• 0.12,1.00
  • 0.17,5.00
  • 0.15,2.00
  • 0.15,2.00

Integrated Case Management provided personalized case management to single-parent Aid to Families with Dependent Children (AFDC) applicants and recipients to help them improve educational and vocational skills in preparation for securing a job.

Integrated Case Management provided personalized case management to single-parent Aid to Families with Dependent Children (AFDC) applicants and recipients to help them improve educational and vocational skills in preparation for securing a job.  

Integrated Case Management participants worked with a single case manager to improve their educational and vocational skills and determine their welfare eligibility and payment issuance. Participants who did not have a high school diploma or general education diploma were assigned to basic education classes; participants with basic education credentials were assigned to vocational training, postsecondary education, or work experience. Case managers provided job search assistance after they determined that participants were employable. Supportive services offered included  child care, transportation, and other incidental work costs, and the program had an on-site child care center. Case managers closely monitored and enforced program participation and imposed sanctions on participants who did not meet the program participation requirements by reducing their monthly welfare payments. Services ended when clients exited AFDC. Participants in Integrated Case Management were single-parent AFDC applicants and recipients whose youngest child was at least 3 years old. The intervention was implemented in Columbus, OH, and was mandatory for all participants as part of the Job Opportunities and Basic Skills Training welfare-to-work program, unless they met one of several exclusion criteria. 

The demonstration also included a Traditional Case Management program and a comparison of the Traditional and Integrated Case Management programs. While participants in Integrated Case Management worked with a single case manager to improve their educational and vocational skills and determine their welfare eligibility and payment issuance, participants in Traditional Case Management worked with separate case managers for these services. Integrated Case Management case managers also worked with fewer cases than case managers in the Traditional Case Management program did and were therefore able to provide more personalized attention and careful monitoring. Case managers in the Traditional Case Management program had larger caseloads and did not monitor participation as closely.

Year evaluation began: 1992
Populations and employment barriers: Cash assistance recipients, Parents, Single parents
Intervention services: Case management, Academic instruction, Sanctions, Soft skills training, Supportive services, Training, Occupational or sectoral training, Unpaid work experience, Work experience, Job search assistance
Setting(s): Tested in multiple settings

Effectiveness rating and effect by outcome domain

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Outcome domain Term Effectiveness rating Effect in 2018 dollars and percentages Effect in standard deviations Sample size
Increase earnings Short-term Little evidence to assess support favorable $335 per year 0.016 4672
Long-term Supported favorable $1,987 per year 0.095 4672
Very long-term No evidence to assess support
Increase employment Short-term Little evidence to assess support favorable 2% (in percentage points) 0.038 4672
Long-term Supported favorable 3% (in percentage points) 0.061 4672
Very long-term No evidence to assess support
Decrease benefit receipt Short-term Supported favorable $-338 per year -0.123 4672
Long-term Supported favorable $-465 per year -0.169 4672
Very long-term No evidence to assess support
Increase education and training All measurement periods Little evidence to assess support unfavorable 0% (in percentage points) -0.001 728

Participant race and ethnicity
Black or African American
52%
White
47%
Unknown, not reported, or other
1%

Implementation details

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Dates covered by study

A total of 7,242 JOBS-mandatory, single-parent AFDC applicants were randomly assigned to study group from September 1992 to July 1994. A survey was administered two years in the study to a subset of participants randomly assigned from January to December 1993.

Organizations implementing intervention

The Ohio Department of Human Services and Franklin County Department of Job and Family Services (previously the Department of Human Services) implemented the intervention.

Populations served

Participants included single-parent AFDC applicants and recipients whose youngest child was at least age 3 and who did not meet federal exemption criteria for the JOBS program. Of those randomly assigned, the mean age was 32, 94 percent were female, and approximately half were Black and half were White. All were eligible for cash assistance, 4 percent were employed at time of random assignment, and 43 percent did not have a high school diploma or GED.
Unless participants met an exemption, participation in the JOBS program was mandatory. Participants were referred to JOBS at the welfare office.

Description of services implemented

Random assignment occurred at the income maintenance office by program administrators before recipients entered program orientation.

  • Personalized case management. Participants receiving Integrated Case Management worked with one staff member—an integrated case manager—who supported both (1) their employment and training and (2) their welfare eligibility determination, including public assistance benefits. The single, integrated case manager was the defining feature of the intervention. Participants worked with the same integrated case manager regardless of the employment or educational activities pursued. Integrated case managers were assigned to all welfare recipients at the same address and could refer any eligible household member to JOBS. Duties of the integrated case manager included handling all public assistance benefits, authorizing payments for JOBS-related expenses, conducting JOBS orientations and assessment, assigning recipients to JOBS activities, monitoring JOBS attendance and progress, imposing sanctions for noncompliance, and working with recipients’ entire households. Caseloads for integrated case managers averaged 140 and were higher than planned. Still, integrated case managers provided personalized attention and encouragement of participants throughout the program, according to integrated case managers and their recipients. Integrated case managers closely monitored participation, were quick to follow up on attendance problems, and had authority to issue sanctions.
  • Education and training. Integrated Case Management prioritized skills building for participants and encouraged participants to obtain a GED certificate before entering the labor market. Participants without a high school diploma or GED were usually referred to basic education classes, whereas participants with basic education credentials were assigned to vocational training, postsecondary education, or unpaid work experience before seeking employment. Case managers usually only referred their most employable participants (those with basic education credentials, some work experience, and no serious problems that would interfere with working) to job search services.
  • JOBS program activities. Administrators prioritized JOBS program activities. Participants in Integrated Case Management were required to participate in the integrated JOBS program or face a reduction in their cash assistance, enforceable by their case manager. Participants who received Integrated Case Management had access to JOBS program activities such as:
    • Job search (job clubs): In partnership with Goodwill, the Columbus JOBS center combined classroom instruction on how to search for a job with actual job search. Some participants were required to search for jobs on their own with check-ins by their case manager.
    • Basic education, postsecondary education, vocational training, and work experience (unpaid positions)
    • Life skills workshops: The local community college offered career exploration, self-esteem–building activities, and advice on time management and study skills through a pre-education retention program.
  • Supportive services were also offered, including child care and work allowances (transportation and other incidental costs). Child care was provided on-site at the Columbus JOBS center for children 2.5 to 5 years old, and the JOBS program also paid child care costs associated with participation in the program. Some participants were eligible to be reimbursed for child care expenses incurred due to employment, despite no longer receiving cash assistance.

The JOBS program operated in a recently renovated facility located in a physically separate space from the welfare office. It included an on-site classroom and child care facility. Case managers received high levels of administrative support, including an automated case record information system.

Service intensity

During the two-year follow-up period, participants receiving Integrated Case Management participated in program activities for an average of 3.3 months. However, the average length of participation increased to 6.5 months when participants who did not participate in an activity were removed from the analysis.

Comparison conditions

Comparison group members were not eligible to participate in the JOBS program but could access other employment-related services in the community and receive child care assistance. Comparison group members also received income maintenance services (financial assistance).

Partnerships

The Franklin County Department of Job and Family Services contracted with several institutions as part of its JOBS program. The public school system offered basic education classes at the JOBS center. Public vocational schools offered vocational training, and the local community college conducted life skills workshops.

Staffing

Participants worked with one integrated case manager. On average, integrated case managers were employed with the Franklin County Department of Job and Family Services for five years, 73 percent had a bachelor’s degree or higher, and the racial composition of staff reflected that of study participants. Newly hired integrated case managers received four weeks of training.

Local context

The intervention occurred in Columbus, Ohio. In the mid-1990s, Columbus was a growing metropolitan area, marked by low unemployment levels and employment growth. The welfare caseload in Columbus decreased by nearly one-third over the study’s follow-up period.

Fidelity measures

The study did not discuss any tools to measure fidelity to the intervention model.

Funding source

JOBS was created by the 1998 Family Support Act, which required states to provide education, employment, and supportive services to AFDC recipients.

Cost information

The total cost per person for Integrated Case Management was $3,018 ($1,361 by the welfare department and $1,657 by non-welfare agencies) in 1994 dollars. The study did not discuss a comparison of costs and benefits. The Franklin County Department of Job and Family Services’ operating expenses and costs of supportive services, in addition to expenses from non-welfare agencies (community colleges, vocational training institute, and local adult education providers), made up the total program costs.

Studies of this intervention

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Study quality rating Study counts per rating
High High 1