Title
Contents
Acknowledgements 7
The Authors 8
Abbreviations and glossary 9
Summary 12
1. Introduction 19
2. Evolution of US return-to-work initiatives for people with disabilities 21
2.1 Introduction 21
2.2 Several private and public service providers provide rehabilitation and employment supports in the US 21
2.3 Increasing interest in expanding supports in more integrated settings 22
2.4 Tests of integrated employment interventions have targeted subgroups of people with disabilities 23
2.5 Evaluations have led to some changes in service delivery, though providers continue to deliver untested employment service models in segregated settings 25
3. Influence of programmer rules on return-to-work outcomes 26
3.1 Introduction 26
3.2 SSA disability programme rules discourage work 26
3.3 UK has more-integrated system for providing disability cash and employment supports 27
3.4 Differences in US and UK disability programmes are important considerations in applying cross-national lessons 29
4. Findings from large-scale return-to-work initiatives that targeted SSDI and SSI claimants 30
4.1 Introduction 30
4.2 Key project features 32
4.2.1 Structured Training and Employment Transitional Services 32
4.2.2 Transitional Employment Training Demonstration 33
4.2.3 Project NetWork 36
4.2.4 The State Partnership Initiative 37
4.2.5 Ticket to Work 37
4.3 Evaluation designs 38
4.4 Participation rates 39
4.5 Impact findings 41
4.5.1 Employment 46
4.5.2 Earnings 47
4.5.3 Benefit receipt 48
4.5.4 Subgroup and regional impacts 48
4.6 Cost benefit analyses of programmes 49
5. Supported employment initiatives targeting people with psychiatric conditions 52
5.1 Key project features 53
5.1.1 Individual randomised control trials of supported employment model, especially the Individual Placement and Support model 53
5.1.2 Employment Intervention Demonstration Programme 55
5.2 Evaluation design 55
5.3 Impact findings 56
5.3.1 Employment and earnings 56
5.3.2 Income and benefits 56
5.3.3 Subgroup, model and regional impacts 56
5.4 Benefit cost analyses of programmes 57
6. Return-to-work initiatives for low-income mothers with disabilities 58
6.1 Key features of PRIDE 58
6.2 Evaluation design 59
6.3 Impact findings 60
6.3.1 Employment and earnings 60
6.3.2 Income and benefits 60
6.4 Cost benefit analyses of programmes 60
7. Lessons for future research and programme development in the UK 61
7.1 Pathways evaluation indicates promising impacts, but some groups might need additional supports to achieve employment outcomes 61
7.2 Lessons for enhancing employment and tracking outcomes from Pathways to Work 62
7.2.1 Pathways participants with psychiatric conditions might benefit from additional supports, especially supported employment services 62
7.2.2 Adding work incentives to allow people to work more than 16 hours per week might further enhance Pathways outcomes 63
7.2.3 Long-term claimants will be likely to need more intensive supports than those currently offered in Pathways to move into employment 63
7.2.4 Additional data on delivered services could be helpful in understanding the effects of Pathways on its intended population 64
7.3 Lessons for evaluating future UK employment initiatives for people with disabilities 64
7.3.1 Interventions are unlikely to reduce caseload sizes among long-term programme participants 64
7.3.2 Identifying outcomes that can measure the success of the programme before implementation is important to a clear articulation of key evaluation findings 65
7.3.3 Creating a research database from administrative files on programme participation is a valuable tool in tracking the progress of disability policies 65
7.3.4 Rigorous evaluation findings, especially those based on random assignment designs, can be an important factor in building consensus on evidence-based practices 66
7.3.5 When using non-experimental methods, use multiple approaches to conduct sensitivity tests on programme impacts 66
8. Discussion 67
Appendix A. Description of US disability programmes 69
Appendix B. Detailed descriptions of US return-to-work initiatives 78
References 89
Table 1. Summary of major evaluation findings from US return-to-work initiatives for people with disabilities 14
Table 4.1 Summary of key features of return-to-work initiatives that targeted SSDI and SSI claimants 34
Table 4.2 Participation rates from return-to-work initiatives that targeted SSDI and SSI claimants 40
Table 4.3 Summary of impact estimates from return-to-work initiatives that targeted SSDI and SSI claimants 43