Work first programs (and case managers within programs) vary in the extent to which they help participants cope with personal and family problems that may interfere with their ability to find and keep a job. Most programs take a narrow view, preferring that case managers address only those issues which are immediate barriers to participation. In addition, participants may not initially disclose personal issues to case managers; problems are more likely to become evident in the course of the program. However, when issues do arise that threaten successful employment, case managers should be able to work with participants to address them.
For many issues, case managers may be able to identify resources that participants can utilize on their own. Work first offices should develop local resource lists that can guide case managers and participants in choosing appropriate options. This can also be an opportunity to teach participants problem-solving skills that can improve their self-confidence and help them when they are off welfare and working. Even when they have referred participants elsewhere, however, case managers may find that they need to follow up, encouraging participants to utilize the services or acting as advocates on participants' behalf. It can be helpful for programs to develop formal or informal relationships with community agencies that can provide services to participants. Programs should also make arrangements to monitor participants' progress in these services, without compromising confidentiality. If needed services are not available in the community, programs might try to provide the services themselves (for example, by setting up a clothing bank on site) or find other ways to meet those needs (for example, by contracting with a local provider to start offering the service).
In Florida and Utah, program staff have found that these issues become more prominent as a work first program matures and more participants find jobs. Those who remain may be more likely to face significant personal issues that have kept them from finding employment. Case managers in those states felt frustrated in working with these hard-to-serve participants and felt unqualified to identify or address many of the barriers they faced. Administrators in both Florida and Utah have responded by hiring specialized staff-often professional social workers with master's degrees-to help case managers deal with these issues. The specialized staff may assist case managers in several ways: training them to identify issues, providing advice for working with participants, offering short-term counseling to participants, or acting as a resource for appropriate referrals to outside providers.
Some participants may have serious problems that may warrant deferral from participation in other program activities. If so, the participant's progress in addressing the problems should be closely monitored, and employment activities should begin as soon as the participant is able. Many issues, however, can be addressed either quickly or simultaneously with participation in job search, other activities, or employment-and staff and participants should recognize that the same issues confront many working people as well. The goal of staff is generally to get participants to the point where they are able to work. Participants can then continue to address the issues while they are working.
Additional Suggestions for Dealing with Personal Issues
Case managers in the Minnesota Family Investment Program (MFIP)-who have been operating an employment-focused program for long-term welfare recipients for more than two years-have identified some common issues that arise when working with participants, and they and others have proposed strategies for addressing them. The discussion that follows is less about dealing with hard-core problems than about addressing smaller ones that may arise along the way as participants move through the program. In addition, many of these strategies involve referring participants to specialized service providers; the ability of case managers to assist participants with these issues may depend largely on the presence of such providers in the community.
- Child care and transportation. Work first programs generally provide comprehensive support for the child care needs of participants. Most programs also provide transportation assistance to participants in the form of passes for public transportation, reimbursement for gas, or funds for car repairs. Section 7 discusses these support services; see section 35 for ideas on how the program can facilitate child care and transportation arrangements.
- Clothing. Some participants do not have an adequate wardrobe for interviews and work. Think about either starting a clothing bank or providing vouchers for a local thrift shop. It is also a good idea to discuss with participants what is appropriate attire and to help them plan their outfits for interviews and work. Participants might be asked to attend program activities dressed as if for a job interview, or one day a week might be designated as "Dress for Success" Day. Program staff should set an example by dressing professionally themselves.
- Physical health problems. Any physical limitations that participants have should be accommodated in their employment goals, job search strategies, and employment plans. Case managers should also be prepared to make appropriate referrals for health care services. If medical documentation is required to determine whether exemption or deferral may be warranted, obtain signed releases to get participants' medical records. Case managers may also want to understand SSI eligibility rules and the SSI application process so that they can help participants complete the application and assemble the required documentation.
- Depression and other mental health issues. Depression is a common problem among participants in welfare-to-work programs. Case managers need to be trained to identify the signs of depression. Failure to make progress in program activities, apathy, and apparent laziness may all be signals of depression. Some programs refer participants to short-term activities that focus on building self-esteem. Case managers should also have information about treatment facilities that accept Medicaid coverage and should be able to provide referrals to those facilities.
- Limited cognitive functioning. The first step in addressing a suspected cognitive limitation is to document the problem through an assessment. Many programs contract out such assessments to licensed psychologists or certified school psychologists. If an assessment documents an impairment that significantly limits the participant's ability to obtain or retain employment, exemption from the program may be warranted. Otherwise, look for employment or activity options at the participant's ability level. For example, community organizations may offer sheltered workshops or other employment and training programs for people with limited cognitive abilities. In addition, some service industries (including Wal-Mart, McDonald's, and Hardee's) have employment opportunities designed for people who have a low level of cognitive functioning. Try to identify participants' strengths and then match them with a job that will both challenge them and provide the necessary support, and one in which the employer is sensitive to the issue.
- Domestic abuse. Relationship problems are a common cause of disruptions in participation and employment. When they arise, case managers should try to figure out the seriousness of the problem and the dynamics of the situation. A referral to short-term counseling-for the participant or the couple-can address some problems. Issues of domestic abuse may not emerge in the early interactions between participants and case managers, since participants may fear the possible consequences of disclosure (for example, removal of children to foster care). Case managers should also be able to refer participants to local resources, such as hotlines and battered women's shelters, and can encourage participants to cooperate with agencies designed to help alleviate abusive situations. If case managers suspect that children are in danger, they need to report the case to the appropriate agency. The family violence provisions in the 1996 welfare law give states the option to screen for domestic abuse and to temporarily waive program requirements that would either prevent participants from escaping violence or unfairly penalize them.
- Substance abuse. This may be a particularly difficult issue to address because participants may not be willing or able to admit to or work on the problem. Programs can offer training to case managers in identifying substance abuse problems. Substance abuse problems among partners or family members may also create barriers to participants' employment or program completion. Case managers should have information available on treatment, counseling, and support programs and should make appropriate referrals when necessary. The case manager will have to discuss the issue openly with the participant, because the participant will have to agree to utilize available services. Participants may be extremely reluctant to admit they have substance abuse problems, particularly in states whose primary response to such an admission is sanction or other penalty. In addition, the 1996 federal law makes ineligible for TANF benefits anyone who-since the bill's enactment-has been convicted of a drug-related felony (unless a state opts out of this provision).
- Legal problems. Program participants may be involved in child custody battles, court-ordered visitation agreements with a nonresident parent, or child support hearings and trials. Case managers should be aware of participants' court dates and other commitments that might interfere with program participation. It is also useful to include Legal Services or other court advocates or representatives on the program's resource lists. Some participants may have a criminal record and may be dealing with parole or probation officers. Work first staff should discuss with participants how such information should be presented on a job application or in a job interview.
- Lack of a telephone. Not having a telephone can impede job search and can impair communication between participants and case managers. Case managers can help participants who do not have a telephone to get one installed-for example, by providing information on low-cost installation options or by working out agreements for payment of arrears. Programs should also have telephones available for use by participants and should consider providing an answering machine on which participants can receive messages regarding interview appointments and hiring decisions. (See also section 26, on the job club phone room.)
- Housing issues. Case managers should learn the best way to reach a participant who does not have a permanent residence, whether through a post office box, message center, or family member or friend who can relay messages. If a participant is or becomes homeless, encourage her to consider all options, including temporarily residing with relatives or friends, or in local emergency and transitional shelters. Help participants put their names on waiting lists for subsidized housing and sign up for local housing assistance programs. Participants who live in subsidized housing may face increased rents as they go to work and their income rises; make sure participants are aware of this possibility and recognize how it affects the trade-off for them between welfare and work..