TANF Recipients as Caregivers for Family Members with Disabilities

In light of the dramatic reduction in welfare caseloads following the passage of the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996, much attention has been given to those recipients of Temporary Assistance to Needy Families (TANF) who still remain on the roles. Many of these recipients have been categorized as “hard-to-serve,” or are described as having individual or multiple barriers to successful employment. Some of those with barriers to employment run the risk of being sanctioned for not participating in required work activities or of reaching their 60-month lifetime limit to benefits before achieving stable employment and self-sufficiency.

Disabilities are one category of barrier that can make stable employment difficult. There has been a significant amount of research on adult recipients of TANF who have disabilities, but less attention has been focused on adult recipients who are caregivers to family members with disabilities. Under the Aid to Families with Dependent Children (AFDC) program, prior to 1996, caregivers were exempted from work requirements, as were those with disabilities. However, under TANF, these recipients are now subject to work participation requirements and lifetime limits to benefits, unless included in the 20 percent of each state’s caseload that may be exempted from time limits due to “hardship.”

Adequate screening and assessment by TANF agencies is critical in identifying TANF recipients with caregiving responsibilities and in providing services to help them fulfill their work requirements while providing for their family members who are disabled. Many of these recipients may need services beyond those typically provided by TANF agencies, such as special-needs child care, transportation, or assistance in applying for SSI or Medicare for family members. This Resources for Welfare Decisions provides an overview of research and resources related to TANF families who are caring for those with disabilities, as well as examples of state initiatives to help them achieve self-sufficiency.

Publications and Electronic Resources

Brandon, Peter D. and Dennis P. Hogan, The Effects of Children with Disabilities on Mothers’ Exit from Welfare, prepared for the September 20-21, 2001 Research Institute, “The Hard-to-Employ and Welfare Reform” at http://www.jcpr.org/wpfiles/brandon_hogan_SRI2001.pdf.

Brown, Amy, Beyond Work First: How to Help Hard-to-Employ Individuals Get Jobs and Succeed in the Workforce. (New York, NY: Manpower Research Demonstration Corporation, April 2001) at http://www.mdrc.org/Reports2001/HardtoServe/MDRCHow-ToHardtoEmploy.pdf.

Cahalan, Margaret, Evaluation of the Effects of the 1996 Welfare Reform Legislation on Children with Disabilities: Survey Design and OMB Clearance Package. Final Options Report. (Washington, DC: Mathematica Policy Research, Inc., June 1999).

Goldberg, Heidi, Improving TANF Outcomes for Families with Barriers to Employment. (Washington, DC: Center on Budget and Policy Priorities, January 2002) at http://www.cbpp.org/1-22-02tanf3.pdf.

Johnson, Amy and Alicia Meckstroth, Ancillary Services to Support Welfare-to-Work. (Princeton, NJ: Mathematica Policy Research, Inc., June 1998) at http://aspe.hhs.gov/hsp/isp/ancillary/front.htm.

Loprest, P.J., Supplemental Security Income for Children with Disabilities: Part of the Federal Safety Net. (Washington, DC: Urban Institute, July 1997) at http://newfederalism.urban.org/html/anf_a10.html.

Meyers, Marcia K., Anna Lukemeyer and Timothy M. Smeeding, The Cost of Caring: Childhood Disability and Poor Families. (Syracuse, NY: Center for Policy Research, Maxwell School of Citizenship and Public Affairs, Syracuse University, July 1997) at http://www-cpr.maxwell.syr.edu/incomsec/pdf/pp16.pdf.

Meyers, Marcia K., Henry E. Brady and Eva Y. Seto, Expensive Children in Poor Families: The Intersection of Childhood Disabilities and Welfare. (San Francisco, CA: The Public Policy Institute of California, October 2000) at http://www.ppic.org/publications/PPIC140/index.html.

Pavetti, LaDonna, Krista Olson, Demetra Smith Nightingale, Amy-Ellen Duke and Julie Isaacs, Designing Welfare-to-Work Programs for Families Facing Personal or Family Challenges: Rationale and Program Strategies. (Washington, DC: Urban Institute, August 1997) at http://www.urban.org/welfare/report2.htm#4.

Rosman, Elisa, Jan McCarthy and Maria Woolverton, Focusing on Families in Welfare Reform Reauthorization: Adults with Mental Health Needs & Children with Special Needs, Issue Briefs 1-9. (Washington, DC: Georgetown University, October 2001) at http://gucdc.georgetown.edu/wfbriefs.html.

Thompson, Terri S., Pamela A. Holcomb, Pamela Loprest and Kathleen Brennan, State Welfare-to-Work Policies for People with Disabilities: Changes Since Welfare Reform. (Washington, DC: U.S. Department of Health and Human Services, Office of the Assistant Secretary for Planning and Evaluation, October 1998) at http://aspe.os.dhhs.gov/daltcp/reports/wel2work.pdf.

Georgetown University Child Development Center, Elisa Rosman, 703/243-8431, or elisa_rosman@yahoo.com.

The National Association of State Directors of Developmental Disabilities Services (NASDDDS), Charles Mosely, 703/683-4202 at www.nasddds.org.

National Center for Children in Poverty, Columbia University, Jane Knitzer, 212/304-7124, or jk340@columbia.edu.

National Governors Association (NGA) Center for Best Practices, Courtney Smith, 202/624-5300 at http://www.nga.org.

Anne Arundel County, Maryland – The Anne Arundel County Department of Social Services has developed a program to provide comprehensive vocational assessments for cash assistance applicants and recipients who are disabled or who care for disabled family members full-time in the home. In order to assist these customers in finding employment, or receiving treatment, the agency refers recipients to their contractor, the Chesapeake Career Center (CCC), a local non-profit partnership between Goodwill Industries of the Chesapeake and the Providence Center, a local developmental disabilities service provider. Services include individually tailored plans for each customer and training programs for home-based jobs, such as medical transcription. For more information, contact Vesta Kimble at 410/269-4500.

Providence, Rhode Island – The Comprehensive, Evaluation, Diagnosis, Assessment, Referral and Re-evaluation (CEDARR) Family Centers serve as a one-stop source of information for families with children with special health care needs. CEDARR Family Centers provide information, professional assessment, specialty clinical evaluation, care planning, coordination of services, and ongoing referral assistance and support, all in a family-centered, strengths-based environment. Families can be referred to CEDARR Centers from any local or community agency. Services are available to all children who are eligible for Medicaid and RIte Care, Rhode Island’s state health insurance program for children and families. CEDARR services are funded and administered by the Department of Human Services. For more information, contact the RI Department of Human Services’ Center for Child and Family Health Info Line at 401/462-1300 or see http://www.dhs.state.ri.us/dhs/dcedarr.htm.

Utah – Utah assists TANF recipients, through case management, in developing an individual plan for finding employment and attaining self-sufficiency. As part of this plan, the state will support self-employment for recipients of assistance who are caregivers for disabled family members. Ideally, self-employment will bring in at least minimum wage and the TANF agencies will only support this type of employment if it appears to be moving the family towards self-sufficiency.

Utah also encourages their child care system to provide services to special needs children. TANF and Child Care Development Fund (CCDF) monies have been set aside to provide higher reimbursement rates for child care providers who choose to serve children with special needs. Grants are also available that allow a provider to pay for services that help to care for special needs children, such as making the family child care home or facility accessible (excluding major construction efforts), purchasing educational toys or materials, receiving training on care for special-needs children, and other technical assistance. Parents of disabled children are referred to these child care providers through individual case management. For more information, contact Cathie Pappas at 801/526-9760, or cmpappas@ws.state.ut.us.

Washington – When a caseworker or social worker discovers that a TANF recipient has a child with special needs, the client is referred to a Public Health Nurse (PHN) at the local public health department. The PHN conducts an assessment of the impact of the child’s special needs on the parent’s ability to find and keep employment. She will then work with the individual and the case manager to develop an individual responsibility plan to ensure that the child’s needs are being met and that the parent is participating in Work First activities to the fullest possible extent. The plan is very flexible and could include activities like taking a child to treatment appointments as an allowable activity preparing that individual to work. If child’s condition is severe enough, the family could also be exempted from the 60-month time limit. For more information, contact Allen Shanafelt at 360/413-3243, or shanaad@dshs.wa.gov.

Wisconsin – Currently, full-time caregiving for a disabled family member is counted as an allowable work activity in Wisconsin. In addition, Wisconsin is looking for funding to contract with a social service agency that would employ TANF recipients as caregivers in the home and would compensate these individuals for their work and provide benefits for their caregiving activities. This plan is in the developmental stages and the state is looking at different options for funding this project including: 1) applying for a Medicaid waiver to fund the program; 2) applying for a Federal waiver to allow more than 10 percent of TANF funds to be transferred to the Social Services Block Grant (SSBG), where they would be used to administer this program under the Department of Health and Family Services; or 3) pursuing a state statutory change to enable Wisconsin to target existing SSBG funds for the project. The Medicaid waiver would provide a more permanent solution, would make the caregiver eligible for additional services like respite care and would remove the family from the TANF system, where they would be subject to time limits; however, the state previously applied for a waiver and did not receive it. For more information, contact Heidi Hammes at 608/267-0939, or hammehe@dwd.state.wi.us.

The Welfare Information Network is supported by grants from the Annie E. Casey Foundation the Charles Stewart Mott Foundation, the David and Lucile Packard Foundation, the William and Flora Hewlett Foundation, the Ford Foundation, and the Administration for Children and Families, U.S. Department of Health and Human Services.