Ticket to Work, a product of the Ticket to Work and Work Incentives Improvement Act of 1999 (TWWIIA), has had a new facelift that is supposed to make it easier to use and more appealing to both employers and potential employees (See "Will New Changes Save Ticket to Work?", June 23, 2008). Congress made amendments last year to the act's regulations, which have been in operation since 2001.

The changes enable state and private parties to work together with Social Security Disability clients toward getting them into full- or part-time paying jobs. But the program still has a long way to go. The new rules have only been in effect since July 21, 2008, and it's hard to determine if they will have any impact on occupational therapy private practice.

One of the problems is following the success of these efforts and educating or re-educating potential clients and providers about them.

The Social Security Administration Office of Employment Support Services signed an $18.2 million contract with a Virginia consulting firm, Axiom Resource Management Inc., three years ago to construct an outreach program for Ticket to Work. The contract made Axiom's CESSI division its Ticket to Work program manager for recruitment and outreach (PMRO). Last April that company launched a 120-day PR program called the New Ticket to Work Express, designed to kick off the effort.

In order to figure out how much had to be done, CESSI had to research the penetration of Ticket to Work throughout the country right now.

Last spring, New York, California, Indiana and Texas had the most active programs (between 43 and 74 each). The fewest existed in Alaska, Hawaii, Wyoming, South Dakota, Utah, Nebraska, New Mexico, North Dakota, Oklahoma, Mississippi, Alabama, South Carolina, West Virginia, Maine, Delaware, Rhode Island, New Hampshire and Vermont, which all had fewer than 10.

SSA/PMRO had four primary goals for its four-month outreach program:

• to analyze employment network (EN) and beneficiary data to improve focus on targeted communities;

• to partner with service systems, associations and other qualified organizations and individuals to get the word out about the new Ticket to Work program and recruit new ENs;

• to develop and enhance programs and models for spreading the word about the program and training the new team on tools and processes; and

• to develop a shared, longer-term vision and strategic plan at SSA headquarters using feedback from the New Ticket Express campaign.

The 16 states included in the tour were Washington, California, Colorado, Texas, Missouri, Illinois, Florida, Georgia, North Carolina, Virginia, Ohio, Pennsylvania, New Jersey, Michigan, Massachusetts and Rhode Island. Conferences and events also were scheduled in 19 other states.

Within targeted communities, CESSI analyzed concentrations of ENs (both active and inactive) to find out where more ENs are needed for outreach to beneficiaries, based on unemployment rates. Target states would be identified by analyzing general population data to identify employment rates and link to delivery systems and partnership models, according to the plan.

SSA knows it cannot do this alone. It will need to partner with both public and private firms to meet recruitment and outreach needs. That means creating regional outreach infrastructures to locate more partners. The Express offered partnership meetings focused on educating the public and providers about the New Ticket program, work incentives, EN recruitment and beneficiary outreach.

The plan was to identify an event manager for each activity in a targeted state, establish relationships there and identify a local partner who would champion the program and help place or put on a major conference about the New Ticket program. Real or potential local partners to Ticket could participate on panels that highlighted multifaceted support for the New Ticket program, EN recruitment fairs or other events. CESSI would leave behind toolkits the new local coordinators could use to do this. All this was to continue until "every state has sufficient outreach efforts to recruit significant numbers of new ENs that can facilitate beneficiary outreach and improve.access."

How well is it working? There's no evaluation yet on the Express project, but a three-day Ticket partners summit in Falls Church, VA, last March offers a glimpse of what SSA was trying to achieve. CESSI managed the summit, which convened 450 Ticket partners and potential partners in ENs and potential ENs, state vocational rehabilitation agencies, work incentives planning and assistance programs (WIPAs), state protection and advocacy programs, federal agencies, and key SSA staff as well as advocates and beneficiaries.

Four plenary sessions and 36 different workshops featured panel members who represented diverse programs and interests and who spoke from their own individual perspectives. The final 10 break-out sessions were meant to encourage region-specific networking and partnership development, so they grouped attendees by geographic areas, "where they could identify what was needed and available specifically in their regions..."

Derek Shields, CESSI's project director, reported that he felt the summit was "a resounding success for SSA in its mission to launch the New Ticket program."

In its next report, ADVANCE will offer a glimpse of a demonstration project.

E.J. Brown is ADVANCE editor.