Case Management at Work for SSA Disability Beneficiaries: Process Results of the Project NetWork Return-to-Work Demonstration

This article presents the results of the process analysis of the evaluation of the Project NetWork demonstration, a Federal demonstration undertaken by the Social Security Administration (SSA) in 1991 to test alternative methods of providing rehabilitation and employment services to SSA's Disability Insurance beneficiaries and Supplemental Security Income disabled and blind applicants and recipients. The major findings are: (1) from an operational standpoint, it is feasible to expand access to vocational rehabilitation (VR) services to a broad spectrum of SSA beneficiaries, and (2) roughly similar results are achieved, in terms of client intake and provision of services, when case management services are provided by SSA staff, contracted out to State VR agencies, or contracted with private VR providers. Later evaluation reports will trace demonstration impacts on earnings and disability benefits and report the overall benefits and costs of return-to-work services for this population. by Valerie Leiter, Michelle L. Wood, and Stephen H Bell* Introduction Project NetWork was a Federal demonstration project initiated by the Social Security Administration (SSA) in 1991 to test alternative methods of providing rehabilitation and employment services to SSA's Disability Insurance (DI) beneficiaries and Supplemental Security Income (SSI) disabled and blind applicants and recipients. The ultimate objective of the demonstration was to return disabled beneficiaries to work, thereby helping them to improve the quality of their lives and lessen their dependence on government income support. The demonstration project was conducted in eight locations nationwide between 1992 and 1995, using a case management approach to broker services and to encourage and facilitate movement into the labor force. In addition to testing the feasibility and efficacy of the case management approach, the demonstration represents the first time SSA has provided employment services directly to its client population. The policy innovations tested by Project NetWork address many of the issues confronting decisionmakers, both inside and outside SSA, seeking to expand rehabilitation and employment options for people with severe disabilities. Many of these issues have been explored in earlier writings on the project (Rupp and others 1994; 1996). The current article focuses on the administrative and operational questions that arise in providing return-to-work services to a diverse range of clients using a case management approach. In particular, it asks: Is it feasible, from an operational standpoint, to increase participation in services among people with severe disabilities, such as SSA's DI beneficiaries and SSI applicants/recipients? What processes can be used for broad, large-scale outreach to a population of this sort, when the goal is to inform and encourage as many disability beneficiaries as possible to consider a return-to-work effort? What range of services will need to be provided when working with clients of such diverse circumstances and employment goals? Is it possible to always formulate advance plans for service delivery that identify vocational goals and the steps for achieving them, given the great variety of disability types and interests represented among SSA beneficiaries? Is it feasible to access needed services from the existing VR provider community, given the many, highly varied requirements likely to emerge in an individualized case management approach? In dealing with each of these challenges, does it matter what type of organization provides the case management services-SSA, State VR agencies, or private sector providers? Can less resource-intensive strategies such as referral management get results similar to case management, in terms of client intake and service delivery? In total, this analysis provides a number of practical lessons on the strategies available to those seeking to implement innovative approaches to helping people with severe disabilities return to work. …