Enhanced Services for the Hard-to-Employ Demonstration and Evaluation Project: Rhode Island, Working Toward Wellness

The Enhanced Services for the Hard-to-Employ (HtE) Demonstration and Evaluation Project was a 10-year study (taken on by the MDRC) that evaluated strategies aimed at improving employment and other outcomes for groups who face serious barriers to employment. The Enhanced Services for the Hard-to-Employ was the first comprehensive attempt to understand the diverse low-income population and to test interventions aimed at the most common barriers to this population's employment. The HtE demonstration was designed to assess ways to boost employment, reduce welfare receipt, and promote well-being in low-income populations. This study analyzed the effectiveness of the Rhode Island "Working toward Wellness" (WTW) program, a one-year program that provided telephonic care management to depressed parents receiving Medicaid in Rhode Island. The Quick Inventory of Depressive Symptomatology Self Report (QIDS-SR) questionnaire was administered to parents in order to identify those with major depression. All consenting parents who were found to have major depression were then assigned to the study. The Working Toward Wellness full research sample consisted of 499 individuals randomly assigned between November 2004 and October 2006 (245 members in the program group and 254 in the control group). The research team followed the two groups for three years using surveys. All 400 sample members completed a baseline survey at random assignment, providing basic demographic information, data on depression, other health outcomes, employment, participation in outreach programs, receipt of behavioral health services, and material hardship prior to enrollment in the study. Three follow up surveys were collected at the sixth month, eighteenth month, and thirty-sixth month marks. The WTW 6, 18, and 36 month reports include data from surveys administered to parents and children; however, only measures used in the adult/parent analysis are included due to restrictions. Care managers recorded information on attempted and completed calls with 230 members in the program group. Data was collected on respondent's general health, depression scores and treatments, substance abuse, work performance and attendance, as well as wages and income. Demographic information includes age, race, marital status, education, employment status, individual and household monthly income, as well as social security and disability status.