Can Case Management Teams Solve the Dilemmas of the Street-Level Bureaucrat? Evidence from Texas

Background purpose: Past research on poverty and work has typically not considered innovative, experimental programs that occur in nonprofit settings. This oversight is important, not only because of the resources nonprofits expend on serving low-income families, but also because such organizations are less encumbered by governmental rules in designing creative and “ground-up” programs to support employment compared to welfare agencies. This study draws on a randomized trial at a major nonprofit in Texas in which the treatment group received intensive case management services provided by a team of two caseworkers in order to facilitate work and reduce bureaucratic burden among staff in order to offer more comprehensive services to low-income families and improve outcomes.

 

Methods: We draw on approximately 300 hours of participant-observations (2015-2017) in the form of caseworker-client interactions and interviews with all caseworker teams (N=32) at two points in time (2015 and 2016). We interviewed caseworkers within two months of the intervention’s implementation in order to reduce the potential influence of caseworkers’ and teams positive or negative economic outcomes on staff perspectives. One year later, we interviewed caseworkers a second time to assess expectations and actual outcomes. Caseworkers were asked questions at each point in time in the following domains: 1) expectations of the use of teams in reducing bureaucratic burden and enhancing client outcomes 2) organizational influences (promising practices and challenges) in implementing intensive case management teams in addressing work and income outcomes 3) bureaucratic burdens in the context of team-based work; 4) perspectives on case management teams as a tool for addressing client needs and; 5) recommendations for improvement of team collaboration in service to client outcomes. Content analyses of field notes and case management team interviews were employed to elucidate a prior and emergent themes as they related to case management teams expectations, processes, and associated client outcomes.

 

Results: The study found that early on staff were enthusiastic about delivering services via casemanagement teams but already displayed some misgivings about clients with chronic barriers to work especially in the area of mental health. Interviews one year later found that teams found it difficult to overcome structural barriers to poverty including child care, transportation, and housing issues among clients. Moreover, teams reported significant interpersonal barriers at both points in time between team members that hindered the delivery of services and subsequent client outcomes.

 

Conclusions and Implications: This study suggests that case management teams may only be effective with the least disadvantaged families—those without or with few barriers to work. And, that case management teams likely need ongoing training in navigating team relationships in order to facilitate client outcomes. Given the burgeoning interest in teams to solve the dilemmas of street-level bureaucrats providing more comprehensive and therefore effective services, this study offers timely information for administrators, front-line staffs, and researchers in this area of scholarship.