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Subgroups
Individuals determined eligible to participate were randomly assigned to the intervention or comparison group. Participants were eligible for the study if they were ages 18-62, had a mental illness, worked at least 40 hours per month, were not receiving other public benefits, and were not receiving Supplemental Security Income or Social Security Disability Insurance Benefits. DMIE enrollment in Minnesota focused on eligible workers with a behavioral health diagnosis who were participating in a means-tested public insurance program, and Texas enrollment focused on eligible workers who were members of a safety net program in the Houston area and had a behavioral health diagnosis co-occurring with a physical impairment. In Minnesota, participants were randomly assigned with a 3:1 ratio to the intervention and comparison groups, using a stratified random sample based on age, functional status, geographic location, and income. In Texas, participants were randomly assigned with equal probability of being in the intervention or comparison group.
Random assignment was conducted between January 2007 and July 2008, and participant outcomes were measured for two years after enrollment in the study.
Minnesota Department of Human Services; Texas Health and Human Services Commission Working Well Program
Adults ages 18 to 62 who were working at least part time and had a behavioral health condition were eligible to participate in the Demonstration to Maintain Independence and Employment (DMIE) in Texas and Minnesota. DMIE participants in these states could receive a suite of services including intensive case management, health benefits supplementing their existing coverage, employment supports, and financial assistance. Intensive case management involved developing an individual plan and goals and addressing barriers to services. Health benefits included enhanced medical services such as chemical dependence treatment, expanded dental coverage, medical transportation, improved access to mental health services, and a subsidized health club membership. Employment supports included career counseling, access to a 24-hour employee assistance program, a peer support group, workplace visits, accommodation assessments, and résumé and interview skill building. Financial assistance included health care premium subsidies, lower health insurance co-payments, and low or no deductibles for health care.
The comparison condition applied to adults ages 18 to 62 who were working at least part time and had a behavioral health condition, but did not receive enhanced health services, employment supports, or financial assistance related to health insurance. Comparison group members remained eligible to receive standard health services in their community.
None
The program took place in seven counties in Minnesota and Texas, including the Twin Cities, MN, and Houston, TX, metropolitan areas and rural counties. The intervention was administered through two Minnesota public health programs, MinnesotaCare and General Assistance Medical Care, and a Texas county hospital district health services program.
Physical and mental health; Disability benefit applications