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The SSRC Library allows visitors to access materials related to self-sufficiency programs, practice and research. Visitors can view common search terms, conduct a keyword search or create a custom search using any combination of the filters at the left side of this page. To conduct a keyword search, type a term or combination of terms into the search box below, select whether you want to search the exact phrase or the words in any order, and click on the blue button to the right of the search box to view relevant results.

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  • Individual Author: Meyers, Marcia K.; Lukemeyer, Anna; Smeeding, Timothy M.
    Reference Type: Report
    Year: 1996

    This paper addresses issues which arise at the juncture of welfare and disability policies. Using preliminary data from a recent survey of current and recent AFDC recipients in California, we find that disabilities and chronic health problems affect the mothers or children in 43 percent of all households in the AFDC system. The presence of one or more children with disabilities or chronic illnesses is found to have an impact on the economic well-being of families, with increased levels of direct hardship reported by families caring for one or more severely impaired children. Potential causes of higher levels of hardship are examined by considering the impact of direct expenses associated with the care of the child(ren) and reductions in the mother's probability of paid employment. SSI receipt is found to have a modest antipoverty effect for families with special needs children, reducing the prevalence of poverty and extreme poverty for families even after the additional direct costs of caring for these children are considered. (author abstract)

    This paper addresses issues which arise at the juncture of welfare and disability policies. Using preliminary data from a recent survey of current and recent AFDC recipients in California, we find that disabilities and chronic health problems affect the mothers or children in 43 percent of all households in the AFDC system. The presence of one or more children with disabilities or chronic illnesses is found to have an impact on the economic well-being of families, with increased levels of direct hardship reported by families caring for one or more severely impaired children. Potential causes of higher levels of hardship are examined by considering the impact of direct expenses associated with the care of the child(ren) and reductions in the mother's probability of paid employment. SSI receipt is found to have a modest antipoverty effect for families with special needs children, reducing the prevalence of poverty and extreme poverty for families even after the additional direct costs of caring for these children are considered. (author abstract)

  • Individual Author: Fox, Harriette B.; McManus, Margaret A.
    Reference Type: Journal Article
    Year: 1998

    The rapid transition of state Medicaid beneficiaries into fully capitated managed care plans requires a special focus on children with chronic or disabling conditions, who often depend on numerous pediatric physicians and other specialty services for health care and related services. Because managed care arrangements for this population are growing in popularity nationwide, it is important that states craft managed care contracts to address the unique needs of children with complex physical, developmental, and mental health problems. Based on the research reported in this article, in-depth interviews with state Medicaid agency staff, interviews with medical directors and administrators of managed care plans serving Medicaid recipients, and input from experts in pediatrics and managed care, a set of recommendations is made for tailoring managed care contracts to meet the needs of this vulnerable group of children.

    Six contracting elements that should be adopted by state Medicaid agencies include (1) clarifying the specificity of...

    The rapid transition of state Medicaid beneficiaries into fully capitated managed care plans requires a special focus on children with chronic or disabling conditions, who often depend on numerous pediatric physicians and other specialty services for health care and related services. Because managed care arrangements for this population are growing in popularity nationwide, it is important that states craft managed care contracts to address the unique needs of children with complex physical, developmental, and mental health problems. Based on the research reported in this article, in-depth interviews with state Medicaid agency staff, interviews with medical directors and administrators of managed care plans serving Medicaid recipients, and input from experts in pediatrics and managed care, a set of recommendations is made for tailoring managed care contracts to meet the needs of this vulnerable group of children.

    Six contracting elements that should be adopted by state Medicaid agencies include (1) clarifying the specificity of pediatric benefits, (2) defining appropriate pediatric provider capacity requirements, (3) developing a medical necessity standard specific to children, (4) identifying pediatric quality-of-care measures, (5) setting appropriate pediatric capitation rates, and (6) creating incentives for high-quality pediatric care.

    Nine approaches that should be adopted by managed care practices interested in providing high-quality care for children with special needs also are identified. These include (1) ensuring that assigned primary care providers have appropriate training and experience, (2) offering support systems for primary care practices, (3) providing specialty consultation for primary care providers, (4) establishing arrangements for the comanagement of primary and specialty pediatric services, (5) arranging for comprehensive care coordination, (6) establishing flexible service authorization policies, (7) implementing provider profiling systems that adjust for pediatric case mix, (8) creating financial incentives for serving children with special needs, and (9) encouraging family involvement in plan operations.

    Implementing these changes to managed care contracting could have a major impact on the quality and comprehensiveness of health care received by children with special needs. Successful implementation, however, requires strong support from both state Medicaid agencies and the managed care plans dedicated to serving this population. (author abstract)

  • Individual Author: Thompson, Terri S.; Holcomb. Pamela A.; Loprest, Pamela; Brennan, Kathleen
    Reference Type: Report
    Year: 1998

    The focus of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) on work and temporary cash assistance is likely to have significant implications for welfare recipients with disabilities and individuals who care for recipients with disabilities (caregivers). Prior to welfare reform, disabled recipients and caregivers were generally exempt from participating in welfare-to-work programs and cash assistance was available for an unlimited period. The purpose of this study is to determine the extent to which states have used the flexibility provided under PRWORA to change their welfare-to-work policies as applied to individuals with disabilities and caregivers. States' decisions about policy changes must be balanced against two key challenges presented by welfare reform:

    1. States must consider the diverse needs of individuals with disabilities while meeting the work participation and other requirements established in federal law. States now have the latitude to design their welfare-to-work programs in ways they believe will best meet...

    The focus of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) on work and temporary cash assistance is likely to have significant implications for welfare recipients with disabilities and individuals who care for recipients with disabilities (caregivers). Prior to welfare reform, disabled recipients and caregivers were generally exempt from participating in welfare-to-work programs and cash assistance was available for an unlimited period. The purpose of this study is to determine the extent to which states have used the flexibility provided under PRWORA to change their welfare-to-work policies as applied to individuals with disabilities and caregivers. States' decisions about policy changes must be balanced against two key challenges presented by welfare reform:

    1. States must consider the diverse needs of individuals with disabilities while meeting the work participation and other requirements established in federal law. States now have the latitude to design their welfare-to-work programs in ways they believe will best meet the needs of their clients. States may also decide who among the welfare population will be required to participate in these programs. However, states are required to meet increasing work participation requirements or face financial penalties. Additionally, states must continue to comply with the Americans with Disabilities Act of 1990 (ADA), Section 504 of the Rehabilitation Act of 1973, and other civil rights statutes.

    2. The imposition of state and federal time limits increases the immediacy of welfare recipients' need for help in overcoming their barriers to work and self-sufficiency. Welfare agencies have not historically been required to focus on the needs of many clients with serious barriers to employment or self-sufficiency—including individuals with disabilities—and now must develop service strategies that achieve this end within 60 months (or less in some states).

    This study represents a first attempt to provide a nationwide overview of welfare-to-work policies for individuals with disabilities and caregivers. To obtain this overview of state policies, Temporary Assistance for Needy Families (TANF) plans and other relevant policy documents were reviewed and conversations were held with welfare agency staff in each of the 50 states and the District of Columbia. This report does not provide detail on local-level implementation or local pilot projects. Additional detail about policy implementation will be obtained through case studies of a small number of policy approaches to be conducted in the second phase of this project.

    The major findings of this report are:

    • The majority of states have changed their work participation policies to require participation among some individuals with disabilities and caregivers who were previously exempt.
    • States are in the early stages of making decisions about who should be required to participate in welfare-to-work services, who should be expected to move off welfare within 60 months, and what services will best help recipients achieve this objective.

    (author abstract)

  • Individual Author: Storen, Duke; Dixon, K.A.
    Reference Type: Report
    Year: 1999

    On August 22, 1996, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, known as the federal welfare reform bill or PRWORA, was signed by President Clinton. This legislation created the Temporary Assistance for Needy Families (TANF) program to replace the Aid to Families with Dependent Children (AFDC) and JOBS programs. Unlike the previous open-ended federal financial participation system, TANF is funded through a block grant. The new TANF program advocates a “work first” philosophy to public assistance, placing a time limit on benefits and requiring that TANF recipients engage in work or work-related activities to participate in the program. Under federal law, TANF-funded assistance to families is limited to sixty months unless the family is exempt under the hardship exception that applies to up to twenty percent of the caseload. States can choose to place more restrictive time limits on TANF recipients, and they can choose to use state funds to help families after five years. Under the JOBS program, people with disabilities (those “ill or incapacitated...

    On August 22, 1996, the Personal Responsibility and Work Opportunity Reconciliation Act of 1996, known as the federal welfare reform bill or PRWORA, was signed by President Clinton. This legislation created the Temporary Assistance for Needy Families (TANF) program to replace the Aid to Families with Dependent Children (AFDC) and JOBS programs. Unlike the previous open-ended federal financial participation system, TANF is funded through a block grant. The new TANF program advocates a “work first” philosophy to public assistance, placing a time limit on benefits and requiring that TANF recipients engage in work or work-related activities to participate in the program. Under federal law, TANF-funded assistance to families is limited to sixty months unless the family is exempt under the hardship exception that applies to up to twenty percent of the caseload. States can choose to place more restrictive time limits on TANF recipients, and they can choose to use state funds to help families after five years. Under the JOBS program, people with disabilities (those “ill or incapacitated”) were categorically exempt from working. Under TANF, many states are taking a narrower view of who should be exempt from work requirements.

    Federal law prevents states from using federal dollars to help families who have received federal TANF assistance for more than sixty months in their lifetime. The intent is to move as many people off the welfare rolls and into gainful employment as possible. However, many TANF recipients, including people with disabilities, face barriers to employment that make the transition from welfare to work difficult. According to the Department of Labor (DOL), people who are disabled are more likely to live below the poverty line than those who are not disabled. In 1995, thirty percent of working age people with disabilities had incomes below the poverty line, three times higher than people without disabilities. In addition, people with disabilities that do work earn less than their nondisabled peers, and are more likely to have jobs that pay below minimum wage and lack opportunities for training and advancement. In an economy that increasingly requires technical skills and life-long learning, many people with disabilities are entering the workforce at a disadvantage. Particularly for TANF recipients with disabilities, the challenge of finding and keeping a good job can be considerable. (author abstract)

  • Individual Author: Dreilinger, Danielle; Timmons, Jaimie C.
    Reference Type: Report
    Year: 2000

    On August 22, 1996, President Clinton signed into law the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA). One of the many stated goals under PRWORA was to encourage recipients of welfare to improve their economic status by returning to or entering employment. The emphasis on employment presents challenges for welfare caseworkers who must assist individuals in acquiring the necessary skills and training to enter employment. People with disabilities offer an additional challenge to caseworkers who in the past were not required to be familiar with disability-specific public supports, disability rights protections, and employment supports.

    This study examined how welfare reform affected Department of Transitional Assistance (DTA) case-workers in Massachusetts who may work with individuals with disabilities and investigated how their roles as caseworkers have changed since the reform. This brief will describe the findings of this research and share recommendations and resources with welfare caseworkers as they serve individuals with disabilities in...

    On August 22, 1996, President Clinton signed into law the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA). One of the many stated goals under PRWORA was to encourage recipients of welfare to improve their economic status by returning to or entering employment. The emphasis on employment presents challenges for welfare caseworkers who must assist individuals in acquiring the necessary skills and training to enter employment. People with disabilities offer an additional challenge to caseworkers who in the past were not required to be familiar with disability-specific public supports, disability rights protections, and employment supports.

    This study examined how welfare reform affected Department of Transitional Assistance (DTA) case-workers in Massachusetts who may work with individuals with disabilities and investigated how their roles as caseworkers have changed since the reform. This brief will describe the findings of this research and share recommendations and resources with welfare caseworkers as they serve individuals with disabilities in their caseloads. Although the findings are specifically related to DTA caseworkers in Massachusetts, it is our hope that the strategies provided are relevant to caseworkers in other states as well. (author abstract)

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