Magazine article AI Magazine

An Intelligent System for Case Review and Risk Assessment in Social Services

Magazine article AI Magazine

An Intelligent System for Case Review and Risk Assessment in Social Services

Article excerpt

Case review and assessment of client need is an important task in many social service areas. The services and benefits that clients receive are based largely on such reviews and assessments. The failure to perform accurate reviews and assessments in a timely manner can result in a client being denied access to services when they most need them.

The typical scenario with regard to case review and assessment in social services situations involves a professional caseworker reviewing a client's file, conducting a phone or in-person interview if necessary, and making an assessment using the information obtained from the review and heuristics developed from experience. The caseworker is generally a professional who possesses expertise in the appropriate field. Some examples of fields where this expertise is found include medicine, mental health, and education.

As pointed out by Ferns (1995), social service organizations are faced with a variety of challenges, including increased need for services, decreased funding for service, and growing government regulation. Many social service organizations have developed large backlogs of cases waiting for review and assessment. These backlogs have reduced the time that caseworkers can spend on other services, such as counseling clients. These pressures have forced many social service organizations to investigate technologies suitable for relief of their burden (Lewis 1994; Murrelle et al. 1992). One such technology is intelligent systems. The possibility of the development of intelligent systems that would contain the domain knowledge and heuristics exhibited by the most effective professionals in the review and assessment process became attractive.

Social Security Disability Screening

The 1934 Social Security Act provides for financial assistance for individuals who have been declared disabled. In New York State, the task of disability determination for acceptance into either the Title XVI Supplemental Security Income (SSI) or Title II Social Security Disability Insurance (SSDI) program rolls rests with the New York State Department of Social Services Office of Disability Determination (ODD). In addition to its primary responsibility for disability determination, ODD refers any person whom they feel might benefit from vocational rehabilitation services to the New York State Department of Education Office of Vocational and Educational Services for Individuals with Disabilities (VESID).

The assessment of social security disability cases for referral to VESID has been accomplished through a cooperative program between ODD and VESID. The program consists of VESID professionals stationed at the ODD performing case assessments and referring appropriate social security-accepted cases directly to the VESID district offices.

The 1981 amendments the Social Security Act changed the method by which the Social Security Administration (SSA) was authorized to pay for vocational rehabilitation services. Prior to the 1981 amendments, the SSA provided grants to cover the cost of vocational rehabilitation services for social security recipients. With enactment of the amendments, the SSA was authorized to pay for services only on a case-by-case basis and only in those instances where vocational rehabilitation services have resulted in the recipient performing at substantial gainful activity for a continuous period of nine months.

This change in reimbursement methods had an immediate and dramatic effect on the level of SSA funding available to New York VESID. SSA, under the grant system, used to provide approximately $5 million a year to New York VESID. Post-1981 amendments reduced the funding to approximately $1 million a year. The amendments forced New York VESID to reexamine its level of participation in the social security vocational rehabilitation assessment process with ODD. The effect of this reexamination was a sharp cutback in the number of VESID employees dedicated to the assessment effort. …

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