Absence of conflict of interest.
Citation
Highlights
- The study's objective was to examine the impact of Substantial Gainful Activity (SGA) Project on employment and earnings.
- The study was a randomized controlled trial that assigned Kentucky Office of Vocational Rehabilitation (OVR) service districts to the treatment or control group. Using administrative data from OVR case management systems, the authors conducted statistical models to compare the outcomes of treatment and control group participants.
- The study found that SGA Project participants had significantly higher rates of competitive employment and SGA-level earnings compared to the control group participants.
- This study receives a high causal evidence rating. This means we are confident that the estimated effects are attributable to the SGA Project, and not to other factors.
Intervention Examined
Substantial Gainful Activity (SGA)
Features of the Intervention
The Institute for Community Inclusion (ICI) received a grant in 2010 for the implementation of the Substantial Gainful Activity (SGA) Project. The SGA Project's purpose was to identify Vocational Rehabilitation (VR) agency practices that improve the employment and earnings outcomes of nonblind Social Security Disability Insurance (SSDI) beneficiaries. Specifically, the SGA Project aimed to increase the earnings of nonblind SSDI beneficiaries to or above the SGA-level. ICI implemented the SGA Project in two states: Kentucky and Minnesota.
The SGA Project in Kentucky included four main components. First, clients of Kentucky's Office of Vocational Rehabilitation offices received services at a quicker pace. Second, the clients received financial counseling from trained and certified incentive coordinators. Third, clients received enhanced job placement services from dedicated staff. Fourth, the VR counselors, incentive coordinators, and job placement specialists were required to take a coordinated team approach to service delivery.
Features of the Study
The study used a randomized controlled trial to compare outcomes of OVR clients who received SGA Project enhanced services to OVR clients who received the usual VR services. The study randomly assigned 14 OVR service districts to the treatment or control conditions. Before conducting the random assignment, the study authors matched OVR service districts with similar districts based on their geographic characteristic and employment outcomes of SSDI-only clients prior to the implementation of SGA Project. Afterwards, the study authors randomly assigned one OVR service district to implement the SGA Project and one OVR service district to provide the usual VR services.
The study enrolled all individuals who applied for OVR services from May 1, 2015, to July 29, 2016, and who were eligible for services. To be considered eligible, applicants were required to have a nonblind disability, receive SSDI, and not receiving SSI. The sample consisted of 522 clients at OVR service districts implementing the SGA Project (treatment group) and 447 clients at OVR service districts providing business-as-usual VR services (control group).
Clients receiving services from an OVR service district assigned to the treatment group received services at a faster pace, financial planning services, job placement assistance from dedicated staff, and case management reflecting a coordinated team approach. Clients at OVR service districts in the control group received business-as-usual VR services. The authors examined the effects of the SGA Project using administrative data from OVR case management systems. The study used statistical models to examine differences in outcomes for clients in the treatment and control group. The study authors controlled for OVR district outcomes prior to the SGA Project and client characteristics in their statistical models.
Findings
Employment
- The study found that the rate of cases closed with competitive employment at treatment group sites was significantly higher than the rate at control group sites (25.5% vs. 14.4%).
Earnings and wages
- The study found that the rate of cases closed with SGA-level earnings at treatment group sites was significantly higher than the rate at control group sites (8.2% vs. 2.2%).
Considerations for Interpreting the Findings
The study’s analysis used administrative data available through April 7, 2017. At the time cut off, about a third of the cases were still open at sites in both the treatment and control conditions. As time progresses, the rates of cases closing with competitive employment are likely to increase. However, the authors suggest that rates of cases closed with competitive employment at the sites in the control condition are unlikely to exceed those of the sites that implemented the SGA project.
Causal Evidence Rating
The quality of causal evidence presented in this report is high because it is based on a well-implemented randomized controlled trial. This means we are confident that the estimated effects are attributable to the SGA Project, and not to other factors.