[Expertising according to the federal German social welfare legislation and child and adolescent welfare laws by public health offices--results of an inquiry]

Between December 2000 and February 2001 a survey among public health offices was conducted on the practice of expert reports on recipients of income support. More than 50 % (232) of the German public health offices participated; they carried out 164.000 of these reports in 1999. The analysis of the data shows considerable differences between the states (Bundesländer) concerning reasons and practice of expert reports which cannot be explained by a different social structure of population but indicate that quality of orders from Social Services and the work process in Public Health Offices may be inadequate. The findings result in recommendations for social services and public health offices to develop standards and improve quality, which can help to achieve greater equality.

Social work advocacy in the post-TANF environment: lessons from early TANF research studies

This study examined early research findings concerning the well-being of people who leave Temporary Assistance for Needy Families (TANF) programs and then applies these findings in the development of TANF-related advocacy strategies. Based on secondary data analysis of TANF leaver studies from 12 states with large TANF caseloads, the authors focus on the employment and earnings experiences of leavers; TANF recidivism and its relationship to job stability; and the use of support services. State studies typically have found employment levels among leavers in the 55 percent to 65 percent range, but average earnings fall below the poverty level. Although those who remain employed can expect earnings growth, job instability is a significant problem and contributes to TANF recidivism rates of 21 percent to 35 percent within the first year. Available support services such as Medicaid, food stamps, and child care subsidies are underused, often because leavers do not understand that they are eligible. Recommended advocacy strategies include policy interventions to improve the economic well-being of low-income working people, as well as administrative and direct practice strategies to improve the implementation of existing policies. The authors argue that attention to such advocacy efforts is both critical and opportune for social work, given the profession's historical mission, impending federal TANF reauthorization, and unspent TANF allocations.

TANF: what went wrong and what to do next

The Temporary Assistance for Needy Families (TANF) program, widely heralded as the "end to welfare as we know it," is in its sixth year of implementation. According to many, the welfare debate has been settled, and both legislators and the public have proclaimed the program a success. This article examines the accumulated data on the effect of welfare reform, which shows, contrary to popular opinion, the goal of self-sufficiency remains elusive for many, and poor women and their families are being hurt, not helped, by TANF. It is argued that the booming economy and consequent expanding labor market have led to the perceived success of TANF and that the optimism expressed about dwindling welfare rolls is misplaced. The failure of TANF to adequately address obstacles to self-sufficiency in the workplace threatens to create an even worse welfare problem in the future. During the TANF evaluation period, social workers are urged to take a more active role in urging TANF modifications.

Federalism and social justice: implications for social work

Federalism is a system of government that divides power between two or more levels of government. During the current conservative political climate in the United States, power has shifted increasingly from the federal government to states, a move that has implications for the achievement of social justice. Consequently, it is now necessary for social workers to engage in political activity at the state and local levels, in addition to the federal level, to promote social justice. Implications for social work policy practice, research, and education for advancing social justice within the federal system of government are explored.

Charitable choice and faith-based welfare: a call for social work

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 contains a little known section referred to as "Charitable Choice." This section encourages states to involve community and faith-based organizations in providing federally funded welfare services. Most social workers are unfamiliar with this part of the legislation and its far-reaching implications for society as a whole and for the social work profession as it opens the door for mixing religion and publicly supported social services provision. This article reviews how Charitable Choice has shifted the way government engages faith-based organizations in social services delivery. A review of the public discourse and research findings regarding the relevance and implementation of Charitable Choice is also presented. Implications for social work are discussed, and a call for social work involvement is made.

UK court rules government erred in denying housing assistance to woman with HIV

In March 2002, the English High Court of Justice ruled that municipalities have a duty to use their powers to provide assistance where refusal to do so would infringe an applicant's rights under the European Convention on Human Rights and Fundamental Freedoms.

Welfare reform and American Indians: critical issues for reauthorization

With reauthorization of the Personal Responsibility and Work Opportunity Reconciliation Act (P.L. 104-193) under consideration in Congress, this issue brief examines some key features of the welfare reform legislation as it applies to American Indians and reviews its impact on this population. It looks at the flexibility the act has given American Indian tribes to design and operate their own Temporary Assistance for Needy Families programs and explores barriers they face in doing so. The paper also examines some of the policy issues and opportunities surrounding welfare reform for American Indians.

Urban homelessness and poverty during economic prosperity and welfare reform: changes in self-reported comorbidities, insurance, and sources for usual care, 1995-1997

Little is known of how homeless and other urban poor populations have fared during the robust economy and within structural changes in health care delivery and entitlement programs of the 1990s. This is important in determining the need for population-specific services during a vigorous economy with low unemployment and increasing Medicaid managed-care penetration. This study compared health insurance status and availability of a source for usual medical care, psychiatric and substance abuse comorbidities, and perceived causes of homelessness in homeless adults surveyed in 1995 and 1997. Cross-sectional, community-based surveys were conducted in 1995 and 1997 at sites frequented by urban homeless adults residing in Pittsburgh, Pennsylvania. Self-reported medical, mental health, and substance abuse comorbidities, health insurance, and source for usual care were measured. Compared to the 388 individuals surveyed in 1995, the 267 homeless adults surveyed in 1997 had more medical comorbidity (56.6% vs. 30.2%, P <.001) and mental health comorbidity (44.9% vs. 36.9%, P =.04) and required more chronic medication (52.1% vs. 30.3%, P <.001). More respondents in 1997 than 1995 reported having no health insurance (41.4% vs. 29.4%, P <.001). While there was no difference in the overall proportion reporting a source for usual care (78.3% in 1997 vs. 80.2% in 1995, P =.55), fewer persons reported use of the emergency department and more persons reported using a shelterbased clinic for usual care in 1997 compared with 1995. These findings suggest more need for medical care among homeless and urban poor persons in 1997 compared with 1995 and support the continued need for outreach and support services despite a vigorous economy.

Welfare reform and substance abuse: innovative state strategies

This issue brief highlights key facts about the impact of substance abuse on welfare reform and recipients of Temporary Assistance to Needy Families, or TANF. After outlining some of the data on the incidence of substance abuse as well as its costs and treatment, it concludes by describing innovative state welfare programs attempting to lower barriers to employment and self-sufficiency.

Organizational and community health changes under welfare reform

This article comments on changes made by health-related organizations and in community health during the first years of New Jersey's welfare reform policy implementation in Camden, Essex, and Hudson counties (1992-1998). Throughout these years, county welfare agencies made organizational changes that shifted their focus from supporting family well-being to encouraging work. Health care provider organizations now are beginning to make organizational changes in response to the ripple effects of welfare reform policy. Specific actions to initiate and influence healthy welfare policy reformulation are presented.

Knowledge of welfare reform program provisions among families of children with chronic conditions

OBJECTIVES

This study examined the knowledge of and application for health-related welfare program provisions among beneficiaries with children who have chronic conditions.

METHODS

We administered a survey to 143 parents of children aged 3 to 16 years with asthma or sickle cell anemia in 2 clinical settings.

RESULTS

Respondents indicated incomplete knowledge of work requirements (69.9%) and work exemptions (50.3%). Applications for work exemptions were rare, even among Supplemental Security Income recipients (30%).

CONCLUSIONS

Welfare beneficiaries with children who have chronic conditions show limited knowledge and use of program provisions, placing them at risk for penalties or benefit termination.

Welfare reform and parenting: reasonable expectations

Although the primary goals of federal welfare reform legislation were to move welfare mothers into the workforce and reduce births outside of marriage, promotion of responsible parenting was also an important underlying theme. Parenting is a complex, multifaceted phenomenon, however, encompassing a wide range of functions related to nurturing, discipline, stimulation, values, activities, and routines. This article provides a framework for assessing the impact of welfare reform on various dimensions of parenting, with the following key findings: Many aspects of life affect parenting and child development, such as parent characteristics, child characteristics, family economic resources, family structure, parental mental health, marital or partner relationships, and the quality of parents' kin and social networks. About two-thirds of states are using federal welfare funds to promote better parenting through programs such as home visits to new parents and parenting classes, but virtually no state parenting programs have been evaluated. Welfare reform appears to have limited effects on parenting. The only dimension of parenting significantly affected by some welfare demonstration programs was parents' choice of child care settings and extracurricular activities for their children. The programs with the greatest positive impact on parenting were those with more generous work supports and more flexible work requirements. Not only did these programs lead to different choices concerning child care and activities for preschool and school-age children, but they also resulted in more stable marriages and less violence between partners, which also could lead to improved parenting. The authors conclude that many important aspects of the connection between welfare reform and parenting have yet to be examined, and that further research is needed to identify the ways states' welfare programs can promote better parenting.

Experimental studies of welfare reform and children

Even prior to passage of federal welfare reform, many demonstration programs anticipated key features of the 1996 law, such as "work-first" strategies, time limits on welfare receipt, and financial incentives to work. Over the past decade, 10 experimental evaluations of these programs have extended their studies to examine the impacts on children. This article provides a synthesis of findings from the first seven of these studies to release results concerning child impacts. Key observations include the following: Across the different types of welfare-to-work programs examined, researchers found neither widespread harm nor widespread benefit to young children, but some significant impacts did occur. Favorable impacts tended to occur in programs that improved family economic status or maternal education, but these programs still did not bring children to the level of national norms for positive child development. Unfavorable impacts tended to occur when families did not show economic progress or when their economic situation worsened, when the children were adolescents, and--unexpectedly--when the families were believed to be at lower risk for long-term welfare receipt. Thus, although impacts were not widespread, these programs did have the potential to affect children for both better and worse across a range of developmental outcomes. The authors conclude that these findings underscore the importance of strengthening program approaches to enhance developmental outcomes for children in families being served by the welfare system.

Welfare reform and child care options for low-income families

For the changes under welfare reform to positively affect children, the gains that mothers make from employment must lead to improvements in children's daily settings at home, in child care, at school, or in the community. This article focuses on the role child care can play in promoting the development of, and life opportunities for, low-income children. Key observations include: Total federal and state funding for child care for welfare and working poor families has increased dramatically since welfare reform, from $2.8 billion in 1995 to $8.0 billion in 2000. The majority of welfare mothers tend to rely on informal child care arrangements when first participating in welfare-to-work programs, but as they move off welfare and into more stable jobs, they are more likely to choose a center or a family child care home. Although children from poor households stand to benefit the most from high-quality care, they are less likely to be enrolled in high-quality programs than are children from affluent families, partly due to uneven access to high-quality options in their neighborhoods. Less than one-quarter of all eligible families use child care subsidies, and usage varies widely across states and local areas reflecting various barriers to access and scarcity of quality center-based care. The authors conclude that to achieve welfare reform's ultimate goal of breaking the cycle of intergenerational poverty and dependence on government benefits, welfare-to-work programs should promote learning and development among children in welfare and working poor families by increasing access to high-quality child care in low-income neighborhoods.

Family economic resources in the post-reform era

Aided by the longest economic expansion in U.S. history and other policy changes designed to make work pay, federal welfare reform legislation has spurred mothers to leave welfare at an unprecedented rate. The majority of mothers who left welfare are working, but most have jobs with low pay and limited benefits. This article discusses the relationship between economic resources and child well-being, and how family economic resources have changed under welfare reform. A survey of the research conducted since reform indicates the following: Families' economic resources clearly matter to child well-being, but the connections are complex and vary by the age of the child. Without the benefit of supports designed to "make work pay," many families working full time at the minimum wage have resources beneath the poverty line, and the poverty line itself falls substantially short of the needs of most working families. Although poverty overall has declined under welfare reform, a significant segment of families are worse off--in part because after leaving welfare, many families do not receive other government supports designed to help them. Most states are still struggling to design more effective systems for delivering supports to help low-income working families move out of poverty. The author cautions that the evolving story of welfare reform will need to be monitored carefully to achieve long-term positive impacts on family economic resources and child well-being.

Reforms and child development

Since their inception in the 1930s, U.S. welfare and income support programs have played an important role in providing benefits to children. Unlike programs directly targeted to children, however, welfare programs are designed to produce economic and employment impacts on adults, so that any effects on children would be indirect. This article explores the influence of such programs on children's well-being and development, first by defining goals for children's healthy development, then by proposing a framework for understanding the impact of welfare policies on children. A review of the literature within each component of this framework reveals the following: Measures of children's well-being should encompass physical, intellectual, social, and emotional development. The physical and material environment, family environment, and social and community environment can all affect a child's healthy development. Policies designed to increase maternal employment, reduce welfare use, and strengthen families do not necessarily lead to more positive environmental contexts and increased child well-being. The author concludes that to ensure positive impacts on children, welfare and income support policies must move beyond their exclusive emphasis on adults and include goals that focus on improving children's social and physical environments at home and in the community.

The 1996 welfare law: key elements and reauthorization issues affecting children

The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 changed the social policy landscape for children in many ways. It replaced the prior welfare program with block grants to the states entitled Temporary Assistance for Needy Families, and modified a broad array of other programs and initiatives affecting low-income children. This article describes the key themes dominating the debate over welfare reform in 1996, specifically: Increased state discretion in program design, leading to more variability in states' eligibility requirements and services provided to low-income families; More stringent work requirements even for parents of very young children; Time limits on the use of federal funds for cash assistance, and a strong focus on caseload reduction; Increased emphasis on parental responsibility, with stronger child support requirements; and Increased emphasis on reducing out-of-wedlock births, including bonuses to states with the largest reductions, and special requirements for unmarried teen parents who seek welfare. Although child well-being received little attention during the congressional debates in 1996, the authors conclude with the hope that improving child outcomes and child well-being will emerge as a key theme when the law is reauthorized in 2002.