The dual responsibility for eligibility determination and service planning may make it difficult for case managers to identify unobserved barriers to employment.
As noted above, the responsibilities of case managers are multi-faceted and commonly include service planning, monitoring, and making referrals. Some case managers are also responsible for determining financial eligibility for TANF, Food Stamps, and Medicaid (this was the case in Montgomery County, KS, Kent, WA, and Owensboro, KY). In other sites (Minneapolis, MN, Las Vegas, NV, and Arlington, VA), clients meet with a separate eligibility worker to determine financial eligibility for TANF before being referred to a case manager for service planning.25
The dual responsibility for eligibility determination and service planning may provide a TANF case manager the opportunity to begin the barrier identification process early in a client’s TANF experience and provide more holistic services. However, this dual responsibility may also make it difficult for case managers to identify unobserved barriers to employment. The TANF, Food Stamp, and Medicaid programs place a high priority on accurate and timely eligibility determination that may detract from efforts to identify barriers during the eligibility interview. The completion or collection of often voluminous eligibility-related paperwork may detract from efforts to establish rapport and encourage disclosure of barriers. For example, the completion of formal assessment tools may be perceived as just another form to be completed to be deemed financially eligible. Additionally, as indicated by focus group respondents, clients may be hesitant to disclose their barriers to this worker for fear that it will affect their eligibility for benefits.
In two of the study sites (Montgomery County, KS and Kent, WA), eligibility determination and case management functions were combined to create an integrated worker when welfare reform was implemented. While such integration was intended to provide more holistic services to clients, some staff reported that this dual responsibility makes it difficult for them to carry out their case management and barrier identification responsibilities. In part, this challenge was created because the priority and workload associated with timely and accurate eligibility determination did not diminish even though integrated staff assumed new and very different responsibilities.
At the time of our visit, one office in Montgomery County, KS was attempting to address the challenge integrated workers face. In this office, an eligibility worker was paired with case managers who had the dual responsibility of eligibility determination and service planning. Although the case manager collected documentation related to financial eligibility when interviewing clients, the eligibility worker entered the data in the computer system and conducted other eligibility-related tasks. It was hoped that this structure would allow the case managers to focus more on developing service plans, uncovering barriers, and monitoring progress toward achieving self-sufficiency. In two other study sites (Owensboro, KY, and Kent, WA) where eligibility and case management are integrated under one worker, the challenge of these combined responsibilities is addressed by involving specialized staff to assist with barrier identification and service referrals (discussed further below).
25 In Minneapolis, MN, employment service provider staff are contracted to provide case management/ service planning function in addition to other employment-related functions. In Las Vegas, NV and Arlington, VA the case manager is an employee of the TANF agency.