Although many public assistance recipients suffer from depression, few receive consistent treatment. This report presents results through six months of a one-year telephonic care management program in Rhode Island that tried to encourage depressed parents who were receiving Medicaid to seek treatment from a mental health professional. The program, called “Working toward Wellness,” represents one of four strategies being studied in the Enhanced Services for the Hard-to-Employ Demonstration and Evaluation to improve employment for low-income parents who face serious barriers to employment. The project is sponsored by the Administration for Children and Families and the Office of the Assistant Secretary for Planning and Evaluation in the U.S. Department of Health and Human Services, with additional funding from the Department of Labor. In Working toward Wellness, master’s-level clinicians (“care managers”) called the study participants in the program group to encourage them to seek treatment, to make sure that they were complying with treatment, and to provide telephonic counseling. The effects of the program are being studied by examining 499 depressed Medicaid recipients with children, who were randomly assigned to the program group or the control group from November 2004 to October 2006. Participants were given a list of mental health professionals in the community from whom they could receive treatment. (author abstract)

This study, conducted by Mathematica Policy Research, Inc. and its subcontractors, American Management Systems, Inc. and the George Washington University Center for Health Services Research and Policy, was commissioned by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture to identify strategies states and local welfare offices are using to promote participation in food stamps, Medicaid and SCHIP and the ongoing challenges they face in providing support to working families. (author abstract)

This economic analysis of the Nurse Family Partnership (NFP) addresses three randomized trials carried out to examine long-term effects of the NFP on maternal, child, and family functioning. The analysis presented in this report provides information on both the persistence of home visitation program effects on government expenditures and on their ability to be reproduced in different settings. The authors analyzed government expenditures incurred by both comparison and treatment groups for three sites. Because of the differential timing of the intervention in the three sites, government expenditure data was analyzed for different periods in the lives of the study families. For Elmira families, government expenditures were analyzed for the period from the birth of the study child until the family was interviewed during the child’s 15th year. For Memphis, expenditures were analyzed for the period from the study child’s birth until the family was interviewed when the child was 4 ½. For Denver, the period analyzed was birth to 4 years. The study conducted is a net-cost analysis from the standpoint of government spending. (author abstract)

The emphasis on placing TANF recipients into paid employment quickly is consistent with employment assistance approaches employed by several recent demonstration projects (outside of TANF) for youth and adults living with a disability. However, because TANF recipients living with a disability may have other deficits such as low education levels and limited work experience that further limit their employment prospects, they may not be successful at finding paid competitive employment within the time allotted. When this occurs, TANF agencies may choose to create work opportunities outside of the competitive labor market as a first step towards permanent unsubsidized employment. In this practice brief, we profile three programs that use different approaches (unpaid work experience, subsidized employment, and unsubsidized transitional employment) to create work opportunities for TANF recipients who are living with a disability and have not been successful in finding competitive employment. (author abstract)

Some TANF recipients may have disabilities that would qualify them for the specialized employment preparation services Vocational Rehabilitation (VR) agencies provide. TANF recipients may seek out VR services on their own, or be referred to VR by a TANF case manager on his or her own accord, however, because VR is an unfamiliar service system, few may be inclined to do so. Creating a formal partnership between the agencies can ensure that all TANF recipients who can benefit from VR services have access to them. Though linking the services of these two agencies through formal cooperative agreements is not a widespread strategy, some states have had such partnerships in place for many years and other states are developing them. This practice brief explores the benefits and challenges of linking TANF and VR services, describes partnerships that have been formed in Vermont and Iowa, then discusses key features that appear to be critical to developing a successful partnership. (author abstract)

Authors in this paper, published in the Health Affairs journal, provide estimates of the rates across States for participating children as well as uninsured eligible children. Nationally, 7.3 million were uninsured on any given day in 2008, and around sixty-five percent or 4.7 million were eligible but not enrolled in the public programs. Authors also give variation in participation rates across States, which range from fifty-five to ninety-five percent.

From the Administration for Children and Families, Office of Planning, Research and Evaluation, this report provides findings from the implementation evaluation of Head Start programs that participated in the "I Am Moving, I Am Learning" trainings. From the programs that participated in the spring 2006, program administrators, classroom teachers, and home visitors across many programs reported that they had increased children’s movement time and improved the food choices available to children.

As part of their Rural Communities Initiative Technical Assistance Action Plan, the Montana team identified the prevalence of substance abuse challenges within their TANF caseload as among one of their chief concerns. The site was particularly interested in exploring new techniques that would simultaneously promote work attachment and higher work participation rates (WPR) along with facilitating overcoming drug and alcohol addiction. Based on these goals, the Montana team convened a substance abuse case management training where TANF staff from Roosevelt County and the Fort Peck Reservation were introduced to new and effective case management approaches for participants with substance abuse barriers. The training also included job development and job placement strategies tailored for TANF participants with substance abuse barriers. The training took place November 17-19, 2009 and was led by staff from the UC Davis Center for Human Services. As a result of the substance abuse centered TA they received, the Montana site developed new approaches to managing participants with substance abuse challenges. In addition to utilizing a more assets-based case management approach (e.g. motivational interviewing strategies), the site is also working to implement community involvement strategies that incorporate substance abuse prevention techniques.

As a strategy to provide asset-based training for caseworkers and serve New Mexico's growing population of individuals with substance abuse barriers, New Mexico Works requested a substance abuse case management training, with a focus on motivational interviewing techniques. The training was designed and delivered by Dr. Alyssa Forcehimes from the University of New Mexico Center on Alcoholism, Substance Abuse and Addictions. The curriculum was delivered over one day in April 2009 and two days in July 2009. The training provided participants with an overview of substance abuse in the TANF population, strategies for building self-efficacy in TANF participants, and ways to motivate participants to make positive behavioral changes. The New Mexico substance abuse case management training was attended by 35 caseworkers and managers. Evaluations from the training indicated that participants acquired a set of tools that can assist their clients in overcoming substance abuse barriers. A section of the training was also dedicated to strategies for conducting train-the-trainer sessions at participants' home sites.

From the National Poverty Center at the University of Michigan, this policy brief outlines the health effects of social and economic policy. Non-health related policies may have positive impacts on the health and wellbeing of the beneficiaries of certain policies. Specifically, social and economic policy that may not be health-related can help supplement health care spending by helping participants maintain and improve their health.