Insights about the transition system for SSI youth from the national evaluation of Promoting Readiness of Minors in SSI (PROMISE)

Abstract

BACKGROUND:

PROMISE was a federal initiative to support youth receiving Supplemental Security Income (SSI) during the transition to adulthood.

OBJECTIVE:

This article discusses insights gained from the national PROMISE evaluation about the current transition system.

METHODS:

The national evaluation relied on a randomized controlled trial design and information obtained from staff interviews, surveys of parents and youth, and program administrative data.

RESULTS:

The authors found that: (1) many SSI youth received transition services without PROMISE, but that there was substantial room for PROMISE to improve service use; (2) intensive case management, facilitating early work experiences, and a family focus were the primary PROMISE innovations to usual services; (3) formal partnerships enhanced interagency collaboration but required time to form, service benchmarks, and regular communication; (4) identifying SSI youth for outreach is challenging under the current system; (5) PROMISE service costs represented relatively large investments; and (6) the intensive case management offered by PROMISE might be difficult to sustain in the current system.

CONCLUSIONS:

Lessons from PROMISE are relevant to current initiatives supporting youth with disabilities during the transition to adulthood. The evaluation will assess the longer-term impacts of PROMISE and provide information about its potential for generating long-term benefits.

Keywords

Disability youth transition supplemental security income PROMISE social security administration

1 Introduction

Youth with disabilities— particularly those receiving Supplemental Security Income (SSI)— face individual, family, and systemic barriers to achieving education and employment outcomes, which potentially undermines the foundation for their longer-term success. Along with the challenges faced by youth with disabilities, the large number of children with disabilities who receive SSI generates concerns about the long-term fiscal burden on the federal government and the consequences of long-term reliance for these children, because many of them will continue to receive SSI and other public assistance as adults (Burkhauser & Daly, 2011; Duggan, Kearny, & Rennane, 2016). In 2018, about 1.2 million children received SSI payments totaling about $9.4 billion (Social Security Administration [SSA], 2018a). Over the past decade, federal policymakers have identified as a high priority not only the improvement in the education and employment outcomes of youth with disabilities but also the reduction in their long-term dependence on SSI.

PROMISE— Promoting Readiness of Minors in SSI— was a joint initiative of the U.S. Department of Education (ED), SSA, the U.S. Department of Health and Human Services, and the U.S. Department of Labor to address these and other critical issues related to supporting youth with disabilities. The initiative provided funding for implementing and evaluating programs designed to promote positive change in the lives of youth receiving SSI and their families. Under cooperative agreements with ED, six projects across 11 states implemented model demonstration projects in which they enrolled SSI youth ages 14 through 16. The projects intended to (1) provide educational, vocational, and other services to youth and families, and (2) make better use of existing resources by improving service coordination between state and local agencies. ED announced the PROMISE cooperative agreements in September 2013, and the projects began enrolling youth between April and October 2014; enrollment continued through April 2016. All projects delivered PROMISE services through September 2018; some of them delivered services longer under no-cost extensions.

This article draws important insights based on the findings from various analyses conducted under the national evaluation of PROMISE by considering how this initiative fit into the landscape of policies and practices that support transition-age SSI youth, the successes and challenges of implementing the PROMISE projects, and their costs and early impacts on key outcomes. Under contract with SSA, Mathematica is conducting the national evaluation of PROMISE to understand how the projects were implemented and operated; their impacts on education and employment outcomes, as well as on SSI payments and other public benefits for youth and their families, and their cost-effectiveness. We highlight policy-relevant insights gained from PROMISE at this early stage, without yet fully understanding the impact of the projects on the employment and education outcomes of SSI youth as they become young adults.

2 Background

Two important federal acts govern many of the key transition services and supports provided to youth with disabilities. The Individuals with Disabilities Education Act (IDEA), 1 initially authorized in 1975 and most recently amended in 2004, guarantees access to free and appropriate public education, tailored to their specific needs, for youth with disabilities. IDEA requires schools to begin transition planning by the time special education students reach age 16; the plan becomes a part of the students’ Individualized Education Program (IEP). The transition plans are supposed to consider postsecondary education, vocational training, employment, and independent living goals for youth based on their needs and interests, and outline a set of services and activities that will help them achieve those goals. These transition services and activities often take place in the secondary school environment, delivered by special education teachers and transition counselors. They also may occur through partnerships that schools maintain with other community organizations, referrals to other resources, and tools that families use on their own. Although the IDEA requires transition planning to occur during high school, national data suggest that many special education students (30 percent) and their parents (40 percent) never engage in post-high school transition planning with school staff (Liu et al., 2018).

More recently, the Workforce Innovation and Opportunity Act (WIOA) of 2014 introduced provisions intended to enhance services to transition-age youth with disabilities. Broadly, the WIOA seeks to improve the coordination of and referrals among various programs; reduce overlap in service provision; encourage certain occupational pathways; and shift the emphasis of services from sheltered employment to competitive, integrated employment for people with disabilities. Provisions particularly relevant to transition-age youth are those that require vocational rehabilitation (VR) agencies to provide pre-employment transition services for high school and postsecondary education students with disabilities, and use 15 percent of their federal funding on these services. VR agencies are also permitted to work with students potentially eligible for services; previously, agencies could have provided services similar to pre-employment transition services but did not specify the level of such provision. Also, agencies could not serve students before they applied and were found eligible for VR services.

Governed by IDEA, WIOA, and other legislation, numerous federal, state, and local programs offer income, health, educational, employment, and other types of supports for transition-age youth with disabilities (Honeycutt & Livermore, 2018). The assistance they offer includes work supports and programs sponsored by SSA to facilitate the employment of participants in the SSI and Social Security Disability Insurance (SSDI) programs, employment supports through state VR agencies and state workforce development agencies, and education and training offered by local education agencies and postsecondary educational institutions. These investments are intended to help youth with disabilities become more successful in the labor market as adults and avoid long-term reliance on public income support and a lifetime of poverty.

2.1 Transition system challenges when the PROMISE initiative was launched

Despite the number and variety of public programs available, youth with disabilities and their families face many challenges in accessing and using them (U.S. Government Accountability Office, 2012, 2016; Hirano, Rowe, Lindstrom, & Chan, 2018). These challenges include encountering different eligibility rules for programs, navigating a fragmented and uncoordinated transition system, facing limited or delayed access to services, and not having enough information about services and the transition process. Further, youth with disabilities might be inadequately prepared for postsecondary education and employment because many of them are not accessing career development learning and experiential activities despite the potential availability through federal and state programs (Carter et al., 2010a; Carter, Trainor, Cakiroglu, Swedeen, & Owens, 2010b). For example, despite a majority of special education students receiving support services at school, only 13 percent engaged in school-sponsored work activities in 2012, and the proportion with paid work experiences outside of school declined from 27 percent in 2003 to 19 percent in 2012 (Liu et al., 2018). These challenges might be more prevalent for SSI youth and their families because of their poverty, limited resources, and significant health conditions for both youth and other family members (Rupp et al., 2006).

Failure to overcome these challenges can limit the success of youth with significant disabilities as they become young adults, and creates concerns about the long-term fiscal burden on the federal government. The child SSI program is an important pathway to the adult SSI program. Individuals who enter the federal disability programs at a young age may go on to receive benefits for many decades. Although the eligibility rules for adults are more stringent than those for children, approximately 65 percent of youth SSI recipients go on to receive SSI as adults (Hemmeter & Bailey, 2015). Adults who receive SSI payments for decades incur large lifetime disability program and other expenditures. One study estimated that individuals who enter SSI or DI as adults before the age of 30 remain on benefits for an average of 33 years and incur average SSI, DI, Medicare, and Medicaid expenditures of about $600,000 (in 2012 dollars) during that period (Riley & Rupp, 2015). Others have estimated the lifetime expenditures of SSI youth who remain on benefits to be even greater (Enayati & Shaw, 2019). About one in four adult SSI recipients, and nearly two in three adult SSI recipients under the age of 30, first started receiving benefits as children (SSA, 2018c). These estimates suggest potentially large lifetime fiscal outlays associated with many youth SSI recipients.

Thus, before PROMISE, youth with disabilities, their families, as well as service providers and practitioners, faced a complex and fragmented transition service system that lacked coordination and comprehensiveness in meeting the needs of the youth and their families. The system also did little to mitigate the risks of lifetime dependency on public transfer payments for the youth and long-term fiscal burden on the federal government. It was in this environment that the federal partners implemented the PROMISE initiative to apply a service model that would address these challenges and rigorously test it in a variety of settings around the country.

2.2 The PROMISE approach to addressing the challenges

The federal agencies sponsoring PROMISE envisioned projects that would address many of the challenges cited above, including by providing services to both youth and their families, and improving partnerships among service-providing agencies at federal, state, and local levels. Based on evidence from the literature, input from the public, and consultation with subject matter experts, the federal partners postulated that two main features of the PROMISE projects would make them more effective: (1) strong partnerships between the agencies that provide services to SSI youth and their families, and (2) an individual- and family-centered approach to case management and service delivery. The federal partners also identified a set of services that could achieve the desired results and thus required the PROMISE projects to include the following core components (ED 2013): 2

Formal partnerships between state agencies that provide the following services: VR services, special education and related services, workforce development services, Medicaid services, income assistance from Temporary Assistance for Needy Families, and services provided by federally funded state developmental disability and mental health services programs

Case management to ensure that PROMISE services would be appropriately planned and coordinated, help participants navigate the broader service delivery system, and help with transition planning for post-school goals and services

Benefits counseling and financial education for youth and their families on SSA work incentives, eligibility requirements of various programs, rules governing earnings and assets, and topics promoting families’ financial stability

Career and work-based learning experiences, including paid and unpaid work experiences in an integrated setting while youth were in high school

Parent training and information in two areas: (1) the parents’ role in supporting and advocating for their youth to help them achieve their education and employment goals, and (2) resources for improving the education and employment outcomes of the parents and the economic self-sufficiency of the family

Each of the six PROMISE projects implemented the core services in ways they believed would be most effective in addressing the challenges faced by SSI youth in their states. They also offered a variety of services in addition to the core requirements. Some examples of these include the following: education services (such as supporting families at school IEP meetings and connecting youth to postsecondary education opportunities); offering youth self-determination training; and providing funds for individual development and Achieving Better Life Experience accounts. Beginning in September 2013, ED awarded a total of $230 million to six PROMISE projects, initially for five years, but later offered the option to extend the projects for up to one more year. Table 1 summarizes the location, enrollment period, service end date, and number of youth enrolled in the research sample of each PROMISE project. The projects enrolled youth in the PROMISE study from April 2014 through April 2016. From April 2014 through August 2019, the projects delivered services to youth for periods ranging from 53 to 58 months.

Table 1
The Six PROMISE Projects

Project name Location Enrollment period End month for services Number of youth in research sample

Arkansas PROMISE 25 of the state’s 75 counties 9/2014– 4/2016 6/2019 1,805

ASPIRE Statewide in six states: Arizona, Colorado, Montana, North Dakota, South Dakota, and Utah 10/2014– 4/2016 5/2019 1,953

CaPROMISE 18 local sites covering 20 LEAs 8/2014– 4/2016 6/2019 3,097

MD PROMISE Statewide 4/2014– 2/2016 9/2018 1,866

NYS PROMISE Capital Region, Western New York, and New York City 10/2014– 4/2016 8/2019 1,967

WI PROMISE Statewide 4/2014– 4/2016 9/2018 1,896

Project name	Location	Enrollment period	End month for services	Number of youth in research sample
Arkansas PROMISE	25 of the state’s 75 counties	9/2014– 4/2016	6/2019	1,805
ASPIRE	Statewide in six states: Arizona, Colorado, Montana, North Dakota, South Dakota, and Utah	10/2014– 4/2016	5/2019	1,953
CaPROMISE	18 local sites covering 20 LEAs	8/2014– 4/2016	6/2019	3,097
MD PROMISE	Statewide	4/2014– 2/2016	9/2018	1,866
NYS PROMISE	Capital Region, Western New York, and New York City	10/2014– 4/2016	8/2019	1,967
WI PROMISE	Statewide	4/2014– 4/2016	9/2018	1,896

ASPIRE = Achieving Success by Promoting Readiness for Education and Employment. LEA = local education agency; MD = Maryland; NYS = New York State. Source: Mamun et al. (2019), updated to reflect actual service end dates.

3 Methods

The insights we discuss in this article are based on several analyses conducted for the national evaluation of PROMISE. Here we briefly summarize the methods used to conduct these analyses. Detailed information about the evaluation design and methods is available in Fraker, Livermore, Kauff, & Honeycutt (2014) and from the sources cited below.

3.1 Study design and samples

The PROMISE evaluation is based on a random assignment design. PROMISE-eligible youth who agreed to participate in the study were randomly assigned to either a treatment group, which meant they were eligible to receive PROMISE services, or a control group, which meant they were not eligible for PROMISE services but could receive other services available in their communities independent of the PROMISE project. The evaluation design allowed an assessment of the extent to which PROMISE affected participation in youth transition and family support services while accounting for the fact that similar services were available to the control group from other sources. Random assignment is expected to lead to the creation of two groups of youth with similar pre-intervention experiences and characteristics, on average. As a result, we can attribute any observed differences in outcomes between the two groups to be an accurate estimate of the project’s impacts.

To be eligible for PROMISE, youth had to be age 14 through 16 at the time of enrollment, in SSI current pay status at some time during the PROMISE enrollment period (and not terminated from SSI before enrolling in the evaluation), living in a PROMISE project service delivery area, and not residing in an institution. Each PROMISE project was required to recruit at least 2,000 eligible youth into the study, using lists of eligible youth provided by SSA. A total of 12,584 randomly assigned treatment and control group youth participated in the PROMISE evaluation; as intended, the two groups were largely similar on demographic, disability, and family characteristics. These youth were statistically similar to SSI youth who did not enroll in PROMISE on nearly all observable characteristics (with differences varying by project), but likely differed in unobservable ways related to their own and their parents’ motivation for seeking the opportunity to obtain transition services and enrolling in the study.

3.2 Process analyses

The process analyses for the PROMISE evaluation documented the choices made by the projects to deliver services, along with the resultant experiences with respect to enrollment, service delivery, and agency partnerships. Specifically, the analysis addressed four research objectives: (1) document the project’s intended design and fidelity to the PROMISE model; (2) assess partner organization development, maintenance, and roles; (3) support the evaluation’s impact analysis; and (4) identify lessons and promising practices. The analysis achieved these objectives by collecting and analyzing data from multiple sources, including interviews with project staff, observations of service delivery, focus groups conducted with youth and families, management information systems developed by each project, and monthly calls with state and federal partners involved in each project. Details about the process analysis methods and findings can be found in each project’s process analysis report (Anderson et al., 2018; Honeycutt et al., 2018a; Kauff, Honeycutt, Katz, Mastrianni, & Rizzuto, 2018; Matulewicz et al., 2018; McCutcheon et al., 2018; Selekman et al., 2018).

3.3 Cost analyses

The PROMISE cost analyses produced estimates of the economic cost to implement each PROMISE project, including the costs not directly incurred by the project, such as volunteer labor and donated facilities or supplies. These cost estimates represent the resources needed to implement a similar project and may differ from the funding that each PROMISE project received. We followed a seven-step analytic framework to compute a project’s total annual costs, annual cost per treatment group enrollee regardless of participation in PROMISE services, and annual costs by project component. That framework involved collecting costs directly from each PROMISE project for a specified 12-month period after start-up and enrollment were completed, and separating the costs into various categories and components. Details of the cost analysis methods can be found in Mamun et al. (2019). An important caveat regarding the cost estimates is that they reflect the average service intensity observed during the targeted 12-month accounting period, though youth and families might not have received services at that same intensity throughout their involvement in the project.

3.4 Impact analyses

The impact analyses for the PROMISE evaluation relied on analyses of survey and administrative data (from SSA, VR, and state Medicaid programs) as of 18 months after youth and the families enrolled in PROMISE. The basic approach for estimating impacts was to compare average outcomes for the treatment and control groups while using a regression-based adjustment to account for any differences in baseline characteristics. Details about the impact analysis methods and findings can be found in Mamun et al. (2019). The results reflected in this article represent early or interim evidence from the PROMISE impact evaluation. The evaluation will follow youth and families for five years after they enrolled to observe longer-term impacts on employment, education, and program participation. The findings from the impact evaluation are limited by the fact that the youth who enrolled in PROMISE were volunteers who were not necessarily representative of all PROMISE-eligible youth in the areas served by each project. However, because participation in most transition-related services and efforts is voluntary rather than mandatory, the PROMISE impact findings are likely indicative of the transition-related activities in which SSI youth in the PROMISE states typically engage and the impacts PROMISE may have on youth outcomes.

4 Insights about the transition system gained from the PROMISE evaluation

4.1 Although many SSI youth received transition services in the absence of PROMISE, there was substantial room for PROMISE to improve on the use of existing services

The data on control group youth collected via the national evaluation’s 18-month follow-up survey provide a picture of the transition services that SSI youth typically accessed in the 11 states participating in PROMISE. These data suggest that the large majority of control group youth received at least some type of transition services during the first 18 months after they enrolled in the study (Table 2). Roughly 90 percent of control group youth in all PROMISE states received at least one transition service; the exception was Arkansas (82 percent). School transition planning was the most common, reported for at least 60 percent of control group youth in all states. This finding is not surprising, given the IDEA provisions that require schools to engage in transition planning with the families of youth with disabilities enrolled in special education. Most of the SSI youth enrolled in PROMISE were receiving special education (74 to 93 percent across the projects; not shown). Life skills training was also commonly reported; nearly half or more of control group youth in all states except Arkansas (42 percent) received this service.

Table 2
Transition Services Used by SSI Youth under the Status Quo: Control Group Receipt of Services during the 18 Months after Study Enrollment (Percentages)

Service Arkansas ASPIRE PROMISE CaPROMISE MD PROMISE NYS PROMISE WI PROMISE

Any transition services 82.3 88.5 91.3 89.9 91.4 89.7

Core PROMISE services

Case management 27.2 41.1 31.0 40.5 35.2 43.5

Employment-promoting services 37.4 46.0 36.0 51.9 45.6 54.0

Benefits counseling 4.5 4.7 6.5 6.1 6.7 8.4

Financial education 21.2 20.2 14.8 19.2 16.9 15.2

Any of the above 50.2 62.1 50.8 65.2 58.3 63.8

Other services

School transition planning 61.1 62.9 76.0 72.1 72.8 67.9

Self-determination training 34.5 38.3 36.2 41.5 38.7 38.1

Help accessing education or training 30.3 26.2 28.2 37.0 30.4 31.8

Life skills training 41.5 52.7 47.0 55.9 50.0 55.0

Help with assistive technology 19.8 23.3 24.3 27.9 26.3 23.7

Other 6.5 8.5 4.3 7.2 8.2 8.2

State VR services

Applied for VR services 4.2 7.8 3.8 5.9 1.7 14.0

Received VR services 1.1 4.7 2.5 5.6 0.9 8.8

Service	Arkansas	ASPIRE PROMISE	CaPROMISE	MD PROMISE	NYS PROMISE	WI PROMISE
Any transition services	82.3	88.5	91.3	89.9	91.4	89.7
Core PROMISE services
Case management	27.2	41.1	31.0	40.5	35.2	43.5
Employment-promoting services	37.4	46.0	36.0	51.9	45.6	54.0
Benefits counseling	4.5	4.7	6.5	6.1	6.7	8.4
Financial education	21.2	20.2	14.8	19.2	16.9	15.2
Any of the above	50.2	62.1	50.8	65.2	58.3	63.8
Other services
School transition planning	61.1	62.9	76.0	72.1	72.8	67.9
Self-determination training	34.5	38.3	36.2	41.5	38.7	38.1
Help accessing education or training	30.3	26.2	28.2	37.0	30.4	31.8
Life skills training	41.5	52.7	47.0	55.9	50.0	55.0
Help with assistive technology	19.8	23.3	24.3	27.9	26.3	23.7
Other	6.5	8.5	4.3	7.2	8.2	8.2
State VR services
Applied for VR services	4.2	7.8	3.8	5.9	1.7	14.0
Received VR services	1.1	4.7	2.5	5.6	0.9	8.8

Source: Mamun et al. (2019).

Control group youth were generally less likely to have used the core PROMISE services offered to treatment group youth than other services. The share of control group youth receiving at least one of the core PROMISE services (case management, employment-promoting services, benefits counseling, and financial education) ranged from about 50 percent in Arkansas and California to 65 percent in Maryland.

Among the PROMISE core services, parents of control group youth most commonly reported their youth receiving employment-promoting services (such as training to learn new job skills or help finding or applying for a job); these services were used by 36 to 54 percent of control group youth in all PROMISE states. Interviews with staff of the PROMISE projects and other agencies in their states suggest that schools and the state VR agencies were primary sources for employment-promoting services under the status quo. In some of the states, local schools had relationships with the VR agencies even before implementation of WIOA to offer employment-promoting opportunities for youth.

However, administrative data from the state VR agencies suggest that the state VR agencies were not a significant source of employment services for control group youth during the period represented by the data— from October 2014 through October 2016 (see bottom panel of Table 2). In all programs except Wisconsin, less than 10 percent of control group youth had applied for VR services and less than 6 percent had received any services. These data might underrepresent VR’s involvement with younger SSI youth (PROMISE enrollees were under age 18 for all or most of the period covered by these data); also, during this period, most states had not yet begun to formally track the provision of pre-employment transition services required by WIOA for students with disabilities. Nonetheless, it appears that during the early years of WIOA implementation, VR agencies were not a significant source of employment-promoting services for SSI youth under age 18. Information learned from the process analysis interviews conducted for the national evaluation is consistent with these administrative data findings, underscoring that in many of the PROMISE states, the pre-employment transition services prompted by WIOA were slow to result in actual service delivery. In addition, during this period, some state VR agencies remained reluctant to serve youth until they were nearing the time they would leave high school, which could occur as late as age 21 for special education students in most of the PROMISE states.

Nontrivial shares of control group youth also received case management, another core PROMISE service (ranging from 27 to 44 percent across the projects). The PROMISE evaluation survey did not query the source of the case management services, but the interviews conducted for the process evaluation suggest they were offered through Medicaid, developmental disability, independent living, and VR programs. Case management offered by these entities typically focused on specific services— for example, employment and training or health conditions and medical care. The process evaluation interviews identified very few instances in which more broad-based case management of the variety that the PROMISE projects offered was available to control group youth and their families under the status quo.

Control group youth were unlikely to have received the other two core PROMISE services: financial education and benefits counseling. Parents of about 15 to 20 percent of control group youth reported their children receiving financial education. Financial education services were inconsistently a part of the counterfactual service environment in PROMISE states. Although these services might have been offered by some schools or community providers, their availability or consistency varied by geographic location within states or might not have been tailored either to youth or youth with disabilities. Less than 10 percent of control group youth in all states received benefits counseling. These services were available through providers funded by the SSA Work Incentives Planning and Assistance (WIPA) grants. Other entities also provided these services using funding through other avenues, with state VR agencies being a primary source.

Although financial education and benefits counseling services were widely available in the absence of PROMISE, SSI youth under age 18 in general do not routinely access them for a variety of reasons. First, parents may be unaware of them or not view them as necessary because their youth are still young. Findings from the process analysis interviews suggest that this latter reason contributed to relatively low take-up of benefits counseling services among PROMISE treatment group youth who were offered these services. Second, WIPA-funded providers are supposed to prioritize services to SSA disability beneficiaries who are employed or soon to be employed, which might exclude many in-school youth not yet working or not planning to work extensively. The process analysis interviews with WIPA staff suggest that outside of PROMISE, they typically did not serve many SSI recipients under age 18 and generally did not conduct any particular outreach to this group. Finally, as noted above, few control group youth interacted with the state VR programs, and these programs are a primary source of referrals for and provision of benefits counseling services.

The differences in the control group youth experiences in receiving transition services across the PROMISE states suggest there are state differences in their transition service systems, which, in turn, influenced the PROMISE project’s ability to engage the system in serving PROMISE treatment group youth. As described in the projects’ process analysis reports, each project encountered different challenges and experiences while implementing aspects of PROMISE, some of which were unique to their service environments. For example, whether a state VR agency was in order of selection (and thus limiting its services only to those with the most significant disabilities) or its philosophy about serving youth as young as age 14 affected the ability of the PROMISE projects to successfully connect youth with VR services. Limited community capacity to provide services or a lack of any organization qualified to provide a particular service affected the PROMISE projects’ decisions about how to structure partnerships and whether to have their own staff deliver a particular service. Employment-promoting services, self-determination training, and benefits counseling are examples of services for which some of the projects encountered limited community capacity and had to develop ways to increase it.

PROMISE and other interventions that seek to improve access to and use of transition services by SSI youth have a greater potential for generating impacts for those services that relatively few youth access, whether because of limited community capacity, lack of family interest or awareness, or other reasons. Based on the experiences of the control group youth depicted in Table 2, it appears that although most SSI youth received some type of transition services, there was substantial room to improve their use of every type of service shown, especially those required under the PROMISE initiative.

4.2 Intensive case management, facilitating early work experiences, and a family focus were the primary innovations aside from usual services; PROMISE had large impacts in these areas

PROMISE projects had positive impacts on most of the youth and family services measured by the national evaluation (Table 3). For most projects, this was true even for those services that were more common among youth in the control group, such as school transition planning and life skills training. However, among the greatest impacts of the projects were two specific services for youth—case management and employment-promoting services—both of which reflect the core PROMISE model and have been found to positively influence postsecondary outcomes (Enayati & Karpur, 2019; Haber et al., 2016; Mazzotti & Plotner, 2016). In addition, the projects had positive impacts on service use by other family members. Below, we summarize findings from the PROMISE evaluation for these three innovations.

Table 3
PROMISE Impacts on Service Use for Youth and Families during the 18 Months after Study Enrollment

Service Arkansas ASPIRE PROMISE CaPROMISE MD PROMISE NYS PROMISE WI PROMISE

Any transition services ++ ++ ++ ++ ++ ++

Core PROMISE services to youth

Case management ++ ++ ++ ++ ++ ++

Employment-promoting services ++ ++ ++ ++ ++ ++

Benefits counseling ++ ++ ++ ++ ++ ++

Financial education ++ ++ ++ ++ ++ ++

Any of the above ++ ++ ++ ++ ++ ++

Other services to youth

School transition planning ++ ++ ++ 0 0 0

Self-determination training ++ ++ ++ ++ ++ ++

Help accessing education or training ++ ++ ++ ++ ++ ++

Life skills training ++ ++ ++ 0 ++ ++

Help with assistive technology ++ ++ ++ 0 0 ++

Other ++ ++ ++ ++ + ++

State VR services to youth

Applied for VR services ++ ++ ++ 0 0 ++

Received VR services 0 ++ ++ 0 0 ++

Job-related training services to youth

Any job-related training ++ ++ ++ ++ ++ ++

Job-related training credential ++ ++ ++ 0 0 ++

Services to family members

Case management ++ ++ ++ ++ ++ ++

Education or training supports ++ + 0 + 0 ++

Employment-promoting services + 0 0 ++ 0 ++

Benefits counseling ++ ++ ++ ++ ++ ++

Financial education ++ ++ ++ ++ ++ ++

Parent training and information on youth’s disability ++ ++ ++ ++ ++ ++

Parent networking support ++ ++ ++ 0 ++ 0

Service	Arkansas	ASPIRE PROMISE	CaPROMISE	MD PROMISE	NYS PROMISE	WI PROMISE
Any transition services	++	++	++	++	++	++
Core PROMISE services to youth
Case management	++	++	++	++	++	++
Employment-promoting services	++	++	++	++	++	++
Benefits counseling	++	++	++	++	++	++
Financial education	++	++	++	++	++	++
Any of the above	++	++	++	++	++	++
Other services to youth
School transition planning	++	++	++	0	0	0
Self-determination training	++	++	++	++	++	++
Help accessing education or training	++	++	++	++	++	++
Life skills training	++	++	++	0	++	++
Help with assistive technology	++	++	++	0	0	++
Other	++	++	++	++	+	++
State VR services to youth
Applied for VR services	++	++	++	0	0	++
Received VR services	0	++	++	0	0	++
Job-related training services to youth
Any job-related training	++	++	++	++	++	++
Job-related training credential	++	++	++	0	0	++
Services to family members
Case management	++	++	++	++	++	++
Education or training supports	++	+	0	+	0	++
Employment-promoting services	+	0	0	++	0	++
Benefits counseling	++	++	++	++	++	++
Financial education	++	++	++	++	++	++
Parent training and information on youth’s disability	++	++	++	++	++	++
Parent networking support	++	++	++	0	++	0

Source: Mamun et al. (2019). ++ = Positive PROMISE impact significant at the p < 0.05 level. + = Positive PROMISE impact significant at the p < 0.10 level. 0 = No statistically significant PROMISE impact.

4.2.1 Case management

Case management— working with project participants and their families to identify needs, and connecting them to services to address those needs— was a cornerstone of all PROMISE projects. Case management staff were typically a PROMISE project’s focal point of contact for participants and the face of the project for families because they coordinated the efforts of project staff, contracting agencies, and outside providers. Each project differed with respect to the provider organization responsible for the case management function, the expectations for that function, and the title of the position. Despite these differences, case management was typically (though not always) the service on which the project had the largest impact, with projects increasing the likelihood that youth received case management services by 21 to 46 percentage points during the 18 months after enrollment (Mamun et al., 2019).

It is also important to note that the case management services received by PROMISE treatment group youth likely differed from the kinds of those services control group youth received, although this difference was documented only qualitatively by the evaluation. As noted previously, we identified numerous examples of programs that provided case management services in the existing system but found only a few examples of such services purporting to be as broad based as those provided by PROMISE. One indicator of the broader nature of PROMISE case management services is the impact the projects had on the number of service providers youth used during the first 18 months after enrollment in the study. Relative to their control group counterparts, PROMISE treatment group youth in all projects were involved with a significantly larger number of providers on average; in some cases, the number was about twice the control group average (Mamun et al., 2019).

4.2.2 Career and employment services

The PROMISE projects focused on providing a variety of career and employment services to youth (Honeycutt, Gionfriddo, & Livermore, 2018b), including the following:

Career assessments to evaluate participants’ vocational and educational goals, needs, and interests

Career awareness learning opportunities for participants, such as through career exploration, job shadowing, and career planning

Work-based exploration activities, whether paid by the project or an employer

Soft skills training, provided either directly by project staff or through contracted community service providers

Postsecondary education supports, such as identifying postsecondary education goals related to career aspirations, encouraging participants to attend college fairs, and facilitating campus tours

These types of services are integral to transition practice frameworks (the National Collaborative on Workforce and Disability for Youth, 2009; Kohler, Gothberg, Fowler, & Coyle, 2016) and have strong empirical evidence linking them to postsecondary outcomes (Mamun et al., 2017; Fraker et al., 2016; Haber et al., 2016; Mazzotti & Plotner, 2016).

As a result of this focus, all six PROMISE projects had significant impacts on youth’s use of employment-promoting and training services, though the relative size of the impacts differed across projects. PROMISE increased employment-promoting service receipt by 12 to 38 percentage points, so from 58 percent to 76 percent of youth received these services across the projects (compared with roughly half or less of control group youth). Similarly, PROMISE increased the proportion of youth receiving job-related training by 6 to 32 percentage points; one-fifth to about one-half of treatment group youth received these services, compared with one-fifth or less of youth in the control group. The greater use of employment-promoting services by treatment group youth led to all PROMISE projects having positive and, in some cases, rather large impacts on the likelihood that youth had engaged in paid employment (Mamun et al., 2019).

One of the more significant changes required by WIOA is VR agencies’ provision of pre-employment transition services to students with disabilities. Some of these services correspond to PROMISE’s employment-promoting services. As noted above, as of 18 months after study enrollment, relatively few control group youth had applied for or received VR services, which also was generally true for treatment group youth, although some of the PROMISE projects had a positive impact on these outcomes. WIOA has likely increased the number of youth receiving services from VR agencies since the time of the interim evaluation; in 2017, individuals under age 24 represented more than half of all VR customers, up from less than one-third during the previous decade (Stapleton, Honeycutt, & Schechter, 2010; ED, 2019).

4.2.3 Services to parents and other family members

Providing services to family members other than the SSI youth, particularly the youths’ parents, was another innovative feature of PROMISE. PROMISE parent training and information services revolved around two types of services: (1) information and training to help parents support and advocate for their youth in ways that help them achieve their education and employment goals, and (2) services and referrals intended to improve the education and employment outcomes of the parents, and the economic well-being of the family. As of 18 months after enrollment, the projects had experienced more success with the former than the latter.

PROMISE projects had positive impacts on family member use of services, such as case management, parent training and information, and parent networking supports. The proportion of families receiving services across projects ranged from 10 percent to 18 percent for case management services, 13 percent to 17 percent for parent networking support, and 22 percent to 33 percent for parent training and information on youths’ disability. All of the projects had positive impacts on receiving case management and parent training and information services; most had a positive impact on parent networking support (from 5 to 20 percentage points, depending on the project and service), but in no project did a majority of families in the treatment group receive these services. Fewer families received employment or education services for family members other than the SSI youth, and the projects did not consistently have positive impacts on those services (Mamun et al., 2019).

These findings reflect what was learned from the process evaluation: it can be challenging to serve families. Challenges that PROMISE project staff described include the following: (1) family members believing that only the SSI youth needed services; (2) competing demands on family members’ time (such as work, other children, and addressing more immediate crises stemming from their vulnerable financial situations); and (3) family members not wanting to attend group sessions. To overcome these challenges, projects tailored their services to family needs and schedules, offered individualized services, traveled to meet with families or conducted trainings in convenient locations throughout the state, provided incentives to facilitate and encourage family participation, and provided summary information and other resources to facilitate families’ access to information and increase knowledge.

4.3 Formal partnerships can enhance interagency collaboration around transition services but require time to develop, service benchmarks, and regular communication

Interagency collaboration is a key component of promoting transition success for youth with disabilities (Kohler et al., 2016; Oertle & Seader, 2015; ED, 2017). The characteristics of collaboration for transition include formal relationships among agencies via agreements and designated staff; a shared understanding of the goals, activities, and challenges; and coordinated service delivery, planning, and information for youth and families. Because of its importance, such collaboration was a feature of the PROMISE projects. ED required applicants to document their collaborations and the involvement of certain state agencies as project partners. As a result, all or almost all PROMISE projects included state representatives from education, labor, VR, health, human or social services, and developmental disability agencies, as well as nonprofit service providers, on their state-level steering committees. These committees advised the projects on service development; addressed implementation challenges; and offered support, information, and connections throughout the projects’ service areas.

For interagency collaboration to result in enhanced services on the ground, state-level partnerships must carry over to the local level where staff interact directly with youth. Experiences from the PROMISE projects offer several lessons about how to promote successful local-level collaboration.

4.3.1 Formal contracts, through which a project pays organizations for their services, are the most direct way to specify expectations for interagency collaboration but can take time to develop

PROMISE projects relied on a combination of contractual and noncontractual arrangements to deliver particular service components (Table 4). The formal contracts for services explicitly stated the roles, responsibilities, and processes for communicating and working with other PROMISE partners. For example, Maryland PROMISE issued contracts for all of its services; it employed a community behavioral health organization for case management and employment services, a for-profit corporation for benefits counseling, and a statewide nonprofit organization for financial education services. Arkansas PROMISE relied primarily on contracts for important service components, such as with the VR agency for education and career services, and with local workforce agencies for the provision of summer work experiences. In both states, however, development of these contracts took time and delayed the provision of certain services. Because of the lengthy contract procurement process in Maryland, for example, the state issued a small grant for benefits counseling until the larger contract could be awarded, but very little such counseling was provided under that grant. Project managers reported that case managers were reluctant to develop relationships with and refer participants to temporary benefits counselors. The Arkansas Department of Workforce Services process for contracting with workforce investment boards was difficult to complete in a timely fashion for the first two years of summer work experiences. These delays affected coordination among project staff, workforce board staff, and job coaches, and some youth received notification about their summer work experiences only a week before they started their jobs. Similar delays in identifying qualified providers and issuing contracts delayed the delivery of other types of services in some projects.

Table 4
PROMISE Service Delivery Arrangements

Arrangement Arkansas ASPIRE PROMISE CaPROMISE MD PROMISE NYS PROMISE WI PROMISE

PROMISE case management

Staff-provided X X X X X X

Contracts with providers X

Referral without contract

Employment-promoting services for youth

Staff-provided X X X X X X

Contracts with providers X X X

Referral without contract X X X X

Benefits counseling and financial education

Staff-provided X X

Contracts with providers X X X X X

Referral without contract

Parent training and information

Staff-provided X X X

Contract with providers X X X X

Referral without contract X X

Arrangement	Arkansas	ASPIRE PROMISE	CaPROMISE	MD PROMISE	NYS PROMISE	WI PROMISE
PROMISE case management
Staff-provided	X	X	X	X	X	X
Contracts with providers	X
Referral without contract
Employment-promoting services for youth
Staff-provided	X	X	X	X	X	X
Contracts with providers	X	X	X
Referral without contract	X	X	X	X
Benefits counseling and financial education
Staff-provided	X	X
Contracts with providers	X	X	X	X	X
Referral without contract
Parent training and information
Staff-provided	X	X	X
Contract with providers	X	X	X	X
Referral without contract	X	X

Note: Staff-provided services refer to those provided by PROMISE project staff that exclusively served PROMISE treatment group families, regardless of their employment or contractual relationship with the lead PROMISE agency.

4.3.2 Inclusion of service benchmarks within formal contracts gives projects something to which they can hold partners accountable and thereby ensure consistent service delivery

For instance, referral and service take-up rates under the project in New York State were initially low and for a limited set of services. This situation was due in part to the lack of awareness reported by case managers, family coaches, and service provider staff about the service benchmarks that project managers had established. Broader awareness of the benchmarks among the project’s partners might have lent additional urgency and accountability to their provision of services. The project’s experience in contracting with Marriott Foundation’s Bridges to Work (Bridges) initiative to supervise community employment specialists in New York City provides an indication of the potential effectiveness of a greater emphasis on benchmarks. When Bridges joined the project, it established benchmarks for the number of work experiences the community employment specialists were to arrange for treatment group youth each month and clearly conveyed the benchmarks to these employment specialists. Project managers and frontline staff reported positive results from this effort. The ASPIRE project relied on uniform scopes of work for contractors operating in all six ASPIRE states. Although the states used a variety of contractors and methods for delivering services, the uniform scopes of work specifying service benchmarks helped to ensure consistent expectations for service delivery across the states. In many instances, the contracts ASPIRE developed involved only small, lump sum annual payments to providers. Nonetheless, these payments formalized the relationship and increased the providers’ capacity to provide the services envisioned by ASPIRE.

4.3.3 In the absence of formal contracts, programs seeking to promote interagency collaboration could communicate expectations, provide supports for collaboration, and monitor progress

Although some state agency representatives on the steering committee for the project in California introduced their agency’s local administrators to the project’s local managers and staff, they did not track or facilitate the ongoing development of relationships. Also, though project managers provided guidance on partnership development to local sites, there was no clear process for monitoring progress in this area. As a result, the local project sites in California varied significantly in their development of relationships with their partners, potentially resulting in lost opportunities in services and work experiences for some youth and their families. In the Maryland project, leadership fostered collaborations with education authorities at the state level and encouraged intervention staff to develop relationships with district and individual school staff. Districts were receptive to different levels and types of collaboration with project staff. Midway through project operations, the Maryland project invited staff from each school district to a meeting about the project and how it could work collaboratively with schools to better serve participating youth. Project and school district staff alike described that effort as successful, and it resulted in most districts developing communication and service coordination protocols vis-á-vis the project. These protocols gave the intervention team greater access to school personnel and regular participation in IEP meetings.

4.3.4 Regular communication among partners at all levels is key to facilitating ongoing local interagency collaboration

Staff of the ED-funded PROMISE technical assistance center, in their assessment of lessons that emerged from PROMISE (Nye-Lengerman, Gunty, Hawes, & Johnson, 2018), identified the importance of leadership in the collaboration process. A robust management structure, involving leadership at the project director and middle management levels, was needed for managing services and operations, coordinating among partners and staff, ensuring accountability, and maintaining fidelity to the project model. Experience from Wisconsin PROMISE highlights the importance of regular communication not only among management, but also among partner staff. Its project staff were expected to develop a resource team for each treatment group youth. Resource teams consisted of representatives from many of the systems and networks with which the youth and family interacted, including schools, churches, friends, and case workers from other programs. Resource team members would collaborate on an as-needed basis to identify supports for the youth. Project management found that “employment outcomes for youth were better when the various services and supports were integrated and worked together to support PROMISE youth and their family members.” Also, when local education agency staff were included on a youth’s resource team, those youth had better employment and earnings outcomes relative to youth who either did not have a resource team or had no local education agency (LEA) staff on the team (Wisconsin PROMISE, 2018; Hartman, Schlegelmilch, Roskowski, & Anderson, 2019).

The experiences of PROMISE projects regarding collaboration are relevant for WIOA implementation. WIOA requires increased interagency collaboration and integrated service delivery through three processes: (1) a combined state plan developed by the six federal-state programs addressed by the legislation; (2) new data requirements to identify individuals concurrently served by other programs and report on a set of common performance accountability measures to track employment, earnings, and skills gains after program completion; and (3) expanded VR agency involvement in coordinating activities with workforce agencies and LEAs, attending secondary school transition meetings, and planning meetings. Regarding these processes, the experiences of the PROMISE projects suggest that (1) state-level collaborations may not be sufficient to help connect local programs and providers, and (2) state and local collaborations might require formal partnerships, role clarity, and mechanisms for accountability to be successful.

4.4 Targeting services to SSI youth is difficult without knowing who they are

Low rates for the use of certain services among control group youth, along with the demand for transition services by SSI youth and families as illustrated by their enrollment in PROMISE, suggest that state and local programs might reach more SSI youth if the programs could identify them. The PROMISE projects enrolled 16 to 43 percent of the families with SSI youth they contacted. The sizeable enrollment rates in most of the projects reflect the interest in and demand for transition services by SSI youth and families. The PROMISE projects expended considerable effort on outreach attempts and benefited from the use of SSI family contact lists provided by SSA under its demonstration authority. Similar lists for targeting SSI youth generally cannot be used by community service providers because federal law limits how SSA may share information about its program participants.

Without access to SSA information to identify SSI youth, other methods for targeting them for transition services might be considered. State agencies involved with education, Medicaid, and VR could develop interagency agreements that would allow them to share Medicaid data to identify SSI youth for outreach and service delivery. Researchers affiliated with Wisconsin PROMISE proposed such a plan for the VR agency to use in a proposal to sustain features of PROMISE after the demonstration had ended (Anderson, Schlegelmilch, & Hartman, 2019). Programs serving youth with disabilities could also make more concerted efforts to identify families receiving SSI and refer them to relevant resources, such as the WIPA programs. American Job Centers (referred to as One-stop Career Centers at the time) faced a similar issue in attempting to identify job seekers with disabilities to serve under the Disability Program Navigator initiative (Livermore & Coleman, 2010). This issue was addressed under the U.S. Department of Labor’s subsequent Disability Employment Initiative (DEI) by requiring the centers implementing DEI innovations to participate as employment networks under SSA’s Ticket to Work program (Klayman, Di Biase, Searson, Hock, & Ketema, 2019). As employment networks, they had access to information about Ticket-eligible SSI and SSDI beneficiaries and thus could identify them among their customers if they chose to do so. However, in the case of SSI youth with disabilities, this mechanism would not be available because they are not Ticket eligible until after turning age 18 and found eligible for SSI or SSDI based on the criteria used for adults. In early 2018, SSA sought public input on strategies for improving the adult economic outcomes of SSI youth to inform its deliberations about potential policy changes and the design of future demonstration projects (SSA, 2018b). Expanding the Ticket to Work program to SSI youth was a specific area in which the agency sought detailed input regarding how such an expansion could be implemented.

4.5 Though PROMISE service costs varied across projects, they represented a relatively large investment to support SSI youth

The national evaluation analyzed the costs of PROMISE project services during a period when the projects were in a relatively steady state— neither ramping up nor winding down services. Based on this analysis, and on information collected about specific staff activities, the evaluation produced estimates of how project efforts were distributed across key activities and the average (per treatment group enrollee) annual costs of each project (Table 5). Direct services delivered to youth and their families (including services delivered by project staff, contractors, and through formal nonmonetary agreements with other organizations) accounted for the majority of costs for each PROMISE project. Among direct services, case management constituted the largest share of total costs in all projects, generally followed by career and work-based learning experiences. At the same time, the share of costs that direct services accounted for varied across PROMISE projects— ranging from 52 percent of the total costs for NYS PROMISE to 75 percent for Arkansas PROMISE, with the remaining share accounted for by administrative costs.

Table 5
Estimated Annual Costs per PROMISE Treatment Group Enrollee and Percentage Distribution of Costs by Service Component

Cost/component Arkansas ASPIRE PROMISE CaPROMISE MD PROMISE NYS PROMISE WI PROMISE

Annual cost per treatment group enrollee $9,148 $5,490 $7,182 $5,670 $7,456 $6,915

Percentage distribution of costs by component

Direct services 74.7 58.0 54.9 59.4 51.9 66.9

Case management 29.7 40.0 20.6 19.1 27.2 17.3

Career and work-based learning experiences 27.9 2.1 12.0 14.7 8.7 22.2

Youth self-determination 5.8 5.8 6.2 9.7 0.8 2.5

Education and school-related services 5.4 2.3 5.9 4.6 1.7 2.2

Parent training and information 3.8 2.2 6.9 1.4 13.4 17.0

Benefits counseling and financial education 2.1 5.6 3.4 9.9 0.2 5.8

Program administration^a 25.3 42.0 45.1 40.6 48.1 33.1

Cost/component	Arkansas	ASPIRE PROMISE	CaPROMISE	MD PROMISE	NYS PROMISE	WI PROMISE
Annual cost per treatment group enrollee	$9,148	$5,490	$7,182	$5,670	$7,456	$6,915
Percentage distribution of costs by component
Direct services	74.7	58.0	54.9	59.4	51.9	66.9
Case management	29.7	40.0	20.6	19.1	27.2	17.3
Career and work-based learning experiences	27.9	2.1	12.0	14.7	8.7	22.2
Youth self-determination	5.8	5.8	6.2	9.7	0.8	2.5
Education and school-related services	5.4	2.3	5.9	4.6	1.7	2.2
Parent training and information	3.8	2.2	6.9	1.4	13.4	17.0
Benefits counseling and financial education	2.1	5.6	3.4	9.9	0.2	5.8
Program administration^a	25.3	42.0	45.1	40.6	48.1	33.1

Source: Mamun et al. (2019). Note: Percentages might not sum to 100 due to rounding. ^aIncludes costs associated with program administration, staff training and technical assistance, and evaluation.

The national evaluation’s estimates of annual cost per enrollee ranged from $5,490 for ASPIRE to $9,148 for Arkansas PROMISE (Table 5). A key factor potentially explaining the variation in the per enrollee costs is the extent to which the project provided services directly as opposed to leveraging existing services available in the community. Arkansas PROMISE delivered or paid for most of its services directly; its cost per enrollee was high compared to the other projects. ASPIRE leveraged existing services to a relatively large extent; its cost per enrollee was low compared to the other projects. If the costs of services received from other agencies (that is, the cost of the existing services the projects leveraged) could be accounted for, all of the projects’ costs would be higher than the estimates shown.

To put these costs into context, in 2014 the federal government spent an estimated $5,000 per youth with disability (under age 18) on public programs and supports specific to them or that represented assistance programs used by many such youth (Shenk & Livermore, 2019). 3 Thus, the annual cost per enrollee across the PROMISE projects was roughly similar to the average annual cost of all federal programs currently available to youth with disabilities, and this investment was in addition to the existing federal outlays for youth with disabilities.

4.6 Under the current system of transition services and supports, the intensive case management component of the PROMISE model might be difficult to sustain

Intensive case management was the central feature of all of the PROMISE projects and represented the largest component of service costs. To enable case managers to provide broad-based case management that addressed a variety of youth and family needs, PROMISE case managers carried relatively small caseloads— about 30 or fewer families each in most projects. Although some PROMISE case managers were on the staff of education and VR agencies, they generally functioned independently of those agencies’ other programs— necessary to ensure that project demonstration funds were spent as intended and only treatment group members would receive PROMISE services. As of the writing of this article, none of the PROMISE states has continued to provide the kind of broad-based case management to SSI youth offered under PROMISE.

Certainly costs and limited resources are important reasons why intensive targeting and case management services for SSI youth have not been adopted outside of PROMISE. Moreover, state and local agencies have little incentive to invest significant resources in providing specialized services to this population that go beyond their usual services. For some providers, this population is relatively small and difficult to identify from among its service users overall, and there is little justification for shifting limited resources away from other users to serve SSI youth. Under the current system, SSA has the most to gain from the successful transition of SSI youth to adulthood. However, SSA currently lacks the resources and authority to provide case management services to its beneficiaries; its primary function is to provide income support. SSA does reimburse VR agencies and other providers when they help beneficiaries find and maintain employment, but currently does so only for adult beneficiaries. Expanding the Ticket to Work program to SSI youth might help address this but there are numerous complexities that SSA would need to address in designing and implementing such an expansion. VR agencies seem a logical place to house case management services tailored to SSI youth and families, especially if successful employment and independence are the primary goals of the transition services. However, other community organizations could function in this capacity, given appropriate funding and incentives to serve this population, which under the current system appear to be insufficient.

5 Conclusions

The outcomes of youth with disabilities broadly, and SSI youth specifically, underscore the need for additional transition supports for these youth. Low educational achievement and employment rates, challenges accessing services and transitioning to adult services, and reliance on income support and public health insurance suggest that the current transition system may not adequately meet the needs of SSI youth and their families. Although WIOA has improved the availability of transition services for youth with disabilities (particularly from state VR agencies), it remains to be seen whether those services will result in gains in employment and education outcomes among SSI youth. A key question, then, is whether PROMISE is a model that can supplement existing transition supports and fill the various gaps in the current system.

The answer to that question largely lies in whether the longer-term benefits of PROMISE projects are found to be greater than their costs. On the one hand, PROMISE projects involved significant investments of resources, and not just in terms of their average annual costs. Each of the projects hired staff for specific functions; trained staff on issues such as disability, services, and benefits; and built substantive collaborative relationships with multiple state and local entities. The projects also required substantial effort to identify, find, and enroll SSI youth to serve, and— once enrolled— maintain their interest in PROMISE services. On the other hand, PROMISE projects successfully engaged youth in key transition services and, in many instances, had large impacts on service receipt, particularly in those areas lacking in the current transition system. Although the PROMISE national evaluation has yet to estimate the anticipated benefits relative to project costs, the early findings on service impacts support the idea that PROMISE has the potential to generate net benefits.

Although the PROMISE project costs represent a substantial federal investment in supporting the successful transition of SSI youth to adulthood, the value of the investment ultimately must be judged based on its returns. When SSI youth are unable to prepare themselves for participating in the labor market through education and training, they are unlikely to attain stable employment during adulthood. They then may end up relying on income assistance, public health insurance, and other public supports for most of their lives. As noted earlier, the cumulative lifetime costs of SSI, SSDI, Medicare, and Medicaid are substantial when individuals enter these programs as young adults and remain on their rolls. If PROMISE has a significant impact on the long-term employment of SSI youth, it is conceivable that the benefits will exceed the costs. Some anticipate that the lifetime savings in SSI benefits and Medicaid for even a handful of youth will exceed the projects’ costs for all participants (Enayati & Shaw, 2019). It remains to be seen whether a short-term intervention like PROMISE can make a long-term impact on the lives of youth in their chances of employment and economic independence.

The insights and lessons for providing transition supports to SSI youth gained from PROMISE are relevant for WIOA implementation, and for SSA and other federal partners in their efforts to better meet the needs of SSI youth. The size of the investments required to implement the PROMISE projects makes it difficult for state and local agencies to maintain the original projects. The national evaluation of PROMISE will conduct a formal benefit-cost analysis based on the youth outcomes observed five years after PROMISE enrollment. This analysis will demonstrate the potential for PROMISE projects to pay for themselves in the long run and provide evidence to help inform future decisions about how best to support youth with disabilities in making successful transitions to adulthood.

Conflict of interest

None to report.

Footnotes

Acknowledgments

The authors are grateful to Jeffrey Hemmeter for comments he provided on an early draft. The opinions and conclusions expressed in this article are solely those of the authors and do not represent the opinions or policy of any federal, state, or local government agency.

The act was originally titled Education for all Handicapped Children Act but was changed to Individuals with Disabilities Education Act with the 1990 reauthorization.

The core services offered by the PROMISE programs are consistent with the practices and predictors deemed effective by two primary sources of information about effective transition services and supports— Guideposts for Success (developed by the National Collaborative on Workforce and Disability for Youth, 2009), and the Effective Practices and Predictors matrix maintained by the National Technical Assistance Center on Transition (NTACT, 2017). However, only one of these core services— paid work experiences— has strong evidence supporting its effectiveness (Honeycutt et al., 2018a). The level of evidence for other PROMISE services and practices is weaker because none has been rigorously tested.

The estimates include the costs of supports and programs that specifically target youth with disabilities (for example SSI, VR, and special education) as well as the proportional costs of selected other public assistance programs that support youth (for example, Temporary Assistance for Needy Families and child nutrition programs).

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