Secretaries' Innovation Group


Early Intervention Disability Demonstration Projects - -
Concepts for Action

Hosted by:

Secretaries' Innovation Group

UMD-School of Public Policy

February 12, 2015

David Weaver, Associate Commissioner, Office of Research Demonstration, and Employment Support, SSA

Respondent:  Mike Fishman, President, MEF Associates

The proposal would test early-interventions for workers with mental illness under 50 targeted to two sub-groups:  those receiving services from a state vocational rehabilitation agency who are not DI or SSI disability beneficiaries; and those who have recently applied for disability benefits and were denied.  Participants would receive an intensive set of behavioral health and related services to help them remain in or return to the labor market rather than seek SSA disability benefits.

David Stapleton, Director, Center for Studying Disability Policy, Mathematica

Respondent: Steve Bell, Vice President, Social & Economic Policy, Abt Associates

The Integrated Employment Support and Eligibility Determination proposal would integrate timely employment support systems after the onset or worsening of a medical condition, along with an improved disability determination process so as to improve economic outcomes for workers and reduce entry into SSDI.

"A Roadmap to A 21st Century Disability Policy" By: Dave Mann and David Stapleton

"Committee on Ways and Means Subcommittee on Social Security Responses to Questions for the Record" 

David Autor, Associate Department Head, MIT Department of Economics

Respondent: Terri Rhodes, Vice President and Executive Director, DMEC

The proposal would extend private disability insurance coverage so as to support workers for up to 2.25 years following onset of disability.  It would provide partial income replacement and supports geared toward helping individuals maximize work readiness and self-sufficiency. After receiving private insurance benefits for twenty-four months, individuals who are unable to engage in substantial gainful employment would transition into the SSDI system.

"Supporting Work: A Proposal for Modernizing the U.S. Disability Insurance System" By: David H. Autor and Mark Duggan

Philip de Jong, Partner, APE Inc. and Professor of Economics of Social Security, University of Amsterdam (known as the “father of disability reform in Holland”)

Respondent: Dave Wittenberg, Senior Researcher, Mathematica Policy Research

The proposal is based on a comprehensive 2004 Netherlands reform requiring employers to cover wages during a two year waiting period before DI entitlement; the inclusion of effective gatekeeper protocol; required employer and employee active measures for health and continued work as a condition of enrollment after two years; and adoption of a competitive market for employer provided sickness and disability insurance as between government and private carriers for the first two years.  Post- reform disability inflow in Holland is 20 – 40% of pre-reform 2001 base year.

"Recent changes in Dutch disability policy" By: Philip R. de Jong

Grant Collins, Senior Vice President, FedCap, and NYC We Care Director; and Jason Turner, Executive Director, Secretaries’ Innovation Group

Respondents: Ted McCann, Staff Director, Ways and Means Social Security Committee; and Jon Baron, President, Coalition for Evidence-Based Policy

The proposal would adapt to DI and SSI a 13 year old NYC large-scale program for TANF recipients who claim health as reasons for inability to seek or obtain jobs. The intervention uses an independent vendor under a performance contract to maximize employment rather than push recipients to SSI.   Vendor comprehensive medical health assessment is followed by vocational and job search efforts where practical.  Fewer than 20% are referred to SSI, the balance to health and vocational activities followed by work. 

Mark Swindells, District Operations Manager, UK Department for Work and Pensions, Work Services Directorate; and Zach Morris, University of California Berkeley School of Social Welfare

Respondent: Mike Wiseman, Research Professor of Public Policy, Public Administration, and Economics, George Washington University

The proposal is based on UK reforms which include an independent medical and functional assessment from a government contracted service provider; a fixed term disability period followed by reassessment; a “Fit for Work Service” provided by a vendor which includes a telephone and internet service to offer advice to businesses for their workers who have experienced a health shock; engagement of MD general practitioners to understand the health benefits of work over disability;  and a triage of disability applicants into three categories - -  permanently disabled, work capable with accommodations, and ready to work.  Post-reform new disability intakes in the UK are no longer rising. 

Eloise Anderson, Secretary, WI Department Children and Families

Respondent: Matt Weidinger, Staff Director, Ways and Means Human Services Committee

The proposal would change SSI children benefits from cash payments going to adult family heads with its undesirable dependency effects, and substitute the same fund contributions for services to covered child using a flexible spending account.  The service objective is to help overcome a child’s disability, do better in school and transition to adult employment. 

Tom Wickizer, Stephen F. Loebs Distinguished Professor of Health Services & Chair, Division of Health Services Management and Policy, College of Public Health, Ohio State University

Respondent: Yoni Ben-Shalom, Senior Researcher, Mathematica Policy Research

The proposal would adapt to DI a quality improvement intervention currently implemented within Washington State’s workers’ compensation system.  The program provides WC financial incentives to health providers for using best practices, coupled with support and care management. Patients treated by providers who more often adopted occupational health best practices have on average 57% fewer WC disability days.  The program is now being adopted statewide.  

"Improving Quality, Preventing Disability and Reducing Costs in Workers’ Compensation Healthcare: A Population-based Intervention Study" By: Thomas M. Wickizer et all

"Improving Quality, Preventing Disability and Reducing Costs in Workers’ Compensation Healthcare: A Population-based Intervention Study" By: Thomas M. Wickizer et all

DC Disability Event February 2015

**To view power point presentations, click on underlined speaker name.

**To view paper, click on underlined paper title.