Interventions Details | Pathways to Work

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The FAST program sought to improve employment outcomes by incorporating motivational interviewing and an Individual Placement and Support (IPS) model into the Family Stabilization Services (FSS) program. FAST served people who received Temporary Assistance for Needy Families (TANF) and had disabilities, and TANF recipients who shared a household with someone who had a disability.

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The FAST program sought to improve employment outcomes by incorporating motivational interviewing and an Individual Placement and Support (IPS) model into the existing Family Stabilization Services (FSS) program. FAST served people who received Temporary Assistance for Needy Families (TANF) and had disabilities, and TANF recipients who shared a household with someone who had a disability.

FAST provided extra services to participants who qualified for FSS. FAST integrated the IPS supported employment model into the FSS program to provide participants with individualized job search assistance, job development services, and related supports based on their preferences and abilities. FAST also integrated motivational interviewing and a vocational assessment into the FSS program alongside IPS. To better support FAST participants, the caseload of FAST case managers was reduced to 50 active cases from an average of 75 to 100. FAST served TANF recipients who had a disability or shared a household with someone who had a disability. IPS is a model of supported employment focused on rapidly searching for jobs and prioritizing participant preferences in finding competitive employment in the community. FAST is a specific version of the IPS model. FAST was implemented in Ramsey County, MN.

Year evaluation began: 2011

Implementing organization(s): Ramsey County Workforce Solutions—the department within the county government providing employment and training services for families who qualify for FSS in Minnesota’s TANF program—developed this pilot program. Ramsey County Workforce Solutions selected four partner organizations through a request-for-proposal process.

Implementing organization(s): The county TANF office oversaw implementation. Four private organizations provided services: (1) Goodwill/Easter Seals Minnesota provided individual placement and support (IPS) services, vocational rehabilitation, and mental health services; (2) HIRED (a nonprofit) provided case management and employment services; (3) Open Cities Health Center (a health clinic) provided physical health services; and (4) People Incorporated (a nonprofit) provided mental health services.

Populations and employment barriers: Cash assistance recipients, Disability(ies)

Intervention services: Case management, Employment retention services, Substance use disorder treatment and mental health services, Physical health services, Sanctions, Work and work-based learning, Individual Placement and Support, Work readiness activities, Job search assistance, Job development/job placement

Setting(s): Urban only

Intervention services:

Case management, Employment retention services, Health services (Physical health services, Substance use disorder treatment and mental health services), Sanctions, Work and work-based learning (Individual Placement and Support), Work readiness activities (Job development/job placement, Job search assistance)

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Effectiveness rating and effect by outcome domain

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Outcome domain	Term	Effect in 2018 dollars and percentages	Effect in standard deviations	Sample size
Increase earnings	Short-term	$5,041 per year	0.241	389
	Long-term
	Very long-term
Increase employment	Short-term	7% (in percentage points)	0.175	389
	Long-term
	Very long-term
Decrease benefit receipt	Short-term	$25 per year	0.009	379
	Long-term
	Very long-term
Increase education and training	All measurement periods

* This intervention was assessed as supported for this domain, meaning it achieved one or more statistically significant, favorable effects. However, the intervention has an average effect size that is unfavorable because the average includes all effects in this domain - both statistically significant and favorable effects and statistically insignificant but unfavorable effects.

Effectiveness rating key:

Well-supported
Supported
Not supported
Mixed support
Insufficient evidence
No evidence

Effectiveness rating terms?

Sample characteristics

State or region:

Minnesota

Participant race and ethnicity

Black or African American	43%
White, not Hispanic	43%
Hispanic or Latino of any race	3%
Asian	6%
Another race	1%
Unknown or not reported	3%

Implementation details

Dates covered by study

The FAST program began in April 2011, and participants were randomly assigned until December 2011. The study followed participants for one year after random assignment. FAST operated in this context until 2015. A FAST program still exists (as of 2021), although the program has undergone multiple changes.

Organizations implementing intervention

Ramsey County Workforce Solutions—the department within the county government providing employment and training services for families who qualify for FSS in Minnesota’s TANF program—developed this pilot program. Ramsey County Workforce Solutions selected four partner organizations through a request-for-proposal process.

Populations served

FAST served families receiving TANF who had a family member with a serious disability, qualifying them for the FSS track in the state’s TANF program. Conditions included mental illnesses; developmental disabilities; IQ below 80; learning disabilities; or another illness, injury, or incapacity that limited employment. Families on the FSS track were not subject to federal work requirements, but they engaged in activities to improve their economic and family stability. To be eligible for FAST, these families also had to meet the following criteria: did not need interpreters, did not have Social Security Income applications pending, were not taking a work exemption for having a child younger than age 1, and had not received 50 months or more of the 60-month TANF time limit.

The majority of FAST participants were women (83 percent). About 89 percent of families were single-parent families and had an average of 1.7 children. Forty-three percent of participants were Black or African American, not Hispanic; 43 percent were White, not Hispanic; 6 percent were Asian; and 3 percent were Hispanic or Latino of any race. All FAST participants either had a disability or lived with a household member who had a disability.

About 37 percent of families enrolled in the study were found ineligible for FAST after they enrolled in the study but before they began the FAST program. Some families moved from the FSS track to the regular TANF track because of employment. Other families had moved out of the county; had children younger than age 1; were no longer receiving cash assistance; or had Social Security Income cases pending, rendering them ineligible for TANF. These families did not receive FAST services, but the participant characteristics described in this brief include these families.

Description of services implemented

The FAST pilot program sought to provide comprehensive, co-located services based on the IPS model for eligible TANF recipients at the TANF office. FAST participants first attended a one-hour orientation to learn the services and goals of the FAST program. Program services included the following:

Case management. Case managers helped participants develop an employment plan outlining their goals and steps to achieve those goals. Case managers conducted state-mandated employability assessments, updated participants’ employment plans, tracked participation and service receipt, maintained participants’ TANF eligibility documentation, and referred participants to outside services. They used motivational interviewing techniques to help participants commit to engaging with IPS. FAST case managers carried smaller caseloads (about 50 cases) than case managers serving the comparison group (about 75 to 100 cases).

Job development and job placement. IPS is a supported employment model focused on rapidly searching for jobs and prioritizing participant preferences in finding competitive employment in the community. Employment support counselors developed vocational or career profiles for clients based on their interests and then contacted employers with jobs that aligned with client preferences. Counselors could provide follow-along supports to clients once they were employed as long as clients were still receiving TANF benefits.

Mental health services. The IPS model integrated employment services with mental health services. A child and family therapist served FAST families, meeting clients either in the service office or in their homes. Case managers could also refer participants to a mental health clinic run by Goodwill offering psychiatry, psychology, clinical social work, mental health counseling, and family therapy. Staff members also could refer participants to Goodwill’s Adult Rehabilitative Mental Health Services program, which helped develop psychiatric stability, social competency, and independent living skills.

Work-readiness activities. Although vocational assessments were not part of the IPS model, Goodwill staff assessed participants who weren’t engaging with their employment counselor. The assessments identified a participant’s interest in certain jobs and included an on-the-job assessment in which the participant worked at a Goodwill for a week to identify strengths and areas for improvement.

Physical health services. A part-time nurse practitioner served participants at the Goodwill clinic, prescribing medications and referring participants to doctors. A part-time community health worker served participants at the clinic, too, conducting home visits, answering questions about health and wellness, and making appointments with doctors and dentists.

Integrated services. Once a week, the entire FAST staff, including a staff member from the Goodwill mental health clinic and the child and family therapist, met to discuss cases. Employment support counselors provided updates on individuals in their caseloads, and staff could offer advice on supporting those participants. In addition, FAST staff from various services held meetings with participants to review their cases and progress.

Benefits counseling. Goodwill and the TANF agency developed a benefits counseling program to inform participants how work would affect their TANF and other benefits.

Early in the pilot, case managers referred participants to employment support counselors soon after their first case management meeting. However, employment support counselors found some participants were not fully engaging in IPS. Case managers started spending more time with clients using motivational interviewing techniques to encourage them to commit to IPS before referring them to employment support counselors.

Service intensity

Participants were expected to meet every month with their case manager. One-year follow-up data showed FAST staff met in person with participants an average of 7.7 times and spoke with participants by telephone an average of 13.7 times throughout the year.

Study authors noted the FAST staff sometimes had trouble staying in contact with clients. Participants often had multiple barriers to employment beyond having a disability, such as mental health challenges, substance use disorders, lack of workplace skills, or lack of social support. Nearly half faced housing instability. These challenges contributed to inconsistent communication with some clients.

Participants could receive services for at least 10 months if they remained eligible for TANF. If participants reached the 60-month TANF time limit, they had to leave the FAST program, even if they received a TANF cash assistance extension.

Comparison conditions

Families assigned to the comparison group received case management and employment services from the traditional FSS service track. Comparison group members met with case managers and employment counselors to identify goals and develop employment plans to promote personal and family stability. The activities often focused on addressing barriers to employment instead of finding employment. The comparison and intervention group faced the same mandates and sanctions, including losing benefits if sanctioned for noncompliance.

Partnerships

The following four organizations operated FAST:

Goodwill/Easter Seals Minnesota, a nonprofit offering employment and training services to people with disabilities, provided IPS services, vocational rehabilitation, and mental health services for adults. Goodwill also contracted with the Dartmouth IPS Supported Employment Center to provide a two-day IPS training for FAST staff to ensure fidelity to the IPS model.

HIRED, a nonprofit employment and service contractor for the state’s TANF program, provided FSS case management and employment services.

Open Cities Health Center, a nonprofit community health center providing primary, dental, and behavioral health care, provided the part-time nurse practitioner and community health worker.

People Incorporated, a nonprofit mental health agency, provided the part-time child and family therapist.

An oversight committee with decision makers from each of these agencies governed the FAST program.

Staffing

Three full-time FAST case managers provided case management services to program participants.

Two full-time employment support counselors, one full-time workforce development manager, and a part-time supported employment consultant managed and provided IPS services.

One adult mental health therapist, one child and family therapist, one nurse practitioner, and one community health worker provided medical and behavioral health care.

The study authors did not include information on staff training, degrees, or certifications.

Local context

FAST was implemented in Ramsey County, MN, which includes the state capital St. Paul.

Fidelity measures

A review team assessed how closely FAST was implemented in accordance with the IPS fidelity scale, making it the first time a full IPS model was implemented with a TANF population. Several elements of IPS do not align with TANF programs. For example, although IPS is intended for people voluntarily engaging in work activities when they believe they are ready, families on the FSS track (and therefore eligible for FAST) are required to create employment plans and progress toward those goals. In addition, TANF cash benefits are time limited, whereas IPS employment services are not; FAST program participants had to leave the program when they reached their TANF time limit. Even with these expected deviations from fidelity, FAST received a “fair” rating, which reviewers said was higher than average for any initial IPS fidelity review.

Funding source

Ramsey County funded the FAST pilot program through the FSS program, which is Minnesota’s state-funded track for serving certain TANF recipients, including those with a disability.

Cost information

The study did not discuss a cost per participant or a comparison of costs and benefits.

Studies of this intervention

Study quality rating	Study counts per rating
High	1

Families Achieving Success Today (FAST)