    [House Hearing, 112 Congress]
    [From the U.S. Government Publishing Office]

                               WORK INCENTIVES IN
                      SOCIAL SECURITY DISABILITY PROGRAMS

    =======================================================================

                                 JOINT HEARING

                                   before the

                        SUBCOMMITTEE ON SOCIAL SECURITY

                                      and

                        SUBCOMMITTEE ON HUMAN RESOURCES

                                     of the

                          COMMITTEE ON WAYS AND MEANS
                         U.S. HOUSE OF REPRESENTATIVES

                          ONE HUNDRED TWELFTH CONGRESS

                                 FIRST SESSION

                                   __________

                               SEPTEMBER 23, 2011

                                   __________

                         Serial No. 112-SS10 & 112-HR08

                                   __________

             Printed for the use of the Committee on Ways and Means

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    75-187                    WASHINGTON : 2012
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                          COMMITTEE ON WAYS AND MEANS

                         DAVE CAMP, Michigan, Chairman

    WALLY HERGER, California             SANDER M. LEVIN, Michigan
    SAM JOHNSON, Texas                   CHARLES B. RANGEL, New York
    KEVIN BRADY, Texas                   FORTNEY PETE STARK, California
    PAUL RYAN, Wisconsin                 JIM MCDERMOTT, Washington
    DEVIN NUNES, California              JOHN LEWIS, Georgia
    PATRICK J. TIBERI, Ohio              RICHARD E. NEAL, Massachusetts
    GEOFF DAVIS, Kentucky                XAVIER BECERRA, California
    DAVID G. REICHERT, Washington        LLOYD DOGGETT, Texas
    CHARLES W. BOUSTANY, JR., Louisiana  MIKE THOMPSON, California
    PETER J. ROSKAM, Illinois            JOHN B. LARSON, Connecticut
    JIM GERLACH, Pennsylvania            EARL BLUMENAUER, Oregon
    TOM PRICE, Georgia                   RON KIND, Wisconsin
    VERN BUCHANAN, Florida               BILL PASCRELL, JR., New Jersey
    ADRIAN SMITH, Nebraska               SHELLEY BERKLEY, Nevada
    AARON SCHOCK, Illinois               JOSEPH CROWLEY, New York
    LYNN JENKINS, Kansas
    ERIK PAULSEN, Minnesota
    KENNY MARCHANT, Texas
    RICK BERG, North Dakota
    DIANE BLACK, Tennessee
    TOM REED, New York

                           Jon Traub, Staff Director

                      Janice Mays, Minority Staff Director

                                     ______

                        Subcommittee on Social Security

                          SAM JOHNSON, Texas, Chairman

    KEVIN BRADY, Texas                   XAVIER BECERRA, California,
    PATRICK J. TIBERI, Ohio              Ranking
    AARON SCHOCK, Illinois               LLOYD DOGGETT, Texas
    RICK BERG, North Dakota              SHELLEY BERKLEY, Nevada
    ADRIAN SMITH, Nebraska               FORTNEY PETE STARK, California
    KENNY MARCHANT, Texas

                                     ______

                        Subcommittee on Human Resources

                        GEOFF DAVIS, Kentucky, Chairman

    ERIK PAULSEN, Minnesota              LLOYD DOGGETT, Texas, Ranking
    RICK BERG, North Dakota              JIM MCDERMOTT, Washington
    TOM REED, New York                   JOHN LEWIS, Georgia
    TOM PRICE, Georgia                   JOSEPH CROWLEY, New York
    DIANE BLACK, Tennessee
    CHARLES W. BOUSTANY, JR., Louisiana

    Pursuant to clause 2(e)(4) of Rule XI of the Rules of the House, public
    hearing records of the Committee on Ways and Means are also published
    in electronic form. The printed hearing record remains the official
    version. Because electronic submissions are used to prepare both
    printed and electronic versions of the hearing record, the process of
    converting between various electronic formats may introduce
    unintentional errors or omissions. Such occurrences are inherent in the
    current publication process and should diminish as the process is
    further refined.

                                C O N T E N T S

                                   __________

                                                                       Page

    Advisory of September 23, 2011, announcing the hearing...........     2

                                   WITNESSES

    Robert W. Williams, Associate Commissioner, Office of Employment
      Support Programs, accompanied by Dr. Robert R. Weathers II,
      Deputy Associate Commissioner, Office of Program Development
      and Research, Social Security Administration...................    10
    Daniel Bertoni, Director, Education, Workforce, and Income
      Security Issues, U.S. Government Accountability Office.........    23
    Deb Russell, Manager, Outreach and Employee Services, Walgreen
      Company, Deerfield, Illinois...................................    44
    James Hanophy, Assistant Commissioner, Texas Department of
      Assistive and Rehabilitative Services, Austin, Texas, on behalf
      of the Council of State Administrators of Vocational
      Rehabilitation.................................................    55
    Cheryl Bates-Harris, Senior Disability Advocacy Specialist,
      National Disability Rights Network, on behalf of the Consortium
      for Citizens with Disabilities Employment and Training Task
      Force..........................................................    70
    John Kregel, Professor, Special Education and Disability Policy,
      Virginia Commonwealth University, Richmond, Virginia...........    88

                           SUBMISSIONS FOR THE RECORD

    Arizona Bridge to Independent Living, statement..................   270
    Corporation for Enterprise Development, statement................   278
    Linda Landry, statement..........................................   281
    Health and Disability Advocates, statement.......................   283
    National Association of Benefits and Work Incentives Specialists,
      statement......................................................   294
    National Disability Rights Network, statement....................   297
    Oregon Department of Human Services Office of Vocational
      Rehabilitation Services, statement.............................   300
    Steve Kofahl, statement..........................................   301
    APSE, statement..................................................   304

                               WORK INCENTIVES IN
                      SOCIAL SECURITY DISABILITY PROGRAMS

                                  ----------

                           FRIDAY, SEPTEMBER 23, 2011

                 U.S. House of Representatives,
                           Committee on Ways and Means,
                               Subcommittee on Social Security,
                               Subcommittee on Human Resources,
                                                        Washington, DC.

        The Subcommittee met, pursuant to notice, at 9:05 a.m., in
    room 1100, Longworth House Office Building, Hon. Sam Johnson
    (Chairman of the Subcommittee on Social Security), presiding.
        [The advisory announcing the hearing follows:]

    ADVISORY

    FROM THE
    COMMITTEE
     ON WAYS
    AND
    MEANS

                      SUBCOMMITTEE ON SOCIAL SECURITY AND

                        SUBCOMMITTEE ON HUMAN RESOURCES

                                                    CONTACT: (202) 225-1721
    FOR IMMEDIATE RELEASE
    September 23, 2011
    SS-10 & HR-08

                      Chairman Johnson and Chairman Davis

                 Announce a Joint Hearing on Work Incentives in

                      Social Security Disability Programs

        U.S. Congressman Sam Johnson (R-TX), Chairman of the House
    Committee on Ways and Means Subcommittee on Social Security, and U.S.
    Congressman Geoff Davis (R-KY), Chairman of the House Committee on Ways
    and Means Subcommittee on Human Resources, announced today that the
    Subcommittees will hold a joint oversight hearing on work incentives in
    Social Security disability programs. The hearing will take place on
    Friday, September 23, 2011, in room 1100, Longworth House Office
    Building, beginning at 9 a.m.

        In view of the limited time available to hear witnesses, oral
    testimony at this hearing will be from invited witnesses only. However,
    any individual or organization not scheduled for an oral appearance may
    submit a written statement for consideration by the Committee and for
    inclusion in the printed record of the hearing. A list of invited
    witnesses will follow.

    BACKGROUND:

        The Social Security Administration (SSA) administers two programs,
    Social Security Disability Insurance (SSDI) and Supplemental Security
    Income (SSI), which together provide benefits each year to nearly 14
    million beneficiaries unable to work because of severe disabling
    conditions. The SSDI program pays benefits to those who have sufficient
    past employment covered by Social Security to qualify. The SSI program
    pays benefits to those who currently have limited income and assets,
    regardless of prior work history.

        After being awarded benefits based on an inability to work,
    individuals may attempt to return to work and are offered a variety of
    programs and supports provided by the SSA. In the most recent
    beneficiary survey, 40 percent of beneficiaries were interested in
    working, yet in 2009, only one half of 1 percent left the rolls to
    return to work. The experience of a cohort of new SSDI beneficiaries
    tracked over 10 years showed that nearly 30 percent worked at some
    time, and 6.5 percent were able to sustain earnings sufficient to have
    their benefits suspended.

        The Ticket to Work and Work Incentives Improvement Act of 1999
    (P.L. 106-170) established the Ticket to Work and Self-Sufficiency
    program, expanded the availability of health care coverage, and
    provided for demonstration projects and studies. The Ticket to Work
    program, administered by the SSA, increases choice in obtaining
    rehabilitation and vocational services, and provides greater
    opportunities for SSDI and SSI recipients to receive assistance to help
    them return to work.

        Services are furnished through the current system of State
    Vocational Rehabilitation (VR) agencies or a ticket holder's choice of
    an approved public or private sector, program-specific Employment
    Network (EN) to assist them in entering or re-entering the workforce.
    When the ticket program was implemented, the SSA automatically issued
    tickets to most adult beneficiaries on the rolls, and has continued to
    issue them to new beneficiaries. Through June of this year, according
    to the SSA, of the approximately 12.7 million tickets that have been
    issued since the program's inception, 290,189 or approximately 2.3
    percent have been assigned to an EN or VR agency.

        In July 2008, the SSA made major regulatory changes to the Ticket
    to Work program in an effort to increase participation by ENs and
    beneficiaries. These changes, however, have not been in place long
    enough for an accurate assessment of their impact. However, a May 2011
    Government Accountability Office (GAO) assessment concluded ``at this
    time, the agency [SSA] still lacks critical management and oversight
    mechanisms to assess whether the program is achieving its original
    purpose, and ultimately, whether the program is viable.''

        The Ticket to Work Act also authorized two programs now known as
    the Work Incentive Planning and Assistance (WIPA) program and the
    Protection and Advocacy for Beneficiaries of Social Security (PABSS)
    program. Under the WIPA program, SSA funds community-based
    organizations to assist beneficiaries in understanding and utilizing
    SSA's complex work incentives policies. Under the PABSS program, SSA
    funds protection and advocacy systems to provide assistance to help
    beneficiaries secure, maintain, or regain employment. The authorization
    for both programs will expire on September 30, 2011, but existing
    funding permits WIPAs to continue providing services until June 30,
    2012 and PABSS programs to continue serving their clients until
    February 29, 2012.

        SSA is also developing or conducting several demonstration projects
    to test new work incentive policies for Social Security disability
    beneficiaries, including a sliding scale benefit reduction. However,
    because SSA's demonstration authority for disability insurance
    beneficiaries expired in December 2005, SSA can continue demonstrations
    already initiated, but cannot begin new projects. Reports issued by the
    GAO in 2004 and 2008 raised concerns about SSA's management of its
    demonstration projects. The President's FY 2012 budget included a
    proposal to reauthorize for 5 years SSA's demonstration authority for
    the DI program and require the Commissioner to conduct a demonstration
    project testing alternative methods of treating work activity by DI
    beneficiaries.

        Last, past testimony before the Subcommittees has reported that
    former beneficiaries have been overpaid tens of thousands of dollars
    due to SSA's delays in terminating benefits, even if beneficiaries have
    informed the agency that they are working. The threat of receiving
    large overpayments, which must later be repaid, can be a significant
    work disincentive for disability beneficiaries.

        In announcing the hearing, Chairman Sam Johnson (R-TX) stated,
    ``Those receiving disability benefits who want to work are looking for
    a hand up, not a hand out, to help them achieve a better life for
    themselves and their families. Now, more than ever, how every taxpayer
    dollar is spent matters. Programs that don't achieve results must be
    changed or must end. This hearing will help us determine whether the
    work incentive programs are getting those who can back to work and a
    life of self sufficiency.''

        Chairman Geoff Davis (R-KY) went on to add, ``Work lets individuals
    build a better life for themselves and their families. We should help
    individuals with disabilities who want to work to achieve that better
    life. That starts with reviewing what we are doing now to assist
    individuals with disabilities who want to work, and then holding SSA
    and its work incentive programs more accountable for improving on and
    achieving that critical goal.''

    FOCUS OF THE HEARING:

        The hearing will focus on the current work incentives in the SSDI
    and SSI programs, their impact on the number of individuals exiting the
    benefit roles, including the data and reports documenting such impact.
    The Subcommittees will also examine recommended performance standards
    to guide future evaluations of work incentives programs, with
    particular focus on Ticket to Work, WIPA, PABSS, and Vocational
    Rehabilitation Services. In addition, ongoing and proposed SSDI
    demonstration projects will also be reviewed.

    DETAILS FOR SUBMISSION OF WRITTEN COMMENTS:

        Please Note: Any person(s) and/or organization(s) wishing to submit
    for the hearing record must follow the appropriate link on the hearing
    page of the Committee website and complete the informational forms.
    From the Committee homepage, http://waysandmeans.house.gov, select
    ``Hearings.'' Select the hearing for which you would like to submit,
    and click on the link entitled, ``Click here to provide a submission
    for the record.'' Once you have followed the online instructions,
    submit all requested information. ATTACH your submission as a Word or
    WordPerfect document, in compliance with the formatting requirements
    listed below, by the close of business on Friday, October 7, 2011.
    Finally, please note that due to the change in House mail policy, the
    U.S. Capitol Police will refuse sealed-package deliveries to all House
    Office Buildings. For questions, or if you encounter technical
    problems, please call (202) 225-1721 or (202) 225-3625.

    FORMATTING REQUIREMENTS:

        The Committee relies on electronic submissions for printing the
    official hearing record. As always, submissions will be included in the
    record according to the discretion of the Committee. The Committee will
    not alter the content of your submission, but we reserve the right to
    format it according to our guidelines. Any submission provided to the
    Committee by a witness, any supplementary materials submitted for the
    printed record, and any written comments in response to a request for
    written comments must conform to the guidelines listed below. Any
    submission or supplementary item not in compliance with these
    guidelines will not be printed, but will be maintained in the Committee
    files for review and use by the Committee.

        1. All submissions and supplementary materials must be provided in
    Word or WordPerfect format and MUST NOT exceed a total of 10 pages,
    including attachments. Witnesses and submitters are advised that the
    Committee relies on electronic submissions for printing the official
    hearing record.

        2. Copies of whole documents submitted as exhibit material will not
    be accepted for printing. Instead, exhibit material should be
    referenced and quoted or paraphrased. All exhibit material not meeting
    these specifications will be maintained in the Committee files for
    review and use by the Committee.

        3. All submissions must include a list of all clients, persons,
    and/or organizations on whose behalf the witness appears. A
    supplemental sheet must accompany each submission listing the name,
    company, address, telephone, and fax numbers of each witness.

        Note: All Committee advisories and news releases are available on
    the World Wide Web at http://www.waysandmeans.house.gov.

        The Committee seeks to make its facilities accessible to persons
    with disabilities. If you are in need of special accommodations, please
    call 202-225-1721 or 202-226-3411 TDD/TTY in advance of the event (four
    business days notice is requested). Questions with regard to special
    accommodation needs in general (including availability of Committee
    materials in alternative formats) may be directed to the Committee as
    noted above.

        Chairman JOHNSON. Good morning. We had a late night last
    night, and some of our guys haven't woken up yet.
        But this hearing will come to order. I welcome and thank
    Chairman Davis and Ranking Member Doggett and the Members of
    the Subcommittee on Human Resources for joining us in this
    joint hearing.
        Our Nation's most vulnerable citizens are at the center of
    a perfect storm. Record deficits, a still struggling economy,
    and an unsustainable future spending path, driven by the aging
    of Americans, all threaten the essential programs those with
    disabilities count on. We have been warned by the Social
    Security trustees that the disability insurance program will
    soon be unable to pay full benefits beginning just 7 years from
    now, in 2018. Those who depend on these critical benefits are
    counting on us to act, and we will.
        This Committee will soon hold hearings on the many
    challenges facing Social Security disability. Today we turn to
    the issue of helping those already receiving benefits who want
    to work. To achieve that end, Social Security administers a
    number of work-incentive programs. Congress established the
    current State Vocational Rehabilitation Reimbursement program--
    that is a mouthful, isn't it--in 1981 to encourage State
    vocational rehabilitation agencies to provide services that
    would result in work by disability beneficiaries. Last year,
    Social Security paid over $100 million for these services.
        In 1999, Congress passed the Ticket to Work and Work
    Incentives Improvement Act to make it easier for beneficiaries
    to return to work. The Ticket program allows beneficiaries to
    choose a public- or private-sector service provider, known as
    an employment network, to get the training and support they
    need to find jobs, which, in turn, leads to benefit savings
    because they leave the benefit rolls, theoretically.
        Two grant programs were also created as part of the Ticket
    legislation. One helps beneficiaries understand Social
    Security's complex rules, and the other assists in the
    resolution of potential disputes with employers. The
    authorization for these two programs expires September 30,
    though their funding continues until the next year.
        So where are we today? As we will soon hear, while there is
    some progress to report, the results are disappointing, and
    problems remain. A recent report by the GAO found Social
    Security's oversight and management of the Ticket to Work
    program isn't where it needs to be. For example, certain
    employment networks were telling ticket holders how they could
    work and keep their full benefits. This is simply unacceptable.
    Other employment networks are increasingly splitting the Ticket
    payment with beneficiaries while providing no direct services.
        At the same time, I have seen for myself how beneficiaries
    and employers benefit when the system works. While back home
    this August, I visited the Walgreens distribution center in
    Waxahachie, Texas. There, with the help of the Texas Department
    of Assistive and Rehabilitative Services, those with
    disabilities, including former beneficiaries, work side by side
    with other workers doing the same job for the same pay with the
    same performance. I look forward to hearing more of their
    inspiring stories today.
        Despite these and other work incentives, the fact is less
    than half of 1 percent of those receiving disability has left
    the benefit rolls to work. Now more than ever, how every
    taxpayer dollar is spent matters. Programs that don't achieve
    results must be fixed, or they must end. The question we must
    answer today is how work incentives can achieve the results
    Congress and the taxpayers expect and those with disabilities
    deserve.
        I now recognize Mr. Doggett, the Ranking Member of the
    Subcommittee on Human Resources, for his opening statement.
        Mr. DOGGETT. Well, thank you very much, Chairman Johnson,
    Chairman Davis. And to all of our witnesses this morning, we
    look forward to hearing from you.
        I think we all want a system here where any American who
    wants to work can work, and recognize that our workforce needs
    to provide a range of services or of functional levels so that
    we can make reasonable accommodation, where necessary, to allow
    those who have limitations and disabilities to participate to
    the full extent of their disability. We must also recognize
    that there are some people who have a disabling condition that
    is so severe that they cannot participate in the workforce.
    Those who are unable to work must have the guarantee of a
    safety net that is more net than hole and that helps them live
    in dignity.
        As the recent U.S. census data indicates, we have an
    increasing number of individuals with disabilities who are
    poor. Nearly 30 percent of people who suffer from a disability
    live in poverty today in the United States. And to some extent,
    with reference to the Supplemental Security Income program,
    that is because the payment is not overly generous. Last year,
    the monthly benefit was a little less than $500 on the average,
    which would carry you to just a little over half of the poverty
    measure, according to the Congressional Research Service. The
    majority of those who receive SSI have a disability that is
    expected to last at least a year or result in death, and
    renders them incapable of performing a substantial level of
    work. So it is not surprising that those who are on SSI,
    receiving those limited benefits, may have difficulty or it may
    be impossible for them to move back into the workforce.
        At the same time, when you look at the way the law is
    written and the way it has been in effect since 1974, when
    someone who relies on SSI does see improvement in their
    condition, they want to begin to provide some type of
    employment service, they face the limitation that after the
    first $20 of income, their SSI benefit is reduced by $1 for
    every $2 of earned income exceeding $65 a month until the
    benefit level reaches zero. This income disregard used to
    determine program eligibility of benefit levels, and it has not
    been replaced since originally set up in 1974.
        As Chairman Johnson mentioned, we have made some progress
    through the Ticket to Work Act, but it is important to analyze
    how that has worked here and what we can do to make it more
    effective.
        In my home State of Texas, which I share with Chairman
    Johnson, one of the organizations working in this area is
    Disability Rights Texas. They helped a 41-year-old Austinite
    with spina bifida who receives SSI and had always assumed that
    he wouldn't be able to work because he was afraid he would lose
    his benefits. Although he had acknowledged that his disability
    is very severe, and he had no work experience or training, he
    nonetheless decided he would try to work. Disability Rights
    Texas referred him to rehabilitative services and a customized
    employment program that ultimately helped him receive a job
    placement where he is experiencing some success and taking
    pride in the value of his work.
        Another example is a gentleman who lives in Maynard, Texas,
    outside of Austin, who experiences a combination of both
    physical and mental problems that severely affect him. The
    administrative law judge who decided his case noted that he was
    living in a car in the woods and would just sit there most of
    the day and talk to himself and the animals. By the time he had
    his disability determination hearing, he had been living in the
    nonrunning vehicle for over 4 years and had undergone five
    psychiatric hospitalizations. Now that he receives SSI
    benefits, he has access to housing and regular medical and
    psychiatric care.
        A contrasting set of examples about why we need to continue
    to strive to improve SSI, but why it will be necessary for some
    individuals who are not able to become productive members of
    our workforce.
        Mr. Chairman, thank you for holding today's hearing, and we
    look forward to cooperating with you in seeking improvements in
    the program while maintaining this vital safety net. Thank you.
        Chairman JOHNSON. Thank you.
        I will now recognize the chairman of the Subcommittee on
    Human Resources, Chairman Davis, for his opening statement.
        Chairman DAVIS. Thank you, Chairman Johnson.
        As my colleagues have discussed, today's hearing examines
    the effectiveness of work incentives administered by the Social
    Security Administration designed to help people with
    disabilities go to work. Chairman Johnson and Ranking Member
    Doggett focused on the effects, especially on individuals who
    receive disability checks from the Social Security Disability
    Insurance program.
        As Chairman of the Human Resources Subcommittee, I want to
    discuss the implications for people on the Supplemental
    Security Income, or SSI program, which falls under our
    Subcommittee's jurisdiction. This is our first hearing this
    year specifically on the SSI Program, and I can't think of a
    more appropriate topic than how we help people go back to work,
    and whether those efforts are succeeding.
        Since SSI first started paying benefits in 1974, this
    means-tested cash assistance program has always encouraged work
    and earnings by reducing benefits by only $1 for every $2 in
    earnings. In other words, SSI, by design, tries to overcome
    disincentives to work inherent in a benefit program for
    disabled people with very low income. Even though SSI
    recipients have less work experience than SSDI recipients, an
    average of 5 percent leave the SSI rolls each year due to
    income from work or other sources--this is 10 times the rate
    for SSDI recipients. Still, 5 percent is a very low rate.
        The key questions we have today are, do current programs
    and policies actually promote work? And if not, what else
    should we be doing? Our focus is on working-age, disabled
    individuals, nearly 40 percent of whom have expressed an
    interest in working. Disability applicants spend months and, in
    most cases, years proving they are disabled enough to merit
    benefit payments. Once they successfully prove they are too
    disabled to work, we encourage them to try to work with the
    goal of leaving the benefit rolls again. If it sounds
    complicated and contradictory, that is because it is.
        SSA manages a complex system of work incentives that
    include various exemptions and exceptions and disregards that
    are both difficult for beneficiaries to understand and for SSA
    to efficiently administer. This confusing diagram up on the
    screen in front of you displays just the SSI work incentives,
    and it says it all. A similarly confusing chart exists for the
    SSDI program. What this all suggests is we need more balance.
    Balance for the beneficiary when it comes to easing the
    transition to work while reducing complexity that has become an
    obstacle to work. And balance for the Social Security
    Administration in administering complex work incentives
    efficiently and effectively. Ultimately, this involves a
    balance of taxpayer dollars, too.
        What is the right balance of incentives for individuals who
    are unable to work due to disability and who receive cash
    benefits, health coverage, and support for a range of
    assistance and other programs? Is there more assistance that
    would better help them work, or would more assistance make it
    even harder for them to work if the benefits of not working
    increasingly outweigh the benefits of working? The question is,
    what is the right balance? This discussion is why today's
    hearing is so important.
        Encouraging work and self-sufficiency improves the well-
    being of individuals and families regardless of their
    disability status. We need to look deeper into these programs
    to hold SSA, current work incentives, and ourselves accountable
    for achieving this goal in a fiscally responsible manner. We
    can't continue to just ``do more'' and ``spend more'' and hope
    that it helps. We need to start by reviewing whether what we
    are already doing is working to help beneficiaries so we can
    ensure taxpayer resources are properly targeted.
        We have an excellent panel of witnesses with us today to
    discuss these complicated issues and more. We look forward to
    all of their testimonies.
        With that, I yield back.
        Chairman JOHNSON. Thank you. I appreciate your comments.
        I will now recognize the Ranking Member on the Subcommittee
    on Social Security Mr. Becerra for his comments.
        Mr. BECERRA. Thank you, Mr. Chairman, to both chairmen, for
    holding this hearing today.
        We are examining today some of the tools SSA has to assist
    disabled Americans who receive benefits, but want to try to
    return to work. I hope that this will be the starting point for
    moving legislation to continue the Social Security services
    that have allowed disabled Americans to live and work with
    dignity.
        Let us put things into perspective. Social Security's
    disability programs; the Social Security Disability Insurance,
    DI, program; and the Supplemental Security Income program, SSI,
    are designed for people with severe work disabilities. In order
    to qualify, Americans must suffer from a medical condition so
    severe that, according to medical and vocational experts, it
    essentially prevents them from doing any work at all.
        Most Americans receiving DI or SSI benefits are quite sick.
    About 1 out of every 5 men awarded DI benefits dies within 5
    years of starting benefits, and about 1 in every 10 Americans
    awarded DI benefits suffers from cancer. Yet only the very
    sickest cancer patients qualify for benefits. In 2010, 1.6
    million Americans were diagnosed with cancer, but fewer than 10
    percent of them were awarded DI benefits because they had
    cancer.
        New beneficiaries are also likely to be older. Almost 6 of
    every 10 Americans who are awarded benefits are 50 years or
    older. Nevertheless, a small number of severely disabled
    Americans courageously manage to work despite very serious
    challenges, and many others want to try. We should encourage
    work whenever possible, such as by providing support to workers
    and employers without punishing those who are truly unable to
    work.
        This year's budget cuts imposed on the Social Security
    Administration, nearly $1 billion below what Social Security
    needs to do its job, will make it difficult for SSA to support
    Americans with disabilities who are trying to return to work.
    Americans who are attempting to work often need specialized
    help that SSA can't provide. Congress has authorized some small
    grants paid out of SSA's regular operating budget to help these
    Americans secure the specialized support they need. We should
    do all we can to ensure that these services continue their
    successful record of helping disabled Americans return to work.
        Counselors funded through the Work Incentives Planning and
    Assistance program, or WIPA, help Americans understand and
    properly use the incentives offered by SSA that encourage the
    transition back to work. The Protection and Advocacy for
    Beneficiaries of Social Security program, or PABSS, supports
    the efforts of disabled Americans to stay on the job; for
    example, by helping them obtain necessary accommodations like
    assistive technology or adjusted work hours.
        Mr. Chairman, I hope that we move quickly to extend and
    reauthorize these two important programs that result in more
    disabled Americans working with dignity. At the same time, we
    must be careful that we do not do anything that puts Americans
    with severe disabilities and illnesses in danger of losing
    benefits they paid for with their contributions and tax
    dollars.
        Mr. Chairman, I look forward to hearing the witnesses
    today, and I am also hoping that at some point we are able to
    try to move on a bipartisan basis in reauthorizing many of
    these important programs, making the improvements where
    possible.
        With that, I yield back the balance of my time.
        Chairman JOHNSON. It can only be bipartisan if you stay on
    the committee.
        Mr. BECERRA. That is a super idea.
        Chairman JOHNSON. Before we move on, I want to remind
    witnesses to please limit their oral statements to 5 minutes,
    if possible. However, without objection, all the written
    testimony will be made a part of the hearing record.
        We have one panel today, and our witnesses who are seated
    at the table are from the Social Security Administration.
    Robert W. Williams, Associate Commissioner, Office of
    Employment Support Programs, who is accompanied by Robert R.
    Weathers II, Deputy Associate Commissioner, Office of Program
    Development and Research; Dan Bertoni, Director of Education,
    Workforce, and Income Security Issues, U.S. Government
    Accountability Office; Deb Russell, Manager, Outreach and
    Employee Services, Walgreens Company, Deerfield, Illinois;
    James Hanophy, Assistant Commissioner, Texas Department of
    Assistive and Rehabilitative Services, Austin, Texas, on behalf
    of the Council of State Administrators of Vocational
    Rehabilitation; Cheryl Bates-Harris, Senior Disability Advocacy
    Specialist, National Disability Rights Network, on behalf of
    the Consortium for Citizens with Disabilities Employment and
    Training Task Force; John Kregel, Professor, Special Education
    and Disability Policy, Virginia Commonwealth University,
    Richmond, Virginia.
        Mr. Williams, I understand you will be making a statement
    on behalf of the Social Security Administration, and Mr.
    Weathers is accompanying you to also answer questions. I
    welcome you all, and thank you for being here. You may proceed,
    Mr. Williams. You are recognized.

    STATEMENT OF ROBERT W. WILLIAMS, ASSOCIATE COMMISSIONER, OFFICE
       OF EMPLOYMENT SUPPORT PROGRAMS, ACCOMPANIED BY ROBERT R.
     WEATHERS II, DEPUTY ASSOCIATE COMMISSIONER, OFFICE OF PROGRAM
        DEVELOPMENT AND RESEARCH, SOCIAL SECURITY ADMINISTRATION

        Mr. WILLIAMS. Good morning, Chairman Johnson, Chairman
    Davis, Ranking Members, and Members of the Subcommittees. I am
    pleased to have this opportunity to discuss the Social Security
    Administration's employment support and self-sufficiency
    efforts. I want to start by offering you an overview of my view
    of where we need to take our programs.
        I took this job a few months ago for two reasons. The first
    is that my own life and career convince me that many more
    Americans with significant disabilities can work and become
    fully self-supporting if provided with the right opportunities
    and support. Second, I think we have an opportunity to ``right-
    size'' our expectations around the Ticket to Work program and
    our other employment support programs.
        We need to be realistic and strategic about the number of
    beneficiaries who will become financially independent due to
    work and earnings, even in the best of economies. We must also
    ensure that the Ticket program and our other work incentives
    provide a path to good jobs, good careers, and better self-
    supporting futures. Frankly, it is the only way we can create a
    tipping point that will enable more beneficiaries to actually
    earn their way off of the disability rolls and to create
    better, more secure lives for themselves and their families.
        It is time to change our ``any job will do'' mentality of
    job placement, where we focused on getting beneficiaries into
    low-wage jobs that offer little in the way of either career
    security or a better life. We need to focus less on the numbers
    of beneficiaries who work just above the substantial gainful
    activity level and focus instead on the quality of support
    services we provide and, most importantly, the outcomes we
    successfully support those beneficiaries to achieve and sustain
    over time. If we truly want to produce positive outcomes for
    the Vocational Rehabilitation, the Ticket, and Work Incentives
    Planning Assistance programs, the best way of doing so is by
    recognizing, supporting, reinforcing, and, yes, rewarding the
    initiative and hard-won financial independence of these
    American workers.
        The Ticket program is not where we want it to be or where I
    believe it can be in the future. Despite an unfavorable job
    market, though, we are making progress, the Ticket regulations
    we published in 2008 have significantly increased beneficiary
    and employment network participation in the program. Building
    on this momentum, we are improving the data we collect on
    working beneficiaries. This is enabling us to focus on those
    most likely to use the Ticket program and to support more
    beneficiaries to become and remain self-sufficient. I believe
    taking these steps will help make work truly work for more
    Americans with significant disabilities and, thus, advance the
    basic aims Congress set when it passed the Ticket to Work and
    the Work Incentives Improvement Act of 1999.
        As you know, last year the Congress extended funding for
    the WIPA and PABSS programs through the end of this month.
    Unless those programs are reauthorized, the money for the WIPA
    and PABSS programs will effectively run out on June 30, 2012,
    and September 29, 2012, respectively.
        Disseminating accurate information to beneficiaries with
    disabilities about work-incentive programs in support of their
    efforts to work and become self-supporting is critical, and we
    will work with Congress to improve the effectiveness of the
    program.
        We are aware of a few concerns regarding the current
    structure of WIPA grants. Findings from the most recent
    evaluation of WIPA will be available shortly, and we look
    forward to reviewing these new findings and working with
    Congress to ensure the best approach going forward.
        The Ticket Act also granted Social Security authority to
    conduct demonstration projects to test how certain changes in
    the program would affect beneficiary work and we have initiated
    several projects. My colleague Bob Weathers will answer any
    questions you may have about these projects.
        In closing, we are firmly committed to assisting
    beneficiaries with disabilities who want to work and become
    self-supporting. To increase our success, we need to refocus
    our efforts and promote real pathways that more beneficiaries
    can pursue to gain and sustain financial independence.
        Thank you for your interest in this matter. I am happy to
    answer any questions you may have.
        Chairman JOHNSON. Thank you. I appreciate your comments.
        [The prepared statement of Mr. Williams follows:]

        Chairman JOHNSON. Mr. Bertoni, welcome. Please go ahead.

     STATEMENT OF DANIEL BERTONI, DIRECTOR, EDUCATION, WORKFORCE,
      AND INCOME SECURITY ISSUES, U.S. GOVERNMENT ACCOUNTABILITY
                                 OFFICE

        Mr. BERTONI. Mr. Chairmen, Ranking Members, Members of the
    Subcommittee, good morning. I am pleased to discuss work
    incentives for disability program beneficiaries; in particular,
    SSA's Ticket to Work program. The Ticket program has been under
    way for more than a decade and utilizes approved providers to
    assist beneficiaries, known as ticket holders, in obtaining
    employment and ultimately reducing their dependence on
    benefits.
        Our prior work and the work of others has questioned the
    viability of the program due to low participation and costs
    that are not offset by beneficiaries returning to work. In an
    effort to attract more ticket holders and employment network
    providers, SSA revised its regulations in 2008 to include
    additional incentives for both groups. My testimony this
    morning summarizes our May 2011 report and discusses trends in
    ticket holder and employment network participation over time,
    services provided by the various employment networks in SSA's
    management and oversight of the Ticket program.
        In summary, we found that beneficiaries assigning their
    tickets to employment network providers have more than doubled
    since 2008 to about 49,000; however, that number is relatively
    small compared to 12 million eligible beneficiaries. And
    despite increased enrollments, the extent to which
    beneficiaries are returning to work and leaving the rolls is
    unknown because SSA has not yet evaluated program outcomes as
    required by law. Because such an evaluation is key to assessing
    a program's effectiveness and long-term viability, we have
    recommended that SSA prioritize and carry through with its
    plans to study ticket holder exits from disability rolls.
        Since 2008, employment network participation has also
    increased to about 1,600 providers; however, the bulk of
    activity in more than 70 percent of the $13 million SSA paid
    out last year went to only 20 providers, and just 3 received
    nearly a third of all payments. Our analysis show that
    employment networks offer a range of services including
    assistance with job search, retention, and transportation;
    however, since 2008, an increasing number of providers are
    specifically targeting beneficiaries who are already working or
    don't need help finding work, and the largest are simply
    passing a portion of the Ticket payment back to the ticket
    holder, taking a substantial percentage for themselves and
    providing no direct services. Such transactions essentially
    result in a benefit subsidy to the ticket holder and fairly
    easy money for providers.
        We have recommended that SSA compile data and assess trends
    in employment network service provisions to determine whether
    they are consistent with the program's goal of helping
    individuals find and retain sustainable employment and reduce
    dependence on benefits.
        Finally, we found that SSA lacks management tools for
    evaluating providers and beneficiaries to ensure program
    integrity and effectiveness. For example, SSA had not developed
    clear guidance and performance measures or providers, which can
    lead to confusion about program goals and cause them to send
    mixed messages to beneficiaries about expected outcomes. In
    fact, despite the program's stated purpose to reduce benefit
    dependence, our investigator, posing as a brother of a
    fictitious ticket holder, documented multiple providers
    promoting indefinite part-time work and keeping ticket holders
    below certain income thresholds so as not to jeopardize their
    disability benefits. Similar information was conveyed on other
    providers' Web sites and recorded phone messages.
        We also found weaknesses in SSA's oversight of ticket
    holders' timely progress toward employment due to the agency's
    suspension of required progress reviews between 2005 and
    November 2010. As a result, thousands of ticket holders have
    been exempt, per program rules, from undergoing medical
    continuing disability reviews, or CDRs, for many years,
    regardless of whether they are actually moving toward self-
    sustaining employment, intentionally resulting in improper
    payments to individuals who are no longer medically eligible.
        We have recommended that SSA develop program performance
    measures consistent with the Ticket law and a strategy for
    completing the backlog of required progress reviews, which SSA
    estimates to be between 13,000 and 22,000 cases per month, over
    the next year. Moreover, we have recommended that SSA
    independently verify the information reported by beneficiaries
    to more accurately assess timely progress toward sustained
    employment.
        Mr. Chairman, Members of the Subcommittee, this concludes
    my statement. I am happy to answer any questions that you may
    have. Thank you.
        Chairman JOHNSON. Thank you, sir.
        [The prepared statement of Mr. Bertoni follows:]

        Chairman JOHNSON. Ms. Russell, welcome. It is good to see
    you again. Please proceed.

       STATEMENT OF DEB RUSSELL, MANAGER, OUTREACH AND EMPLOYEE
            SERVICES, WALGREEN COMPANY, DEERFIELD, ILLINOIS

        Ms. RUSSELL. Thank you. Chairmen Johnson and Davis, Ranking
    Members Becerra and Doggett, thank you for the opportunity to
    testify today on behalf of our company.
        My name is Deb Russell, and I am a corporate manager at
    Walgreens. In this role I am responsible for our efforts to
    include people with disabilities in our 20 distribution centers
    that serve our 7,700 stores in all 50 States, the District of
    Columbia and Puerto Rico. Overall, this division employs nearly
    10,000 full-time employees.
        Walgreens is committed to offering and enhancing employment
    opportunities for people with disabilities. I realize that this
    hearing is dedicated to individuals who are recipients of SSI
    and SSDI, but it is difficult to speak about employing them
    without speaking about our overall experience. And to qualify,
    when we speak of people with disabilities, we are speaking
    about people who have disclosed their disabilities to us.
        Walgreens started intentionally recruiting people with
    disabilities with the opening of our distribution center in
    Anderson, South Carolina. Since the opening of that facility,
    we have found that our model works in new as well as older
    buildings and in our stores. However, the most rewarding
    demonstration of our success is the high number of companies
    who have toured our facilities and asked us for assistance in
    the development of a strategy that will work for them.
    Companies like Lowe's, Best Buy, AT&T and Procter & Gamble have
    dedicated staff and time to learn about our inclusion and then
    gone back and designed efforts that have brought them great
    success as well.
        We teach them about the factors we think made us successful
    and seem to be universally true, which are that we need
    partners, education, and high standards. We have learned that
    we do not need to have all the answers, and, in fact, we have
    found that companies who approach inclusive employment with
    that requirement seem to struggle to get their initiatives off
    the ground. We do not pretend to be perfect at this nor to have
    all the answers, but we are always happy to share our story in
    hopes that it will inspire others.
        Our relationship with Social Security started in 2007. As
    we discovered our success in Anderson, we looked for ways to
    ensure we could sustain our efforts. The Ticket to Work seemed
    like a good fit. The program has offered us a way to access
    resources that sustain needed accommodations, like sign
    language interpreters.
        The Ticket to Work's outcome payment method is a good match
    since we employ everyone in our distribution centers full time
    and at a starting pay average of over $12 per hour.
        We have three criteria for participating in this program.
    We do not want a heavy administrative burden. We do not want to
    compete with any other ENs to assign an employee's ticket and
    therefore provide the supports needed, and we do not want to
    have to manage mass inquiries from ticket holders. We also want
    to avoid the real or perceived conflict of interest of being an
    employer which requires our employees to achieve high standards
    and for each month the employee remains with us.
        Throughout our experience as an EN, multiple changes to the
    program and the contract have made it more difficult for us to
    maintain our status. Each round of changes seems to focus on
    the services an EN will offer prior to employment, which is not
    a good fit for us. And the changes usually require more
    documentation and information that we do not have access to as
    an employer. During this time both Maximus and the staff at the
    Social Security Administration's Office of Employment Supports
    have worked with us to be sure that they had the information
    needed, but allow us to deliver it in the easiest way possible.
        We have had 27 tickets assigned during our time as an EN.
    The most we have had at one point in time was 16. And to date,
    we have collected a little more than $300,000. We now have
    seven tickets that have reached maximum reimbursement, meaning
    they have worked for us long enough to no longer have their
    ticket high value. We are sure that many more of our employees
    have had tickets, but for many reasons have not surfaced
    through our Ticket activities.
        In addition to the Ticket program, we have interacted with
    WIPA. In Anderson, the benefits person attended multiple new
    employee benefit sessions to ensure he could provide thorough
    information to our employees regarding the impact of earnings
    and employee benefits on their public benefits. In all other
    buildings, our human resources staff are familiar with where to
    find their local WIPA contact information if an employee
    expresses a concern.
        As we continue to partner with the disability community, we
    still hear from agencies and parents that loss of benefits is
    an issue, but we do not hear this from our employees. We have
    no knowledge of anyone terminating their employment with us due
    to overpayments or the desire to maintain benefits as an
    alternative to work. I admit that many of our employees need
    assistance with wealth management and learning how to manage a
    life that is no longer deep in poverty, but they are not
    electing to stay home and collect a small check and stay
    immersed in the system.
        As we move our inclusion efforts into our stores, we do
    anticipate benefits being more of an issue since the nature of
    the retail industry is lower hourly pay combined with part-time
    and sometimes irregular schedules. Many of our retail employees
    will probably straddle employment and benefits, which is why we
    will not expand our role of an EN for our store employees.
    However, we will continue to offer information on local WIPA
    services to hopefully alleviate doubts and issues that come
    with remaining part of the benefits system while being
    successful in a job.
        For many of our employees with disabilities, Walgreens is
    their first full-time job. We have seen the improvements in
    their lives as they earn and receive recognition for a job well
    done and build relationships with other team members.
        I do not minimize the extraordinary challenges facing
    people with disabilities who join the workforce, but the
    toughest challenge of all is when people with disabilities are
    seen as ``them'' and not as ``us.'' A job changes that. A job
    is more than a paycheck. It is a source of dignity. The
    workplace can be a fulfilling place, a place where people with
    disabilities transform their lives from the margins to the
    mainstream. At Walgreens, we feel fortunate to have made the
    commitment to invest in employing people with disabilities,
    people who make such an enormous contribution to our company,
    our customers and their community.
        Thank you for the opportunity to tell our stories. I would
    be happy to answer any questions.
        Chairman JOHNSON. Thank you, ma'am. I appreciate that.
    Thank you for letting us visit your center down there.
        [The prepared statement of Ms. Russell follows:]

        Chairman JOHNSON. Mr. Hanophy is from the great State of
    Texas. Is your son the one that caused Texas A&M to leave the
    Big 12 conference?
        Mr. HANOPHY. I didn't want to mention that, but----
        Chairman JOHNSON. Welcome. Please go ahead with your
    testimony.

       STATEMENT OF JAMES HANOPHY, ASSISTANT COMMISSIONER, TEXAS
     DEPARTMENT OF ASSISTIVE AND REHABILITATIVE SERVICES, AUSTIN,
      TEXAS, ON BEHALF OF THE COUNCIL OF STATE ADMINISTRATORS OF
                       VOCATIONAL REHABILITATION

        Mr. HANOPHY. Good morning, Chairman Johnson, Chairman Davis
    and Ranking Members. I am here representing the Council of
    State Administrators of Vocational Rehabilitation to discuss
    Ticket to Work and work incentives designed to help
    beneficiaries with disabilities return to work.
        The public vocational rehabilitation system serves over 1
    million people with disabilities every year, and in 2010 helped
    approximately 172,000 people become employed and taxpaying
    citizens. On average, the typical VR consumer will pay back
    through their taxes the cost of their VR services in just 2 to
    4 years.
        The VR program has a longstanding partnership with Social
    Security. Social Security reimburses the VR agencies for the
    cost of services provided to the beneficiary only after that
    individual has achieved earnings above substantial gainful
    activity, which is approximately $1,000 a month for 9 months of
    any 12-month period. The reimbursements earned from Social
    Security enable VR agencies to serve more consumers and in some
    States serve consumers on their waiting list.
        CSAVR is grateful to Social Security for initiating
    positive changes in the new Ticket to Work regulations, such as
    Partnership Plus that redefines the relationship between SSA
    beneficiaries who want to work, VR agencies, and ENs. This, in
    my opinion, creates a five-way win. VR and the EN win because
    we are able to help a beneficiary go to work in a coordinated
    way with funding supports. The taxpayers win as people become
    less reliant on benefits and more self-supporting. The business
    wins because they are able to hire a qualified applicant who
    has been screened and will be well supported. And most of all,
    the beneficiary wins because they are able to go to work in a
    job that meets their talents, interests, and receive the work
    supports they may need.
        VR agencies and ENs are developing innovative arrangements
    to provide services to meet the needs of beneficiaries. In
    Texas, the VR program offers incentive payments called
    Employment Advancement Payments to EN providers for services
    from the EN if a beneficiary reaches and maintains substantial
    gainful activity. Partnership Plus also funds ongoing supports
    for ENs who provide embedded training within the Texas VR
    within our business customers where we do preemployment
    training.
        In Connecticut, Utah, Vermont, Virginia, as well as many
    other States, VR programs and ENs are working creatively to
    streamline processes, coordinate services, and leverage funding
    to increase successes for beneficiaries. These arrangements are
    as different as the States themselves, which adds to the value
    of Partnership Plus.
        In Connecticut, the VR program is also working with
    Walgreens, who is an EN, to meet their business needs.
    Walgreens built a state-of-the-art distribution center where
    now currently 45 percent of the employees are people with
    disabilities.
        In addition to highlighting the Partnership Plus successes,
    these examples also illustrate the success the VR program has
    had in developing a dual-customer approach, whereby VR works
    for both a person with a disability and a business as
    customers. The VR National Employment Team consists of VR
    agencies that have developed a network of business partners
    committed to hiring qualified applicants who have disabilities,
    resulting in more full-time jobs with benefits and career
    opportunities for SSA beneficiaries. An example of this is the
    partnership with Walgreens and Texas, where one-third of the
    people hired at the distribution center in full-time jobs with
    benefits are SSA beneficiaries.
        We would also like to offer some suggestions for program
    improvements. People who come on the disability rolls earlier
    stay longer, cost more, and lose out on work opportunities.
    Social Security might explore an option of paying more for
    outcome payments or offering bonus payments for serving younger
    beneficiaries.
        Also, while not inherently part of the Ticket, we urge the
    Committee and SSA to aggressively explore an early intervention
    model for applicants for SSI and SSDI benefits. CSAVR has
    developed a risk-free early intervention proposal that might
    help applicants try to work first. This is attached to our
    written testimony. This completely voluntary program would not
    stop the disability application process; however, before
    eligibility for benefits is determined, an applicant would be
    provided immediate access to temporary cash assistance,
    immediate access to health care, and immediate access to
    vocational services designed to help a person go to work. The
    proposal would suspend the Social Security disability
    application once employment above SGA is found. However, if
    employment fails, the work effort would not be considered as
    evidence against the participant in their application for
    disability benefits. We believe a pilot targeted to a select
    number of States with a sample of applicants would cost little
    and inform us greatly about the potential.
        Last, it is important to keep in mind the effort to help
    SSA beneficiaries return to work is more than just a matter of
    having a ticket. SSA funds the Work Incentive Planning and
    Assistance project, or WIPA, and we cannot stress strongly
    enough how important benefits planning is to helping SSA
    beneficiaries understand the various work incentives in SSI and
    SSDI. CSAVR respectfully requests the Committee to reauthorize
    the WIPA program in a timely fashion and provide the resources
    needed to ensure this critical service is available to
    beneficiaries. The WIPA project is a proven benefit that works
    and deserves our full support.
        Again, thank you for the opportunity to testify, and I will
    answer any questions you have.
        Chairman JOHNSON. Thank you, sir.
        [The prepared statement of Mr. Hanophy follows:]

        Chairman JOHNSON. Ms. Bates-Harris, welcome. Please
    proceed.

     STATEMENT OF CHERYL BATES-HARRIS, SENIOR DISABILITY ADVOCACY
     SPECIALIST, NATIONAL DISABILITY RIGHTS NETWORK, ON BEHALF OF
     THE CONSORTIUM FOR CITIZENS WITH DISABILITIES EMPLOYMENT AND
                          TRAINING TASK FORCE

        Ms. BATES-HARRIS. Good morning. Thank you, Chairman
    Johnson, Chairman Davis, and other distinguished Members of the
    Committee for this opportunity to testify today regarding work
    incentives in the Social Security disability programs. As
    indicated, I am representing the CCD, Consortium for Citizens
    with Disabilities Employment and Training Task Force. The CCD
    Employment and Training Task Force believes that meaningful
    employment represents one of the best opportunities for people
    with disabilities as they work toward becoming a productive and
    fully included member of society.
        Social Security work programs are among the many critical
    avenues for Social Security beneficiaries to gain access to
    employment. We support improvements to Social Security to make
    it more effective in serving those that rely on it; however, we
    stand firm in our belief that changes to the Social Security
    system should not be made in the hothouse environment of
    deficit reduction.
        Considerable attention is being given to the plight of
    long-term umemployed, and it is important that policymakers
    understand that millions of people with disabilities are
    disconnected from the workplace and do not fall within the
    traditional definitions of long-term unemployment. Therefore,
    these critical services are essential to ensure their
    participation and return to employment.
        Employment of individuals with disabilities requires a
    comprehensive approach that addresses all aspects of the
    service system to ensure that the vision of integrated
    competitive employment is fostered and promoted. Ongoing staff
    development, among systems staff and service providers, is
    vital so that they not only embrace the vision, but have the
    technical knowledge to implement it. A holistic approach
    requires addressing a wide range of other issues: outreach to
    and engagement with employers, service monitoring and quality
    assurance, engagement of individuals and families, and the
    availability of benefits counseling and protection and advocacy
    support which will allow community employment, transportation,
    interagency collaboration, just to name a few.
        Over the past decade, Congress has focused most of its
    attention only on the Ticket to Work program. Revised
    regulations and things have drastically changed the program, so
    I am not going to talk so much about the Ticket as much as the
    supports of the two critical programs that are soon to expire.
        The first is, of course, the Protection and Advocacy for
    Beneficiaries of Social Security. It is the responsibility of
    these programs to provide information and advice about
    obtaining vocational rehabilitation and employment services,
    information and referral services to beneficiaries on work
    incentives, advocacy, and, most importantly, legal services
    that a beneficiary needs to secure, maintain, or regain
    employment, including the investigation and remedy of
    complaints of employment discrimination and other civil and
    legal rights violations. Despite the extensive set of duties
    and growing demand for services, the PABSS program has been
    funded at the same level, and its authorization expires at the
    end of the fiscal year.
        The WIPA programs inform beneficiaries on the impact that
    employment will have on disability income and medical coverage,
    and addresses many of the fears that individuals have about
    going to work at the risk of losing health coverage. Authority,
    again, for these grants will expire.
        More needs to be done to ensure that individuals and
    families are aware of the availability of these critical
    services, and that consistently provides the message that
    encourages employment in the community rather than simply the
    preservation of benefits. So we believe that it is really
    important to address those.
        Some of the other issues that we also think are critically
    important to continue are the expanded use of the employment
    networks; the Medicaid Infrastructure grants, the Partnership
    Plus model. The Social Security Administration's revised Ticket
    regulations improved the overall effectiveness of the program,
    and it is important that these things continue.
        The Ticket program is poised to benefit from data-matching
    advances.
        And one area that has slipped due to staffing shortages is
    the process of earnings reported by beneficiaries. When
    beneficiaries get overpayment notices, it is shocking to
    beneficiaries when they receive these notices and assume that
    the information has been processed properly.
        The rest of my testimony is written and can be submitted
    for the record, and I am happy to answer any questions that you
    have.
        Chairman JOHNSON. Thank you, ma'am. It will be entered into
    the record.
        [The prepared statement of Ms. Bates-Harris follows:]

        Chairman JOHNSON. Dr. Kregel, please go ahead.

      STATEMENT OF JOHN KREGEL, PROFESSOR, SPECIAL EDUCATION AND
    DISABILITY POLICY, VIRGINIA COMMONWEALTH UNIVERSITY, RICHMOND,
                                VIRGINIA

        Mr. KREGEL. Thank you, Chairman Johnson, Chairman Davis.
    Thank you very much for this opportunity. I will focus my
    comments today on the Work Incentives Planning and Assistance,
    or WIPA, program.
        Individuals with disabilities who receive SSI and SSDI are
    frequently viewed as unemployable when in reality millions of
    beneficiaries have clear goals to work and reduce their
    reliance on disability benefits. Of the 13 million current SSA
    beneficiaries, it is estimated that 2.7 million see themselves
    working in the near future, and an additional 2.6 million have
    also been employed or looked for work in the past 12 months.
    These 5.3 million individuals should be the primary focus of
    SSA's employment and return-to-work initiatives.
        So why aren't more people working? First, disincentives in
    our SSA program rules often penalize beneficiaries who attempt
    to work. Most depend on their SSA benefits to meet their basic
    needs and would tremendously benefit from working.
    Unfortunately, beneficiaries are repeatedly told that
    employment will quickly lead to loss of their benefits. This is
    absolutely not the case. Yet fear of losing benefits leads them
    to unnecessarily choose not to work or to needlessly restrict
    their work hours and earnings.
        Second, while many beneficiaries would willingly forgo
    their cash benefits for the possibility of increasing their
    income through employment, they still fear potential loss of
    their corresponding Medicaid or Medicare coverage. Many
    beneficiaries possess serious chronic health conditions that
    would make the loss of health care coverage catastrophic to
    them personally.
        Third, beneficiaries fear potential overpayments or sudden
    benefit termination. Local Social Security offices, facing
    enormous pressures while attempting to respond to the large
    increases in program applications, simply lack the personnel
    and time necessary to accurately administer the work-incentives
    provisions. The result is an abundance of disruptive
    overpayments and a sudden loss of benefits that often lead
    beneficiaries to abandon their hopes for long-term employment.
        To address these problems, SSA has established the Work
    Incentives Planning and Assistance, or WIPA, program. The WIPA
    program is an employment support that is designed to enable SSA
    beneficiaries to pursue their goals of personal employment and
    economic self-sufficiency. WIPA services refer to efforts by a
    rigorously trained community work incentive counselor to
    provide accurate and complete information to SSA beneficiaries
    to enable them to obtain employment, return to work, and reduce
    dependence on SSI and SSDI.
        Currently the WIPA initiative is comprised of 102 projects
    providing benefits to SSA beneficiaries in all 50 States and
    territories. Collectively the projects employ 500 rigorously
    trained Community Work Incentive Coordinators, many of whom are
    themselves individuals with disabilities. Since their inception
    in 2000, WIPA programs have provided work-incentive counseling
    services to over 450,000 SSI, concurrent and SSDI
    beneficiaries, including 60,000 persons served over the past
    year.
        So what do they do? In Dallas, a 40-year-old gentleman
    named Danny secured a heart transplant after a 6-year battle
    with heart disease. He thought he could never work again
    without losing his $1,800-per-month SSDI check. After working
    with the WIPA project for 3 months, he is working 15 hours per
    week and is earning over $1,500 a month for a heavy equipment
    sales company. In November, his $1,800 check will go to zero,
    saving SSA $20,000 per year for hopefully many years to come.
        Jay in Louisville is a young man with developmental
    disabilities, who receives SSI and has a Medicaid waiver for
    personal and employment supports. His father contacted a CWIC
    when Jay began working with a new supported employment
    provider. The family has received work incentive counseling and
    information that have allowed them to feel comfortable in
    letting Jay go to work for the University of Louisville in a
    job that provides him earnings at a level of over $1,000 per
    month. Each month he works results in a savings of $400 to SSA.
    Given his age, these savings will compound over the next
    several decades. If his earnings increase, the savings to SSA
    will increase as well.
        In Los Angeles, Michael received a termination letter on
    his benefits. The letter also stated that he had an overpayment
    of $79,000, money he was ordered to pay back to the Social
    Security Administration. The CWIC assigned to this beneficiary
    thoroughly reviewed his case and discovered the client was
    incorrectly terminated. Due to the CWIC's diligence, attention
    to detail, and excellent rapport with SSA Claims
    Representatives and community partners, both issues were
    resolved. The beneficiary received reentitlement to his SSDI
    check, and the alleged $79,000 overpayment was cleared.
        Services provided by WIPA projects lead to increased
    employment, improved earnings, and reduced dependence on
    disability benefits. These outcomes lead to significant
    reductions in the overall amount of general funds and trust
    fund payments to beneficiaries. These savings are large enough
    to offset the cost of the program and could be expected to
    compound steadily over time as individuals leave the disability
    rolls after receiving WIPA services and remain in the workforce
    for many years to come.
        Thank you, Mr. Chairman, and I appreciate the opportunity
    to answer any questions.
        [The prepared statement of Mr. Kregel follows:]

        Chairman JOHNSON. I thank all of you for your testimony. We
    will now turn to questions. And as is customary for each round
    of questions, I will limit my time to 5 minutes and ask my
    colleagues and my companion chairman here to limit your time to
    5 minutes as well.
        Mr. Bertoni, GAO found employment networks paid by Social
    Security who were essentially coaching ticket holders to work
    part time so they wouldn't lose their benefits even though the
    goal of Ticket to Work is to get individuals back to work and
    off disability. I understand you have taped conversations to
    prove this. I would appreciate it if you would play a couple of
    these conversations for us and then tell me, one, how
    widespread it is; two, what Social Security has done to address
    it; and three, what this says about Social Security's ability
    to manage this or other work-incentive programs.
        Mr. BERTONI. Sure. Let me quickly preface this by saying
    that in interviewing the employment networks, 15 of 25 of them
    told us that SSA had not articulated any specific outcomes for
    them, nor had they provided performance goals. So in an
    environment like that, you really run the risk of, number one,
    confusion in terms of how you explain the rules; lack of
    consistency across the various profiles in terms of how those
    rules are applied; and last, it is an opportunity for a
    potential abuse. So any one of those things could be coming
    into play with these recordings. It just shows that when you
    have that type of environment, that these types of things can
    happen. So if you want to roll those tapes, that would be
    great.
        [Tape played.]
        Mr. BERTONI. It looks like they just went with two calls.
        Your question was, how pervasive? We don't know how
    pervasive this is. What we did is we followed the money. We
    went with the top 20 providers, and we talked to an additional
    5 providers. We had three lines of questioning. We had lines
    for shared payment approaches. We had calls for employer-driven
    approaches, and we had calls for vendors that we didn't know
    what they were doing. Based on the descriptions of their Web
    sites, and interviews that we had, and documents that we looked
    at, we really couldn't discern what the services that were
    being offered, so we felt that we had to call these individuals
    and sort of get behind that information.
        We made eight calls to different providers. We had multiple
    no answers, no contacts where we couldn't get through. But
    three of those eight resulted in these conversations where it
    appeared that there was some real coaching going on.
        SSA doesn't have a good sense of this either. We do know
    there are other Web sites and other providers that are
    promoting this type of activity, but we don't have a good sense
    of the universe or what is going on amongst the 1,600
    providers. But SSA could do that. They could get behind that.
        You asked actions they can take and are taking. They do a
    secret shopper program. They have a secret shopper program. You
    could systematically do exactly what we did: sample or go
    through the entire range of employment networks, the larger
    providers, and sort of get a sense of the extent to which this
    is happening.
        I think one of the primary things that has to happen here
    is they really need to establish performance metrics that are
    designed to move employment networks toward pushing employment
    that is beyond part-time work. Until you establish that metric
    and you hold these folks accountable, again, you have
    opportunity for confusion, inconsistent application, and
    perhaps abuse.
        Chairman JOHNSON. Thank you. My time has expired. I
    appreciate you all looking at that. Thank you so much.
        Mr. Williams, would you care to respond?
        Mr. WILLIAMS. Yes, I would.
        Chairman JOHNSON. Go ahead.
        Mr. WILLIAMS. We have established clear performance
    standards and expectations that coaching people to limit their
    earnings is completely unacceptable, and we are weeding out
    those that do. We have instituted a contract process that will
    enable us to terminate bad actors and have done so already.
    Additionally, we will submit a response for the record.
        [The information follows:]

        Chairman JOHNSON. Thank you, sir.
        Mr. Bertoni, are you guys on top of most of the States in
    the country?
        Mr. BERTONI. In terms of----
        Chairman JOHNSON. Looking at this program.
        Mr. BERTONI. The distribution of the 25 providers gave us
    some good geographic distribution, but I don't know if we
    covered--we certainly didn't cover every State.
        Chairman JOHNSON. Well, no two States are alike, I presume.
        Mr. BERTONI. No. But the rules of the program should be
    alike, and they should be applied very consistently.
        Chairman JOHNSON. Agreed. Okay. Thank you for your
    comments. And I have extended my time.
        I recognize Chairman Davis. And thank you for having your
    Subcommittee join us today.
        Chairman DAVIS. It is a privilege, Mr. Chairman.
        Mr. Bertoni, I want to follow on the line of having SSA get
    necessary program information. Do we know how much taxpayers
    have spent on the Ticket to Work program since it started,
    including amounts paid to employment networks?
        Mr. BERTONI. Sure. I can give you recent information from
    our reporting period a little bit before that. When we
    reported, it was about $34 million in administrative costs and
    about $13 million paid out in Ticket dollars to ticket holders.
    In 2007, that amount--Ticket payments were about $3.8 million.
    By 2008, they were $5.6 million. By 2009, they were up to
    $12.6, and partial-year 2010 were $13 million. So that is about
    $41.5 million in Ticket payments.
        This year here, though, we have a real rapid increase in
    these payments. We see that is a pretty significant increase
    post-2008, primarily driven by the rapid increase in
    beneficiaries from 22,000 to 49,000. So this program has
    grown--well, the numbers are relatively small. It has grown
    quickly in terms of the payments. And when you look at the
    potential eligible beneficiaries, there are 12 million people
    out there who have a ticket who could come forward at some
    point in the near future. So this program is poised to grow,
    and it could be significantly, based on the numbers that could
    take up the tickets.
        Chairman DAVIS. It sounds like a disproportionately high
    amount of administrative costs for the current payout. Do we
    know what aspects of the Ticket program are working?
        Mr. BERTONI. I think, as SSA and others have said, I think
    they have done a very good job of increasing the number of
    employment networks and are doing a significant job in
    increasing the number of folks who are taking up tickets and
    using them.
        Chairman DAVIS. I guess maybe a bigger question is, in my
    mind, getting people into a program is not necessarily a
    definition of effectiveness. Would you rate the Ticket program
    as effective? And do you believe that SSA is adequately
    collecting and analyzing proper information to be able to
    answer these sorts of questions?
        Mr. BERTONI. To date, no. I think the front part of that is
    getting folks in the program is important. You have to work
    with something. But there is a management aspect to this, and
    from that standpoint, I think they have not been effective in
    many ways in terms of vetting and approving the employment
    networks to ensure they are qualified; in terms of monitoring
    individual ticket holders; certainly establishing performance
    measures to hold employment networks accountable; and also to
    evaluate and reevaluate the program, determine what is working
    and what isn't, what are the trends in service provisions, and
    what are the outcomes that are coming out of this program. That
    is what is not happening, and that is what we don't know, and
    that is what SSA does not know to date.
        Chairman DAVIS. Dr. Weathers, do you have anything to add?
        Mr. WEATHERS. Yes. We do have an independent evaluator,
    Mathematica. They have been doing an evaluation of the Ticket
    program since its inception. Many of their earlier reports--
    they have already produced five reports--were used in order for
    us to change the program in 2008 with the new regulations.
        Since 2008, we have been collecting data on outcomes of
    ticket beneficiaries, and we just completed a national
    beneficiary survey. Mathematica is conducting an analysis of
    that national beneficiary survey so we will be able to measure
    outcomes of ticket beneficiaries since the new regulations went
    into place in 2008. But it does take time for a new program and
    new rules to be communicated to the public and to
    beneficiaries, and we need to wait a period of time before we
    can effectively evaluate how the new rules are working.
        Chairman DAVIS. Okay. Dr. Kregel, as an academic, do you
    think Dr. Bertoni's findings are acceptable, and what do you
    recommend we do to hold Ticket to Work and other work-incentive
    programs accountable?
        Mr. KREGEL. I think that it is important to set performance
    standards for each of these programs. Looking at, for example,
    the Ticket program, it is important to ask, in the absence of
    this program, would these people still return to work? And if
    you look at the examples that have been cited that effectively
    indicate that individuals are assigning their ticket with an
    EN, they are working, but the EN is not providing them any
    service, then it is very reasonable to say, in the absence of
    this program, wouldn't this person have gone to work anyway? So
    the notion is, if the program is not there, would these
    individuals return to work? Would it result in savings to the
    government, savings to SSA? And that is the question that needs
    to be addressed going forward.
        Chairman DAVIS. I will just leave you with a thought. And
    perhaps those of you on the panel that feel so moved, but
    specifically from Dr. Weathers and Mr. Bertoni, I would
    appreciate just a response in writing for the sake of time.
        It seems that there are compelling disincentives for people
    to want to go to work, particularly what I have seen in the
    eastern portion of my district, an outright racket with
    attorneys who are advertising on the radio for benefits, that
    make outrageous fees, and, you know, really want to discourage
    folks from going back to work and the benefits of that.
        I would be interested just as an adjunct in this, in order
    to make Ticket to Work work, what are some things that might be
    able to be done to curtail the program from an inappropriate
    perspective; wanting to help people, but at the same time
    avoiding folks profiteering off the backs of these folks in
    need?
        [The information follows:]

        Chairman DAVIS. With that, I thank the chairman for his
    additional indulgence, and I yield back.
        Chairman JOHNSON. Thank you. I appreciate your comments.
        Mr. Becerra, you are recognized for 5 minutes.
        Mr. BECERRA. Thank you, Mr. Chairman.
        And thank you all for your testimony and your work.
        Mr. Bertoni, I want to focus in on some of the things that
    you have been saying, because you are going to get most of the
    attention here. I want to see if I can get ahold of a threshold
    question. We are talking about folks who qualify for SSI or
    SSDI benefits. We are talking about folks who have proven to
    have a health condition that is severe enough that they would
    qualify to receive some form of assistance, disability
    assistance. No one is questioning that the folks that we are
    talking about are disabled in some form that are interested in
    trying to work.
        Mr. BERTONI. Correct.
        Mr. BECERRA. So having said that, as I listen to those
    tapes, my sense was that we may have to work on these
    employment networks.
        Mr. Bertoni, do you have anything to share with us that
    shows that beneficiaries were trying to game the system?
        Mr. BERTONI. No. I think the--our recommendations in my
    introduction was that it is between the agency and the
    employment networks where the guidance needs to be clarified,
    and these networks need to be educated as to what you can't say
    and what you can say, and how best to screen and counsel folks
    to get them back to work.
        Mr. BECERRA. So you have given us some good guidance on how
    to zero in to try to make these programs work better, because I
    don't hear anyone saying here that beneficiaries are trying to
    game the system, get benefits that they don't deserve, or game
    the system by saying they are working or working enough and
    then keep both benefits and salaries.
        Mr. BERTONI. No. In fact, if you listen to the tapes, you
    go to the Web sites, or you read any of SSA's materials that
    they put out, that is what is said: You can work. You can work
    part time. It is acceptable. But there is a ``for a period of
    time'' in there, of course. But I think these folks are reading
    this as, I can do this.
        Mr. BECERRA. So now I want to get the question to you in
    just a second, but first I want to ask Ms. Russell a question.
        The chairman and I were just chatting about the work that
    Walgreens is doing, which seems to be tremendously helpful to a
    lot of these folks who are receiving these disability benefits
    that are trying to work. So I want to make sure we don't paint
    with a broad brush all these employment networks, because there
    seem to be some that are trying to do this the right way. And I
    would hate for folks who are trying to really connect someone
    who is receiving these disability benefits with a job, all of a
    sudden I feel like, gosh, I am getting bashed over the head for
    trying to do this, and I am also investing some pretty
    significant resources to make it work.
        Have you found a particular formula that helps you succeed
    so that you don't find that your folks on the other end of the
    phone doing something like this?
        Ms. RUSSELL. Yeah. I think that our formula for success
    overall mirrors our formula for success with the Ticket
    program, and that is that education is key. Our individuals,
    our staff people who are involved in the Ticket program, are
    well educated on what parameters within our role as an employer
    and our role as an employment network they need to operate
    within. They are provided a lot of information about what they
    can and can't say, what they can and can't do. We maintain a
    lot of the control at corporate, which prevents us from having
    to worry about things happening out in the field that would be
    inappropriate.
        Mr. BECERRA. I will ask Mr. Williams and Dr. Weathers, I
    know you have some budgetary issues, staffing issues, but I
    suspect that there are some employment networks that are out
    there that produce well and most folks that, say, are doing the
    right thing. I am not sure if it is a matter of getting the
    best practices from some of these folks or somehow doing things
    because I know you are shy of money. But I think there has got
    to be a way, short of making very expensive investments, to try
    to make this program work.
        I think what Mr. Bertoni had pointed out through these
    taped phone conversations is that either the employment network
    folks are trying to help these folks maintain as much of an
    income as possible, or they are trying to avoid having to bring
    them on full time. Either way I think we need to figure that
    out.
        Mr. Bertoni, let me ask you this: SSA just took a massive
    hit in its budget. It is receiving $1 billion less than it said
    it needed just to try to keep pace with an already growing
    caseload. What you are suggesting that they do is program
    integrity isn't cheap, and it is not free. They would have to
    hire more folks or put more investments up front with people
    who are already steeped with work in order to try to up front
    catch some of this gaming activity. Is that correct?
        Mr. BERTONI. There is no question with more resources you
    can do more. I guess the position we have is this program has
    been around since 1999. It has been growing, expanding. There
    were some new initiatives in play. And there is some blame to
    be laid at the agency's management doorstep in terms of what
    could have been done in prior years.
        Luckily, we are here at a time when the program is not
    huge. Five years from now, we could have a bigger problem on
    our hands. These are issues that need to be addressed. And
    within the resources they have, I think they can leverage some
    of that to do better. If they had more resources, could they do
    more? Absolutely.
        Mr. BECERRA. Thank you for that. And I just hope that what
    SSA does is takes some of this information, perhaps talks to
    some of those who have shown some good practices, and try to
    quickly take advantage of those best practices so that we can
    move the program forward, you know, make it work better,
    because I think what we are showing is that there are a lot of
    Americans who are receiving disability benefits who would love
    nothing more than to be able to go to work as much as possible.
    So thank you all for your testimony.
        Mr. WILLIAMS. If I might, sir, I agree we need to do more
    to identify what is working, and a prime way we need to do this
    is to learn more about the over 5,000 people that have left the
    rolls with the support of an employment network. That, to me,
    is where to start.
        Chairman JOHNSON. Thank you, sir.
        Mr. Brady, you are recognized for 5 minutes.
        Mr. BRADY. Thank you, Mr. Chairman. Both of you, thanks for
    holding this hearing.
        Ticket to Work is a great concept, it makes great sense not
    just for taxpayers, but for those with disabilities that, as
    technology progresses, it allows them to move back into the
    workforce. It makes sense. My frustration is that after 15
    years, we don't know if this works.
        Dr. Weathers, a simple question. A decade and a half, what
    percentage of those using Ticket to Work have now gone on to
    full-time, sustained employment? What percentage?
        Mr. WEATHERS. A very, very small percentage. We are
    currently conducting an evaluation of the percentage of people
    who have returned to sustained full-time employment since the
    new regulations were in place in 2008. We needed a 3-year
    period in order to track.
        Mr. BRADY. Do you have numbers prior to that?
        Mr. WEATHERS. We do have numbers prior to that, yes,
    between 2001 and 2006, and the numbers were very, very small.
    And that is what inspired the impetus behind changing the
    regulations in 2008.
        Mr. BRADY. What was that percentage? I am not trying to pin
    you down. I am trying to figure out what we can do to make this
    really work.
        Mr. WEATHERS. I can provide that number for the record for
    you.
        Mr. BRADY. Bigger than a bread box; 5 percent, 10 percent?
        Mr. WEATHERS. No. I would say around 5 to 10 percent is the
    ballpark. But I can provide you with a more precise number for
    that.
        [The information follows:]

        Mr. BRADY. What do you expect the new numbers to be?
        Mr. WEATHERS. I would hope that we could get it up much
    higher than that.
        Mr. BRADY. What do you think it ought to be?
        Mr. WEATHERS. I would hope that we could make it work for
    everybody that is using a ticket. But I think if we could get
    50 percent, that would be a pretty good number.
        Mr. BRADY. My frustration, this is a great concept. This
    ought to be working. After 15 years, it isn't. So my
    frustration is, you know, Mr. Williams talked sincerely about
    having performance standards clearly lined out. Mr. Bertoni
    said 15 out of 20 of the employment networks say they don't
    have it. Clearly there is gaming of this system. It seems to me
    we need a fresh start on this program. You know, 5 percent, 10
    percent, 20 percent just aren't the numbers I think anyone was
    hoping for when, in a bipartisan way, we put this program
    together.
        Let me ask the panelists, if we could start with a fresh--I
    don't mean end it--if we could start with a blank page and
    redesign this, knowing what the technologies are today, knowing
    what the common disabilities are today, what would you do
    differently? How would we start with a fresh slate and recreate
    a program that really did help people get back to sustainable
    work? Any panelists?
        Ms. BATES-HARRIS. I would like to say something. As a
    representative of the National Disability Rights Network, I
    feel compelled to remind people that people on Social Security
    benefits are among the most disabled people in this country,
    and many of them want to return to work. And unfortunately, as
    my boss would say, discrimination is our business, and business
    is good. And sometimes you can get all the perfect services in
    place, but discrimination is alive and well, and people do not
    get employed.
        Mr. BRADY. I understand.
        What do you believe is an acceptable rate? What do you
    think our goal ought to be? Five percent?
        Mr. KREGEL. I would like to answer that directly. The
    evaluation that Dr. Weathers talks about has identified that
    currently in this country, there are about 2.6 million SSA
    beneficiaries who indicate that they would like to work, and
    they see themselves working in the foreseeable future.
        Mr. BRADY. How many, Doctor----
        Mr. KREGEL. 2.6 million.
        Mr. BRADY [continuing]. Would like to go back to work?
        Mr. KREGEL. Would like to go back to work, and who have
    either worked during the past year or have taken action toward
    working in the past year, such as applied for a job, taken a
    training course or something like that.
        What should the number be? Well, the programs should first
    focus on those 2.6 million people, and then we can look at
    other people whose health conditions may improve. And then we
    move our services toward those individuals as well.
        In terms of starting over with the Ticket program, I think
    that it is important to keep in mind that 12 years have passed,
    and not only has the situation changed for SSA beneficiaries,
    but the situation has also changed in terms of how employment
    services are designed and delivered to people with disabilities
    generally. And I think that to start all over, it would be
    important to incorporate some of the cutting-edge best
    practices that have been described to you by Mr. Hanophy and
    described to you in terms of the Walgreens operation. These are
    the kinds of things--employer partnerships, working in
    collaboration with public and private enterprises that really
    need to be included in the redesign of the Ticket program. By
    incorporating the resources out there, we can get a lot farther
    along in terms of who we are serving.
        The other thing that needs to be done, as Mr. Hanophy
    pointed out, is to look at people who have been on the rolls
    for a very short period of time, and that includes transition-
    age youth. Returning to work for someone who has been on the
    rolls for 22 years and is now 45 years old is a different
    challenge than for someone who is 22 years old. We don't want
    these individuals locked into lifelong dependency on Federal
    benefits. So targeting the Ticket program to transition-age
    youth and involving private-public partnerships with business,
    I think, are the major areas that we can explore in terms of
    redesigning the program for more effective services.
        Mr. BRADY. Well, thank you. Again, this is such an
    important program. For those who want to go back to work, there
    has got to be a smarter, better way to do this.
        Mr. Chairman, thank you.
        Chairman JOHNSON. Thank you.
        The gentleman's time has expired. Mrs. Black, you are
    recognized for 5 minutes.
        Mrs. BLACK. Thank you, Mr. Chairman.
        And I thank you, panel, for being here today.
        Mr. Bertoni, I want to go to what we heard on the audio in
    reference to the misinformation that is being given by those
    who should know the correct information. Is it your opinion
    that we are just not training those who are working in the
    offices, that they don't know the information? Or how do we get
    such misinformation being given out?
        Mr. BERTONI. I don't know what the extent of training is. I
    would defer to the SSA on that. I would say that over time, and
    with the changes to the regulations--basically the regulations,
    it is a couple key things. Number one, they lowered the bar at
    which employment networks could be paid, so that made part-time
    earnings attractive to both ticket holders as well as
    employment networks. They were trying to entice more
    individuals on both sides of the equation into the program.
        Another thing the regulations did was to make it acceptable
    for employment networks to directly pay the ticket holders from
    the Ticket money, so that essentially increased the value of
    the shared payment model.
        And thirdly, it also allowed for those whose medical
    improvement was expected to participate in the program.
        So we have sort of a convergence of folks here who could,
    in fact, benefit from part-time work and early payments.
        So we see this new guidance come out. We see these are
    allowable things. And the firewall between SSA and the field,
    the employment networks, is there. And someone has to work
    through this firewall to communicate even with those changes
    that are acceptable, what are the ultimate end goals for this
    program. Yes, part time should be the start for many. It might
    be it for many. But certainly if we can get people into part-
    time work, and for those that can move up to more substantive
    employment, that should be the end goal, because that is the
    stated purpose of the program. I am not sure everybody knows
    that.
        Mrs. BLACK. Well, thank you. I think you are right. And
    obviously, the people that were taking these phone calls did
    not know that. But you also made mention that you thought they
    should develop program performance measures. How would you see
    those performance measures? What would be in those?
        Mr. BERTONI. I would hate to be too prescriptive here,
    because any one that I threw out, the people would come behind
    me and tell me I had a bad measure.
        I guess right now I believe there is one measure for the
    program. That is the number of ticket holders with an assigned
    ticket. To me, that is the start. You have found the person.
    You have given them the ticket. They have assigned it to an
    employment network.
        But the outcome measures are not there. We have outputs,
    but not outcomes. Really, the number of folks who have moved
    on, who have transitioned to sustainable, long-term employment
    that has allowed them to reduce dependency and benefits, part
    of that should be in the equation when you are evaluating how
    effective an employment network is.
        Mrs. BLACK. And I know I am going to run out of time very
    quickly here. So, Dr. Weathers, do you agree that this is a
    good recommendation? And if so, what do you all plan on doing
    to initiate those kinds of measures that will help to show what
    kinds of outcomes are there?
        Mr. WEATHERS. Bob Williams' office is responsible for
    putting together a report card, and I think he could say a word
    or two about what they are doing.
        Mr. WILLIAMS. We have, in fact, initiated such benchmarks,
    including one that will hold ENs responsible for moving some
    beneficiaries into jobs that pay at least twice the poverty
    level. It is not enough to get someone off benefits if doing so
    makes them worse off than they are now.
        Mrs. BLACK. Thank you.
        Mr. Chairman, if I may ask in writing, Ms. Russell, could
    you tell us about some of the barriers that you have found in
    working with the program? I congratulate you for doing what you
    have done.
        And then, Ms. Bates-Harris, you talked about
    discrimination. And if I could have you in writing tell us a
    little bit more about where those discrimination factors are
    and how you think we might overcome those. I appreciate that.
        Thank you, Mr. Chairman.
        Chairman JOHNSON. You are welcome.
        Could you two respond that way, in writing, please? Thank
    you.
        [The information follows:]

        Chairman JOHNSON. Mr. Stark, you are recognized.
        Mr. STARK. Thank you. Thank you, Mr. Chairman. Thank you
    for this hearing. And I thank the witnesses for enlightening
    us.
        I must take this opportunity to thank SSA, and in
    particular their San Jose office, which services our office
    nearby for the numerous inquiries we get. We just get wonderful
    service from them. And I am afraid they are going to need help.
    The number of inquiries is growing. The number of the elderly
    people is growing. And the money to fund that growth in service
    has got to come from somewhere. I don't think there is an SSA
    fairy that is going to sprinkle that dust on you and allow you
    to hire the people or pay them for overtime. So as we see more
    people with more severe health problems, I hope that we can
    find the additional funding to let you continue to provide that
    good service.
        I want to make sure that you have cleared your phone
    messages with the PATRIOT Act. And I didn't notice that you had
    inquired about the offers for half-price Viagra that Sam and I
    keep getting. And are those legitimate offers or not? If you
    could look into that for us, and we would appreciate it very
    much.
        The one question that I wanted to direct to Ms. Bates-
    Harris is the question of the disregards. We have disregards
    for beneficiaries' income in determining their eligibility. And
    it is my understanding that those were set about the time that
    I came to Congress. And the average benefit was under $500, and
    SSI benefits were reduced for income that exceeded $65 a month,
    and if a recipient earned as little as $20 a month from any
    source, the disregards came into effect. Do you think that it
    is time that we have a modest change in that and bring those
    disregards from the seventies up to standards of today, that
    that would just be a fair and proper thing to do?
        Ms. BATES-HARRIS. Absolutely, positively. The $20 general
    income disregard and the $65 earned income disregard have
    remained static, and, in fact, people have basically lost money
    on that with the cost of inflation. So we really believe that
    they should be indexed and increased just the same as how the
    SGA and the other factors in the Social Security program are
    indexed.
        Mr. STARK. Thank you.
        I want to thank all of you for your work in this area. It
    is important to our seniors, to our people with disabilities,
    and that is a growing population. Thank you for your service.
    Thank you for your testimony today.
        Chairman JOHNSON. Thank you, Mr. Stark.
        Mr. Reed, you are recognized for 5 minutes.
        Mr. REED. Thank you, Mr. Chairman.
        Maybe it is because I was up late last night and then I had
    to listen to that. That angers me. That angers me, that tape,
    and it angers me on multiple levels. But most importantly it
    angers me because there is a good mission that you are trying
    to accomplish with these programs and with SSA and the disabled
    Americans across the country. And we applaud that. I support
    that. I don't think you are going to get any opposition up here
    on both sides of the aisle from that mission. But when you hear
    stuff like that and the people that are abusing the system at
    the cost of the true people that are disabled and doing the
    right thing day in and day out, I want to know, what is the
    result of that? Are those two individuals that were taped, are
    they still involved in this process? Have they been terminated,
    out of this program? Yes or no?
        Mr. WILLIAMS. Yes.
        Mr. REED. Excellent. And I hope that continues, because
    that oversight needs to be done because that type of behavior
    needs to end.
        Mr. WILLIAMS. It will.
        Mr. REED. What I would like to ask--and I am also getting a
    little tired of the mantra of, we need more funding in order to
    accomplish the mission. The harsh reality of our country and
    our fiscal resources are we don't have the funding. I would
    love to be able to give you all the funding you needed, but I
    think the harsh reality of our world today and our Nation today
    is that we don't have those unlimited pots any longer.
        So I am looking to you, Dr. Weathers and Mr. Williams, to
    tell me, what is your plan to deal with the reality of the
    situation where more funding is just not going to be on the
    table? When I ran my businesses, and I hit hard times, I had to
    make tough choices. I had to reprioritize my mission and my
    goals. I had to reallocate employees to areas that were
    critical objectives of my business in order to accomplish the
    mission. Do you have that plan in place?
        Mr. WEATHERS. We recognize these are lean times.
    Commissioner Astrue has said that we are going to have to make
    difficult choices about service delivery. Mr. Williams and I
    aren't involved in our day-to-day operations and budget
    process, but we would be happy to submit to the record more
    information on your question.
        Mr. REED. I would appreciate that. And also, what that new
    mission plan or that business plan, if you would, for SSA going
    forward in the reality of these times would be.
        [The information follows:]

        Mr. REED. And that gets to my last question. I am hearing,
    as I read this testimony and hear this testimony and look at
    the evidence, I feel there is a big issue here of duplication
    of services. And I know there was a hearing here on this
    Subcommittee before looking at the benefits planning services
    or grants to community organizations, work incentives planning,
    protection advocacy for beneficiaries of Social Security, the
    laundry list of programs that are out there. Is that an example
    of efficiency? Would anyone like to----
        Mr. WILLIAMS. Yes. Both the WIPA and the Protection and
    Advocacy programs serve distinct functions. One focuses on
    providing information and assistance on using our complex work
    incentives, and the other on legal assistance. Whether there
    are efficiencies to be had by a better cooperation and
    coordination. In that area we would be glad to explore.
        Mr. REED. I would be glad to be a partner in that effort.
        With that, I yield back, Chairman.
        Chairman JOHNSON. Thank you.
        Mr. Paulsen, you are recognized for 5 minutes.
        Mr. PAULSEN. Thank you, Mr. Chairman, also for holding this
    hearing and for all the witnesses being here.
        Let me switch gears a little bit. Dr. Kregel, the Social
    Security inspector general was rather critical of WIPAs in
    their recent report for not having adequate performance
    measures. And when reviewing the data provided on all WIPAs,
    there are a lot of process measures that are in there. How
    quickly was the beneficiary contacted? Were they informed about
    possible options, et cetera?
        But what there aren't so much in there are these outcome
    measures or performance measures, like did the beneficiary
    attempt to return to work or actually return to work? Isn't
    that what this is all about? If you go back to maybe what Mr.
    Brady was asking about earlier, about how would you redesign
    this with a blank piece of paper, et cetera, tell us a little
    bit about that. How much does the WIPA program cost to date?
    How many people have obtained work as a result of it, and how
    would we redesign it and look on those performance measures?
        Mr. KREGEL. The WIPA program costs $23 million per year to
    fund the 102 projects, including the Minnesota Work Incentive
    Connection, which is really recognized as one of the top
    programs in the country. They estimate that they save $1.7
    million per year as a result of the $300,000 funding level that
    they receive to do their ongoing work.
        But you are absolutely right. Performance measures to date
    have focused on the process, what are we doing. And outcome
    measures really need to be the focus of what we look at going
    forward, particularly in light of whether or not this program
    should be continued for an extended period of time. This would
    include whether individuals are working at a level that would
    result in reduced benefits, or working at a level that would
    result in terminated benefits? Are they working at all? Or do
    they have access to the health insurance so that they continue
    to meet their complex health care needs?
        But also there needs to be savings, return on investment
    from the moneys that are invested in the WIPA program or any of
    the other programs. That would be increasing the number of
    individuals exiting the rolls, reduction in the cost of
    disability payments, reduction in the cost of public health
    care benefits and reduction in the number and amount of benefit
    overpayments, something that hasn't been talked about today,
    but another area where the WIPA program and several of these
    other programs can make a huge difference looking at the
    billion-dollar problem that exists in the area of overpayments
    today.
        Mr. PAULSEN. Why are not some of these standard measures
    when reviewing WIPA in general? For that matter, for any of
    these work incentives?
        Mr. KREGEL. I think that the focus has been, as these
    programs have evolved, to look at how effective is the process,
    with the assumption that the process will lead to the outcomes.
    But now these are more mature programs. There is information
    that exists, for example, that says that the WIPA program will
    generate a 3-for-1 return on investment if you look at the
    resources that are devoted to this effort and the savings in
    benefits payments and that type of thing. But this has only
    been done with very recent information and it really needs to
    be looked at on a broad scale to make sure that we are not
    paying for an outcome that might have occurred anyway, given
    the nature of the situation.
        So these things are long overdue, and I know that these
    benchmarks are being established by SSA, and they are looking
    at that going forward.
        Mr. PAULSEN. Dr. Weathers or Mr. Williams, can you follow
    up on that a little bit?
        Mr. WEATHERS. I can follow up.
        We are going to be releasing a report on the WIPAs looking
    at the outcomes of the beneficiaries that they serve within the
    next few weeks. We just received the final report last week,
    and we are reviewing it, and we are happy to submit it for the
    record. But I do think that it shows some positive outcomes in
    terms of employment for beneficiaries who are served by the
    WIPA organizations.
        [The information follows:]

        Mr. WILLIAMS. We have established in the grantees'
    contracts that went into effect this July many of the outcome
    measures that John mentioned. We are not where we need to be
    at. It is going to take a constant push for a culture change,
    because, frankly, the perception is that working full time and
    being financially independent cannot and does not work for
    people with significant disabilities. We know that many young
    people on SSI who go to college either never finish, or, if
    they do, they do not go to work. That is a national tragedy,
    but, likewise, a huge opportunity to, as I say, right-size what
    this program is about and what we need to be held accountable
    for achieving.
        Chairman JOHNSON. Thank you.
        Dr. McDermott, you are recognized for 5 minutes.
        Mr. MCDERMOTT. Thank you, Mr. Chairman.
        I may be the only one on the dais, maybe in the room, who
    has actually sat in hearings with people applying for SSI. As a
    psychiatrist, I used to see them frequently in Seattle. And as
    I listen to this discussion, I keep thinking about SSI
    patients. And I don't know that people--if you have never
    talked to someone who is on SSI and spent some time with them
    and realized what their life is about, it is important to
    realize what this system is.
        You have to have a disability that is going to keep you off
    the rolls for a year, that you are going to be unable to work
    for a year, or die. Those are the sort of end points of the
    assessment. So you don't get on easily. If you get on SSI, it
    means you have never had any connection to the workforce or any
    substantial connection to the workforce. So you are really at
    the bottom of the working population in this country, if you
    can be considered that at all.
        Then we designed the program in 1974, and we haven't
    upgraded it. I mean, tell me nothing has changed in cost since
    1984, right? If you get $65 of income from earnings and $20
    from any other source--your brother gives you $20--$85 you now
    have on top of your $499 on SSI--that is the average--you start
    to lose $2 for every $1 that you earn. Now, you tell me what
    the incentive is to go out for a job and know that for every
    hour you work or every 2 you work or 3 hours you work, you are
    going to lose the pay for 2 of those hours. It is a program
    that is designed poorly and needs to be reformed from the
    basics of the way it works.
        And I think that a lot of this performance stuff we are
    looking for--I mean, I can give you all kinds of cases from
    Missouri and Illinois and New Mexico. You know, there are
    endless problems. And I would like for Ms. Harris to talk a
    little bit about what you see out there. Give us a picture so
    everybody on this Committee can understand who these SSI people
    are as human beings.
        Ms. BATES-HARRIS. Well, first of all, they are individuals
    who are very poor because the program is means-tested. So they
    can basically have no or very, very limited resources. They are
    significantly disabled or impaired and, as you indicated, with
    very little work history, which means that either their
    disability has been so prevalent over their lifetime that they
    have been unable to enter the workforce or possibly even
    benefit from the education system and have not obtained the
    necessary skills required for jobs.
        So we are talking about people who need a lot of support
    and need a lot of assistance, and who are extremely dependent
    on the income supports from the Social Security program to have
    a place to live and to be able to put food on their table. And
    to those individuals, the thought of returning to work and
    risking the benefits because the work incentives are
    complicated, or they don't understand them, or people have told
    them if they go back to work, they are going to lose their
    Medicaid, or if they go back to work, they are going to lose
    their cash benefit, these are individuals who are in a very,
    very precarious situation and who very much need the services
    and supports that are offered by both the WIPA, the PABSS
    program, and other community programs out there that will help
    them improve their quality of life.
        Mr. KREGEL. May I follow up to that as well?
        Mr. MCDERMOTT. Yes.
        Mr. KREGEL. I agree entirely with your analysis of the SSI
    program. And you wonder what makes these people want to go to
    work. Well, the answer basically is that the mean benefit is
    $500, and 71 percent of the SSI population live below the
    poverty level, 71 percent. So the situation is these are
    individuals who are at risk of not having food on the table.
    They are at risk of not having shelter over their heads. And
    they are courageous enough, some of them, to go ahead and try
    to increase their income, even though the rules are stacked
    against them, out of sheer economic necessity in many, many
    situations.
        I agree entirely with your comments in terms of the
    disincentives within the SSI Program. I just think that we need
    to understand that the reason that people take some of these
    courageous steps is out of sheer economic need to meet the
    basic needs, including food and shelter.
        Mr. MCDERMOTT. The bottom line being if you keep them poor
    enough and hungry enough, they will ultimately finally find
    some way to get out of it; is that what you are saying?
        Mr. KREGEL. The situation is that also their health is
    impacted by living in poverty the way that they are, and they
    look at extensive health care costs.
        So I think anything that can be done so that when SSI
    beneficiaries work that they are not penalized for working is a
    very, very sound approach in terms of moving forward. It is the
    best way to go.
        Mr. MCDERMOTT. Thank you.
        Chairman JOHNSON. Thank you.
        Mr. Berg, you are recognized for 5 minutes.
        Mr. BERG. Thank you, Mr. Chairman.
        I come from a State where, quite frankly, we are looking
    for employees. We have got around a 3 percent unemployment
    rate. And I am just sitting here. And again, the big problem as
    I see it is in 2018, we are broke. So we have kind of been
    dancing around a lot of these questions. But it seems to me
    that that is really the number one thing that we need to focus
    on.
        Having said that, if there are 2.6 million people who would
    like to work, it seems like that is almost 25 percent of the
    people that would like some sort of work. And if in 2018,
    according to the numbers that we are given, we would only be
    able to fund 84 percent. Well, quite frankly, if half the
    people that wanted to work found work and became self-
    sufficient from an income standpoint, that would certainly push
    that 2018 date out.
        So I guess--and I appreciate the concern of not wanting
    people to coach to the program, but, quite frankly, I don't
    think anyone really needs any coaching to look at the program
    and realize that if you make more than $1,000, you are going to
    lose all your benefits. It is not that complicated for anyone
    that is on the program. So it seems to me that there are really
    some fundamental flaws in the program that need to, quite
    frankly, encourage people and partner with people getting on
    their own rather than creating some sort of barrier. When they
    figure it out, they are making $2, $3 an hour for the extra
    work. So, I mean, that is kind of one of the big chunks.
        We are running out of time here, and it appears to me that,
    obviously, what we have heard from the employers, that is one--
    I mean, there are two ways of doing this, from my perspective.
    We could take from the employers and kind of work an
    environment where we have work and opportunities, or it seems
    like we can also just push people from the bottom up. I would
    like to hear from Mr. Hanophy about how can we encourage
    employers to--are there barriers there? Are there things that
    we can do that would encourage employers to say, here is a real
    opportunity to bring a valuable person into my company long
    term?
        Mr. HANOPHY. Sure. Thank you.
        Essentially there are three parts to that. Number one is
    what we identified earlier, which is the dual customer; in
    other words, knowing the business and knowing your applicant,
    the person with a disability. That means understanding what the
    business needs, but understanding how they operate, how the
    jobs operate, the work culture. Once you are able to do that,
    you are able to have a discussion with this business about your
    ability to bring them a qualified applicant.
        Study after study shows that the reason why people get
    hired is because they can do the job. And so this isn't about
    charity. This is about helping them find an applicant who can
    do the job. So the key for the providers is to provide the
    supports and also do the screening and make sure these
    applicants are qualified.
        Number two is helping a business increase their access to
    an applicant pool of people with disabilities. The term we
    prefer to use is ``multiple portals.'' We have had examples
    with Walgreens and several other companies where by providing a
    little bit more training on the front end or a little better
    adjustment on the front end, we are able to help--we call it
    embedded training, for lack of a better term, where an
    applicant with a disability can hear the noise, smell the dust,
    be a part of the work environment, but learn at a pace to where
    they will be able to get up to speed to eventually be hired by
    that employer. So different portals of entry.
        And then the third piece is support. Companies very often
    are very interested in supporting people with disabilities, but
    don't know how. We hear the term ``reasonable accommodations.''
    I prefer to use the term ``adjustments,'' because a reasonable
    accommodation is nothing more than a commonsense adjustment to
    help somebody go to work. My favorite example is, if your job
    requires you to reach something on the top shelf, and you can't
    get that thing on the top shelf, let us move it down. And it
    doesn't matter if you are 4 feet 11 or you are in a wheelchair.
    Let us just move it down and move on.
        And providing supports about how to help folks with
    significant disabilities adjust to work tasks. This is where
    the Partnership Plus model, I think, has been effective in
    partnering with Social Security in being able to provide some
    of those longer-term supports.
        The bottom line is know your business and know your
    individual with a disability.
        Mr. BERG. Thank you.
        Ms. Russell, I would like to ask you a kind of similar
    question. If from a business-down approach you are going to
    develop or increase it, are there barriers that are out there?
    Or what changes would you like to see?
        Ms. RUSSELL. I think the barrier we experience is trying to
    locate the talent. And that is, as Mr. Hanophy just described,
    something that we have been able to find in Texas with their
    assistance is being able to locate the individuals who have the
    skills that match what we are requiring. It is unfortunate that
    we have a lot of situations where a week goes by, and I see
    that we have hired 50 new workers, and not one of them is
    identified as somebody with a disability. It is 50
    opportunities that our partners have passed on by not being
    able to help us find the individuals with disabilities who have
    the skills to do our jobs. So it is all about a talent pool and
    finding the talent, developing the talent, and then being able
    to match it to the business' needs.
        Mr. BERG. Thank you, all.
        I will yield back, Mr. Chairman.
        Chairman JOHNSON. Mr. Crowley, would you care to question?
    You are recognized for 5 minutes.
        Mr. CROWLEY. Thank you, sir. Let me thank you and Chairman
    Davis for holding this hearing today. I want to thank the
    witnesses for their testimony.
        My office frequently hears from our constituency about
    navigating the Social Security benefits, the disability system,
    and, quite frankly, it is one of the most frustrating things
    about our office, I think. I think I speak for both sides of
    the aisle in this because they are repeated, and, over a period
    of time, one of the most time-consuming aspects of the office.
    I am not complaining about that. That is what we do. That is
    why we are here to help them navigate.
        But, Ms. Bates-Harris, if I could ask you to just comment.
    Obviously not everyone can work. There are some people in this
    world who, by no fault of their own, simply just do not have
    the wherewithal for various reasons to work. Is that correct?
        Ms. BATES-HARRIS. My philosophical--because my original
    work in the field came from the Rehab Act, and the premise of
    the Rehab Act is that all individuals, regardless of the
    significance of disability, are capable of engaging in an
    employment outcome if they are given the proper services and
    supports, my gut reaction is to say that everyone can work. But
    unfortunately all the resources and supports are not in place,
    so there are individuals who cannot work.
        Mr. CROWLEY. In the perfect world--just clarify this for
    me. There are some people in this country who do not have the
    ability to work. Those individuals do exist. Am I not correct?
        Ms. BATES-HARRIS. Yes, they do.
        Mr. CROWLEY. So in a perfect world, if the Ticket to Work
    program worked perfectly, there would still be a need for SSI
    and SSDI benefits; is that not correct?
        Ms. BATES-HARRIS. Absolutely, positively.
        Mr. CROWLEY. That is an important point just to note. I
    appreciate the recording of that was played as well, understand
    that that could be disturbing, as many of the things in life
    are disturbing to all of us, I think. But also, when people are
    asked a question and are answering to the best of their ability
    and following the guidelines of the law, I think that also
    needs to be taken into consideration regardless of the
    characterization of how that question is asked.
        One of the questions my office often gets from constituents
    is, can I still work while receiving disability benefits? Ms.
    Bates-Harris, in your written testimony you mentioned the
    importance of the Work Incentives Planning Assistance program,
    which supports benefits counselors in the community to answer
    just those types of questions. What kind of impact will our
    constituents see if this program is not reauthorized,
    particularly once the funding begins to run out?
        Ms. BATES-HARRIS. I think that it would have a devastating
    impact on those people who are motivated and want to return to
    work, because we would fall back onto the old beliefs that if
    you go back to work, you are going to immediately lose your
    benefits, you are going to lose access to your health care, and
    you are going to lose access to the other supports.
        I think it has been a very slow process getting the public
    and people with disabilities to understand that, yes, there is
    going to be an impact on your benefits, but depending on
    whether you are getting SSI or SSDI, the impact is not
    immediate. If people understand what is going to happen and how
    it is going to happen, then it allows them to plan their lives
    and plan their return to work and make the adjustments that
    they need to be successful in it. And without it, people would
    simply give up and not even try.
        Mr. CROWLEY. You mentioned the Affordable Care Act and the
    opportunity it gives disabled individuals to receive health
    care without having to rely upon public assistance. What are
    some of the several beneficial provisions included in this law
    which would be lost if the law were to be repealed?
        Ms. BATES-HARRIS. I am sorry, would you repeat the
    question?
        Mr. CROWLEY. You mentioned the Affordable Care Act in your
    written statement, and the opportunities it gives to the
    disabled individual to receive health care without having to
    rely upon public assistance. If that were to be repealed, which
    many of my colleagues on the other side would like to see
    happen, what would be the fallout from that? Do you understand?
        Ms. BATES-HARRIS. I do understand the question. And I am
    sorry, I am a little tired, I traveled late last night.
        I think, you know, the biggest issue right now is that
    people with disabilities face a lot of discrimination in
    insurance and insurance coverages and what will be covered; for
    instance, assistive technology and durable medical equipment
    and things like that. And without access to health care, and
    without access to the services and supports they need, which
    are very different for different people, they would not be able
    to maintain the health status that they have, and would not be
    able to basically, you know, maintain their level of wellness,
    so to speak, to enable them to continue to work. And I am not
    sure that I answered your question.
        Mr. CROWLEY. I think you answered the question just fine.
    And given that you got in late last night, we were up late last
    night.
        Ms. BATES-HARRIS. I know. We were on the same schedule.
        Mr. CROWLEY. Just for the record, I am not picking on you.
    I was going to move on to someone else after that anyway, but I
    ran out of time.
        Ms. BATES-HARRIS. Sorry.
        Mr. CROWLEY. Thank you, ma'am.
        Chairman JOHNSON. Thank you all for your testimony.
        Thank you, Mr. Crowley.
        I appreciate you all being here. Chairman Davis and I are
    interested in improving the system, if we can, and helping the
    people out there that need help.
        Again, thank you all for being here today, for your
    testimony. I look forward to working with you and all my
    colleagues to make sure work incentives achieve the results
    Congress and the taxpayers expect, and those with disabilities
    deserve.
        With that, the Committee stands adjourned.
        [Whereupon, at 11:17 a.m., the Subcommittees were
    adjourned.]
        [Questions for the Record follow:]