<p>Authorized by the Affordable Care Act, the Health Profession Opportunity Grants (HPOG) program from the Administration for Children and Families provides education and training to TANF recipients and other low-income individuals for occupations in the health care field. The <a href="http://www.acf.hhs.gov/ofa/programs/hpog/">HPOG Web site</a> serves as a repository of important grant-related information and a forum for grantee interaction. Among other features, the Web site enables you to: locate contact information for all HPOG grantees in the <a href="http://www.acf.hhs.gov/ofa/hpog/findhpogprograms">Grantee Directory</a>; learn about what other HPOG programs are doing; and find helpful technical assistance toolkits, conference presentations, administrative forms, and other relevant documents in the <a href="http://www.acf.hhs.gov/ofa/resource-library/search?area%5b2400%5d=2400">Resources Section</a>.</p>

Using data from a Pew Research Center survey and the Bureau of Labor Statistics, this report provides information on young adults in the labor market. Only 54 percent of young adults ages 18 to 24 are currently employed, which is the lowest since the data started being collected in 1948. Additionally, those young adults working full time have had the greatest decrease in weekly earnings than any other age group over the past four years (a six percent decline). These trends have had an impact on this population’s long-term plans as many have delayed marriage and starting a family, and 24 percent say they have had to move back home with their parents after living on their own.

The Urban Institute authored this issue brief on the multisite Housing Opportunity and Services Together (HOST) demonstration. The demonstration tests strategies using housing as a way to get vulnerable families services that they need to reach self-sufficiency, such as mental health services, access to literacy and education, and a connection to the labor force. Authors provide an overview of the challenges and successes of the program’s planning stages to help provide peers with information to create similar interventions.

Helping low-income families in rural areas find gainful employment and achieve economic self-sufficiency is an ongoing policy concern. The Rural Welfare-to-Work Strategies demonstration is using rigorous experimental designs to build knowledge about how to help low-income families in rural areas strive toward sustained employment and self-sufficiency. This report examines an employment-focused case management initiative deployed in southern Illinois. Despite a lack of impacts on employment, earnings, and self-sufficiency, the findings imply a need for stronger interventions in rural areas and demonstrate the challenges inherent in designing, implementing, and evaluating programs in these types of settings.(author abstract)

This practice brief is the first in a series of practice briefs being developed by the Tribal HPOG evaluation team, comprised of NORC at the University of Chicago, Red Star Innovations, and the National Indian Health Board. The briefs will be used to disseminate important lessons learned and findings from the Evaluation of the Tribal Health Profession Opportunity Grants (HPOG) program , which is being funded by the Office of Planning, Research and Evaluation within the Administration for Children and Families. The Tribal HPOG program is funded by the Affordable Care Act (ACA) to support 32 demonstration projects, including 5 Tribal Organizations and Colleges, to train Temporary Assistance for Needy Families (TANF) recipients and other low-income individuals as health care professionals. The purpose of this first practice brief is to: (1) describe the unique aspects of the Tribal HPOG grantee organizations and the target populations they serve; (2) introduce the program frameworks of the Tribal HPOG grantees; and (3) provide an overview of the Federally-sponsored evaluation of the Tribal HPOG grantees. (author abstract)

TANF potentially serves as a portal for a wide array of programs that provide cash income support, in-kind nutrition and housing assistance, tax credits, and other services to families with low-incomes. This research brief summarizes what we know about the connections between TANF and other important safety net programs. It reviews the size and scope of the various programs, the receipt of other safety net benefits by TANF families, and the implications for policy and research. (author abstract)

This paper describes several additional analyses and results that go beyond the basic impact findings from the evaluation of the Working toward Wellness (WtW) program in Rhode Island. WtW was a one-year telephone care management intervention for depressed parents who were Medicaid recipients. To encourage individuals with depression to seek treatment from mental health professionals, the WtW program randomly assigned depressed Medicaid recipients to a program group, which had access to telephone care management for up to a year, or to a control group, which had access to the usual mental health services available to Medicaid recipients. Results from the study found that telephone care management modestly increased in-person treatment for depression during the year of the intervention but not after that point. No impacts on average depression severity were observed for the sample as a whole. 

To understand which individuals showed reduced depression over time, the paper examines the relationship between participants’ characteristics and changes in depression scores from baseline to six months and to eighteen months. The results do not, however, suggest a clear means of targeting services like WtW to those who are least likely to improve on their own. Other than baseline depression severity, few participant characteristics were found to be associated with reduced depression over time. This suggests that most subgroups of participants could have benefited from a more effective intervention. 

Also, because only about 40 percent of the study population participated in in-person mental health treatment, the paper examines which factors contributed to receiving treatment and the intensity of that treatment. The results suggest that a number of factors were associated with seeking mental health treatment. In particular, treatment occurred more frequently for those who were more severely depressed, those who were not working at baseline, white sample members, and those who had received treatment for depression prior to random assignment. This may suggest providing more resources and supports to encourage those groups to receive treatment who are least likely to participate, for whom the program might make a larger difference. It may also suggest excluding individuals with prior treatment for depression from future studies of similar interventions. 

Lastly, because the eighteen-month results showed that there were significantly fewer program group members in the very severely depressed group, the paper investigates which baseline characteristics are associated with being very severely depressed at follow-up. It was found that although some characteristics are associated with having severe depression at follow-up, the impacts on depression severity for this high-risk subgroup are not statistically significant. (author abstract)

As part of the multisite Enhanced Services for the Hard-to-Employ Demonstration and Evaluation Project, MDRC, together with its research partners, is leading an evaluation of parental employment and educational services delivered within Early Head Start (Enhanced EHS). The program model tested here aims to dually address the employment and educational needs of parents who are at risk of unemployment and the developmental needs of their children. The study is sponsored by the U.S. Department of Health and Human Services, with additional funding from the U.S. Department of Labor.  The study uses a rigorous random assignment design comparing outcomes for families and  children who were offered Enhanced EHS with outcomes for those who could only access alternative services in the community. This report presents the final impact results approximately 42 months after families and children first entered the study. (author abstract)

This report summarizes the final impact results for the national Employment Retention and Advancement (ERA) project. This project tested, using a random assignment design, the effectiveness of numerous programs intended to promote steady work and career advancement. All the programs targeted current and former welfare recipients and other low-wage workers, most of whom were single mothers. Given that earlier retention and advancement initiatives studied for these groups were largely not effective, ERA sought to examine a variety of programs that states and localities had developed for different populations, to determine whether effective strategies could be identified. In short, nine of the twelve programs examined in this report do not appear to be effective, but three programs increased employment levels, employment stability, and/or earnings, relative to control group levels, after three to four years of follow-up.

Key Findings:

 - Out of the twelve programs included in the report, three ERA programs produced positive economic impacts; nine did not. All three programs increased employment retention and advancement. Increases in employment retention and earnings were largest and most consistent over time in the Texas ERA program in Corpus Christi (one of three sites that operated this program); the Chicago ERA program; and the Riverside County, California, Post-Assistance Self-Sufficiency (PASS) ERA program. These programs increased annual earnings by between 7 percent and 15 percent relative to control group levels. Each of them served a different target group, which suggests that employment retention and advancement programs can work for a range of populations. However, three-fourths of the ERA programs included in this report did not produce gains in targeted outcomes beyond what control group members were able to attain on their own with the existing services and supports available in the ERA sites.

 - Increases in participation beyond control group levels were not consistent or large, which may have made it difficult for the programs to achieve impacts on employment retention and advancement. Engaging individuals in employment and retention services at levels above what they would have done in the absence of the programs was a consistent challenge. In addition, staff had to spend a lot of time and resources on placing unemployed individuals back into jobs, which made it difficult for them to focus on helping those who were already working to keep their jobs or move up.

Before the ERA project began, there was not much evidence about the types of programs that could improve employment retention and advancement outcomes for current or former welfare recipients. The ERA evaluation provides valuable insights about the nature of retention and advancement problems and it underscores a number of key implementation challenges that a program would have to address. In addition, it reveals shortcomings in a range of common approaches now in use, while identifying three distinct approaches that seem promising and worthy of further exploration. (author abstract)