Medical and technological advances allow people with significant impairments and chronic illnesses to lead more fulfilling, independent, and productive lives than they could have in the past. The aspirations of people with disabilities keep pace with the opportunities created by these advances, but policy often lags behind, in part because of inadequate information. Ill-informed policy change can harm people and escalate already rapid growth in public expenditures. We provide the nation's leaders with the information they need to develop disability policies and programs that are suitable for today's world.
Center for Studying Disability Policy
The Center for Studying Disability Policy (CSDP) provides leadership and support for disability research and data collection conducted by Mathematica. To keep our work grounded in the realities facing people with disabilities, we communicate and collaborate closely with leading disability organizations and service providers. CDSP focuses on analyzing and evaluating interventions designed to empower people with disabilities and promote more efficient use of the nation's resources to address two fundamental issues confronting disability policy:
- Fragmentation in financing and service delivery, which can jeopardize well-being, undercut service effectiveness, and waste resources.
- Unintended disincentives, which can discourage people with disabilities from helping themselves, employers from hiring or retaining them, and programs and providers from delivering services.
Children and Youth with Disabilities
Policymakers need up-to-date and high quality information about children with disabilities and their family circumstances to address health care, education, and the transition to adulthood. Our work in this area includes the following:
- Studies of how the early onset of disability and the choices made by youth with disabilities affect their educational attainment, employment, and other aspects of their lives.
- A study of international programs and reforms in countries in the Organisation for Economic Co-operation and Development (OECD). The goal of the study is to identify evidence-based practices and supports that benefit youth as they enter adulthood.
- A study of the extent to which state vocational rehabilitation (VR) agencies aid youth who are making the transition to adulthood, including an analysis of their employment and receipt of disability benefits.
An evaluation of the Youth Transition Demonstration projects that help young people make the transition to adulthood and become more independent and economically secure adults. As they grow older, many of these youth face disincentives to living independently and supporting themselves through work, as well as changes in financing for services and availability of income support. Mathematica has a long history in this area, beginning with the evaluation of the Transitional Employment and Training Demonstration, the first major demonstration to improve adult outcomes for youth with serious intellectual disabilities receiving disability benefits.
Employment issues are the focus of policy research on working-age adults with disabilities but are intertwined with health care, accommodation, parenting, and other issues. Our work in this area includes the following:
- Studies on the use of state VR services, including (1) an analysis of people who enroll in Social Security Disability Insurance (DI) after using VR services and (2) a study of how waiting times for VR services affect the employment of DI beneficiaries.
- The evaluation of the Ticket to Work program, a performance-based voucher initiative to help DI beneficiaries and Supplemental Security Income (SSI) recipients return to work and leave the program.
- A study of state Medicaid Buy-in programs, designed to give workers with disabilities better access to health care without having to enroll in DI or SSI. We produced implementation statistics and also evaluated Medicaid Demonstrations to Maintain Independence and Employment, which have the same goals as the Buy-In programs.
- The design of a payroll tax incentive that would encourage employers to hire and retain people with disabilities who are current or past participants in DI, SSI, or veterans’ compensation programs.
- A study to help state welfare programs deal with challenges created by the Temporary Assistance for Needy Families program, which requires parents with disabilities to work and provides support to help find work, but also encourages some to apply for SSI benefits. We are helping state welfare agencies address these conflicting objectives.
Adults of All Ages
Adults of all ages with disabilities face challenges with health care, personal assistance, and community services needed to live independent and fulfilling lives. The following exemplify our work in this area:
- Evaluations of interventions that address fragmentation in service delivery, including the Program for All-Inclusive Care of the Elderly, Social Health Maintenance Organizations, Community Partnerships for Older Adults Program, Medicare Coordinated Care Demonstration, and Medicare Disease Management Demonstration.
- The evaluation of Money Follows the Person, in which state Medicaid agencies help enrollees transition from institutional facilities to the community.
Collecting and Improving Disability Data
We are at the forefront of efforts to improve disability data and statistics. Our efforts in this area include:
- Conducting and developing question modules for the new National Beneficiary Survey, which focuses on the employment-related activities of working-age SSI and DI beneficiaries.
- Documenting the federal surveys that collect information about people with disabilities, and assessing the need for and potential features of a national disability survey.
- Collecting survey data for the 2012 National Longitudinal Transition Study (NLTS-2012), a five-year study focused on youth ages 13 to 23, their educational experiences, and their transitions to adulthood.
- Developing and maintaining a longitudinal analytic research file on working-age DI and SSI beneficiaries, using the Social Security Administration's Disability Analysis File (DAF). The DAF contains information on more than 19 million working-age adults who received at least one month of DI or SSI benefits from 1996 through 2006. We have supported multi-agency efforts to match DAF records to the administrative records of Medicaid and Medicare beneficiaries as well as clients of state VR programs. Our researchers have used the DAF to conduct the Ticket to Work evaluation, produce statistics on Medicaid Buy-In participants, and help design the Accelerated Benefits and Benefit Offset demonstrations.