Promoting Readiness of Minors in Supplemental Security Income (PROMISE): Early Impacts from a Multi-Site Random Assignment Evaluation

Background PROMISE was a federal initiative to support youth receiving Supplemental Security Income (SSI) during the transition to adulthood. Objectives This article presents estimates of the impacts of the six PROMISE projects on youth and family outcomes as of 18 months after enrolling in PROMISE. Research Design The study uses a randomized controlled trial design. Subjects The six PROMISE projects each enrolled a minimum of 2000 treatment and control youth (and their parents) residing in their service areas who were aged 14 to 16 and receiving SSI. Measures We estimated impacts on outcomes related to youth and family service use, school enrollment, training, employment, earnings, and federal disability program participation using survey and administrative data. Results The projects succeeded in connecting more youth to transition services and more families to support services during the 18 months after enrollment, and most increased the likelihood that youth applied for state vocational rehabilitation services. On average, there was no impact on youth’s school enrollment, but there were favorable impacts on youth’s receipt of job-related training, employment, earnings, and total income. The projects did not affect parents’ employment, earnings, or income, on average. For most outcomes PROMISE affected, the impacts varied substantially across the projects. Conclusions The positive short-term impacts of PROMISE on youth’s use of transition services, youth employment, and families’ use of services are consistent with the program logic model and suggest there might be potential for longer-term favorable impacts on youth and family outcomes.

Technology and Communication Considerations for Engaging Youth Receiving Supplemental Security Income (SSI) Benefits: Vocational Rehabilitation Counselor Perspectives

Technology has been shown to enhance daily activities, increase participation in individualized planning and supports, and accommodate the transition needs of students with disabilities. This study examined the benefits and challenges regarding technology use when providing transition services for youth and families receiving Supplemental Security Income (SSI) benefits. Specifically, it explored the nuances of employing technology to encourage engagement in Wisconsin Promoting the Readiness of Minors in Supplemental Security Income (WI PROMISE) services and foster communication between counselors and participants. This qualitative study used a constant comparative method for analyzing data collected through two focus groups of WI PROMISE counselors. Counselors identified technology as essential to maintaining contact with WI PROMISE participants as well as extant barriers including inconsistent access to the internet, financial expense, and insufficient training and support. Recommendations for using technology to communicate with transition-aged youth and their families will be discussed.

Medicaid Expansions and Participation in Supplemental Security Income by Noncitizens

Objectives. To estimate the effect of Medicaid expansion on noncitizens’ and citizens’ participation in the Supplemental Security Income (SSI) program. The Affordable Care Act (ACA) expanded Medicaid eligibility to cover low-income nonelderly adults without children, thus delinking their Medicaid participation from participation in the SSI program. Methods. Using data from the Social Security Administration for 2009 through 2018 (n = 1020 state-year observations) and the Current Population Survey for 2009 through 2019 (n = 78 776 respondents), we employed a difference-in-differences approach comparing SSI participation rates in US states that adopted Medicaid expansion with participation rates in nonexpansion states before and after ACA implementation. Results. Medicaid expansion reduced the SSI (disability) participation of nonelderly noncitizens by 12% and of nonelderly citizens by 2%. Estimates remained robust with administrative and survey data. Conclusions. Medicaid expansion caused a substantially larger decline in the SSI participation of noncitizens, who face more restrictive SSI eligibility criteria, than of citizens. Our estimates suggest an annual savings of $619 million in the federal SSI cost because of the decline in SSI participation among noncitizens and citizens. (Am J Public Health. Published online ahead of print April 15, 2021: e1–e7. https://doi.org/10.2105/AJPH.2021.306235 )

SSI Youth and Family Case Management: A Taxonomy of Critical Factors, Competencies, and Translation to Practice

Youth who receive Supplemental Security Income (SSI) benefits experience disparate educational, employment, and economic outcomes when compared to youth with disabilities who do not receive these entitlements. Promoting the Readiness of Minors in Supplemental Security Income (PROMISE) was a 6-year national research demonstration project that designed, implemented, and evaluated interventions that led to more successful postschool outcomes for youth SSI recipients ages 14 to 16. Although prior research demonstrations have been conducted testing the combination of case management with other services and supports with SSI populations, research on the taxonomy of those case management strategies considered most effective in supporting positive postschool outcomes is very limited. This article presents a comprehensive taxonomy of case management that provides a common frame of reference for future research on effective case management strategies and translation to practice by discussing implications for policy, practice, and further research when supporting successful postschool outcomes of youth SSI recipients.

Demographic and Transition Service Predictors of Employment Outcomes for Youth Receiving Supplemental Security Income

Racially and ethnically diverse youth with disabilities receiving Supplemental Security Income (SSI) benefits were randomly assigned to usual services, including available school and vocational rehabilitation (VR) transition services, or enhanced case management and transition services through the Wisconsin Promoting Readiness of Minors in SSI (PROMISE) federal demonstration grant. A hierarchical logistic regression analysis demonstrated increased age, being African American, having a psychiatric disability, and transition services predicted higher youth employment rates. However, enhanced PROMISE transition services were no longer significant in the presence of VR services, suggesting the effect of enhanced services was mediated by increasing engagement in VR. Limitations and implications are discussed regarding the relationship between school and state VR transition services and postsecondary competitive integrated employment outcomes.