Working Well

Preventing Disability

Federal disability programs provide financial and medical assistance to workers who become disabled, however there are no federal programs designed to prevent workers with significant health problems from becoming disabled and dependent on federal assistance. In Texas, where one third of workers are uninsured, many workers with significant health conditions become disabled and rely on public programs for assistance.

Working Well, the Texas Demonstration to Maintain Independence and Employment (DMIE) was a ground-breaking study designed to help keep people well and working. Working Well tested whether providing health coverage and employment supports would keep working people with mental and physical disabilities off federal benefits, such as Medicaid, Supplemental Security Income (SSI) or Social Security Disability Insurance (SSDI). The study included over 1,600 participants in the Harris County Hospital District (Houston), making it one of the largest federally-funded scientific studies of its kind in the nation. The study compared participants receiving interventions to a control group of similar people who did not get the interventions. Working Well interventions included:

  • Case Management, including individualized planning, advocacy, navigation
  • Job Training and Employment Services
  • Expedited Clinic Appointments
  • Substance Abuse Services
  • Dental Benefits
  • Vision Benefits
  • Eliminating co-payments for health services or prescriptions

The results of Working Well suggest that these interventions improve outcomes for workers with serious health conditions and could contribute to lower future rates of application for disability.

Learn more about the program and its participants by reading  DMIE publications and participant stories.

About the Project

DMIE grants are authorized by the Ticket to Work and Work Incentives Improvement Act (TTW) of 1999 and are administered by the Center for Medicare and Medicaid Services (CMS). Project oversight is conducted by the Texas Department of State Health Services, and project evaluation is conducted by the University of Texas Addiction Research Institute in Austin, Texas. The Harris County Hospital District provides the interventions.

The study operated from April 30, 2007 through September, 30 2009, with data collection and evaluation activities continuing through November 2010.

Last updated November 13, 2015