Case management at work for SSA disability beneficiaries: process results of the Project NetWork (Leiter & Wood 1997)

Overall, the study found that all the models achieved similar results in terms of meeting recruitment and intake goals and serving a variety of beneficiaries. As intended, the SSA Referral Manager Model provided services at lower intensity. It relied largely on existing assessment information, developed individual referral plans rather than the more comprehensive individual employment plans, and purchased fewer services.

The study also highlighted a number of successes and challenges with various aspects of the program:

• Recruitment. The demonstration met its recruitment targets—5 percent of all eligible beneficiaries volunteered to participate in Project NetWork. Of the variety of recruitment strategies used, quarterly invitation letters to SSA beneficiaries were most successful, bringing in the majority (60 percent) of all volunteers, who numbered 8,248 in total. However, considerable backlogs developed in response to these mailings, which resulted in delays in starting screening procedures and service provision. The authors suggested sending smaller batches of invitation letters more frequently to prevent such backlogs. 
• Intake. After beneficiaries expressed interest in the program, they were invited to take part in an informational interview and randomly assigned to the treatment or control group. During intensive periods of beneficiary intake, those already enrolled in the program did not always receive the attention and support they needed from program staff. Study participants suggested different staff members perform the beneficiary intake and service provision functions in the future to ensure that program participants received the support they required at all times.
• Conducting initial assessments. Managers gathered medical, psychological, and vocational assessment information on the beneficiaries to gain a comprehensive understanding of their goals, needs, and work-related limitations. Most medical and psychological assessments were obtained from the beneficiaries’ existing providers at no cost, which enabled managers to reduce spending, but resulted in delays that had a detrimental effect on beneficiaries’ interest in the project. There were also delays in obtaining vocational assessments, which some managers addressed by conducting the assessments themselves.
• Preparing plans. Staff in three of the four models developed individual employment plans, which specified the beneficiaries’ work-related goals and intermediate objectives, services to be provided to the beneficiary, and core activities to be completed by the case manager and beneficiary. The SSA Referral Manager Model sites prepared individual referral plans, which only described goals and listed referrals to external providers, and took less time to develop than the more comprehensive employment plans. Program managers across all the sites expressed the need for more training on preparing these plans.
• Service delivery. After completing a plan, program managers brokered a variety of rehabilitation services for beneficiaries, of which job placement support was most common (it was provided to 30 percent of all beneficiaries). Other services included training, transportation support, specialized services, and medical and psychological services. Beneficiaries were also provided assistive devices, financial support to cover employment-related costs (such as uniforms and tools), and assistance with emergency costs. In the SSA Case Manager and SSA Referral Manager models, managers found the compilation of lists of service providers particularly challenging given their lack of experience in the field.