Policy Brief June 2005 Employment, the Ticket to Work Program, and Vocational Rehabilitation: Perspectives of People with Disabilities Introduction Historically, the disability community has struggled within the labor market. Current employment rates for people with and without disabilities are 35% and 78%, respectively (Louis Harris & Associates Survey, 2004). Given this employment gap, it is critical to examine the perspectives of the disability community towards disability-related employment policy. In 1999, Congress took steps to address the employment gap with the passage of the Ticket to Work and Work Incentives Improvement Act (TWWIIA). TWWIIA was passed to allow individuals with disabilities to enter the workforce and obtain vocational rehabilitation (VR) and employment services from their choice of Employment Networks (ENs), while still maintaining their medical benefits (e.g., Medicaid and Medicare). ENs are public or private organizations that provide ticket holders with vocational training, job placement, and employment support/retention services. Prior to TWWIIA, people with disabilities received vocational rehabilitation and employment services primarily from a limited number of federal- and state-funded offices of rehabilitation and non-profit organizations. To date, policy makers, policy analysts, advocates, and others have identified critical areas of concern with the Ticket to Work (TTW) program (for example, the payment structure for reimbursing ENs). However, little attention has been paid to the experiences of people with disabilities, who are the primary recipients of the program. The disability community can provide valuable feedback on the awareness and effectiveness of TTW. Given that their voices are too often ignored, feedback from individuals with disabilities is particularly important. This study aimed to provide the disability community with a voice concerning their employment experiences, with a particular focus on the TTW program. Twelve focus groups were conducted in the Chicago area, involving 74 working-age adults with disabilities. Participants included African-Americans, Latinos, and European-Americans with varying types of disabilities. They shared personal experiences as they related to 1) employment, 2) the Ticket to Work program, and 3) VR services. Key findings indicated that there are a number of significant concerns related to these three domains. “This (TWWIIA) createslong-overdue reforms of the job-training program, so people with disabilities can make their own choices about vocational rehabilitation services, the ones that are best for them. Taken together, clearly, this is the most significant advancement for people with disabilities since the Americans with Disabilities Act almost a decade ago. It continues our administration's efforts to replace barriers to opportunity with policies based on inclusion, empowerment and independence.” President Bill Clinton December 17, 1999 Remarks by the President at the Signing Ceremony for Human Rights Work Incentives Improvement Act of 1999. Key Findings Key findings from 74 working-age adults with disabilities, who participated in focus groups, indicated that there are significant concerns within the domains of: 1) employment, 2) the Ticket to Work (TTW) program, and 3) vocational rehabilitation (VR) services. 1) Employment While a high number of participants had a previous employment history (87%), only a handful were employed at the time of the focus group (15%). Participants voiced a number of barriers to obtaining and maintaining a job and they included: * Negative employer attitudes toward disabled workers (32%); * Lack of or unreliable transportation (30%); “It always happens on the day when it’s the coldest. Somebody (public transportation bus driver) will come and say, ‘My lift is not working? Somebody else is coming to pick you up, okay?’ Sometimes they’ll go, ‘Sorry!’…they don’t even try.” (Participant Quote) * Insufficient levels of formal education (28%); and * Difficulties with the English language for Spanish-speaking individuals (24%). 2) The Ticket to Work Program Accurate knowledge of the TTW program was limited. Although 51% of the participants reported knowledge of TTW, close to half of this group (47%) was misinformed. Of this misinformed group: * 78% believed that they would automatically lose their medical benefits and/or Supplemental Security Income (SSI)/Social Security Disability Insurance (SSDI) payments, if they attempted to use their Ticket; and * 44% reported difficulty understanding TTW due to the complexity of the language in written materials about the program. “TTW is very complicated to understand. I went to a training in Columbus, Ohio, and I know about it and I know how it works. And it is not easy for the consumer to understand it. If all they receive in the mail is a TTW (ticket), they throw it away.” (Participant Quote) Several participants expressed concerns with the name of the program, thinking it was a job bank. Others expressed confusion regarding the physical appearance of the Ticket. One participant stated, “It looked like junk mail.” Other participants threw the Ticket away. Further, only three participants had attempted to use TTW, with no success. 3) Vocational Rehabilitation Services Participants shared that their lack of knowledge and use of TTW was influenced by their prior difficulties with the VR system, which included: * Unresponsiveness of VR counselors in terms of returning telephone calls and/or following up with participants’ requests (60%); * Work goals set by VR counselors that differed from participants’ work goals (51%); * Failure of the VR system to meet participants’ specific requests to be placed in jobs (25%); and * Concerns among those placed by the VR system that jobs were short-term, non-meaningful, and low-paying (37%). “Yeah, it is very depressing. Now, I am in this job (cutting strings from clothing), which is ridiculous to me, because I might have a disability, but I can think, right.” (Quote from a participant with a Bachelor’s degree). The Employment Maze A framework was developed to help understand the complex experiences of participants as they attempted to seek work using three distinct pathways: 1) employment through informal networks (e.g., friends, family members); 2) employment through the vocational rehabilitation (VR) system; and 3) employment through Employment Networks (ENs) from the Ticket to Work (TTW) program. This framework can be best understood as a maze with participants entering the job-seeking process intermittently and with varying levels of participation. Early in the job-seeking process, participants held EXPECTATIONS that their efforts would result in jobs that were long-term, well-paying and meaningful. With time, participants became FRUSTRATED with the job hunt when obstacles stood in the way. Among other things, these obstacles included negative employer attitudes toward hiring of people with disabilities and employment counselors who were unresponsive to their needs. DISAPPOINTMENT set in when participants failed to find employment, despite concerted efforts toward this goal. Lastly, participants became DISCOURAGED with the job market and VR system, and this general sense of discouragement transferred to new job initiatives (specifically, TTW). Furthermore, of the three pathways to work, participants relied often on informal networks and/or the VR system to find employment. It was evident that participants did not view TTW as a viable option to seek employment, and even upon learning about the program they wondered if it was “business as usual.” Despite these obstacles and uncertainties, many participants continued their job seeking efforts. Recommendations Our study raises concerns about the Ticket to Work (TTW) program based on the direct experiences of the disability community and calls for a number of recommendations: 1) The Social Security Administration (SSA) should consider changing the physical appearance of the “Ticket” to minimize the appearance of junk mail. “I threw it away because I didn’t know what it was for. And I feel that is the case for many.” (Participant Quote) 2) The name, “Ticket to Work,” may be misleading; some participants believed the program was a job bank. It is recommended that literature related to TTW clearly state that the program is not a job bank. 3) The overall language of TTW materials (letters, brochures, web sites, etc.) should be simplified, keeping in mind that individuals with disabilities tend to have limited levels of formal education. In addition, the purpose of the program and consumer expectations should be clearly specified. “I didn’t understand the whole thing when I read it. I asked a hearing friend of mine to try and help me read it…I didn’t understand a whole lot of what it said.” (Participant Quote) 4) The SSA should improve awareness and knowledge of the TTW program among Spanish-speaking individuals (with limited English proficiency) by making certain that they receive materials in Spanish. Many Latino participants reported that they did not receive the Ticket and its accompanying materials in Spanish. “And there wasn’t a campaign to educate the people who receive SSI… a campaign to send a manual of instructions to the consumer, a description of what is TTW. Not just a Ticket, and not just in English. Asking those who speak a different language to send that info in that language.” (Participant Quote) 5) Knowledge of TTW, Employment Networks, and Maximus should be improved with educational and marketing efforts that are culturally competent and accessible to all disability groups. Recommendations Our study also raises concerns about pre-employment issues and calls for the following recommendations: 6) Given the barriers to employment that were reported, it is apparent that there is a need to improve the availability and quality of both public and private resources (for example, public and private transportation options and quality education systems) to enhance employment opportunities for the disability community. 7) People with disabilities continue to experience negative employer attitudes, despite the passage of the Americans with Disabilities Act (ADA) fifteen years ago. Much work remains to improve the attitudes of employers, as well as their knowledge of the ADA. 8) Lastly, service providers (vocational rehabilitation counselors and Employment Network personnel) need to address their “unresponsive” tendencies. This unresponsiveness has a direct and discouraging impact on people with disabilities who use employment programs. Returning telephone calls in a timely manner would be one way to improve responsiveness rates. “There was very poor communication (with a vocational rehabilitation office)…I started emailing somebody and they would never email me back. I tried to call TTY and leave messages, I never get any calls back…there was no communication.” (Participant Quote) This project was funded by the National Institute on Disability and Rehabilitation Research (NIDRR). The opinions expressed here are those of the researchers and not necessarily those of the funding source. For more information, please contact Brigida Hernandez, PhD, at bhernan4@depaul.edu or (773) 325-4840.