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Failure to Comply: The Disconnect Between Design and Implementation in HRA’s WeCARE Program A Research Project By Community Voices Heard. Presentation Format. WeCARE Program Overview Research Design Research Findings WeCARE Client Testimonies Recommendations. WeCARE

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Failure to Comply:The Disconnect Between Design and Implementation in HRA’s WeCARE ProgramA Research Project By Community Voices Heard


Presentation format
Presentation Format

  • WeCARE Program Overview

  • Research Design

  • Research Findings

  • WeCARE Client Testimonies

  • Recommendations


WeCARE

Program Overview


What is wecare
What is WeCARE?

Wellness, Comprehensive Assessment,

Rehabilitation and Employment

  • HRA program to help PA recipients

    with potential barriers to employment

    to attain their highest levels

    of health and self-sufficiency.

  • Two primary contracting organizations:

    FEGS and Arbor E & T


What is wecare supposed to do
What Is WeCARE Supposed to Do?

  • Individualized and Inclusive Approach

  • Comprehensive Assessment

  • Specialized Services



Why pay attention to wecare
Why Pay Attention to WeCARE

  • High Cost: $201,465,000 allocation

    over 3 years

  • Large Population: 55.7% of the caseload is partially or completely

    unable to work

  • Hard to Reach: Many with multiple and complex barriers to employment



Data source categories
Data Source Categories

  • HRA Documents and Meetings

    • Policy Directives, Contracts, Vendor Guidelines, Testimony

  • Client Conversations

    • Outreach workers held 7-10 minute conversations with 727 clients at 10 WeCARE sites

  • Focus Groups

    • Seven 2.5 hour sessions, 40 participants

  • Client Interviews

    • 7 in-depth interviews conducted


  • Research

    Findings


    Overall finding
    Overall Finding

    Good Program Design

    =

    Good Practice


    Design and implementation divide
    Design and Implementation Divide

    • Assessments

    • Escalating Outreach

    • Federal Disability Benefits

    • Job Search/ Job Placement

    • Program Monitoring and Evaluation


    Finding assessments
    Finding: Assessments

    Design Vs

    • Comprehensive

    • Individualized

    Practice

    • Poor Quality

    • Low Completion Rate


    Incomplete assessments
    Incomplete Assessments

    19 percent of

    those referred for a WeCARE Assessment did not complete it


    Poor assessment quality
    Poor Assessment Quality

    • Long waits

    • Short visits with Doctors

    • Recommendations and Documents from Personal Doctors are Ignored



    Finding escalating outreach
    Finding: Escalating Outreach

    Program DesignVs

    • Help clients meet

      requirements

    • Letters, phone calls, contact with family, home visits

    • No sanctions until all

      outreach has failed

    Practice

    • No outreach

    • Limited Communication

    • Lots of sanctions and case closures



    Finding federal disability benefits
    Finding: Federal Disability Benefits

    Program DesignVs

    • Vendors get $$ to help

      clients obtain federal

      benefits (SSI/ SSDI)

    • Focus on trying to shift cost from NY City and State to Feds

    Practice

    • Clients unaware of assistance

    • Low success rates

    • Many eligible clients

      not applying


    Wecare client testimony
    WeCARE Client Testimony

    Terrance McSween


    Finding job search job placement services
    Finding: Job Search/ Job Placement Services

    Program DesignVs

    • Specialized Work Experience

      Program sites

    • Individual Plan for Employment based on work experience and career goals

    Practice

    • One-size fits all

    • WEP not specialized

    • Low employment placement rate



    Job placement
    Job Placement

    Only 5.4% of those who are employable with limitations obtained employment


    Finding program monitoring
    Finding: Program Monitoring

    Program DesignVs

    • Outside organization to conduct quarterly evaluation

    • Organization should be independent of HRA

    • Ensure quality, effectiveness and integrity of Services

    Practice

    • Only 1 evaluation to date

    • Only medical facilities evaluated

    • No measures of effectiveness



    Assessments
    Assessments

    HRA Should:

    • Create hotline for questions

      about assessment process

    • Allow clients to see personal

      doctors for assessment


    Escalating outreach
    EscalatingOutreach

    HRA Should:

    • create a mandatory 1 month wait period before a case is sanctioned or closed.

    • Create WeCARE liaison at Job Centers to oversee outreach


    Federal disability benefits
    Federal Disability Benefits

    HRA and WeCARE Vendors Should:

    • Subcontract the provision of federal disability services to an organization with expertise

    • Align WeCARE assessment with eligibility criteria for Federal Disability Benefits


    Job preparation
    Job Preparation

    • End unpaid Work Experience Program (WEP)

    • Replace WEP with paid supportive work programs linked to individual’s interest and experience


    Monitoring and transparency
    Monitoring and Transparency

    HRA Should:

    • Establish a WeCARE participant advisory board

    • Hire independent organization to conduct evaluation of ALL WeCARE services and program components

    • Post quarterly monitoring reports and all Vendor statistics on HRA website


    Failure to Comply:

    The Disconnect Between Design and Implementation

    in HRA's WeCARE Program


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