Challenge: Labour market integration of the most disadvantaged

Transforming Disability into Ability

Copenhagen, 5 November 2014

Dr. Rienk Prins

University for Applied Sciences “Progresz” Utrecht (Netherlands)

Contents

• Target group• Demarcation• Backgrounds of increasing interest

• Selected programmes and experiences from: • Netherlands • United Kingdom• Norway

• Observations, evaluations and lessons

Demarcation

• General:• The most disadvantaged / the most vulnerable / the hardest to

help• Multiple disadvantaged groups

• Specific (“operational definitions”): Example Netherlands • Persons on benefit • Simultaneous: two (or more) connected problems / barriers • Unable / unwilling to arrange themselves control or solution of

problems

• Related approaches:• Focus on families (e.g. UK: Troubled Families)• Focus on poverty neighbourhoods (NL: Neighbourhood Coach)

Backgrounds of rising interest

• Current benefit / integration systems not appropriate: • contingency focused (the sick, the disabled, the

unemployed, …) • less effective in helping customers with combinations of

disadvantages• Most disadvantaged:

• passive, often do not take initiative for support to employment

• “grey area clientele”• Service delivery problems

• Oversupply / uncoordinated agencies• Lack of expertise • Organizational conditions (work load case managers)

Small international overview

• Three countries dealing with the target groups:

•Netherlands: exploring scope and delivery problems, pilots and experiments

•UK: targeted programmes, (meta) evaluations

•Norway: generous programme implemented

NL: Scope

• Estimating the size of the problem:• Data sources (2008, 2009): persons receiving

benefits (sickness, disability, unemployment, social assistance)

• Estimate on all benefit recipients: • 40%: “have multiple problems” (2 or more barriers)

• Estimate on some specific categories:• Poorly educated/skilled 66%• Former prisoners 59%• Social assistance recipients 51%• Young persons on benefit 24%

NL: Provision of services (1)

• Providers/case workers/experts interviews (N=27):• Large variation in number of actors/agencies in

the chain of service provision• Large variation in their goals and criteria: e.g.

•Prevention social exclusion, •Empowerment•Mental health rehabilitation•Employment

• Waiting lists, availability of service providers (e.g. debt management)

NL: Provision of services (2)

• Cooperation and coordination “in the chain”• “Who has the lead”, who sets priorities?• Availability of budgets• Many variations in organizational strucures

• Dilemma’s / Paradigms:• Voluntary or forced?• Work First? Health First? Housing First? • “What works for whom?”

• More org. problems: poverty neighbourhood/ poverty family programmes

NL: Pilot projects and Information

• Pilot projects on various aspects, e.g.:• Integrated intake procedures (care needs, integration needs)• Cooperation of mental health care providers and municipal

social welfare office• Integrated approach of health promotion and access to

employment in welfare recipients• IPS oriented (Individual Placement and Support)

• Publications:• Overviews of “promising (integrated) approaches” , “good

practices”• Training material for case workers• Fact sheets (“knowledge documents”)

UK: Demarcation

• Def.: Diverse group with no clear identity• Those with most severe / multiple barriers to

work:• Drug or alcohol dependency• Persistent /ex offenders• Homeless people, • Poor basic skills, learning difficulties,• Poor English language skills, refugees• Persons with mental health conditions

• Many projects on specific categories

UK: Evaluations

• Little information: ”what type of provisions work best” for most disadvantaged:• No/poor collection of customer characteristics

and performances on project level • Heterogeneous client groups • Nature of interventions varies across individuals,

no isolated measures • Lack of control groups

• Lessons: more relying on qualitative evaluations (interviews: staff, administrators, employers, clients)

UK: Lessons (1)

• Lessons from qualitative evaluations of specific programmes (ex offenders, drug abusers): Need for • Support, advice, guidance and motivational confidence-building

assistance• Individually tailored programme / action plan• First step often: addressing mental health conditions, housing

problems, etc. (Not: “Work First”)

• Basic questions on aims: • Realistic aims: Is employment an appropriate and feasible goal?

Or:• Strive for : greater stability in life - but in association with

(further) claiming of benefits?

UK: Lessons (2)

• Delivery aspects:• Clients: least likely to volunteer for support Outreach

approaches needed• One-to-one support from a personal advisor • Staff with empathy, good communication skills• “It takes time to help the most disadvantaged”: 6-12 month

period: insufficient• Appropriate case load for advisor/provider• In depth knowledge of local organizational infrastructure• Practical inter-organizational referral arrangements (to

prevent drop out)

Norway: QP

QP Aims• History:

• 2007: Start pilots• 2009: Interim evaluation / EU Peer Review • 2010: Nation wide implementation (and legal entitlement)• 2014: Evaluation report

• Aim: fight poverty, by promoting self-supporting employment

• Target group: Hard to employ social assistance claimants with reduced work capacity and variety of problems:• Poor language skills, disrupted schooling, little or no work

experience• Often: mental disorders, drugs problems • Aged 19 - 67

QP: Key features (1)

• Programme: • “Costly and ambitious”• Combines generosity and activation• Offers income safety, requires effort to become self sufficient.

• Key elements programme: • Full time (37,5 hours/week)• Duration: initially 1 year (max. 2 years)• Income support (“quasi wage”): € 20 000/ year (< 25 years: 2/3)• Allowances (child support, housing) • QP benefit: taxed and holiday privileges (as regular labour)

QP: Key features (2)

• Tailored qualification and activation programme• Agreed by client and case worker• Plan elements: mixture:

• Consultations• Medical rehabilitation, therapy, sports• Skills upgrading • Employment training• Social training

Structure QP

Initial evaluations (1)

• End 2010: 17 214 participants• Plan completed: 4 968 (29%)• Dropped out: 1 414 (8%)

• After completion:• 31% in regular employment• 7% entered regular education• 62% continued benefit dependency (temporary,

permanent disability benefit, social assistance)

Initial evaluations (2)

• “Success factors” (interviews):• Individually tailored programme, flexibility criteria• Job training with “ordinary employers”• Clients:

• Income support: financial stability • Plans fitted to individual needs

• QP case workers:• Received specific training (employment issues) • Adapted case load: 18 clients (other schemes: ca. 86 clients) • Active follow up approach and adequate IT system

• Weaknesses: • Transfer from health employment interventions• Full time programme: often not feasible

EU Peer Review Evaluation (2010)

• Very positive: QP reflects social inclusion policy EU advocates: • One stop shop• Integrated approach (work and health)• Adequate income support• Coordination of several administrative levels

(municipality, region, national)• One coordinator / case manager:

• both internally (public actors) and • externally (e.g. care provider, employer)

• Clients and case workers: satisfied

“Final” evaluations (2014)

• Register data entrants 2008 – 2011 (N=19 211)• Participating >2 years: 23%• Mean age: 33.7• Non-native: 50.7%• High school: 16.1%

• Main success criterion employment:• QP: reduces employment slightly during first 1-2 years of

participation• 3 years after QP entry: 20% point increase in employment

probability (stat. sign.)• Most additional jobs: poorly paid / very small • So: still high dependency of transfers from welfare state

Some conclusions (1)

• Policy / programme level:• Shared Goals (employment, less barriers, stability)• Programme features:

• Large variations contents/structure of programmes• Long lasting • Shared responsibilities (case worker/client)• Integration work focussed interventions

• Dilemma’s: e.g.• Voluntary vs compulsory

• Evaluations: more on “process” than “effects”

Some conclusions (2)

• Operational level:• Active approach to client:

• Outreach • Close monitoring and supervision

• Organizational issues needing attention: e.g.:• Multidisciplinary cooperation• Commitment and consensus• Various coordination models• Agreement on budgets and criteria• Availability of services (waiting lists)• Working conditions/ work load case managers