Estimated payments to employment service providers for persons with mental illness in the Ticket to Work program.
OBJECTIVE
The Ticket to Work and Work Incentives Improvement Act of 1999 removes work disincentives and promotes access to vocational services for people with disabilities. This study calculated the amount of payments that would have been made to employment service providers if study participants had been enrolled in the Ticket program.


METHODS
Data were from 450 Social Security Disability Insurance beneficiaries with psychiatric disabilities enrolled in a multisite study of supported employment. Earnings over two years were used to calculate provider payments under two reimbursement formulas used in the Ticket program.


RESULTS
Only a quarter of service recipients (26 percent) reached earnings levels that would have triggered provider payments under the first reimbursement formula. Only 4 percent would have completed their trial work period and left the rolls, generating payments under the second formula.


CONCLUSIONS
The current provider payment systems of the Ticket to Work program do not reflect the reality of rehabilitation for individuals with severe mental illness. Reforms should take into account outcomes of return-to-work services for this population.
Cook
Judith A
JA
Department of Psychiatry, University of Illinois at Chicago, 104 South Michigan Avenue, Suite 900, Chicago, Illinois 60615, USA. cook@ripco.com
Leff
H Stephen
HS
Blyler
Crystal R
CR
Gold
Paul B
PB
Goldberg
Richard W
RW
Clark
Robin E
RE
Onken
Steven J
SJ
Shafer
Michael S
MS
Blankertz
Laura E
LE
McFarlane
William R
WR
Razzano
Lisa A
LA
Burke-Miller
Jane K
JK
D000293:Adolescent; D000328:Adult; D003365:Costs and Cost Analysis; D004651:Employment / Q000331:legislation & jurisprudence*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D001523:Mental Disorders; D012050:Rehabilitation, Vocational / Q000191:economics* / Q000706:statistics & numerical data; D012051:Reimbursement Mechanisms; D014481:United States; D019131:United States Social Security Administration