U.S. Government Accountability Office (GAO) Social Security Disability---Ticket to Work Participation Has Increased, but Additional Oversight Needed
The U.S. Government Accountability Office ("GAO") issued a May 6, 2011 report (GAO-11-324) on "Social Security Disability---Ticket to Work Participation Has Increased, but Additional Oversight Need"
To view the complete report, click on the hyperlinks below:
Highlights Page (PDF) Full Report (PDF, 80 pages) Accessible Text Recommendations (HTML)
Summary
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. The 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. The GAO analyzed SSA data, policies, and procedures and interviewed representatives of 25 ENs, disability advocacy organizations and the SSA.
More ticket holders and ENs are participating in the Ticket to Work program since SSA revised regulations in 2008, but the overall participation rate remains low. Ticket holders assigning their tickets to ENs increased from about 22,000 in fiscal year 2007 to more than 49,000 as of July 2010.
However, less than 1 percent of all ticket holders assigned their tickets to ENs and SSA has not yet studied whether regulatory changes enabled more ticket holders to obtain employment and exit the benefit rolls.
During this time, ENs approved to serve ticket holders increased from 1,514 to 1,603, and SSA's ticket payments to ENs increased from $3.8 million to $13 million. However, 20 ENs, or less than 2 percent of those currently participating, have received the majority of total ticket payments from SSA. GAO found that ENs provide a range of services, including job search and retention assistance. Since the 2008 regulatory changes, which explicitly allowed ENs to pay ticket holders, an increasing number used service approaches such as sharing SSA's government-funded ticket payments with ticket holders.
These ENs target ticket holders already working or ready to work, and accounted for a substantial and growing share of payments from SSA. Three ENs among those with the largest payment amounts reported providing limited or no direct services beyond passing back a portion of ticket payments to ticket holders who had sufficient earnings to qualify the ENs for payment.
These ENs received a total of over $4 million in SSA payments-- nearly one-third of all SSA payments--in fiscal year 2009. Two of these ENs passed back 75 percent of SSA's ticket payments to ticket holders and kept the other 25 percent. The extent of these trends is unknown because SSA does not collect sufficient information on service approaches across all ENs. SSA lacks adequate management tools to systematically evaluate ticket holders and ENs.
Since 2005, SSA has not consistently monitored or enforced ticket holders' progress toward self-supporting employment--a regulatory requirement. Ticket holders who show progress are generally exempt from medical reviews to determine their continued eligibility for benefits. Lack of systematic monitoring of timely progress has both program integrity and cost implications, such as the potential for ineligible beneficiaries to continue receiving benefits.
During the course of the GAO's review, the SSA was beginning to resume the progress reviews, but it is too early to assess the effectiveness of these efforts. Moreover, SSA has not developed performance measures for approved ENs, as required by law, that can be used to assess their success in helping ticket holders obtain and retain employment and reduce dependency on disability benefits. Without such measures, multiple ENs communicate to ticket holders how to work and keep full disability benefits, despite the fact the ultimate goal of the Ticket program is to reduce dependence on benefits (to hear audio excerpts of GAO's calls with selected ENs, see http://www.gao.gov/products/GAO-11-324).
Finally, the SSA's EN approval process lacks systemic tools to ensure quality and clear and specific criteria for reviewing EN qualifications.
The GAO is recommending that the SSA take several steps, such as compiling service trend data and monitoring ticket holders' progress, to enhance program oversight. The SSA agreed with two recommendations and offered alternative language for the other two to reflect actions it considers planned or under way.
For more information about a Miami-Dade, Broward and Palm Beach County home health care agency for seniors and other family members, contact Brian Gauthier at A Family Member HomeCare (954) 986-5090 or www.afamilymemberhomecare.com. Serving Coconut Creek Cooper City Coral Springs Dania Beach Davie Deerfield Beach Fort Lauderdale Hallandale Beach, Hillsboro Beach Hollywood Lauderdale Lakes Lauderdale-by-the-Sea Lauderhill Lazy Lake Lighthouse Point Margate Miramar North Lauderdale Oakland Park Parkland Pembroke Park Pembroke Pines Plantation Pompano Beach Sea Ranch Lakes Southwest Ranches Sunrise Tamarac Weston Wilton Manors Aventura Sunny Isles Beach Hialeah Miami Lakes Boca Raton Delray Beach
To view the complete report, click on the hyperlinks below:
Highlights Page (PDF) Full Report (PDF, 80 pages) Accessible Text Recommendations (HTML)
Summary
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. The 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. The GAO analyzed SSA data, policies, and procedures and interviewed representatives of 25 ENs, disability advocacy organizations and the SSA.
More ticket holders and ENs are participating in the Ticket to Work program since SSA revised regulations in 2008, but the overall participation rate remains low. Ticket holders assigning their tickets to ENs increased from about 22,000 in fiscal year 2007 to more than 49,000 as of July 2010.
However, less than 1 percent of all ticket holders assigned their tickets to ENs and SSA has not yet studied whether regulatory changes enabled more ticket holders to obtain employment and exit the benefit rolls.
During this time, ENs approved to serve ticket holders increased from 1,514 to 1,603, and SSA's ticket payments to ENs increased from $3.8 million to $13 million. However, 20 ENs, or less than 2 percent of those currently participating, have received the majority of total ticket payments from SSA. GAO found that ENs provide a range of services, including job search and retention assistance. Since the 2008 regulatory changes, which explicitly allowed ENs to pay ticket holders, an increasing number used service approaches such as sharing SSA's government-funded ticket payments with ticket holders.
These ENs target ticket holders already working or ready to work, and accounted for a substantial and growing share of payments from SSA. Three ENs among those with the largest payment amounts reported providing limited or no direct services beyond passing back a portion of ticket payments to ticket holders who had sufficient earnings to qualify the ENs for payment.
These ENs received a total of over $4 million in SSA payments-- nearly one-third of all SSA payments--in fiscal year 2009. Two of these ENs passed back 75 percent of SSA's ticket payments to ticket holders and kept the other 25 percent. The extent of these trends is unknown because SSA does not collect sufficient information on service approaches across all ENs. SSA lacks adequate management tools to systematically evaluate ticket holders and ENs.
Since 2005, SSA has not consistently monitored or enforced ticket holders' progress toward self-supporting employment--a regulatory requirement. Ticket holders who show progress are generally exempt from medical reviews to determine their continued eligibility for benefits. Lack of systematic monitoring of timely progress has both program integrity and cost implications, such as the potential for ineligible beneficiaries to continue receiving benefits.
During the course of the GAO's review, the SSA was beginning to resume the progress reviews, but it is too early to assess the effectiveness of these efforts. Moreover, SSA has not developed performance measures for approved ENs, as required by law, that can be used to assess their success in helping ticket holders obtain and retain employment and reduce dependency on disability benefits. Without such measures, multiple ENs communicate to ticket holders how to work and keep full disability benefits, despite the fact the ultimate goal of the Ticket program is to reduce dependence on benefits (to hear audio excerpts of GAO's calls with selected ENs, see http://www.gao.gov/products/GAO-11-324).
Finally, the SSA's EN approval process lacks systemic tools to ensure quality and clear and specific criteria for reviewing EN qualifications.
The GAO is recommending that the SSA take several steps, such as compiling service trend data and monitoring ticket holders' progress, to enhance program oversight. The SSA agreed with two recommendations and offered alternative language for the other two to reflect actions it considers planned or under way.
For more information about a Miami-Dade, Broward and Palm Beach County home health care agency for seniors and other family members, contact Brian Gauthier at A Family Member HomeCare (954) 986-5090 or www.afamilymemberhomecare.com. Serving Coconut Creek Cooper City Coral Springs Dania Beach Davie Deerfield Beach Fort Lauderdale Hallandale Beach, Hillsboro Beach Hollywood Lauderdale Lakes Lauderdale-by-the-Sea Lauderhill Lazy Lake Lighthouse Point Margate Miramar North Lauderdale Oakland Park Parkland Pembroke Park Pembroke Pines Plantation Pompano Beach Sea Ranch Lakes Southwest Ranches Sunrise Tamarac Weston Wilton Manors Aventura Sunny Isles Beach Hialeah Miami Lakes Boca Raton Delray Beach
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