The Texas DMIE project is an evaluation study designed to examine the effects of behavioral health services, case management, and vocational services on economic and health outcomes for working individuals with potentially disabling behavioral health disorders. The intent of this study is to examine the hypothesis that a coordinated program of employment and health supports can prevent the loss of employment and independence for workers with potentially disabling health conditions. Intervention participants will have access to an expansion on existing Medicaid-comparable coverage to include enhanced physical and behavioral health services, direct and indirect employment supports, and case management. Adding these enhancements is intended to improve health status, quality of life and employment success, and reduce health care costs. Additionally, Positive health and employment outcomes for participants who receive the enhanced services are expected to lead to reduced rates of needing and seeking disability status.

This  intervention is designed to assist participants in maintaining employment and avoid future disability arising from complications of mental illness and/or substance use disorders. The DMIE project will be implemented in the Harris County Health District, a public healthcare system that provides approximately 1.1 million healthcare visits yearly to Harris County, Texas residents. The sample participants for this study will be drawn from people receiving HCHD medical services and who meet administrative and clinical eligibility.

DMIE services for intervention participants include: a) expanded behavioral, medical and dental health services such as chemical dependence treatment services, prescriptions above the 3 per month limit in Medicaid, expanded access to durable medical equipment, preventative and restorative dental treatment, and enhanced psychological and neuropsychological assessments; b) improved access to services including expedited office or outpatient visits to a psychiatrist, psychologist or master’s level professional; c) case management services including assistance with connection to other resources, development of an individual plan addressing life and health issues, and advocacy, direct services, and coordination and intervention with appropriate systems, and d) employment/vocational supports to maintain employment or improve employment opportunities.

The partners and collaborators in DMIE include: a) The University of Texas Addiction Research Institute will conduct overall implementation of the research framework, evaluation, project reports, and coordination recruitment data management system; b) University of Texas Houston School of Public Health will collect field data; c) the Public Policy Research Institute at Texas A&M University will recruit potential participants and collect annual data; and d) Harris County Hospital District, the site from which participants will be drawn.

The Texas DMIE project is housed at the UT Addiction Research Institute. For more information about this and other ARI research projects, visit the Institute’s website, www.utexas.edu/research/cswr/nida/researchProjects.html