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Summary

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. This evaluation directly compared Integrated Case Management to a separate intervention, Traditional Case Management, in order to better understand which of the two interventions might be more effective. The distinctive features of Integrated Case Management were the assignment of a single case manager for employment services and welfare services and more personalized attention from their case managers.

Integrated Case Management participants worked with a single case manager to improve their educational and vocational skills and to 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 effectiveness of Integrated Case Management when compared with Traditional Case Management indicates the effect of being referred to a set of services that includes those unique to Integrated Case Management; the comparison indicates how much better the offer of Integrated Case Management met participants’ needs than Traditional Case Management. While participants in Integrated Case Management worked with a single case manager,  participants in Traditional Case Management worked with one case manager to improve educational and vocational skills and with a separate income maintenance case manager to determine their welfare eligibility and payment issuance. 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. 

3124.03-National Evaluation
Populations and employment barriers: Cash assistance recipients, Parents, Single parents

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 unfavorable $-460 per year -0.022 5083
Long-term Little evidence to assess support favorable $523 per year 0.025 5083
Very long-term No evidence to assess support
Increase employment Short-term Little evidence to assess support favorable 0% (in percentage points) 0.002 5083
Long-term Little evidence to assess support favorable 1% (in percentage points) 0.022 5083
Very long-term No evidence to assess support
Decrease benefit receipt Short-term Little evidence to assess support favorable $-77 per year -0.028 5083
Long-term Supported favorable $-132 per year -0.048 5083
Very long-term No evidence to assess support
Increase education and training All measurement periods No evidence to assess support
* 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 Well-supported   
  • Supported  Supported   
  • Not supported  Not supported   
  • Mixed support  Mixed support   
  • Insufficient evidence  Insufficient evidence   
  • No evidence  No evidence
Effectiveness rating terms?

Studies of this intervention

Study quality rating Study counts per rating
High High 1
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Implementation details

Dates covered by study

A total of 7,242 JOBS-mandatory, single-parent welfare applicants were randomly assigned to study group from September 1992 to July 1994. A survey was administered two years after assignment 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 the 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 participants 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. Both the integrated and traditional programs were identical aside from the differences in case management.

  • 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 receiving 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, compared to an average of 1.9 months for participants receiving Traditional Case Management.

Comparison conditions

Participants receiving Traditional Case Management worked with one income maintenance worker who oversaw public assistance benefits provided by the welfare department and a separate traditional JOBS case manager who oversaw employment and training activities. The lack of a single, integrated case manager was the defining feature of the intervention. Participants interacted with different JOBS case managers depending on whether they participated in an education and vocational training activity or a job search activity.

Income maintenance workers’ duties included handling all public assistance benefits, authorizing payments for JOBS-related expenses, imposing sanctions for noncompliance, and working with recipients’ entire households.

JOBS case managers’ duties included conducting JOBS orientation and assessment, assigning recipients to JOBS activities, monitoring JOBS attendance and progress, and initiating sanctions for noncompliance.

All other features of Traditional Case Management were identical to the Integrated Case Management, including the various activities and supportive services offered. Participants in the Traditional Case Management group were also required to participate in the JOBS program or face a reduction in their cash assistance, but JOBS case managers could not impose sanctions, whereas integrated case managers had authority to impose sanctions.

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.

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 the Integrated Case Management approach was $3,018 ($1,361 by the Franklin County Department of Job and Family Services department and $1,657 by non-welfare agencies) in 1994 dollars, compared to $2,589 ($962 by the welfare department and $1,627 by non-welfare agencies) per person for the Traditional Case Management approach. Additionally, those in Integrated Case Management received $263 less in AFDC payments over the three-year period than those in Traditional Case Management. 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.

The study did not discuss a comparison of costs and benefits.

The information contained here reflects how the intervention was implemented at the time of the evaluation.

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.

Characteristics of research participants
Black or African American
52%
White, not Hispanic
47%
Another race
1%

The race and ethnicity categories may sum to more than 100 percent if the authors reported race and ethnicity separately; in these cases, we report the category White, rather than White, not Hispanic.

State(s) where implemented

AL AK AZ AR CA CO CT DE DC FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Canada

The Pathways Clearinghouse refers to interventions by the names used in study reports or manuscripts. Some intervention names may use language that is not consistent with our style guide, preferences, or the terminology we use to describe populations.

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