This paper provides an analysis of the dynamics of the transition of child Supplemental Security Income (SSI) recipients into adulthood using linked 2001-2002 National Survey of SSI Children and Families (NSCF) survey and Social Security Administration (SSA) administrative data. We examine the interaction of impairment status, reported health needs, and other self-reported indicators of human capital on SSI program and employment outcomes after age 18. Our primary objective is to examine the differences in pre-age-18 individual characteristics across subgroups of recipients by impairment status and determine whether these differences influence post-age-18 SSI participation and employment outcomes. We find that after controlling for measures of disability severity, duration, and human capital, youth with behavioral disorders and mental disorders other than mental retardation are much less likely to receive SSI at age 19. The findings also suggest that non-health factors, particularly education, employment, and social indicators, play an important role in the probability of a child SSI recipient being on adult SSI after age 18. Our findings indicate that, while some youth appear to be making a successful transition from child SSI benefits to adult benefits or other activities (off of SSI), others appear to have limited prospects for long-term self-sufficiency. A major concern is that some youth no longer on SSI after age 18, particularly those with behavioral disorders and mental disorders other than mental retardation, may not have been sufficiently prepared for life without SSI.

Clients achieved better application outcomes when practitioners provided application assistance by using concepts from SOAR. However, training alone was not sufficient for successful SOAR implementation. Careful systems planning and dedicated staff resources are critical for improved outcomes.

BACKGROUND: PROMISE was a federal initiative to support youth receiving Supplemental Security Income (SSI) during the transition to adulthood. OBJECTIVE: This article discusses insights gained from the national PROMISE evaluation about the current transition system. METHODS:The national evaluation relied on a randomized controlled trial design and information obtained from staff interviews, surveys of parents and youth, and program administrative data. RESULTS:The authors found that: (1) many SSI youth received transition services without PROMISE, but that there was substantial room for PROMISE to improve service use; (2) intensive case management, facilitating early work experiences, and a family focus were the primary PROMISE innovations to usual services; (3) formal partnerships enhanced interagency collaboration but required time to form, service benchmarks, and regular communication; (4) identifying SSI youth for outreach is challenging under the current system; (5) PROMISE service costs represented relatively large investments; and (6) the intensive case management offered by PROMISE might be difficult to sustain in the current system. CONCLUSIONS: Lessons from PROMISE are relevant to current initiatives supporting youth with disabilities during the transition to adulthood. The evaluation will assess the longer-term impacts of PROMISE and provide information about its potential for generating long-term benefits.

The proportion of TANF recipients using mental health services was lower than the proportion of TANF recipients identified through surveys as having a mental disorder, most likely because some TANF recipients had mental disorders that were undiagnosed and untreated. Among those using services, some had patterns of use indicating potential eligibility for SSI, but most appeared to have more modest limitations.