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Highlights

The Social Security Administration (SSA) pays billions of dollars in Disability Insurance and Supplemental Security Income to people with disabilities. The Ticket to Work program, established in 1999, provides eligible beneficiaries (ticket holder) with a ticket they may assign to approved service providers, called employment networks (EN). ENs are to provide services to help ticket holders obtain and retain employment and reduce dependence on SSA benefits. ENs receive payments from SSA once a ticket holder has earnings exceeding a set threshold. Due to low participation, SSA changed program regulations in 2008 to provide ENs and ticket holders with more incentives to participate. GAO examined (1) changes in ticket holder and EN participation over time, (2) the range of service approaches used by ENs, and (3) SSA's efforts to evaluate ticket holders and ENs to ensure program integrity and effectiveness. GAO analyzed SSA data, policies, and procedures, and interviewed representatives of 25 ENs, disability advocacy organizations, and SSA.

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Recommendations

Recommendations for Executive Action

Agency Affected Recommendation Status
Social Security Administration To inform assessments of the program's cost and effectiveness and enhance SSA's oversight and monitoring of ENs and ticket holders, the Commissioner of Social Security should prioritize and carry through with a study of participating ticket holders' exits from the rolls since revisions to the program's regulations took effect in 2008.
Closed - Implemented
In July 2013, SSA contractors published a report examining changes in work activity of ticket holders before and after the 2008 regulatory changes. Specifically, the study assessed whether there were systematic differences in benefits suspensions and terminations due to work, and benefits foregone for work for Ticket to Work participants who assigned their ticket immediately before and after the 2008 regulatory changes.
Social Security Administration To inform assessments of the program's cost and effectiveness and enhance SSA's oversight and monitoring of ENs and ticket holders, the Commissioner of Social Security should adopt a strategy for compiling and using data on trends in employment network service provision to determine whether service approaches, such as sharing SSA ticket payments with ticket holders, are consistent with program goals of helping ticket holders find and retain employment and reduce dependency on benefits; for example, SSA could revise existing tools to compile information on service approaches used by all ENs;
Closed - Implemented
In August 2012, SSA officials reported that they are now reviewing and approving new and existing ENs' business models (service approaches) on an ongoing basis. SSA has identified four business model categories and will track performance by business model. SSA also developed new requirements for Employment Networks (EN) with certain business models. For example, officials told us prospective employer ENs must identify in their applications available jobs paying at or above the substantial gainful activity (SGA) level into which they will place ticket holders. SSA will evaluate these ENs' ability to assist at least 80 percent of their ticket holder clients in achieving SGA-level earnings within 9 months of the ticket assignment. In the report, we raised concerns that the leading service approach entailed sharing ticket payments with ticket-holders while providing no tangible services. According to officials, SSA is now requiring ENs with a shared payment model to convert to a consumer directed services model, which only allows the EN to reimburse the beneficiary for return-to-work related expenses that the beneficiary purchased.
Social Security Administration To inform assessments of the program's cost and effectiveness and enhance SSA's oversight and monitoring of ENs and ticket holders, the Commissioner of Social Security should develop a strategy to ensure on-time completion of timely progress reviews of ticket holders and take steps to ensure the accuracy of information used to make timely progress determinations.
Closed - Implemented
In August 2012, SSA officials reported that they have been initiating and adjudicating timely progress reviews on time since Spring 2011. Officials also reported that SSA began quality reviews in May 2012 to ensure the accuracy of information used to make timely progress determinations. According to a quality assurance procedural document, SSA randomly selects and conducts monthly audits on 5 percent of timely progress review decisions. In cases where the beneficiary self-certifies that he has met work criteria, a quality assurance analyst uses earnings records to verify earnings claims. Additionally, in cases where a beneficiary claims to have met educational criteria, a quality assurance analyst will check for documentation of the beneficiary's reported educational progress, such as transcripts, certificates of completion, and report cards.
Social Security Administration To inform assessments of the program's cost and effectiveness and enhance SSA's oversight and monitoring of ENs and ticket holders, the Commissioner of Social Security should move forward to develop EN performance measures consistent with the requirements of the Ticket law.
Closed - Implemented
On August 8, 2011, SSA notified us that it has developed performance measures for employment networks. The performance measures are outlined in its Request for Quotation, published on April 27, 2011.

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