The Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) created a new work-oriented framework for providing assistance to low-income families. Within this framework, states were given a block grant and considerable flexibility to create new support systems for families that encouraged work and discouraged long-term reliance on government-provided cash assistance. Responding to concerns that families that turn to the welfare system for support may find it hard to leave, states began implementing “diversion” programs to keep families whose needs could be met through other means from ever coming on to the welfare rolls. In response to higher effective work participation rates that followed the reauthorization of the Temporary Assistance for Needy Families (TANF) program in 2005, states have added new policies and programs that divert TANF-eligible families from the TANF system.

This report describes states’ policies on and experiences with diversion programs. To document the states’ diversion strategies, Mathematica Policy Research, Inc. (MPR) conducted the Identifying Promising TANF Diversion Practices Study for the U.S. Department of Health and Human Services (HHS), Administration for Children and Families (ACF). Data for the study were collected through a state survey, a telephone interview with designated representatives in each state, and visits to two states to learn more about their diversion strategies. Data collection began in December 2007 and ended in March 2008. (author abstract)

This report from the Urban Institute details findings from an evaluation of the High Growth Job Training Initiative (HGJTI). The HGJTI was a national grant program administered by the U.S. Department of Labor (DOL), Employment and Training Administration (ETA) to establish industry-focused job training to meet the industry’s workforce challenges. Researchers conducted a review of grant applications and quarterly reports, made site visits to nine sites, collected data from grantee training programs, compiled quarterly earnings data from State unemployment insurance wage records, and analyzed administrative data from public workforce system agencies.

The 1996 federal welfare reform law, which sets time limits on benefits and requires increasing numbers of clients to participate in work-related activities, was designed to encourage families to leave cash assistance for work and thereby reduce the welfare rolls. Aware of the possibility that the new legislation might negatively affect access to Medicaid, policymakers enacted Section 1931 to de-link Medicaid from welfare. Nevertheless, Medicaid enrollment has declined at a rate higher than expected since 1996, leading federal and state policymakers to become concerned that enrollment has indeed been affected by changes in cash assistance programs. Similar concerns have been raised in regard to the dramatic drop in participation in the Food Stamp Program. In response to these concerns, the U.S. Departments of Health and Human Services and Agriculture contracted with Mathematica Policy Research, Inc. (MPR) to identify state policies and procedures that appear to promote enrollment in Medicaid and/or the Food Stamp Program in the post-welfare reform era. We selected Indiana as the site for this study because the state increased Medicaid enrollment by almost 15 percent between 1998 and 1999. This report documents the results of our examination of Indiana's efforts to promote enrollment, primarily for children, in Medicaid and SCHIP and to begin to identify strategies for increasing enrollment
in the Food Stamp Program. (author abstract)

In 1995, the Texas Legislature enacted H. B. 1863, which formed the basis for Texas’ waiver from existing Federal laws governing the Aid to Families with Dependent Children (AFDC) program. The Texas waiver, officially known as the Achieving Change for Texans (ACT) demonstration, aimed to assist participants to achieve independence from welfare through an increased emphasis on employment, training, temporary assistance and support services. It included three primary components: time-limited benefits, a personal responsibility agreement and one-time payments in lieu of welfare payments. The evaluation of the ACT demonstration consisted of three approaches: a process evaluation, a random-assignment impact analysis, and follow-up interviews with persons who reached their time limits or who elected to receive one-time payments instead of cash welfare assistance. This report summarizes findings from all facets of the evaluation and draws conclusions and policy implications for welfare policy development in the post-waiver time period. (author abstract)

This report represents the first step in the process of identifying initiatives intended to assist TANF recipients living with disabilities to obtain and maintain employment that may be worthy of further study. The outcomes and impacts of such initiatives are of substantial interest to program administrators and policymakers for several reasons. First and foremost is the concern over the well-being of these recipients and their families. Second, these initiatives often require considerable staff effort and intensive services and, therefore, can be costly to implement. Third, states and localities are under growing pressure to meet increased federally mandated work participation rates and recipients living with disabilities are one of many groups that program administrators and policymakers may consider targeting to increase those rates. To assist program administrators and policymakers in deciding how they should spend limited resources, it is critical to know whether the initiatives are, indeed, producing their desired effects. The time may be ripe for rigorously testing the impact of employment initiatives for low-income families living with disabilities and this report presents some potential options for doing so. (author abstract)

The National Academy for State Health Policy (NASHP) hosted a webinar on February 9, 2012 from 2:30 to 4:00 p.m. Eastern time. The webinar was designed to help States improve enrollment and eligibility systems by providing an overview of State progress towards updating their systems. Speakers included: Alan Weil, Executive Director, National Academy for State Health Policy; Alice Weiss, Co-Director, Maximizing Enrollment; Judith Arnold, Director, Division of Coverage and Enrollment, New York Department of Health; Manu Tandon, Secretariat Chief Information Officer, Massachusetts Health and Human Services; and Tracy Turner, Applications and Operational Support Manager, Oklahoma Health Care Authority.

The National Academy for State Health Policy (NASHP) authored this report, which was developed as part of the National Workgroup on Integrating a Safety Net into Health Care Reform Implementation. As a result of the Workgroup, this report provides ten key issues that policymakers, who are concerned with the safety net, should consider in order to reach the health care reform’s goals for vulnerable populations.

The National Academy for State Health Policy (NASHP) released this report on the role of community health centers in providing health care. This report provides an overview of community health centers and other types of Federally Qualified Health Centers. Authors provide recommendations to help State policymakers to develop strategies to integrate health centers into State delivery systems.