An Unprecedented Crisis: The WeCARE Program’s Experience Serving People with Mental and Physical Health Challenges During a Pandemic

Publication Date: March 9, 2023
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  • Published: 2023

Introduction

The Wellness Comprehensive Assessment Rehabilitation and Employment (WeCARE) program provides clinical assessment, employment, Social Security application, wellness, and rehabilitation services to tens of thousands of New York City residents who receive public assistance and have physical and/or mental health challenges to employment. This includes single adults who have limited resources and Temporary Assistance for Needy Families recipients who struggle to meet work requirements. The WeCARE program aims to fill a critical need by supporting people who are experiencing a health challenge but can work by finding placements and training, with accommodations, when appropriate. The program also helps those who cannot work apply for disability benefits for which they might qualify.

In March 2020, the COVID-19 pandemic upended the lives of WeCARE clients, staff, and all other New York City residents, affecting their health and job security. New York City’s Human Resources Administration (HRA)—the administrator of WeCARE—faced an unprecedented challenge to its ability to deliver services to New York City residents. Staff had to quickly transition to working from home and offering virtual services. At the direction of the state, WeCARE paused its enrollment and assessment of new clients and made participation in its services voluntary instead of mandatory for all clients. This report documents the experiences of WeCARE staff and participants during the first year of the pandemic and shares lessons learned about maintaining services for clients in a crisis.

Purpose

This study documents how WeCARE served clients before the pandemic, how the program changed in response to the employment and service needs of its clients during the pandemic and economic recession, and the implications of those changes for long-term modifications to the WeCARE model. The lessons WeCARE learned during this tumultuous time could guide other agencies coping with significant shifts in their service delivery environment, including serving people with physical and mental health challenges virtually.

Key Findings and Highlights

  • For WeCARE clients, the pandemic exacerbated existing disparities and challenges to entering the workforce. Job opportunities were even more scarce than before for WeCARE clients who faced physical and/or mental health challenges to working. With the spread of the pandemic, it became increasingly difficult to sustain employment as clients worried about exposing themselves or their loved ones to COVID-19. Disruptions in school, child care, and public transportation also made it challenging for some clients to find work.
  • Providing services virtually is feasible and has some benefits, but it also has risks. Provider staff and clients found advantages to engaging remotely, including flexibility in attending workshops or appointments, and the ability to offer more one-on-one client support as needed. But staff expressed concerns about not being able to get to know clients in person, and concerns about clients who are not accustomed to using technology.
  • The lack of mandatory participation requirements revealed the importance of providing client-centered services. Staff noted they had difficulty getting clients to engage because participation was not mandatory. However, those who did participate appreciated the support they received and found the more individualized attention helpful. In interviews, staff said their experiences during the pandemic reminded them of the importance of connecting clients to a variety of services and resources, and the need to adapt to clients’ changing needs. However, ongoing challenges in hiring staff and a return to mandatory participation in services might mean that staff caseloads will increase, making it difficult to provide individualized support.
  • It is important to support both staff and clients. WeCARE clients highlighted how much they appreciated staff responsiveness during the height of the pandemic. They valued having someone to talk to during lockdown, and WeCARE helped them stay motivated in their job search. HRA and service provider leaders recognized the importance of supporting staff morale and technical capacity so staff could focus on being available to clients. Leaders provided more frequent check-ins and trainings, and reassigned staff instead of letting them go when the needs of the program changed. Staff believed the culture created by leaders also encouraged more collaboration and sharing of lessons across different providers.

Methods

This descriptive study used qualitative and quantitative data to explore themes in the experiences reported by WeCARE staff and clients and trends in the performance data collected by WeCARE providers. The study team conducted interviews and focus groups with 29 staff from HRA and WeCARE providers between April and June 2021. The team also conducted in-depth, one-on-one interviews with 10 WeCARE clients between May and August 2021 who were enrolled in the program before and during the COVID-19 pandemic. Finally, the team analyzed administrative data provided by WeCARE on clients served before and during the pandemic.

The study team used a thematic approach to analyze the qualitative data from the interviews and focus groups, extracting findings related to each of the research questions. To provide more context, the team used administrative data to develop descriptive statistics about client characteristics, services, and outcomes.

Citation

Sattar, Samina, Mary Anne Anderson, Kelsey Chesnut, and Veronica Sotelo Muñoz. “An Unprecedented Crisis: The WeCARE Program’s Experience Serving People with Mental and Physical Health Challenges During a Pandemic.” OPRE Report #2023-036. Washington, DC: Office of Planning, Research, and Evaluation, Administration for Children and Families, U.S. Department of Health and Human Services, 2023.