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November 1, 2002
Honorable E. Clay Shaw, Chairman
Subcommittee on Social Security
U.S. House of Representatives
Committee on Ways and Means
B316 Rayburn House Office Building
Washington, DC 20515
Dear Chairman Shaw,
The Ticket to Work and Work Incentives Advisory Panel appreciates the recent opportunity to provide testimony before the Subcommittee regarding the Social Security Disability Programs' Challenges and Opportunities. We have received your follow up questions of October 17, 2002 and submit the following in response.
Where possible the answers reflect specific recommendations in the Panel's reports and discussions on the general topics relevant to your questions. In some cases, we are unable to answer the question at this point because we have not yet had an opportunity to gather the data needed nor reach a conclusion on the issue. However, in order for the hearing record to be complete, we are submitting our response for your consideration at this time. To aid in clarity of this response, we have separated the five questions as follows:
1. In the opinion of the Advisory Panel, what made the Employment Support Representatives (ESR) pilot so successful? What are the key features that would need to be continued in whatever alternative structure the Social Security Administration (SSA) develops to meet the mandate in the law?
The Panel believes the ESR pilots were successful because they identified and trained work incentive specialist within SSA to assist beneficiaries and their advocates in making informed choices about returning to work and the use of existing work incentives. Local SSA offices have not historically demonstrated great expertise in this area.
The Panel believes the key features that need to continue in any structure SSA develops should follow the specifics outlined in the Statute.
The Ticket to Work and Work Incentive Improvement Act states in Subtitle C, Section 1149(a)(2)(C), "the Commissioner shall establish a corps of trained, accessible, and responsive work incentives specialists within the Social Security Administration who will specialize in disability work incentives under titles II and XVI...."
The Panel also strongly believes national implementation of the ESR position is key to the successful implementation of the programs and work incentives improvements under the Act. It is also critical to improving customer service for beneficiaries who attempt to work and report earnings or attempt to use any of the current work incentives in the SSI and SSDI programs. The Panel's position is that all interested beneficiaries across the country should have reasonable access to work incentive specialists who are dedicated to this task full-time.
2. You indicated the Panel believes the resources allocated to public education, training and marketing of the Ticket program are insufficient. What specific recommendations has the Panel made to SSA on educating the public, conducting better training, and improving the program marketing? How does the Panel plan to assist in these efforts?
In its recent annual report the Panel specifically recommended that SSA dedicate extensive increases in budget to develop outreach, training and technical support in the areas of SSA's disability and return to work programs and work incentive provisions, as well as,other Federal benefit programs and work incentive provisions administered by agencies. Based on public comment, the Panel is convinced that most beneficiaries who will receive a ticket do not know what it is, what to do with it, or why it has been sent to them. In recent public forums, White House staff and senior SSA executives have acknowledged the need for an outreach campaign to market the Ticket Program, not only to beneficiaries but also to employers and providers. An immediate, coordinated public information campaign to explain the provider and employer opportunities, and beneficiary choices and protections under the Ticket Program, is crucial. The Panel is concerned SSA has not allocated sufficient resources for this effort. Given the potential impact of the Ticket Act Programs on the lives of individuals with disabilities and other stakeholders, and the amount of information needed to ensure the effectiveness of these programs, adequate resources must be allocated to training and technical support on national, regional, State and local levels. Readily available, accurate information is key to helping people with disabilities return to work.
The Panel is an advisory body with a very limited staff allotment and budget. As such, it does not foresee the ability to assist SSA directly in these efforts. However, the Panel does continue to publicize the programs on our Web site, www.socialsecurity.gov/work/panel, and to continue to work very closely with the Agency and the Congress in expanding efforts in these areas.
3. You expressed concern that there are not enough service providers, in terms of both geographic location and specialization. What specific recommendations have you made to SSA to remedy this situation?
As the roll out of the Tickets continues, this issue is just beginning to emerge. The Panel first heard complaints about capacity and specialization at its August 2002 meeting. Apparently there has been a much greater response to the Ticket roll out than ENs had anticipated. Many ENs reported being overwhelmed with the volume of calls and contacts from beneficiaries who had received their Ticket. The Panel is very concerned with building service provider capacity and will continue to investigate this issue.
4. Is the Panel addressing the issue of obtaining up-front capital for employment networks in need? Have you made suggestions to SSA?
The Panel is concerned about this issue as a result of testimony received at its most recent meeting in August 2002 but it has not, as yet, made any suggestions to the Social Security Administration.
5. Would you tell us more about why the Panel believes ticket eligibility should be expanded to those under 18 and those whose conditions are expected to improve?
First, the Panel recommended that 16- and 17-year-old beneficiaries should be eligible to participate in the Ticket Program. The Panel takes the position that making transition-aged youth ineligible for the Ticket Program sends the wrong message to youth and could encourage lifelong dependence on benefits. The Panel believes short-term costs were the primary reason youth were excluded, however, the long-term benefits to young beneficiaries and long-term program savings could far outweigh the short-term costs. Numerous studies have found the sooner someone begins receiving employment services, the more likely the person will be to go to work. Delaying the onset of those services, even by a short time, makes it substantially less likely that the individual will attempt to work or succeed.
Second, the Panel takes issue with SSA's assumption that because beneficiaries with Medical Improvement Expected (MIE) designations have medical conditions expected to improve in a relatively short time, they could be expected to return to work without the services under the Ticket Program. Currently, few beneficiaries with the MIE designation are leaving the rolls voluntarily to return to employment. In addition, on average, only 16 percent of beneficiaries with this designation are ceased for medical improvement after their initial continuing disability review (CDR). A substantial number of beneficiaries (51,044 in 1999, for example) will therefore be denied this important benefit for up to 2 years on average, based on what the Panel believes is a faulty assumption.
The Panel also believes the decision to exclude beneficiaries with the MIE designation was based primarily on short-term cost considerations which may have failed to take into account the long-term savings to the programs that could be realized through early intervention. The Panel remains convinced that beneficiaries with the MIE designation will benefit significantly from participation in the Ticket Program and should be included.
We greatly appreciate your interest in the Panel's views on Social Security Disability Programs' Challenges and Opportunities. We look forward to continued involvement with the Subcommittee on these and other Social Security disability concerns. Thank you again for this opportunity. If you need any further information or clarification, please contact Marie Strahan of our staff at 202-358-6419.
Sincerely,
Sarah Wiggins Mitchell, Chair
CC:
Ticket to Work and Work Incentives Advisory Panel
Marie P. Strahan
JoAnne Barnhart
Martin Gerry
Kenneth McGill
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