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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

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

  2. Presentation Format • WeCARE Program Overview • Research Design • Research Findings • WeCARE Client Testimonies • Recommendations

  3. WeCARE Program Overview

  4. 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

  5. What Is WeCARE Supposed to Do? • Individualized and Inclusive Approach • Comprehensive Assessment • Specialized Services

  6. What WeCARE Is Supposed To Do: The Comprehensive Assessment

  7. 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

  8. Research Design

  9. 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

  10. Research Findings

  11. Overall Finding Good Program Design = Good Practice

  12. Design and Implementation Divide • Assessments • Escalating Outreach • Federal Disability Benefits • Job Search/ Job Placement • Program Monitoring and Evaluation

  13. Finding: Assessments Design Vs • Comprehensive • Individualized Practice • Poor Quality • Low Completion Rate

  14. Incomplete Assessments 19 percent of those referred for a WeCARE Assessment did not complete it

  15. Poor Assessment Quality • Long waits • Short visits with Doctors • Recommendations and Documents from Personal Doctors are Ignored

  16. WeCARE Participant Testimony Judith Schraemli

  17. 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

  18. No Escalating Outreach

  19. 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

  20. WeCARE Client Testimony Terrance McSween

  21. 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

  22. Job Search/ Job Preparation

  23. Job Placement Only 5.4% of those who are employable with limitations obtained employment

  24. 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

  25. Recommendations

  26. Assessments HRA Should: • Create hotline for questions about assessment process • Allow clients to see personal doctors for assessment

  27. 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

  28. 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

  29. Job Preparation • End unpaid Work Experience Program (WEP) • Replace WEP with paid supportive work programs linked to individual’s interest and experience

  30. 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

  31. Failure to Comply: The Disconnect Between Design and Implementation in HRA's WeCARE Program

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