Mr. Chairman, Members of the Subcommittee, this concludes my 

statement. I am happy to answer any questions that you may have. 

Thank you. 

Chairman JOHNSON. Thank you, sir. 

[The prepared statement of Mr. Bertoni follows:] 


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Chairman JOHNSON. Ms. Russell, welcome. It is good to see you 

again. Please proceed. 

STATEMENT OF DEB RUSSELL, MANAGER, OUTREACH AND 

EMPLOYEE SERVICES, WALGREEN COMPANY, DEERFIELD, 

ILLINOIS 

Ms. RUSSELL. Thank you. Chairmen Johnson and Davis, Ranking Members Becerra and Doggett, thank you for the opportunity 

to testify today on behalf of our company. 

My name is Deb Russell, and I am a corporate manager at 

Walgreens. In this role I am responsible for our efforts to include 

people with disabilities in our 20 distribution centers that serve our 

7,700 stores in all 50 States, the District of Columbia and Puerto 

Rico. Overall, this division employs nearly 10,000 full-time employees. 

Walgreens is committed to offering and enhancing employment 

opportunities for people with disabilities. I realize that this hearing 

is dedicated to individuals who are recipients of SSI and SSDI, but 

it is difficult to speak about employing them without speaking 

about our overall experience. And to qualify, when we speak of people with disabilities, we are speaking about people who have disclosed their disabilities to us. 

Walgreens started intentionally recruiting people with disabilities with the opening of our distribution center in Anderson, South 

Carolina. Since the opening of that facility, we have found that our 

model works in new as well as older buildings and in our stores. 

However, the most rewarding demonstration of our success is the 

high number of companies who have toured our facilities and asked 

us for assistance in the development of a strategy that will work 

for them. Companies like Lowe’s, Best Buy, AT&T and Procter & 

Gamble have dedicated staff and time to learn about our inclusion 

and then gone back and designed efforts that have brought them 

great success as well. 

We teach them about the factors we think made us successful 

and seem to be universally true, which are that we need partners, 

education, and high standards. We have learned that we do not 

need to have all the answers, and, in fact, we have found that companies who approach inclusive employment with that requirement 

seem to struggle to get their initiatives off the ground. We do not 

pretend to be perfect at this nor to have all the answers, but we 

are always happy to share our story in hopes that it will inspire 

others. 

Our relationship with Social Security started in 2007. As we discovered our success in Anderson, we looked for ways to ensure we 

could sustain our efforts. The Ticket to Work seemed like a good 

fit. The program has offered us a way to access resources that sustain needed accommodations, like sign language interpreters. 

The Ticket to Work’s outcome payment method is a good match 

since we employ everyone in our distribution centers full time and 

at a starting pay average of over $12 per hour. 

We have three criteria for participating in this program. We do 

not want a heavy administrative burden. We do not want to compete with any other ENs to assign an employee’s ticket and therefore provide the supports needed, and we do not want to have to 


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manage mass inquiries from ticket holders. We also want to avoid 

the real or perceived conflict of interest of being an employer which 

requires our employees to achieve high standards and for each 

month the employee remains with us. 

Throughout our experience as an EN, multiple changes to the 

program and the contract have made it more difficult for us to 

maintain our status. Each round of changes seems to focus on the 

services an EN will offer prior to employment, which is not a good 

fit for us. And the changes usually require more documentation 

and information that we do not have access to as an employer. 

During this time both Maximus and the staff at the Social Security 

Administration’s Office of Employment Supports have worked with 

us to be sure that they had the information needed, but allow us 

to deliver it in the easiest way possible. 

We have had 27 tickets assigned during our time as an EN. The 

most we have had at one point in time was 16. And to date, we 

have collected a little more than $300,000. We now have seven tickets that have reached maximum reimbursement, meaning they 

have worked for us long enough to no longer have their ticket high 

value. We are sure that many more of our employees have had 

tickets, but for many reasons have not surfaced through our Ticket 

activities. 

In addition to the Ticket program, we have interacted with 

WIPA. In Anderson, the benefits person attended multiple new employee benefit sessions to ensure he could provide thorough information to our employees regarding the impact of earnings and employee benefits on their public benefits. In all other buildings, our 

human resources staff are familiar with where to find their local 

WIPA contact information if an employee expresses a concern. 

As we continue to partner with the disability community, we still 

hear from agencies and parents that loss of benefits is an issue, but 

we do not hear this from our employees. We have no knowledge of 

anyone terminating their employment with us due to overpayments 

or the desire to maintain benefits as an alternative to work. I 

admit that many of our employees need assistance with wealth 

management and learning how to manage a life that is no longer 

deep in poverty, but they are not electing to stay home and collect 

a small check and stay immersed in the system. 

As we move our inclusion efforts into our stores, we do anticipate 

benefits being more of an issue since the nature of the retail industry is lower hourly pay combined with part-time and sometimes irregular schedules. Many of our retail employees will probably 

straddle employment and benefits, which is why we will not expand our role of an EN for our store employees. However, we will 

continue to offer information on local WIPA services to hopefully 

alleviate doubts and issues that come with remaining part of the 

benefits system while being successful in a job. 

For many of our employees with disabilities, Walgreens is their 

first full-time job. We have seen the improvements in their lives as 

they earn and receive recognition for a job well done and build relationships with other team members. 

I do not minimize the extraordinary challenges facing people 

with disabilities who join the workforce, but the toughest challenge 

of all is when people with disabilities are seen as ‘‘them’’ and not 


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as ‘‘us.’’ A job changes that. A job is more than a paycheck. It is 

a source of dignity. The workplace can be a fulfilling place, a place 

where people with disabilities transform their lives from the margins to the mainstream. At Walgreens, we feel fortunate to have 

made the commitment to invest in employing people with disabilities, people who make such an enormous contribution to our company, our customers and their community. 

Thank you for the opportunity to tell our stories. I would be 

happy to answer any questions. 

Chairman JOHNSON. Thank you, ma’am. I appreciate that. 

Thank you for letting us visit your center down there. 

[The prepared statement of Ms. Russell follows:] 


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Chairman JOHNSON. Mr. Hanophy is from the great State of 

Texas. Is your son the one that caused Texas A&M to leave the Big 

12 conference? 

Mr. HANOPHY. I didn’t want to mention that, but—— 

Chairman JOHNSON. Welcome. Please go ahead with your testimony. 

STATEMENT OF JAMES HANOPHY, ASSISTANT COMMISSIONER, TEXAS DEPARTMENT OF ASSISTIVE AND REHABILITATIVE SERVICES, AUSTIN, TEXAS, ON BEHALF OF THE 

COUNCIL OF STATE ADMINISTRATORS OF VOCATIONAL REHABILITATION 

Mr. HANOPHY. Good morning, Chairman Johnson, Chairman 

Davis and Ranking Members. I am here representing the Council 

of State Administrators of Vocational Rehabilitation to discuss 

Ticket to Work and work incentives designed to help beneficiaries 

with disabilities return to work. 

The public vocational rehabilitation system serves over 1 million 

people with disabilities every year, and in 2010 helped approximately 172,000 people become employed and taxpaying citizens. On 

average, the typical VR consumer will pay back through their taxes 

the cost of their VR services in just 2 to 4 years. 

The VR program has a longstanding partnership with Social Security. Social Security reimburses the VR agencies for the cost of 

services provided to the beneficiary only after that individual has 

achieved earnings above substantial gainful activity, which is approximately $1,000 a month for 9 months of any 12-month period. 

The reimbursements earned from Social Security enable VR agencies to serve more consumers and in some States serve consumers 

on their waiting list. 

CSAVR is grateful to Social Security for initiating positive 

changes in the new Ticket to Work regulations, such as Partnership Plus that redefines the relationship between SSA beneficiaries 

who want to work, VR agencies, and ENs. This, in my opinion, creates a five-way win. VR and the EN win because we are able to 

help a beneficiary go to work in a coordinated way with funding 

supports. The taxpayers win as people become less reliant on benefits and more self-supporting. The business wins because they are 

able to hire a qualified applicant who has been screened and will 

be well supported. And most of all, the beneficiary wins because 

they are able to go to work in a job that meets their talents, interests, and receive the work supports they may need. 

VR agencies and ENs are developing innovative arrangements to 

provide services to meet the needs of beneficiaries. In Texas, the 

VR program offers incentive payments called Employment Advancement Payments to EN providers for services from the EN if 

a beneficiary reaches and maintains substantial gainful activity. 

Partnership Plus also funds ongoing supports for ENs who provide 

embedded training within the Texas VR within our business customers where we do preemployment training. 

In Connecticut, Utah, Vermont, Virginia, as well as many other 

States, VR programs and ENs are working creatively to streamline 

processes, coordinate services, and leverage funding to increase 


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successes for beneficiaries. These arrangements are as different as 

the States themselves, which adds to the value of Partnership Plus. 

In Connecticut, the VR program is also working with Walgreens, 

who is an EN, to meet their business needs. Walgreens built a 

state-of-the-art distribution center where now currently 45 percent 

of the employees are people with disabilities. 

In addition to highlighting the Partnership Plus successes, these 

examples also illustrate the success the VR program has had in developing a dual-customer approach, whereby VR works for both a 

person with a disability and a business as customers. The VR National Employment Team consists of VR agencies that have developed a network of business partners committed to hiring qualified 

applicants who have disabilities, resulting in more full-time jobs 

with benefits and career opportunities for SSA beneficiaries. An example of this is the partnership with Walgreens and Texas, where 

one-third of the people hired at the distribution center in full-time 

jobs with benefits are SSA beneficiaries. 

We would also like to offer some suggestions for program improvements. People who come on the disability rolls earlier stay 

longer, cost more, and lose out on work opportunities. Social Security might explore an option of paying more for outcome payments 

or offering bonus payments for serving younger beneficiaries. 

Also, while not inherently part of the Ticket, we urge the Committee and SSA to aggressively explore an early intervention model 

for applicants for SSI and SSDI benefits. CSAVR has developed a 

risk-free early intervention proposal that might help applicants try 

to work first. This is attached to our written testimony. This completely voluntary program would not stop the disability application 

process; however, before eligibility for benefits is determined, an 

applicant would be provided immediate access to temporary cash 

assistance, immediate access to health care, and immediate access 

to vocational services designed to help a person go to work. The 

proposal would suspend the Social Security disability application 

once employment above SGA is found. However, if employment 

fails, the work effort would not be considered as evidence against 

the participant in their application for disability benefits. We believe a pilot targeted to a select number of States with a sample 

of applicants would cost little and inform us greatly about the potential. 

Last, it is important to keep in mind the effort to help SSA beneficiaries return to work is more than just a matter of having a ticket. SSA funds the Work Incentive Planning and Assistance project, 

or WIPA, and we cannot stress strongly enough how important 

benefits planning is to helping SSA beneficiaries understand the 

various work incentives in SSI and SSDI. CSAVR respectfully requests the Committee to reauthorize the WIPA program in a timely 

fashion and provide the resources needed to ensure this critical 

service is available to beneficiaries. The WIPA project is a proven 

benefit that works and deserves our full support. 

Again, thank you for the opportunity to testify, and I will answer 

any questions you have. 

Chairman JOHNSON. Thank you, sir. 

[The prepared statement of Mr. Hanophy follows:] 


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Chairman JOHNSON. Ms. Bates-Harris, welcome. Please proceed. 

STATEMENT OF CHERYL BATES-HARRIS, SENIOR DISABILITY 

ADVOCACY SPECIALIST, NATIONAL DISABILITY RIGHTS NETWORK, ON BEHALF OF THE CONSORTIUM FOR CITIZENS 

WITH DISABILITIES EMPLOYMENT AND TRAINING TASK 

FORCE 

Ms. BATES-HARRIS. Good morning. Thank you, Chairman 

Johnson, Chairman Davis, and other distinguished Members of the 

Committee for this opportunity to testify today regarding work incentives in the Social Security disability programs. As indicated, I 

am representing the CCD, Consortium for Citizens with Disabilities Employment and Training Task Force. The CCD Employment 

and Training Task Force believes that meaningful employment represents one of the best opportunities for people with disabilities as 

they work toward becoming a productive and fully included member of society. 

Social Security work programs are among the many critical avenues for Social Security beneficiaries to gain access to employment. 

We support improvements to Social Security to make it more effective in serving those that rely on it; however, we stand firm in our 

belief that changes to the Social Security system should not be 

made in the hothouse environment of deficit reduction. 

Considerable attention is being given to the plight of long-term 

umemployed, and it is important that policymakers understand 

that millions of people with disabilities are disconnected from the 

workplace and do not fall within the traditional definitions of longterm unemployment. Therefore, these critical services are essential 

to ensure their participation and return to employment. 

Employment of individuals with disabilities requires a comprehensive approach that addresses all aspects of the service system to ensure that the vision of integrated competitive employment 

is fostered and promoted. Ongoing staff development, among systems staff and service providers, is vital so that they not only embrace the vision, but have the technical knowledge to implement it. 

A holistic approach requires addressing a wide range of other 

issues: outreach to and engagement with employers, service monitoring and quality assurance, engagement of individuals and families, and the availability of benefits counseling and protection and 

advocacy support which will allow community employment, transportation, interagency collaboration, just to name a few. 

Over the past decade, Congress has focused most of its attention 

only on the Ticket to Work program. Revised regulations and 

things have drastically changed the program, so I am not going to 

talk so much about the Ticket as much as the supports of the two 

critical programs that are soon to expire. 

The first is, of course, the Protection and Advocacy for Beneficiaries of Social Security. It is the responsibility of these programs 

to provide information and advice about obtaining vocational rehabilitation and employment services, information and referral services to beneficiaries on work incentives, advocacy, and, most importantly, legal services that a beneficiary needs to secure, maintain, 

or regain employment, including the investigation and remedy of 


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complaints of employment discrimination and other civil and legal 

rights violations. Despite the extensive set of duties and growing 

demand for services, the PABSS program has been funded at the 

same level, and its authorization expires at the end of the fiscal 

year. 

The WIPA programs inform beneficiaries on the impact that employment will have on disability income and medical coverage, and 

addresses many of the fears that individuals have about going to 

work at the risk of losing health coverage. Authority, again, for 

these grants will expire. 

More needs to be done to ensure that individuals and families 

are aware of the availability of these critical services, and that consistently provides the message that encourages employment in the 

community rather than simply the preservation of benefits. So we 

believe that it is really important to address those. 

Some of the other issues that we also think are critically important to continue are the expanded use of the employment networks; 

the Medicaid Infrastructure grants, the Partnership Plus model. 

The Social Security Administration’s revised Ticket regulations improved the overall effectiveness of the program, and it is important 

that these things continue. 

The Ticket program is poised to benefit from data-matching advances. 

And one area that has slipped due to staffing shortages is the 

process of earnings reported by beneficiaries. When beneficiaries 

get overpayment notices, it is shocking to beneficiaries when they 

receive these notices and assume that the information has been 

processed properly. 

The rest of my testimony is written and can be submitted for the 

record, and I am happy to answer any questions that you have. 

Chairman JOHNSON. Thank you, ma’am. It will be entered into 

the record. 

[The prepared statement of Ms. Bates-Harris follows:] 


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Chairman JOHNSON. Dr. Kregel, please go ahead. 

STATEMENT OF JOHN KREGEL, PROFESSOR, SPECIAL EDUCATION AND DISABILITY POLICY, VIRGINIA COMMONWEALTH 

UNIVERSITY, RICHMOND, VIRGINIA 

Mr. KREGEL. Thank you, Chairman Johnson, Chairman Davis. 

Thank you very much for this opportunity. I will focus my comments today on the Work Incentives Planning and Assistance, or 

WIPA, program. 

Individuals with disabilities who receive SSI and SSDI are frequently viewed as unemployable when in reality millions of beneficiaries have clear goals to work and reduce their reliance on disability benefits. Of the 13 million current SSA beneficiaries, it is 

estimated that 2.7 million see themselves working in the near future, and an additional 2.6 million have also been employed or 

looked for work in the past 12 months. These 5.3 million individuals should be the primary focus of SSA’s employment and returnto-work initiatives. 

So why aren’t more people working? First, disincentives in our 

SSA program rules often penalize beneficiaries who attempt to 

work. Most depend on their SSA benefits to meet their basic needs 

and would tremendously benefit from working. Unfortunately, 

beneficiaries are repeatedly told that employment will quickly lead 

to loss of their benefits. This is absolutely not the case. Yet fear 

of losing benefits leads them to unnecessarily choose not to work 

or to needlessly restrict their work hours and earnings. 

Second, while many beneficiaries would willingly forgo their cash 

benefits for the possibility of increasing their income through employment, they still fear potential loss of their corresponding Medicaid or Medicare coverage. Many beneficiaries possess serious 

chronic health conditions that would make the loss of health care 

coverage catastrophic to them personally. 

Third, beneficiaries fear potential overpayments or sudden benefit termination. Local Social Security offices, facing enormous 

pressures while attempting to respond to the large increases in program applications, simply lack the personnel and time necessary to 

accurately administer the work-incentives provisions. The result is 

an abundance of disruptive overpayments and a sudden loss of benefits that often lead beneficiaries to abandon their hopes for longterm employment. 

To address these problems, SSA has established the Work Incentives Planning and Assistance, or WIPA, program. The WIPA program is an employment support that is designed to enable SSA 

beneficiaries to pursue their goals of personal employment and economic self-sufficiency. WIPA services refer to efforts by a rigorously 

trained community work incentive counselor to provide accurate 

and complete information to SSA beneficiaries to enable them to 

obtain employment, return to work, and reduce dependence on SSI 

and SSDI. 

Currently the WIPA initiative is comprised of 102 projects providing benefits to SSA beneficiaries in all 50 States and territories. 

Collectively the projects employ 500 rigorously trained Community 

Work Incentive Coordinators, many of whom are themselves individuals with disabilities. Since their inception in 2000, WIPA proVerDate Mar 15 2010 13:08 Aug 01, 2012 Jkt 075187 PO 00000 Frm 00092 Fmt 6633 Sfmt 6602 I:\WAYS\OUT\75187.XXX 75187

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grams have provided work-incentive counseling services to over 

450,000 SSI, concurrent and SSDI beneficiaries, including 60,000 

persons served over the past year. 

So what do they do? In Dallas, a 40-year-old gentleman named 

Danny secured a heart transplant after a 6-year battle with heart 

disease. He thought he could never work again without losing his 

$1,800-per-month SSDI check. After working with the WIPA 

project for 3 months, he is working 15 hours per week and is earning over $1,500 a month for a heavy equipment sales company. In 

November, his $1,800 check will go to zero, saving SSA $20,000 per 

year for hopefully many years to come. 

Jay in Louisville is a young man with developmental disabilities, 

who receives SSI and has a Medicaid waiver for personal and employment supports. His father contacted a CWIC when Jay began 

working with a new supported employment provider. The family 

has received work incentive counseling and information that have 

allowed them to feel comfortable in letting Jay go to work for the 

University of Louisville in a job that provides him earnings at a 

level of over $1,000 per month. Each month he works results in a 

savings of $400 to SSA. Given his age, these savings will compound 

over the next several decades. If his earnings increase, the savings 

to SSA will increase as well. 

In Los Angeles, Michael received a termination letter on his ben- efits. The letter also stated that he had an overpayment of $79,000, 

money he was ordered to pay back to the Social Security Administration. The CWIC assigned to this beneficiary thoroughly reviewed 

his case and discovered the client was incorrectly terminated. Due 

to the CWIC’s diligence, attention to detail, and excellent rapport 

with SSA Claims Representatives and community partners, both 

issues were resolved. The beneficiary received reentitlement to his 

SSDI check, and the alleged $79,000 overpayment was cleared. 

Services provided by WIPA projects lead to increased employment, improved earnings, and reduced dependence on disability 

benefits. These outcomes lead to significant reductions in the overall amount of general funds and trust fund payments to beneficiaries. These savings are large enough to offset the cost of the 

program and could be expected to compound steadily over time as 

individuals leave the disability rolls after receiving WIPA services 

and remain in the workforce for many years to come. 

Thank you, Mr. Chairman, and I appreciate the opportunity to 

answer any questions. 

[The prepared statement of Mr. Kregel follows:] 


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Chairman JOHNSON. I thank all of you for your testimony. We 

will now turn to questions. And as is customary for each round of 

questions, I will limit my time to 5 minutes and ask my colleagues 

and my companion chairman here to limit your time to 5 minutes 

as well. 

Mr. Bertoni, GAO found employment networks paid by Social Security who were essentially coaching ticket holders to work part 

time so they wouldn’t lose their benefits even though the goal of 

Ticket to Work is to get individuals back to work and off disability. 

I understand you have taped conversations to prove this. I would 

appreciate it if you would play a couple of these conversations for 

us and then tell me, one, how widespread it is; two, what Social 

Security has done to address it; and three, what this says about Social Security’s ability to manage this or other work-incentive programs. 

Mr. BERTONI. Sure. Let me quickly preface this by saying that 

in interviewing the employment networks, 15 of 25 of them told us 

that SSA had not articulated any specific outcomes for them, nor 

had they provided performance goals. So in an environment like 

that, you really run the risk of, number one, confusion in terms of 

how you explain the rules; lack of consistency across the various 

profiles in terms of how those rules are applied; and last, it is an 

opportunity for a potential abuse. So any one of those things could 

be coming into play with these recordings. It just shows that when 

you have that type of environment, that these types of things can 

happen. So if you want to roll those tapes, that would be great. 

[Tape played.] 

Mr. BERTONI. It looks like they just went with two calls. 

Your question was, how pervasive? We don’t know how pervasive 

this is. What we did is we followed the money. We went with the 

top 20 providers, and we talked to an additional 5 providers. We 

had three lines of questioning. We had lines for shared payment 

approaches. We had calls for employer-driven approaches, and we 

had calls for vendors that we didn’t know what they were doing. 

Based on the descriptions of their Web sites, and interviews that 

we had, and documents that we looked at, we really couldn’t discern what the services that were being offered, so we felt that we 

had to call these individuals and sort of get behind that information. 

We made eight calls to different providers. We had multiple no 

answers, no contacts where we couldn’t get through. But three of 

those eight resulted in these conversations where it appeared that 

there was some real coaching going on. 

SSA doesn’t have a good sense of this either. We do know there 

are other Web sites and other providers that are promoting this 

type of activity, but we don’t have a good sense of the universe or 

what is going on amongst the 1,600 providers. But SSA could do 

that. They could get behind that. 

You asked actions they can take and are taking. They do a secret 

shopper program. They have a secret shopper program. You could 

systematically do exactly what we did: sample or go through the 

entire range of employment networks, the larger providers, and 

sort of get a sense of the extent to which this is happening. 


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I think one of the primary things that has to happen here is they 

really need to establish performance metrics that are designed to 

move employment networks toward pushing employment that is 

beyond part-time work. Until you establish that metric and you 

hold these folks accountable, again, you have opportunity for confusion, inconsistent application, and perhaps abuse. 

Chairman JOHNSON. Thank you. My time has expired. I appreciate you all looking at that. Thank you so much. 

Mr. Williams, would you care to respond? 

Mr. WILLIAMS. Yes, I would. 

Chairman JOHNSON. Go ahead. 

Mr. WILLIAMS. We have established clear performance standards and expectations that coaching people to limit their earnings 

is completely unacceptable, and we are weeding out those that do. 

We have instituted a contract process that will enable us to terminate bad actors and have done so already. Additionally, we will 

submit a response for the record. 

[The information follows:] 

Chairman JOHNSON. Thank you, sir. 

Mr. Bertoni, are you guys on top of most of the States in the 

country? 

Mr. BERTONI. In terms of—— 

Chairman JOHNSON. Looking at this program. 

Mr. BERTONI. The distribution of the 25 providers gave us some 

good geographic distribution, but I don’t know if we covered—we 

certainly didn’t cover every State. 

Chairman JOHNSON. Well, no two States are alike, I presume. 

Mr. BERTONI. No. But the rules of the program should be alike, 

and they should be applied very consistently. 

Chairman JOHNSON. Agreed. Okay. Thank you for your comments. And I have extended my time. 

I recognize Chairman Davis. And thank you for having your Subcommittee join us today. 

Chairman DAVIS. It is a privilege, Mr. Chairman. 

Mr. Bertoni, I want to follow on the line of having SSA get necessary program information. Do we know how much taxpayers 

have spent on the Ticket to Work program since it started, including amounts paid to employment networks? 

Mr. BERTONI. Sure. I can give you recent information from our 

reporting period a little bit before that. When we reported, it was 

about $34 million in administrative costs and about $13 million 


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paid out in Ticket dollars to ticket holders. In 2007, that amount— 

Ticket payments were about $3.8 million. By 2008, they were $5.6 

million. By 2009, they were up to $12.6, and partial-year 2010 were 

$13 million. So that is about $41.5 million in Ticket payments. 

This year here, though, we have a real rapid increase in these 

payments. We see that is a pretty significant increase post-2008, 

primarily driven by the rapid increase in beneficiaries from 22,000 

to 49,000. So this program has grown—well, the numbers are relatively small. It has grown quickly in terms of the payments. And 

when you look at the potential eligible beneficiaries, there are 12 

million people out there who have a ticket who could come forward 

at some point in the near future. So this program is poised to grow, 

and it could be significantly, based on the numbers that could take 

up the tickets. 

Chairman DAVIS. It sounds like a disproportionately high 

amount of administrative costs for the current payout. Do we know 

what aspects of the Ticket program are working? 

Mr. BERTONI. I think, as SSA and others have said, I think 

they have done a very good job of increasing the number of employment networks and are doing a significant job in increasing the 

number of folks who are taking up tickets and using them. 

Chairman DAVIS. I guess maybe a bigger question is, in my 

mind, getting people into a program is not necessarily a definition 

of effectiveness. Would you rate the Ticket program as effective? 

And do you believe that SSA is adequately collecting and analyzing 

proper information to be able to answer these sorts of questions? 

Mr. BERTONI. To date, no. I think the front part of that is getting folks in the program is important. You have to work with 

something. But there is a management aspect to this, and from 

that standpoint, I think they have not been effective in many ways 

in terms of vetting and approving the employment networks to ensure they are qualified; in terms of monitoring individual ticket 

holders; certainly establishing performance measures to hold employment networks accountable; and also to evaluate and reevaluate the program, determine what is working and what isn’t, what 

are the trends in service provisions, and what are the outcomes 

that are coming out of this program. That is what is not happening, and that is what we don’t know, and that is what SSA does 

not know to date. 

Chairman DAVIS. Dr. Weathers, do you have anything to add? 

Mr. WEATHERS. Yes. We do have an independent evaluator, 

Mathematica. They have been doing an evaluation of the Ticket 

program since its inception. Many of their earlier reports—they 

have already produced five reports—were used in order for us to 

change the program in 2008 with the new regulations. 

Since 2008, we have been collecting data on outcomes of ticket 

beneficiaries, and we just completed a national beneficiary survey. 

Mathematica is conducting an analysis of that national beneficiary 

survey so we will be able to measure outcomes of ticket beneficiaries since the new regulations went into place in 2008. But it 

does take time for a new program and new rules to be communicated to the public and to beneficiaries, and we need to wait a 

period of time before we can effectively evaluate how the new rules 

are working. 


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Chairman DAVIS. Okay. Dr. Kregel, as an academic, do you 

think Dr. Bertoni’s findings are acceptable, and what do you recommend we do to hold Ticket to Work and other work-incentive 

programs accountable? 

Mr. KREGEL. I think that it is important to set performance 

standards for each of these programs. Looking at, for example, the 

Ticket program, it is important to ask, in the absence of this program, would these people still return to work? And if you look at 

the examples that have been cited that effectively indicate that individuals are assigning their ticket with an EN, they are working, 

but the EN is not providing them any service, then it is very reasonable to say, in the absence of this program, wouldn’t this person 

have gone to work anyway? So the notion is, if the program is not 

there, would these individuals return to work? Would it result in 

savings to the government, savings to SSA? And that is the question that needs to be addressed going forward. 

Chairman DAVIS. I will just leave you with a thought. And perhaps those of you on the panel that feel so moved, but specifically 

from Dr. Weathers and Mr. Bertoni, I would appreciate just a response in writing for the sake of time. 

It seems that there are compelling disincentives for people to 

want to go to work, particularly what I have seen in the eastern 

portion of my district, an outright racket with attorneys who are 

advertising on the radio for benefits, that make outrageous fees, 

and, you know, really want to discourage folks from going back to 

work and the benefits of that. 

I would be interested just as an adjunct in this, in order to make 

Ticket to Work work, what are some things that might be able to 

be done to curtail the program from an inappropriate perspective; 

wanting to help people, but at the same time avoiding folks profiteering off the backs of these folks in need? 

[The information follows:] 


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Chairman DAVIS. With that, I thank the chairman for his additional indulgence, and I yield back. 

Chairman JOHNSON. Thank you. I appreciate your comments. 

Mr. Becerra, you are recognized for 5 minutes. 

Mr. BECERRA. Thank you, Mr. Chairman. 

And thank you all for your testimony and your work. 

Mr. Bertoni, I want to focus in on some of the things that you 

have been saying, because you are going to get most of the attention here. I want to see if I can get ahold of a threshold question. 

We are talking about folks who qualify for SSI or SSDI benefits. 

We are talking about folks who have proven to have a health condition that is severe enough that they would qualify to receive some 

form of assistance, disability assistance. No one is questioning that 

the folks that we are talking about are disabled in some form that 

are interested in trying to work. 

Mr. BERTONI. Correct. 

Mr. BECERRA. So having said that, as I listen to those tapes, 

my sense was that we may have to work on these employment networks. 

Mr. Bertoni, do you have anything to share with us that shows 

that beneficiaries were trying to game the system? 

Mr. BERTONI. No. I think the—our recommendations in my introduction was that it is between the agency and the employment 

networks where the guidance needs to be clarified, and these networks need to be educated as to what you can’t say and what you 

can say, and how best to screen and counsel folks to get them back 

to work. 

Mr. BECERRA. So you have given us some good guidance on how 

to zero in to try to make these programs work better, because I 

don’t hear anyone saying here that beneficiaries are trying to game 

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tem by saying they are working or working enough and then keep 

both benefits and salaries. 

Mr. BERTONI. No. In fact, if you listen to the tapes, you go to 

the Web sites, or you read any of SSA’s materials that they put 

out, that is what is said: You can work. You can work part time. 

It is acceptable. But there is a ‘‘for a period of time’’ in there, of 

course. But I think these folks are reading this as, I can do this. 

Mr. BECERRA. So now I want to get the question to you in just 

a second, but first I want to ask Ms. Russell a question. 

The chairman and I were just chatting about the work that 

Walgreens is doing, which seems to be tremendously helpful to a 

lot of these folks who are receiving these disability benefits that 

are trying to work. So I want to make sure we don’t paint with a 

broad brush all these employment networks, because there seem to 

be some that are trying to do this the right way. And I would hate 

for folks who are trying to really connect someone who is receiving 

these disability benefits with a job, all of a sudden I feel like, gosh, 

I am getting bashed over the head for trying to do this, and I am 

also investing some pretty significant resources to make it work. 

Have you found a particular formula that helps you succeed so 

that you don’t find that your folks on the other end of the phone 

doing something like this? 

Ms. RUSSELL. Yeah. I think that our formula for success overall 

mirrors our formula for success with the Ticket program, and that 

is that education is key. Our individuals, our staff people who are 

involved in the Ticket program, are well educated on what parameters within our role as an employer and our role as an employment network they need to operate within. They are provided a lot 

of information about what they can and can’t say, what they can 

and can’t do. We maintain a lot of the control at corporate, which 

prevents us from having to worry about things happening out in 

the field that would be inappropriate. 

Mr. BECERRA. I will ask Mr. Williams and Dr. Weathers, I 

know you have some budgetary issues, staffing issues, but I suspect that there are some employment networks that are out there 

that produce well and most folks that, say, are doing the right 

thing. I am not sure if it is a matter of getting the best practices 

from some of these folks or somehow doing things because I know 

you are shy of money. But I think there has got to be a way, short 

of making very expensive investments, to try to make this program 

work. 

I think what Mr. Bertoni had pointed out through these taped 

phone conversations is that either the employment network folks 

are trying to help these folks maintain as much of an income as 

possible, or they are trying to avoid having to bring them on full 

time. Either way I think we need to figure that out. 

Mr. Bertoni, let me ask you this: SSA just took a massive hit in 

its budget. It is receiving $1 billion less than it said it needed just 

to try to keep pace with an already growing caseload. What you are 

suggesting that they do is program integrity isn’t cheap, and it is 

not free. They would have to hire more folks or put more investments up front with people who are already steeped with work in 

order to try to up front catch some of this gaming activity. Is that 

correct? 


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Mr. BERTONI. There is no question with more resources you can 

do more. I guess the position we have is this program has been 

around since 1999. It has been growing, expanding. There were 

some new initiatives in play. And there is some blame to be laid 

at the agency’s management doorstep in terms of what could have 

been done in prior years. 

Luckily, we are here at a time when the program is not huge. 

Five years from now, we could have a bigger problem on our hands. 

These are issues that need to be addressed. And within the resources they have, I think they can leverage some of that to do better. If they had more resources, could they do more? Absolutely. 

Mr. BECERRA. Thank you for that. And I just hope that what 

SSA does is takes some of this information, perhaps talks to some 

of those who have shown some good practices, and try to quickly 

take advantage of those best practices so that we can move the program forward, you know, make it work better, because I think 

what we are showing is that there are a lot of Americans who are 

receiving disability benefits who would love nothing more than to 

be able to go to work as much as possible. So thank you all for your 

testimony. 

Mr. WILLIAMS. If I might, sir, I agree we need to do more to 

identify what is working, and a prime way we need to do this is 

to learn more about the over 5,000 people that have left the rolls 

with the support of an employment network. That, to me, is where 

to start. 

Chairman JOHNSON. Thank you, sir. 

Mr. Brady, you are recognized for 5 minutes. 

Mr. BRADY. Thank you, Mr. Chairman. Both of you, thanks for 

holding this hearing. 

Ticket to Work is a great concept, it makes great sense not just 

for taxpayers, but for those with disabilities that, as technology 

progresses, it allows them to move back into the workforce. It 

makes sense. My frustration is that after 15 years, we don’t know 

if this works. 

Dr. Weathers, a simple question. A decade and a half, what percentage of those using Ticket to Work have now gone on to fulltime, sustained employment? What percentage? 

Mr. WEATHERS. A very, very small percentage. We are currently conducting an evaluation of the percentage of people who 

have returned to sustained full-time employment since the new 

regulations were in place in 2008. We needed a 3-year period in 

order to track. 

Mr. BRADY. Do you have numbers prior to that? 

Mr. WEATHERS. We do have numbers prior to that, yes, between 2001 and 2006, and the numbers were very, very small. And 

that is what inspired the impetus behind changing the regulations 

in 2008. 

Mr. BRADY. What was that percentage? I am not trying to pin 

you down. I am trying to figure out what we can do to make this 

really work. 

Mr. WEATHERS. I can provide that number for the record for 

you. 

Mr. BRADY. Bigger than a bread box; 5 percent, 10 percent? 


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Mr. WEATHERS. No. I would say around 5 to 10 percent is the 

ballpark. But I can provide you with a more precise number for 

that. 

[The information follows:] 


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Mr. BRADY. What do you expect the new numbers to be? 

Mr. WEATHERS. I would hope that we could get it up much 

higher than that. 

Mr. BRADY. What do you think it ought to be? 

Mr. WEATHERS. I would hope that we could make it work for 

everybody that is using a ticket. But I think if we could get 50 percent, that would be a pretty good number. 

Mr. BRADY. My frustration, this is a great concept. This ought 

to be working. After 15 years, it isn’t. So my frustration is, you 

know, Mr. Williams talked sincerely about having performance 

standards clearly lined out. Mr. Bertoni said 15 out of 20 of the employment networks say they don’t have it. Clearly there is gaming 

of this system. It seems to me we need a fresh start on this program. You know, 5 percent, 10 percent, 20 percent just aren’t the 

numbers I think anyone was hoping for when, in a bipartisan way, 

we put this program together. 

Let me ask the panelists, if we could start with a fresh—I don’t 

mean end it—if we could start with a blank page and redesign this, 

knowing what the technologies are today, knowing what the common disabilities are today, what would you do differently? How 

would we start with a fresh slate and recreate a program that really did help people get back to sustainable work? Any panelists? 

Ms. BATES-HARRIS. I would like to say something. As a representative of the National Disability Rights Network, I feel compelled to remind people that people on Social Security benefits are 

among the most disabled people in this country, and many of them 

want to return to work. And unfortunately, as my boss would say, 

discrimination is our business, and business is good. And sometimes you can get all the perfect services in place, but discrimination is alive and well, and people do not get employed. 

Mr. BRADY. I understand. 

What do you believe is an acceptable rate? What do you think 

our goal ought to be? Five percent? 

Mr. KREGEL. I would like to answer that directly. The evaluation that Dr. Weathers talks about has identified that currently in 

this country, there are about 2.6 million SSA beneficiaries who indicate that they would like to work, and they see themselves working in the foreseeable future. 

Mr. BRADY. How many, Doctor—— 

Mr. KREGEL. 2.6 million. 

Mr. BRADY [continuing]. Would like to go back to work? 

Mr. KREGEL. Would like to go back to work, and who have either worked during the past year or have taken action toward 

working in the past year, such as applied for a job, taken a training 

course or something like that. 

What should the number be? Well, the programs should first 

focus on those 2.6 million people, and then we can look at other 

people whose health conditions may improve. And then we move 

our services toward those individuals as well. 

In terms of starting over with the Ticket program, I think that 

it is important to keep in mind that 12 years have passed, and not 

only has the situation changed for SSA beneficiaries, but the situation has also changed in terms of how employment services are designed and delivered to people with disabilities generally. And I 


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think that to start all over, it would be important to incorporate 

some of the cutting-edge best practices that have been described to 

you by Mr. Hanophy and described to you in terms of the 

Walgreens operation. These are the kinds of things—employer 

partnerships, working in collaboration with public and private enterprises that really need to be included in the redesign of the Ticket program. By incorporating the resources out there, we can get 

a lot farther along in terms of who we are serving. 

The other thing that needs to be done, as Mr. Hanophy pointed 

out, is to look at people who have been on the rolls for a very short 

period of time, and that includes transition-age youth. Returning to 

work for someone who has been on the rolls for 22 years and is now 

45 years old is a different challenge than for someone who is 22 

years old. We don’t want these individuals locked into lifelong dependency on Federal benefits. So targeting the Ticket program to 

transition-age youth and involving private-public partnerships with 

business, I think, are the major areas that we can explore in terms 

of redesigning the program for more effective services. 

Mr. BRADY. Well, thank you. Again, this is such an important 

program. For those who want to go back to work, there has got to 

be a smarter, better way to do this. 

Mr. Chairman, thank you. 

Chairman JOHNSON. Thank you. 

The gentleman’s time has expired. Mrs. Black, you are recognized for 5 minutes. 

Mrs. BLACK. Thank you, Mr. Chairman. 

And I thank you, panel, for being here today. 

Mr. Bertoni, I want to go to what we heard on the audio in reference to the misinformation that is being given by those who 

should know the correct information. Is it your opinion that we are 

just not training those who are working in the offices, that they 

don’t know the information? Or how do we get such misinformation 

being given out? 

Mr. BERTONI. I don’t know what the extent of training is. I 

would defer to the SSA on that. I would say that over time, and 

with the changes to the regulations—basically the regulations, it is 

a couple key things. Number one, they lowered the bar at which 

employment networks could be paid, so that made part-time earnings attractive to both ticket holders as well as employment networks. They were trying to entice more individuals on both sides 

of the equation into the program. 

Another thing the regulations did was to make it acceptable for 

employment networks to directly pay the ticket holders from the 

Ticket money, so that essentially increased the value of the shared 

payment model. 

And thirdly, it also allowed for those whose medical improvement 

was expected to participate in the program. 

So we have sort of a convergence of folks here who could, in fact, 

benefit from part-time work and early payments. 

So we see this new guidance come out. We see these are allowable things. And the firewall between SSA and the field, the employment networks, is there. And someone has to work through 

this firewall to communicate even with those changes that are acceptable, what are the ultimate end goals for this program. Yes, 


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part time should be the start for many. It might be it for many. 

But certainly if we can get people into part-time work, and for 

those that can move up to more substantive employment, that 

should be the end goal, because that is the stated purpose of the 

program. I am not sure everybody knows that. 

Mrs. BLACK. Well, thank you. I think you are right. And obviously, the people that were taking these phone calls did not know 

that. But you also made mention that you thought they should develop program performance measures. How would you see those 

performance measures? What would be in those? 

Mr. BERTONI. I would hate to be too prescriptive here, because 

any one that I threw out, the people would come behind me and 

tell me I had a bad measure. 

I guess right now I believe there is one measure for the program. 

That is the number of ticket holders with an assigned ticket. To 

me, that is the start. You have found the person. You have given 

them the ticket. They have assigned it to an employment network. 

But the outcome measures are not there. We have outputs, but 

not outcomes. Really, the number of folks who have moved on, who 

have transitioned to sustainable, long-term employment that has 

allowed them to reduce dependency and benefits, part of that 

should be in the equation when you are evaluating how effective 

an employment network is. 

Mrs. BLACK. And I know I am going to run out of time very 

quickly here. So, Dr. Weathers, do you agree that this is a good recommendation? And if so, what do you all plan on doing to initiate 

those kinds of measures that will help to show what kinds of outcomes are there? 

Mr. WEATHERS. Bob Williams’ office is responsible for putting 

together a report card, and I think he could say a word or two 

about what they are doing. 

Mr. WILLIAMS. We have, in fact, initiated such benchmarks, including one that will hold ENs responsible for moving some beneficiaries into jobs that pay at least twice the poverty level. It is not 

enough to get someone off benefits if doing so makes them worse 

off than they are now. 

Mrs. BLACK. Thank you. 

Mr. Chairman, if I may ask in writing, Ms. Russell, could you 

tell us about some of the barriers that you have found in working 

with the program? I congratulate you for doing what you have 

done. 

And then, Ms. Bates-Harris, you talked about discrimination. 

And if I could have you in writing tell us a little bit more about 

where those discrimination factors are and how you think we might 

overcome those. I appreciate that. 

Thank you, Mr. Chairman. 

Chairman JOHNSON. You are welcome. 

Could you two respond that way, in writing, please? Thank you. 

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Chairman JOHNSON. Mr. Stark, you are recognized. 

Mr. STARK. Thank you. Thank you, Mr. Chairman. Thank you 

for this hearing. And I thank the witnesses for enlightening us. 

I must take this opportunity to thank SSA, and in particular 

their San Jose office, which services our office nearby for the numerous inquiries we get. We just get wonderful service from them. 

And I am afraid they are going to need help. The number of inquiries is growing. The number of the elderly people is growing. And 

the money to fund that growth in service has got to come from 

somewhere. I don’t think there is an SSA fairy that is going to 

sprinkle that dust on you and allow you to hire the people or pay 

them for overtime. So as we see more people with more severe 

health problems, I hope that we can find the additional funding to 

let you continue to provide that good service. 

I want to make sure that you have cleared your phone messages 

with the PATRIOT Act. And I didn’t notice that you had inquired 

about the offers for half-price Viagra that Sam and I keep getting. 

And are those legitimate offers or not? If you could look into that 

for us, and we would appreciate it very much. 

The one question that I wanted to direct to Ms. Bates-Harris is 

the question of the disregards. We have disregards for beneficiaries’ 

income in determining their eligibility. And it is my understanding 

that those were set about the time that I came to Congress. And 

the average benefit was under $500, and SSI benefits were reduced 

for income that exceeded $65 a month, and if a recipient earned as 

little as $20 a month from any source, the disregards came into effect. Do you think that it is time that we have a modest change 

in that and bring those disregards from the seventies up to standards of today, that that would just be a fair and proper thing to 

do? 

Ms. BATES-HARRIS. Absolutely, positively. The $20 general in- come disregard and the $65 earned income disregard have remained static, and, in fact, people have basically lost money on 

that with the cost of inflation. So we really believe that they should 

be indexed and increased just the same as how the SGA and the 

other factors in the Social Security program are indexed. 

Mr. STARK. Thank you. 

I want to thank all of you for your work in this area. It is important to our seniors, to our people with disabilities, and that is a 

growing population. Thank you for your service. Thank you for 

your testimony today. 

Chairman JOHNSON. Thank you, Mr. Stark. 

Mr. Reed, you are recognized for 5 minutes. 

Mr. REED. Thank you, Mr. Chairman. 

Maybe it is because I was up late last night and then I had to 

listen to that. That angers me. That angers me, that tape, and it 

angers me on multiple levels. But most importantly it angers me 

because there is a good mission that you are trying to accomplish 

with these programs and with SSA and the disabled Americans 

across the country. And we applaud that. I support that. I don’t 

think you are going to get any opposition up here on both sides of 

the aisle from that mission. But when you hear stuff like that and 

the people that are abusing the system at the cost of the true people that are disabled and doing the right thing day in and day out, 


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I want to know, what is the result of that? Are those two individuals that were taped, are they still involved in this process? Have 

they been terminated, out of this program? Yes or no? 

Mr. WILLIAMS. Yes. 

Mr. REED. Excellent. And I hope that continues, because that 

oversight needs to be done because that type of behavior needs to 

end. 

Mr. WILLIAMS. It will. 

Mr. REED. What I would like to ask—and I am also getting a 

little tired of the mantra of, we need more funding in order to accomplish the mission. The harsh reality of our country and our fiscal resources are we don’t have the funding. I would love to be able 

to give you all the funding you needed, but I think the harsh reality of our world today and our Nation today is that we don’t have 

those unlimited pots any longer. 

So I am looking to you, Dr. Weathers and Mr. Williams, to tell 

me, what is your plan to deal with the reality of the situation 

where more funding is just not going to be on the table? When I 

ran my businesses, and I hit hard times, I had to make tough 

choices. I had to reprioritize my mission and my goals. I had to reallocate employees to areas that were critical objectives of my business in order to accomplish the mission. Do you have that plan in 

place? 

Mr. WEATHERS. We recognize these are lean times. Commissioner Astrue has said that we are going to have to make difficult 

choices about service delivery. Mr. Williams and I aren’t involved 

in our day-to-day operations and budget process, but we would be 

happy to submit to the record more information on your question. 

Mr. REED. I would appreciate that. And also, what that new 

mission plan or that business plan, if you would, for SSA going forward in the reality of these times would be. 

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Mr. REED. And that gets to my last question. I am hearing, as 

I read this testimony and hear this testimony and look at the evidence, I feel there is a big issue here of duplication of services. And 

I know there was a hearing here on this Subcommittee before looking at the benefits planning services or grants to community organizations, work incentives planning, protection advocacy for beneficiaries of Social Security, the laundry list of programs that are 

out there. Is that an example of efficiency? Would anyone like 

to—— 

Mr. WILLIAMS. Yes. Both the WIPA and the Protection and Advocacy programs serve distinct functions. One focuses on providing 

information and assistance on using our complex work incentives, 

and the other on legal assistance. Whether there are efficiencies to 

be had by a better cooperation and coordination. In that area we 

would be glad to explore. 

Mr. REED. I would be glad to be a partner in that effort. 

With that, I yield back, Chairman. 

Chairman JOHNSON. Thank you. 

Mr. Paulsen, you are recognized for 5 minutes. 

Mr. PAULSEN. Thank you, Mr. Chairman, also for holding this 

hearing and for all the witnesses being here. 

Let me switch gears a little bit. Dr. Kregel, the Social Security 

inspector general was rather critical of WIPAs in their recent report for not having adequate performance measures. And when reviewing the data provided on all WIPAs, there are a lot of process 

measures that are in there. How quickly was the beneficiary contacted? Were they informed about possible options, et cetera? 

But what there aren’t so much in there are these outcome measures or performance measures, like did the beneficiary attempt to 

return to work or actually return to work? Isn’t that what this is 

all about? If you go back to maybe what Mr. Brady was asking 

about earlier, about how would you redesign this with a blank 

piece of paper, et cetera, tell us a little bit about that. How much 

does the WIPA program cost to date? How many people have obtained work as a result of it, and how would we redesign it and 

look on those performance measures? 

Mr. KREGEL. The WIPA program costs $23 million per year to 

fund the 102 projects, including the Minnesota Work Incentive 

Connection, which is really recognized as one of the top programs 

in the country. They estimate that they save $1.7 million per year 

as a result of the $300,000 funding level that they receive to do 

their ongoing work. 

But you are absolutely right. Performance measures to date have 

focused on the process, what are we doing. And outcome measures 

really need to be the focus of what we look at going forward, particularly in light of whether or not this program should be continued for an extended period of time. This would include whether individuals are working at a level that would result in reduced benefits, or working at a level that would result in terminated benefits? 

Are they working at all? Or do they have access to the health insurance so that they continue to meet their complex health care 

needs? 

But also there needs to be savings, return on investment from 

the moneys that are invested in the WIPA program or any of the 


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other programs. That would be increasing the number of individuals exiting the rolls, reduction in the cost of disability payments, 

reduction in the cost of public health care benefits and reduction 

in the number and amount of benefit overpayments, something 

that hasn’t been talked about today, but another area where the 

WIPA program and several of these other programs can make a 

huge difference looking at the billion-dollar problem that exists in 

the area of overpayments today. 

Mr. PAULSEN. Why are not some of these standard measures 

when reviewing WIPA in general? For that matter, for any of these 

work incentives? 

Mr. KREGEL. I think that the focus has been, as these programs 

have evolved, to look at how effective is the process, with the assumption that the process will lead to the outcomes. But now these 

are more mature programs. There is information that exists, for example, that says that the WIPA program will generate a 3-for-1 return on investment if you look at the resources that are devoted 

to this effort and the savings in benefits payments and that type 

of thing. But this has only been done with very recent information 

and it really needs to be looked at on a broad scale to make sure 

that we are not paying for an outcome that might have occurred 

anyway, given the nature of the situation. 

So these things are long overdue, and I know that these benchmarks are being established by SSA, and they are looking at that 

going forward. 

Mr. PAULSEN. Dr. Weathers or Mr. Williams, can you follow up 

on that a little bit? 

Mr. WEATHERS. I can follow up. 

We are going to be releasing a report on the WIPAs looking at 

the outcomes of the beneficiaries that they serve within the next 

few weeks. We just received the final report last week, and we are 

reviewing it, and we are happy to submit it for the record. But I 

do think that it shows some positive outcomes in terms of employment for beneficiaries who are served by the WIPA organizations. 

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Mr. WILLIAMS. We have established in the grantees’ contracts 

that went into effect this July many of the outcome measures that 

John mentioned. We are not where we need to be at. It is going 

to take a constant push for a culture change, because, frankly, the 

perception is that working full time and being financially independent cannot and does not work for people with significant disabilities. We know that many young people on SSI who go to college either never finish, or, if they do, they do not go to work. That 

is a national tragedy, but, likewise, a huge opportunity to, as I say, 

right-size what this program is about and what we need to be held 

accountable for achieving. 

Chairman JOHNSON. Thank you. 

Dr. McDermott, you are recognized for 5 minutes. 

Mr. MCDERMOTT. Thank you, Mr. Chairman. 

I may be the only one on the dais, maybe in the room, who has 

actually sat in hearings with people applying for SSI. As a psychiatrist, I used to see them frequently in Seattle. And as I listen to 

this discussion, I keep thinking about SSI patients. And I don’t 

know that people—if you have never talked to someone who is on 

SSI and spent some time with them and realized what their life is 

about, it is important to realize what this system is. 

You have to have a disability that is going to keep you off the 

rolls for a year, that you are going to be unable to work for a year, 

or die. Those are the sort of end points of the assessment. So you 

don’t get on easily. If you get on SSI, it means you have never had 

any connection to the workforce or any substantial connection to 

the workforce. So you are really at the bottom of the working population in this country, if you can be considered that at all. 

Then we designed the program in 1974, and we haven’t upgraded 

it. I mean, tell me nothing has changed in cost since 1984, right? 

If you get $65 of income from earnings and $20 from any other 

source—your brother gives you $20—$85 you now have on top of 

your $499 on SSI—that is the average—you start to lose $2 for 

every $1 that you earn. Now, you tell me what the incentive is to 

go out for a job and know that for every hour you work or every 

2 you work or 3 hours you work, you are going to lose the pay for 

2 of those hours. It is a program that is designed poorly and needs 

to be reformed from the basics of the way it works. 

And I think that a lot of this performance stuff we are looking 

for—I mean, I can give you all kinds of cases from Missouri and 

Illinois and New Mexico. You know, there are endless problems. 

And I would like for Ms. Harris to talk a little bit about what you 

see out there. Give us a picture so everybody on this Committee 

can understand who these SSI people are as human beings. 

Ms. BATES-HARRIS. Well, first of all, they are individuals who 

are very poor because the program is means-tested. So they can basically have no or very, very limited resources. They are significantly disabled or impaired and, as you indicated, with very little 

work history, which means that either their disability has been so 

prevalent over their lifetime that they have been unable to enter 

the workforce or possibly even benefit from the education system 

and have not obtained the necessary skills required for jobs. 

So we are talking about people who need a lot of support and 

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income supports from the Social Security program to have a place 

to live and to be able to put food on their table. And to those individuals, the thought of returning to work and risking the benefits 

because the work incentives are complicated, or they don’t understand them, or people have told them if they go back to work, they 

are going to lose their Medicaid, or if they go back to work, they 

are going to lose their cash benefit, these are individuals who are 

in a very, very precarious situation and who very much need the 

services and supports that are offered by both the WIPA, the 

PABSS program, and other community programs out there that 

will help them improve their quality of life. 

Mr. KREGEL. May I follow up to that as well? 

Mr. MCDERMOTT. Yes. 

Mr. KREGEL. I agree entirely with your analysis of the SSI program. And you wonder what makes these people want to go to 

work. Well, the answer basically is that the mean benefit is $500, 

and 71 percent of the SSI population live below the poverty level, 

71 percent. So the situation is these are individuals who are at risk 

of not having food on the table. They are at risk of not having shelter over their heads. And they are courageous enough, some of 

them, to go ahead and try to increase their income, even though 

the rules are stacked against them, out of sheer economic necessity 

in many, many situations. 

I agree entirely with your comments in terms of the disincentives 

within the SSI Program. I just think that we need to understand 

that the reason that people take some of these courageous steps is 

out of sheer economic need to meet the basic needs, including food 

and shelter. 

Mr. MCDERMOTT. The bottom line being if you keep them poor 

enough and hungry enough, they will ultimately finally find some 

way to get out of it; is that what you are saying? 

Mr. KREGEL. The situation is that also their health is impacted 

by living in poverty the way that they are, and they look at extensive health care costs. 

So I think anything that can be done so that when SSI beneficiaries work that they are not penalized for working is a very, 

very sound approach in terms of moving forward. It is the best way 

to go. 

Mr. MCDERMOTT. Thank you. 

Chairman JOHNSON. Thank you. 

Mr. Berg, you are recognized for 5 minutes. 

Mr. BERG. Thank you, Mr. Chairman. 

I come from a State where, quite frankly, we are looking for employees. We have got around a 3 percent unemployment rate. And 

I am just sitting here. And again, the big problem as I see it is in 

2018, we are broke. So we have kind of been dancing around a lot 

of these questions. But it seems to me that that is really the number one thing that we need to focus on. 

Having said that, if there are 2.6 million people who would like 

to work, it seems like that is almost 25 percent of the people that 

would like some sort of work. And if in 2018, according to the numbers that we are given, we would only be able to fund 84 percent. 

Well, quite frankly, if half the people that wanted to work found 


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work and became self-sufficient from an income standpoint, that 

would certainly push that 2018 date out. 

So I guess—and I appreciate the concern of not wanting people 

to coach to the program, but, quite frankly, I don’t think anyone 

really needs any coaching to look at the program and realize that 

if you make more than $1,000, you are going to lose all your benefits. It is not that complicated for anyone that is on the program. 

So it seems to me that there are really some fundamental flaws in 

the program that need to, quite frankly, encourage people and partner with people getting on their own rather than creating some 

sort of barrier. When they figure it out, they are making $2, $3 an 

hour for the extra work. So, I mean, that is kind of one of the big 

chunks. 

We are running out of time here, and it appears to me that, obviously, what we have heard from the employers, that is one—I 

mean, there are two ways of doing this, from my perspective. We 

could take from the employers and kind of work an environment 

where we have work and opportunities, or it seems like we can also 

just push people from the bottom up. I would like to hear from Mr. 

Hanophy about how can we encourage employers to—are there barriers there? Are there things that we can do that would encourage 

employers to say, here is a real opportunity to bring a valuable person into my company long term? 

Mr. HANOPHY. Sure. Thank you. 

Essentially there are three parts to that. Number one is what we 

identified earlier, which is the dual customer; in other words, 

knowing the business and knowing your applicant, the person with 

a disability. That means understanding what the business needs, 

but understanding how they operate, how the jobs operate, the 

work culture. Once you are able to do that, you are able to have 

a discussion with this business about your ability to bring them a 

qualified applicant. 

Study after study shows that the reason why people get hired is 

because they can do the job. And so this isn’t about charity. This 

is about helping them find an applicant who can do the job. So the 

key for the providers is to provide the supports and also do the 

screening and make sure these applicants are qualified. 

Number two is helping a business increase their access to an applicant pool of people with disabilities. The term we prefer to use 

is ‘‘multiple portals.’’ We have had examples with Walgreens and 

several other companies where by providing a little bit more training on the front end or a little better adjustment on the front end, 

we are able to help—we call it embedded training, for lack of a better term, where an applicant with a disability can hear the noise, 

smell the dust, be a part of the work environment, but learn at a 

pace to where they will be able to get up to speed to eventually be 

hired by that employer. So different portals of entry. 

And then the third piece is support. Companies very often are 

very interested in supporting people with disabilities, but don’t 

know how. We hear the term ‘‘reasonable accommodations.’’ I prefer to use the term ‘‘adjustments,’’ because a reasonable accommodation is nothing more than a commonsense adjustment to help 

somebody go to work. My favorite example is, if your job requires 

you to reach something on the top shelf, and you can’t get that 


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thing on the top shelf, let us move it down. And it doesn’t matter 

if you are 4 feet 11 or you are in a wheelchair. Let us just move 

it down and move on. 

And providing supports about how to help folks with significant 

disabilities adjust to work tasks. This is where the Partnership 

Plus model, I think, has been effective in partnering with Social 

Security in being able to provide some of those longer-term supports. 

The bottom line is know your business and know your individual 

with a disability. 

Mr. BERG. Thank you. 

Ms. Russell, I would like to ask you a kind of similar question. 

If from a business-down approach you are going to develop or increase it, are there barriers that are out there? Or what changes 

would you like to see? 

Ms. RUSSELL. I think the barrier we experience is trying to locate the talent. And that is, as Mr. Hanophy just described, something that we have been able to find in Texas with their assistance 

is being able to locate the individuals who have the skills that 

match what we are requiring. It is unfortunate that we have a lot 

of situations where a week goes by, and I see that we have hired 

50 new workers, and not one of them is identified as somebody 

with a disability. It is 50 opportunities that our partners have 

passed on by not being able to help us find the individuals with 

disabilities who have the skills to do our jobs. So it is all about a 

talent pool and finding the talent, developing the talent, and then 

being able to match it to the business’ needs. 

Mr. BERG. Thank you, all. 

I will yield back, Mr. Chairman. 

Chairman JOHNSON. Mr. Crowley, would you care to question? 

You are recognized for 5 minutes. 

Mr. CROWLEY. Thank you, sir. Let me thank you and Chairman 

Davis for holding this hearing today. I want to thank the witnesses 

for their testimony. 

My office frequently hears from our constituency about navigating the Social Security benefits, the disability system, and, quite 

frankly, it is one of the most frustrating things about our office, I 

think. I think I speak for both sides of the aisle in this because 

they are repeated, and, over a period of time, one of the most timeconsuming aspects of the office. I am not complaining about that. 

That is what we do. That is why we are here to help them navigate. 

But, Ms. Bates-Harris, if I could ask you to just comment. Obviously not everyone can work. There are some people in this world 

who, by no fault of their own, simply just do not have the wherewithal for various reasons to work. Is that correct? 

Ms. BATES-HARRIS. My philosophical—because my original 

work in the field came from the Rehab Act, and the premise of the 

Rehab Act is that all individuals, regardless of the significance of 

disability, are capable of engaging in an employment outcome if 

they are given the proper services and supports, my gut reaction 

is to say that everyone can work. But unfortunately all the resources and supports are not in place, so there are individuals who 

cannot work. 


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Mr. CROWLEY. In the perfect world—just clarify this for me. 

There are some people in this country who do not have the ability 

to work. Those individuals do exist. Am I not correct? 

Ms. BATES-HARRIS. Yes, they do. 

Mr. CROWLEY. So in a perfect world, if the Ticket to Work program worked perfectly, there would still be a need for SSI and 

SSDI benefits; is that not correct? 

Ms. BATES-HARRIS. Absolutely, positively. 

Mr. CROWLEY. That is an important point just to note. I appreciate the recording of that was played as well, understand that that 

could be disturbing, as many of the things in life are disturbing to 

all of us, I think. But also, when people are asked a question and 

are answering to the best of their ability and following the guidelines of the law, I think that also needs to be taken into consideration regardless of the characterization of how that question is 

asked. 

One of the questions my office often gets from constituents is, 

can I still work while receiving disability benefits? Ms. Bates-Harris, in your written testimony you mentioned the importance of the 

Work Incentives Planning Assistance program, which supports benefits counselors in the community to answer just those types of 

questions. What kind of impact will our constituents see if this program is not reauthorized, particularly once the funding begins to 

run out? 

Ms. BATES-HARRIS. I think that it would have a devastating 

impact on those people who are motivated and want to return to 

work, because we would fall back onto the old beliefs that if you 

go back to work, you are going to immediately lose your benefits, 

you are going to lose access to your health care, and you are going 

to lose access to the other supports. 

I think it has been a very slow process getting the public and 

people with disabilities to understand that, yes, there is going to 

be an impact on your benefits, but depending on whether you are 

getting SSI or SSDI, the impact is not immediate. If people understand what is going to happen and how it is going to happen, then 

it allows them to plan their lives and plan their return to work and 

make the adjustments that they need to be successful in it. And 

without it, people would simply give up and not even try. 

Mr. CROWLEY. You mentioned the Affordable Care Act and the 

opportunity it gives disabled individuals to receive health care 

without having to rely upon public assistance. What are some of 

the several beneficial provisions included in this law which would 

be lost if the law were to be repealed? 

Ms. BATES-HARRIS. I am sorry, would you repeat the question? 

Mr. CROWLEY. You mentioned the Affordable Care Act in your 

written statement, and the opportunities it gives to the disabled individual to receive health care without having to rely upon public 

assistance. If that were to be repealed, which many of my colleagues on the other side would like to see happen, what would be 

the fallout from that? Do you understand? 

Ms. BATES-HARRIS. I do understand the question. And I am 

sorry, I am a little tired, I traveled late last night. 

I think, you know, the biggest issue right now is that people with 

disabilities face a lot of discrimination in insurance and insurance 


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coverages and what will be covered; for instance, assistive technology and durable medical equipment and things like that. And 

without access to health care, and without access to the services 

and supports they need, which are very different for different people, they would not be able to maintain the health status that they 

have, and would not be able to basically, you know, maintain their 

level of wellness, so to speak, to enable them to continue to work. 

And I am not sure that I answered your question. 

Mr. CROWLEY. I think you answered the question just fine. And 

given that you got in late last night, we were up late last night. 

Ms. BATES-HARRIS. I know. We were on the same schedule. 

Mr. CROWLEY. Just for the record, I am not picking on you. I 

was going to move on to someone else after that anyway, but I ran 

out of time. 

Ms. BATES-HARRIS. Sorry. 

Mr. CROWLEY. Thank you, ma’am. 

Chairman JOHNSON. Thank you all for your testimony. 

Thank you, Mr. Crowley. 

I appreciate you all being here. Chairman Davis and I are interested in improving the system, if we can, and helping the people 

out there that need help. 

Again, thank you all for being here today, for your testimony. I 

look forward to working with you and all my colleagues to make 

sure work incentives achieve the results Congress and the taxpayers expect, and those with disabilities deserve. 

With that, the Committee stands adjourned. 

[Whereupon, at 11:17 a.m., the Subcommittees were adjourned.] 

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