May 24, 2004
The Honorable Joanne Barnhart
Commissioner
Social Security Administration
6401 Security Blvd.
Baltimore, MD 21235
Dear Commissioner Barnhart:
We are writing to express our concern over delays in the regulatory process that are having an adverse impact on the success of the Ticket to Work and Work Incentives Improvement Act (TTWWIIA). As members of the Consortium for Citizens with Disabilities (CCD) Work Incentives Implementation Task Force, we have a keen interest in the effective implementation of this Act. We commend the Social Security Administration (SSA) for the timely roll out of the Ticket to Work program. However, key objectives in Ticket to Work – e.g. encouraging beneficiaries to choose work over reliance on benefits and broadening beneficiary access to vocational rehabilitation services – seem to have been lost because SSA has been slow to respond to concerns raised over several of its policies affecting the program.
Congress gave SSA the authority to revisit certain policy interpretations once actual experience with the Ticket program indicated that those policies were a hindrance to success of the program. Section 1148(h)(5)(A) says that "the Commissioner shall periodically review the percentage specified in paragraph (2)(C) [the fixed percentage of the payment calculation base on which outcome payments are based], the total payments permissible under paragraph (3)(C) [setting the difference in payment between the outcome and milestone-outcome payment schedules], and the period of time specified in paragraph (4)(B) [the 60 month outcome payment period] to determine whether such percentages, such permissible payments and such period provide an adequate incentive for employment networks to assist beneficiaries to enter the workforce, while providing for appropriate economies. The Commissioner may alter such percentage, such total permissible payments or such period of time to the extent that the Commissioner determines, on the basis of the Commissioner's review under this paragraph, that such an alteration would better provide the incentive and economies described in the preceding sentence." After consultation with the Ticket to Work and Work Incentives Advisory Panel, Section 1148(h)(5)(C) states that the Commissioner "shall implement the necessary adjusted payment rates prior to full implementation of the Ticket to Work and Self-Sufficiency Program."
Evidence and testimony from beneficiaries, advocates and providers have repeatedly pointed to weaknesses in Ticket to Work – e.g. eligibility criteria that exclude certain beneficiaries with significant return to work potential, conflicts between the Title I vocational rehabilitation system and Ticket, and a provider payment system that has failed to attract a pool of vendors sufficient to guarantee beneficiary choice in job training and supports. Few beneficiaries and even fewer providers are participating in the Ticket program. As of April 26, 2004, only 47,000 of the 7 million tickets that had been mailed had been assigned. With only 439 of the approximately 1,100 employment networks (ENs) under contract with SSA accepting ticket assignments, most of the ticket assignments are going to State VR agencies.
We do appreciate the fact that SSA increased the number and amount of milestone payments in response to early expressions of dissatisfaction by providers. However, for over a year, SSA has had in process draft regulations to address additional problems that continue to plague the Ticket program. We believe that time is of the essence and urge you to use your existing authority to issue the proposed regulations quickly in order to move forward with the changes that must be made to make the Ticket program work
Our task force would welcome an opportunity to meet with you to discuss the progress of the Ticket to Work and Self-Sufficiency Program. If such a meeting is compatible with your schedule, please feel free to have your staff contact any of the cochairs as follows: Susan Prokop, PVA, 202-416-7707; Cheryl Bates-Harris, NAPAS, 202-408-9514; Andrea Harles, INABIR, 202-543-6353; Paul Seifert, USPRA, 410-789-7675.
American Association on Mental Retardation
American Association of People with Disabilities
American Network of Community Options and Resources
American Occupational Therapy Association
Council of State Agencies for Vocational Rehabilitation
Easter Seals
International Association of Business, Industry and Rehabilitation
National Alliance for the Mentally Ill
National Association of Protection and Advocacy Systems
National Organization of Social Security Claimants' Representatives
NISH
Paralyzed Veterans of America
United Spinal Association
U. S. Psychiatric Rehabilitation Association [formerly IAPSRS]
