Reports

• "Integrating Care for Dual Eligibles in New York: Issues and Options." James M. Verdier, Jenna Libersky, and Jessica Gillooly, February 2012. This report for the New York State Health Foundation provides recommendations to improve the coordination and integration of care dual eligibles receive through Medicare and Medicaid in New York. Key recommendations include using the federal dual eligible demonstration to support and enhance current state initiatives for dual eligibles and encouraging greater integration of all Medicaid and Medicare services in capitated managed care programs.
• "Promoting Readiness of Minors in Supplemental Security Income (PROMISE): Recommendations of the Technical Advisory Panel Regarding the Use of Incentive Payments and the Evaluation Design." Thomas Fraker and Todd Honeycutt, February 2012. PROMISE, a joint program of the Social Security Administration and several federal departments, aims to improve outcomes for children who receive Supplemental Security Income. This report summarizes the technical advisory panel's recommendations for incentive payments and evaluation design. It also assesses relevant evaluation issues. Appendices
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• "Money Follows the Person Demonstration: Overview of State Grantee Progress, January to June 2011." Noelle Denny-Brown, Debra Lipson, Matthew Kehn, Bailey Orshan, and Christal Stone Valenzano, December 2011. This report summarizes the implementation progress of the Money Follows the Person (MFP) demonstration for 30 grantee states (29 states and the District of Columbia) from January 1 to June 30, 2011. Enrollment in MFP continued to grow steadily, with 15,818 cumulative transitions to the community as of June 30, 2011, a 33 percent increase from the end of 2010. During this period, grantees assisted 3,722 people living in institutions to return to the community, more than half of the annual goal. If states continue making progress at this rate throughout 2011, they will achieve or exceed the aggregate 2011 transition goal.
• "Assessing the Need for a National Disability Survey: Final Report." Gina Livermore, Denise Whalen, and David C. Stapleton, September 2011. As state and federal agencies strive to meet the growing needs of people with disabilities while using fewer resources, better disability data are needed for monitoring and improving the health, economic status, and overall well-being of this population. A report by staff from the Center for Studying Disability Policy found gaps in survey data used to inform national disability policies and programs that could negatively affect the ability of state and federal governments to monitor the well-being of this group, and to manage and improve programs. The report identifies limitations in national survey data on disability and outlines a wide range of potential short- and long-term options for addressing them, including developing and fielding a national disability survey.
• *"Money Follows the Person 2010 Annual Evaluation Report." Carol Irvin, Debra Lipson, Audra Wenzlow, Samuel Simon, Alex Bohl, Matthew Hodges, and John Schurrer, October 2011. This is the second annual report on the Money Follows the Person (MFP) demonstration, a federal initiative to help states reduce their reliance on institutional care for people needing long-term care and expand options for elderly people and individuals with disabilities to receive care in the community. During 2010, MFP increased the number of Medicaid beneficiaries transitioned by more than 50 percent over the previous year and expanded into 13 additional states. By the end of 2010, nearly 12,000 beneficiaries transitioned to community living through MFP programs, and participants generally fared well in the community and improved their quality of life.
• *"Provider Experiences Under the Revised Ticket to Work Regulations." Norma Altshuler, Sarah Prenovitz, Bonnie O'Day, and Gina Livermore, September 2011. This report presents findings on the experiences of employment service providers for the Ticket to Work Program, a program intended to increase Social Security beneficiaries’ access to and choice of quality rehabilitation and employment services. The Social Security Administration structured the revised regulations to address important challenges in the original program and successfully educated providers about the revised regulations and instituted related support systems. The revised regulations modestly expanded the number of providers and participating providers are, on average, more active in the program than under the original regulations.
• *"Evaluation of the Recent Experience of the Work Incentives Planning and Assistance (WIPA) Program: Beneficiaries Served, Services Provided, and Program Costs." Jody Schimmel, Allison Roche, and Gina Livermore, September 2011. This report presents findings on the activities of the 103 organizations receiving Social Security Administration grants under the WIPA program, focusing on the period from April 1, 2010 through March 31, 2011. It counts the number of beneficiaries served by the WIPA program as a whole, documents the characteristics of beneficiaries served, and assesses the nature of the services and supports provided by the WIPA program to beneficiaries. It also relates costs and outputs for individual WIPA organizations.
• *"Employment-Related Outcomes of a Recent Cohort of Work Incentives Planning and Assistance (WIPA) Program Enrollees." Gina Livermore, Sarah Prenovitz, and Jody Schimmel, September 2011. This report presents findings of an analysis of beneficiaries who first enrolled for Work Incentives Planning and Assistance services between October 1, 2009, and March 31, 2010. The findings suggest that the program is serving a select group of beneficiaries who are actively working, seeking employment, using the Social Security Administration work incentive provisions, and leaving the disability rolls at relatively high rates. The findings also suggest that Work Incentives Planning and Assistance services might be positively affecting some of these employment outcomes.
• *"Disability Data in National Surveys." Gina Livermore, Denise Whalen, Sarah Prenovitz, Raina Aggerwal, and Maura Bardos, August 2011. The federal government collects extensive disability survey and administrative data used by federal and state agencies for a variety of purposes. This report presents the findings from a review of the disability-related information and other key features of 40 existing national surveys sponsored by the federal government.
• "Demonstration to Maintain Independence and Employment (DMIE): Final Report." Denise Whalen, Gilbert Gimm, Henry Ireys, Boyd Gilman, and Sarah Croake, June 2011, revised February 2012. This is the third and final report on the national Demonstration to Maintain Independence and Employment (DMIE) evaluation. Authorized under the Ticket to Work and Work Incentives Improvement Act of 1999, the program awards funds to states to develop, implement, and evaluate early interventions for workers with potentially disabling health conditions. The evaluation examined impacts on three key outcomes: health and functional status, employment outcomes, and reliance on federal disability benefits. Overall, early interventions such as the DMIE could have positive impacts, although the extent of effects varied across states.
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Journal Articles

• "Competitive Employment Outcomes of Vocational Rehabilitation." Frank H. Martin, Richard T. Walls, Martin Brodwin, Randall Parker, Frances Siu, and Edward Kurata. Journal of Applied Rehabilitation Counselng, Spring 2012 (subscription required). This article examines occupational outcomes for state-federal vocational rehabilitation consumers whose cases were successfully closed in 2008 using the Standard Occupational Classification system. It investigates the top 50 job titles and top 5 occupations by disability categories after vocational rehabilitation. Median hourly wages for participants are reported and compared with those of the general labor force. The authors discuss findings and implications and offer suggestions to rehabilitation counselors about how to expand consumers' job and career options.
• "Adult Employment Assistance Services for Persons with Autism Spectrum Disorders: Effects on Employment Outcomes." John D. Westbrook, Chad Nye, Carlton J. Fong, Judith T. Wan, Tara Cortopassi, and Frank H. Martin. Campbell Systematic Reviews, March 2012. This systematic review of the research on the effectiveness of adult employment assistance interventions for individuals with autism spectrum disorder (ASD) found two quasi-experimental studies that met inclusion criteria. However, the review was not able to identify definitive interventions that predictably and positively supported the development of employment outcomes for individuals with ASD. Qualitative studies and other relevant research studies were also reviewed. While qualitative studies point to a number of promising issues for future research, they do not provide a definitive statement about what works.

• “Out of Sight, Out of Mind: Including Group Quarters Residents With Household Residents Can Change What We Know About Working-Age People With Disabilities.” David Stapleton, Todd Honeycutt, and Bruce Schechter. Demography (online before publication), November 2011. Information about institutional and noninstitutional residents of group quarters, particularly those with disabilities, is limited. This article uses the 2006 and 2007 American Community Surveys to produce descriptive statistics on the working-age population with and without disabilities by major residence type and to assess the sensitivity of disability statistics to residence.

• The Social Security Bulletin has published a special issue (2011) on employment of Social Security Disability Insurance and Supplemental Security Income beneficiaries, based on a series of projects conducted by Mathematica researchers. The following articles are included:
  
  "Employment of Individuals in the Social Security Disability Programs," Paul O'Leary, Gina A. Livermore, and David C. Stapleton.
  
  "Employment among Social Security Disability Program Beneficiaries, 1996–2007," Arif Mamun, Paul O’Leary, David C. Wittenburg, and Jesse Gregory.
  
  "Longitudinal Statistics on Work Activity and Use of Employment Supports for New Social Security Disability Insurance Beneficiaries," Su Liu and David C. Stapleton.
  
  "Social Security Disability Beneficiaries with Work-Related Goals and Expectations," Gina A. Livermore.
  
  "Disability Benefits Suspended or Terminated Because of Work," Jody Schimmel and David C. Stapleton.
  
  "Longitudinal Outcomes of an Early Cohort of Ticket to Work Participants," Gina A. Livermore and Allison Roche.

• "How Common Is 'Parking' Among Social Security Disability Insurance Beneficiaries? Evidence from the 1999 Change in the Earnings Level of Substantial Gainful Activity." Jody Schimmel, David C. Stapleton, and Jae Song. Social Security Bulletin, November 2011. Anecdotal evidence suggests that Social Security Disability Insurance (SSDI) beneficiaries intentionally restrain, or "park," their earnings at a level below substantial gainful activity to retain cash benefits. But there is limited empirical evidence documenting such behavior. This article in Social Security Bulletin looks at the impact of the 1999 change in the substantial gainful activity earnings level on two cohorts of SSDI beneficiaries—one affected by the change and one not. The results show that, in a typical month from 2002 through 2006, between 0.2 and 0.4 percent of all SSDI beneficiaries were parked below the substantial gainful activity level in a typical month.

• “Health Care Costs Are a Key Driver of Growth in Federal and State Assistance to Working-Age People with Disabilities,” Gina Livermore, David C. Stapleton, and Meghan O'Toole. Health Affairs, September 2011. A large and rapidly growing share of U.S. government expenditures pays for assistance to working-age people with disabilities. In 2008 federal spending for disability assistance totaled $357 billion, representing 12 percent of all federal outlays. The states’ share of joint federal-state disability programs, more than 90 percent of it for Medicaid, was $71 billion. The increased cost of health care—which represented 55 percent of combined state and federal outlays for this population in 2008—is one of the two main causes of spending growth for people with disabilities.

• "The Evaluation of the Demonstration to Maintain Independence and Employment." Henry T. Ireys and Paul Wehman. Journal of Vocational Rehabilitation, March 2011 (subscription required). This introduction presents early findings from the evaluation of the Demonstration to Maintain Independence and Employment (DMIE), which used random assignment to test whether a program of enhanced health and employment supports for working adults with potentially disabling conditions can reduce the likelihood of applying for federal disability benefits and improve employment retention.
• "Impact of Early Intervention Programs for Working Adults with Potentially Disabling Conditions: Evidence from the National DMIE Evaluation." Gilbert Gimm, Henry Ireys, Boyd Gilman, and Sarah Croake. Journal of Vocational Rehabilitation, March 2011 (subscription required). This article examines results from a study using random assignment and data from Social Security Administration files and state-based surveys to assess whether the DMIE, as implemented in these states, had a significant impact on the number of applications submitted for federal disability benefit programs and changed participants’ employment outcomes. Among other findings, the study showed that the early intervention programs were effective in reducing applications to federal disability programs 12 months after enrollment in the two states (Minnesota and Texas) with the largest number of participants.
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Issue Briefs

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• "Post-Institutional Services of MFP Participants: Use and Costs of Community Services and Supports." The National Evaluation of the Money Follows the Person (MFP) Demonstration Grant Program, Reports from the Field #9. Carol V. Irvin, Alex Bohl, Victoria Peebles, and Jeremy Bary, February 2012. This report uses aggregate data from annual financial reports and service claims records submitted by grantees to examine the costs and types of community-based services received by participants in the Money Follows the Person program.
• *"How Many Disability Beneficiaries Forgo Cash Benefits Because of Work? Evidence from a New Measure." Issue Brief 12-03. Jody Schimmel and David Stapleton, February 2012. This issue brief summarizes findings from a longer report by Mathematica's disability experts, who used a new indicator to determine how many beneficiaries receiving Social Security Disability Insurance and Supplemental Security Income forgo cash benefits because of work.
• *"The Work Incentives Planning and Assistance Program: Promoting Employment Among Social Security Disability Beneficiaries." Issue Brief 12-02. Jody Schimmel, Bonnie O'Day, and Allison Roche, February 2012. This issue brief summarizes findings from the Work Incentives Planning and Assistance program, a Social Security Administration program to promote employment by providing beneficiaries with information about federal work supports.
• *"Service Providers' Experiences Under the Revised Ticket to Work Regulations." Issue Brief 12-04. Sarah Prenovitz, February 2012. In 2008, Congress revised the regulations for Ticket to Work, a federal program created to improve incentives and supports for people who receive disability benefits to seek employment. This issue brief discusses how Ticket to Work participation by service providers and beneficiaries has changed under the revised regulations. It also describes providers' early experiences with these regulations.
• "A Roadmap to a 21st-Century Disability Policy." Issue Brief, 12-01. David Mann and David Stapleton, January 2012. Despite decades of increases in program participation and spending, the disability support infrastructure in the United States and the economic independence of people with disabilities have eroded. Rather than tighten eligibility or reduce program benefits, this issue brief proposes gradual programmatic reforms and evidence-based structural changes to improve the economic status of Americans with disabilities.
• *"What Determines Progress in State MFP Transition Programs?" The National Evaluation of the Money Follows the Person (MFP) Demonstration Grant Program, Reports from the Field #8. Debra J. Lipson, Christal Stone Valenzano, and Susan R. Williams, October 2011.This report, the eighth in Mathematica's Money Follows the Person series, identifies key factors that have contributed to and hindered state efforts to transition Medicaid enrollees to community living and rebalance their long-term care systems. Three crucial program elements are (1) effective transition coordinators, (2) ability to cover one-time moving expenses, and (3) extra support from transition coordinators or extra home and community-based services beyond what regular Medicaid programs typically cover. The report cites lack of affordable, accessible housing as the single greatest barrier to transitions. The report also identifies strategies states use to transition and maintain participants successfully in the community.
• *"The Youth Transition Demonstration: Interim Findings and Lessons for Program Implementation." Thomas Fraker, October 2011. This issue brief presents findings from a random assignment evaluation of the Social Security Administration’s Youth Transition Demonstration, which is analyzing the implementation of six demonstration projects and their impacts on helping youth with disabilities find jobs and reduce their dependency on federal disability benefits. One of the initial three projects achieved statistically significant impacts on the proportion of youth employed during the year following random assignment. However, demonstration refinements based on the implementation experiences of the early projects may result in stronger interventions among the final three projects and, thus, in stronger results.

• *"Costs, Cuts, and Consequences: Charting a New Course for Working-Age People with Disabilities."Issue Brief #11-03. David Stapleton and Gina Livermore, September 2011. This brief looks at our nation's spending on programs for working-age people with disabilities, a population that seeks greater independence but is commonly misperceived as unemployable. In 2008, an estimated $357 billion (nearly 12 percent of all federal spending) went to support these individuals.

• *"A First Look at How MFP Participants Fare After Returning to the Community" The National Evaluation of the Money Follows the Person (MFP) Demonstration Grant Program, Reports from the Field #7, John Schurrer and Audra Wenzlow, July 2011.
  

• *"The SSDI Trust Fund: New Solutions to an Old Problem." Issue Brief #11-02, David Stapleton and David Wittenburg, June 2011. Social Security Disability Insurance (SSDI) provides cash assistance to workers with disabilities. SSDI has a near-term financing problem and has encountered similar problems in the past. This brief discusses an approach to a long-term solution using a work support policy that could reduce entry into the program and improve the economic outlook for workers with disabilities.

• *"Money Follows the Person: Change in Participant Experience During the First Year of Community Living."  The National Evaluation of the Money Follows the Person (MFP) Demonstration Grant Program, Reports from the Field #6, Samuel E. Simon and Matthew R. Hodges, May 2011. This report presents the quality-of-life experiences of 803 MFP participants who transitioned to community living between January 2008 and December 2009 and responded to grantees’ administration of pre-transition and one-year post-transition surveys. The authors specifically examine how reported quality of life changed after participants transitioned to community living. After one year of community living, participants reported significantly higher quality of life compared with life in institutional settings.

• *"Bending the Employment, Income, and Cost Curves for People with Disabilities." Issue Brief #11-01. David C. Stapleton, April 2011. This issue brief proposes a two-pronged approach for increasing the employment rate for people with disabilities, reducing their reliance on federal support, and increasing their household incomes, while preserving benefits for those who are unable to work. This approach includes introducing an experience-rating system for the disability portion of the payroll tax and expanding the Earned Income Tax Credit for workers in all low-income households, funded by higher taxes on high-income households.
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Working Papers

• "Is There a Trade-off Between Quality and Cost? Telephone Versus Face-to-Face Interviewing of Persons with Disabilities." Debra Wright, Matt Sloan, and Kirsten Barrett, February 2012. This working paper suggests that mode of interview has a modest impact on data quality for people with disabilities. It offers survey design steps that can minimize mode effects and maximize data quality.

Other

• These codebooks describe the content and format of the Public Use Representative Beneficiary data files from rounds 1 to 3 of the National Beneficiary Survey (NBS). The NBS, a component of the Social Security Administrations evaluation of the Ticket to Work and Self-Sufficiency program, collected data from a national sample of Social Security Disability Insurance and Supplemental Security Income beneficiaries, as well as a sample of Ticket to Work participants.
  
  "National Beneficiary Survey: Round 3 Public Use File Codebook." Debra Wright, Shilpa Khambhati, and Beatrice Jones, January 2010.
  "National Beneficiary Survey: Round 3 Public Use Data Files." Debra Wright, Shilpa Khambhati, and Beatrice Jones, January 2010.
  "National Beneficiary Survey: Round 2 Public Use File Codebook."  Debra Wright, Shilpa Khambhati, and Beatrice Jones, December 2009.
  "National Beneficiary Survey: Round 2 Public Use Data Files."  Debra Wright, Shilpa Khambati, and Beatrice Jones, December 2009.
  "National Beneficiary Survey Round 1: Public Use File Codebook." Debra Wright, Shilpa Khambhati, and Beatrice Jones, September 2009.
  "National Beneficiary Survey Round 1: Public Use Data Files."  Debra Wright, Shilpa Khambhati, and Beatrice Jones, September 2009.