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  • Individual Author: United States Government Accountability Office
    Year: 2011

    Between fiscal years 2000 and 2008, TANF child-only cases increased slightly but represented a greater share of the overall TANF caseload because cases with adults in the assistance unit experienced a significant decline. The national composition of the TANF child-only caseload has remained relatively unchanged since 2000. At the end of 2010, the majority of children receiving TANF lived with parents who were ineligible for cash assistance, and one-third lived with nonparent caregivers who were relatives or unrelated adults. However, this composition varies by state. For example, in Tennessee, almost 60 percent of the TANF child-only caseload included children living with nonparent caregivers, compared with about 30 percent in Texas.

    Most nonparent caregivers in TANF child-only cases are unmarried women who are over 50 years old, and research suggests that they often have low incomes and health problems. The children tend to be related to their caregiver, who is often a grandparent, and they remain on assistance for at least 2 years. Some of these children live with...

    Between fiscal years 2000 and 2008, TANF child-only cases increased slightly but represented a greater share of the overall TANF caseload because cases with adults in the assistance unit experienced a significant decline. The national composition of the TANF child-only caseload has remained relatively unchanged since 2000. At the end of 2010, the majority of children receiving TANF lived with parents who were ineligible for cash assistance, and one-third lived with nonparent caregivers who were relatives or unrelated adults. However, this composition varies by state. For example, in Tennessee, almost 60 percent of the TANF child-only caseload included children living with nonparent caregivers, compared with about 30 percent in Texas.

    Most nonparent caregivers in TANF child-only cases are unmarried women who are over 50 years old, and research suggests that they often have low incomes and health problems. The children tend to be related to their caregiver, who is often a grandparent, and they remain on assistance for at least 2 years. Some of these children live with nonparent caregivers as a result of parental abuse or neglect, substance abuse, incarceration, or mental illness, but these circumstances may or may not be known by the child welfare agency.

    The level of benefits and services available to children living with nonparents depends on the extent to which a child welfare agency becomes involved in the family's situation and the licensing status of the caregiver. Children in foster care with licensed foster parents are generally eligible for greater benefits and services than children in other living arrangements, who may receive TANF child-only assistance. For one child, the national average minimum monthly foster care payment is $511 while the average TANF child-only payment is $249. Most children live with relatives who do not receive foster care payments because they are not licensed foster parents or they are in informal arrangements without child welfare involvement. Other factors influencing the assistance made available to children in a relative's care include available federal funding, state budget constraints, and increased state efforts to identify relative caregivers to prevent children from being placed in the foster care system.

    Several state and local efforts are under way to coordinate TANF and child welfare services to better serve children living with relative caregivers, but information sharing is a challenge. Coordination efforts include colocating TANF and child welfare services and having staff from each agency work together to help relative caregivers access services. ACF currently provides grants to states and tribes to support collaboration between TANF and child welfare programs and plans to disseminate the findings. However, information and data sharing between the two programs does not occur consistently, which can hinder relatives' access to available benefits. For example, although HHS provides funding, guidance, and technical assistance to promote data sharing between TANF and child welfare programs, more than half of states reported obstacles to sharing data, such as privacy concerns. GAO recommends the Secretary of HHS direct ACF to provide more guidance on data sharing opportunities. HHS agreed with GAO's recommendation.

    (author abstract)

  • Individual Author: Stoltzfus, Emilie
    Year: 2002

    This report examines recent research findings about Temporary Assistance for Needy Families (TANF) implementation as it has affected the nation's child welfare system. The nation's program of cash aid for needy families with children (TANF) and its program to protect and care for children who are abused or neglected (child welfare services) are linked by history and share some of the same clients who have similar service needs. Assessing the full significance of the 1996 welfare reform law (P.L. 104-193) to the child welfare system is complicated by the 1997 enactment of the Adoption and Safe Families Act (P.L. 105-89), which made direct and major changes to the child welfare system, and by the fact that TANF implementation generally occurred during a strong economy. Some child advocates were concerned that 1996 welfare reform initiatives ? including time limits, family cap policies, and work requirements might harm children and/or place new strains on the child welfare system. Research on the effect of TANF implementation has not produced conclusive findings. Changes in the size...

    This report examines recent research findings about Temporary Assistance for Needy Families (TANF) implementation as it has affected the nation's child welfare system. The nation's program of cash aid for needy families with children (TANF) and its program to protect and care for children who are abused or neglected (child welfare services) are linked by history and share some of the same clients who have similar service needs. Assessing the full significance of the 1996 welfare reform law (P.L. 104-193) to the child welfare system is complicated by the 1997 enactment of the Adoption and Safe Families Act (P.L. 105-89), which made direct and major changes to the child welfare system, and by the fact that TANF implementation generally occurred during a strong economy. Some child advocates were concerned that 1996 welfare reform initiatives ? including time limits, family cap policies, and work requirements might harm children and/or place new strains on the child welfare system. Research on the effect of TANF implementation has not produced conclusive findings. Changes in the size of the child welfare caseload have not been attributed to welfare reform, although certain work requirements may increase the incidence of child neglect. (author abstract)

  • Individual Author: Nadel, Mark V.; Harris, Gale C.; Riedinger, Susan A.
    Year: 1998

    Pursuant to a legislative requirement, GAO provided information on the effects of family violence on the use of welfare programs, focusing on the: (1) prevalence of domestic violence among welfare recipients; and (2) implications of domestic violence for the employment of welfare recipients and other low-income women.

    GAO noted that: (1) while studies on the prevalence of domestic violence among welfare recipients do not provide national estimates of prevalence and vary substantially in terms of methodology and the samples studied, these studies consistently indicate that a sizable proportion of welfare recipients have been or are victims of domestic violence; (2) the one study of those reviewed that was specifically designed to provide a statewide prevalence estimate was based on a representative sample of Aid to Families with Dependent Children recipients in Massachusetts in 1996; (3) this study found that almost 20 percent of the welfare recipients surveyed had experienced domestic violence in the prior 12 months, and about 65 percent had been victims of domestic...

    Pursuant to a legislative requirement, GAO provided information on the effects of family violence on the use of welfare programs, focusing on the: (1) prevalence of domestic violence among welfare recipients; and (2) implications of domestic violence for the employment of welfare recipients and other low-income women.

    GAO noted that: (1) while studies on the prevalence of domestic violence among welfare recipients do not provide national estimates of prevalence and vary substantially in terms of methodology and the samples studied, these studies consistently indicate that a sizable proportion of welfare recipients have been or are victims of domestic violence; (2) the one study of those reviewed that was specifically designed to provide a statewide prevalence estimate was based on a representative sample of Aid to Families with Dependent Children recipients in Massachusetts in 1996; (3) this study found that almost 20 percent of the welfare recipients surveyed had experienced domestic violence in the prior 12 months, and about 65 percent had been victims of domestic violence at some time in their lives; (4) the research available on the effect of domestic violence on the employment of welfare recipients and other low-income women presents a more complex picture; (5) some research indicates that welfare recipients and other low-income women who reported ever having been abused were employed at the same rates as those who had never been abused; (6) but no studies compared employment rates among women currently in abusive relationships, as opposed to women who reported having been abused in the past, with employment rates of women who are not now in abusive relationships; and (7) however, several studies do identify potential negative effects of current domestic violence on victims' employment. (author abstract)

  • Individual Author: Brown, Kay E.
    Year: 2010

    Nationally, TANF work participation rates changed little after DRA was enacted, though states’ rates reflect both recipients’ work participation and states’ policy choices. Although federal law generally requires that a minimum of 50 percent of families receiving TANF cash assistance in each state participate in work activities, both before and after DRA, about one-third of TANF families nationwide met their work requirements. However, after DRA, many states were able to meet federally required work participation rates because of additional factors. For example, 29 states funded cash assistance for certain families that may be less likely to meet the work requirements with state dollars unconnected to the TANF program, as this removed these families from the rate calculation. Further, DRA required other changes to state TANF programs, and states reported challenges with some of DRA’s changes to the TANF work rules, such as verifying participants’ actual work hours.

    From the beginning of the economic recession, in December 2007, to September 2009, the number of families...

    Nationally, TANF work participation rates changed little after DRA was enacted, though states’ rates reflect both recipients’ work participation and states’ policy choices. Although federal law generally requires that a minimum of 50 percent of families receiving TANF cash assistance in each state participate in work activities, both before and after DRA, about one-third of TANF families nationwide met their work requirements. However, after DRA, many states were able to meet federally required work participation rates because of additional factors. For example, 29 states funded cash assistance for certain families that may be less likely to meet the work requirements with state dollars unconnected to the TANF program, as this removed these families from the rate calculation. Further, DRA required other changes to state TANF programs, and states reported challenges with some of DRA’s changes to the TANF work rules, such as verifying participants’ actual work hours.

    From the beginning of the economic recession, in December 2007, to September 2009, the number of families receiving TANF cash assistance, particularly two-parent families, increased in the majority of states but went down in others. At the same time, many states have faced budget deficits and difficult decisions about the use of state resources for TANF programs. Thirty-one states reported that budget constraints led to changes in local TANF service delivery, such as reductions in available services and the number of staff.

    Forty-six states have applied for the Recovery Act’s Emergency Contingency Fund for state TANF programs since it was made available in 2009. More states reported using these funds to maintain their TANF programs rather than expand or create programs and services. Some states reported challenges accessing the funds. For example, some expressed frustration with the amount of time it has taken to receive guidance and responses to questions from HHS, particularly related to qualifying subsidized employment and short-term, nonrecurrent benefit expenditures. State officials also expressed concern about the September 30, 2010, expiration date for the Recovery Act TANF funds. (author abstract)

  • Individual Author: Government Accountability Office
    Year: 2009

    Children's access to Medicaid dental services is a long-standing concern. The tragic case of a 12-year-old boy who died from an untreated infected tooth that led to a fatal brain infection renewed attention to this issue. He was enrolled in Medicaid--a joint federal and state program that provides health care coverage, including dental care, for 30 million low-income children--but, like many children in Medicaid, he experienced difficulty finding a dentist who would treat him. At the federal level, the Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS), oversees Medicaid. In this report, GAO examined (1) state strategies to monitor and improve access to dental care for children in Medicaid and (2) CMS actions since 2007 to improve oversight of Medicaid dental services for children. GAO surveyed all state Medicaid programs and interviewed state and federal officials, and dental researchers and associations

    State Medicaid programs reported that they use multiple strategies to monitor and improve access to...

    Children's access to Medicaid dental services is a long-standing concern. The tragic case of a 12-year-old boy who died from an untreated infected tooth that led to a fatal brain infection renewed attention to this issue. He was enrolled in Medicaid--a joint federal and state program that provides health care coverage, including dental care, for 30 million low-income children--but, like many children in Medicaid, he experienced difficulty finding a dentist who would treat him. At the federal level, the Centers for Medicare & Medicaid Services (CMS), an agency within the Department of Health and Human Services (HHS), oversees Medicaid. In this report, GAO examined (1) state strategies to monitor and improve access to dental care for children in Medicaid and (2) CMS actions since 2007 to improve oversight of Medicaid dental services for children. GAO surveyed all state Medicaid programs and interviewed state and federal officials, and dental researchers and associations

    State Medicaid programs reported that they use multiple strategies to monitor and improve access to dental services for children, but problems persist. Most states responding to our survey use a variety of tools, such as examining claims and utilization data, to monitor the provision of dental services to children in Medicaid. Although all 21 states that provide Medicaid dental services through managed care organizations (MCO) reported that they set measurable access standards for MCOs, 14 states reported that MCOs do not meet all of the state's dental access standards. Almost all states described initiatives to improve access to dental services, including simplifying claims processing, increasing reimbursement rates, recruiting providers, and educating beneficiaries. Nonetheless, access rates remain low and states reported that long-standing barriers hinder further improvement. Since May 2007, CMS has taken steps to strengthen its oversight of Medicaid dental services for children, but gaps remain. For example, CMS reviews of Medicaid dental services in 17 states identified a number of concerns and made recommendations for improvement. Nonetheless, at the time of our review CMS did not plan to perform more reviews, even though other states had utilization rates well below HHS's 2010 target for low-income children receiving a preventive dental service. CMS also provided guidance to states and facilitated collaboration among stakeholders, but states reported needing more CMS support, including guidance on setting dental payment rates, on quality initiatives, and on promoting outreach. States also reported wanting more information on other states' efforts to improve dental utilization. (author abstract)

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