Neil Pessin, PhD¹, David C. Lindy, MD¹, and Tara Mendizabal, MS². (1) Community Mental Health Services, Visiting Nurse Service of New York, 1250 Broadway, 3rd Floor, New York, NY 10001, 212-609-7770, npessin@vnsny.org, (2) Visiting Nurse Service of New York, Community Mental Health Services, 1250 Broadway, 22rd Floor, New York, NY 10001

The Clinton administration enacted far-reaching legislation to reform the welfare system in the United States with the goal of getting people back to work. While many people who once received public assistance are now employed, those who remain on welfare appear to be a more resistant population, particularly difficult to employ. The Human Resources Administration of the City of New York has funded a large welfare-to-work initiative that includes a clinical case management (CCM) component specifically designed to help welfare recipients with histories of substance abuse. These clients must also have histories in one or more of six “domains” (psychiatric illness, homelessness, criminal justice, domestic violence, physical illness, child welfare). To receive welfare benefits, clients are mandated to participate in substance abuse treatment.

The Visiting Nurse Service of New York has operated its CCM program since 2001, with an average daily census of 2000 clients. The program’s goals are to help clients stay compliant with mandated substance abuse treatment, manage multiply complicated systems issues, and find employment. We will present data comparing clients who have achieved and maintained employment in 2003 (N=75) with a matched unemployed, comparison group. The two groups will be compared in terms of demographic, clinical, and case management variables to determine those factors, or patterns of factors, which significantly correlate with successful employment.

Learning Objectives: At the conclusion of the session, the participant in this session will be able to

• Identify early predictors of successful engagement and future work activity.
• Understand welfare reform’s mandated work requirements and the implications they pose for the clinical care of multiply-disabled individuals.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.