Failure to Comply: The Disconnect Between Design and Implementation in HRAs WeCARE Program A Researc

1
Failure to Comply The Disconnect Between
Design and Implementation in HRAs 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
(No Transcript)
5
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

6
What Is WeCARE Supposed to Do?

• Individualized and Inclusive Approach
• Comprehensive Assessment
• Specialized Services

7
What WeCARE Is Supposed To Do The Comprehensive
Assessment
8
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

9

• Research Design

10
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

11

• Research
• Findings

12
Overall Finding

• Good Program Design
• Good Practice

13
Design and Implementation Divide

• Assessments
• Escalating Outreach
• Federal Disability Benefits
• Job Search/ Job Placement
• Program Monitoring and Evaluation

14
Finding Assessments

• Design Vs
• Comprehensive
• Individualized

• Practice
• Poor Quality
• Low Completion Rate

15
Incomplete Assessments

• 19 percent of
• those referred for a WeCARE Assessment did not
  complete it

16
Poor Assessment Quality

• Long waits
• Short visits with Doctors
• Recommendations and Documents from Personal
  Doctors are Ignored

17
WeCARE Participant Testimony

• Judith Schraemli

18
Finding Escalating Outreach

• Program Design Vs
• 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

19
No Escalating Outreach
20
Finding Federal Disability Benefits

• Program Design Vs
• 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

21
WeCARE Client Testimony

• Terrance McSween

22
Finding Job Search/ Job Placement Services

• Program Design Vs
• 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

23
Job Search/ Job Preparation

24
Job Placement

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

25
Finding Program Monitoring

• Program Design Vs
• 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

26

• Recommendations

27
Assessments

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

28
Escalating Outreach

• 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

29
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

30
Job Preparation

• End unpaid Work Experience Program (WEP)
• Replace WEP with paid supportive work
  programs linked to individuals interest and
  experience

31
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

32
Failure to Comply
The Disconnect Between Design and
Implementation in HRA's WeCARE Program