Case management practices vary across welfare agencies, and different models of case management have emerged. Front-line workers have seen their roles and responsibilities expanded to include a range of case management activities. This Issue Note describes case management practices under welfare reform, identifies the kinds of training that workers may need to use for case management, and discusses the role of information systems in supporting case management activities. Strategies that policy-makers, program administrators, and program managers can employ undertake to facilitate effective case management also are highlighted.

At intake, eligibility is reviewed and the client receives information about the agency’s services. Assessment further examines the client’s situation and needs. Goal- setting establishes service goals and desired outcomes that may be incorporated into a contract between the client and the agency. The worker identifies resources that are available to the client and, with information from the assessment, develops with the client an individualized service plan. In the role of service broker, the worker links clients to services, agencies, and community resources. Client advocacy may be needed to ensure that administrative or bureaucratic obstacles to do not prevent a client from receiving services. The worker monitors and evaluates the progress of the client and the performance of the service providers, which may lead to modification of the service plan. Providing supportive counseling is an ongoing case management activity that draws on the benefits of having a direct relationship between the worker and the client. Supportive counseling includes activities such as giving advice and practical help, problem- solving, providing encouragement, and helping clients recognize their strengths (Rothman, 1994). Case managers do not necessarily perform all of the activities described here. Different settings emphasize or allow for different case management activities.

Beginning at intake and eligibility determination, front-line workers in many welfare agencies are giving TANF clients the message that cash assistance is temporary and employment is the goal. Although While welfare agencies may use the job market to assess job readiness, they are also collecting a lot of assessment data. The American Public Human Services Association’s survey of state TANF client assessment policies and practices found that states are assessing almost all clients in areas related to employability, work-related needs, and support issues (Brawley, 2000). The survey found that a TANF case workers or /case managers is are the primary type of worker conducting client assessments in 14 of 15 areas. Front-line workers are using information from assessments to develop personal responsibility and employability plans and to guide ongoing case management. All states require TANF applicants or clients to sign a personal responsibility contract or employability plan, and some require both documents (visit see the State Policy Documentation Project at http://www.spdp.org/). Developing this contract or plan incorporates goal- setting and service- planning activities. This contract or plan between the client and the agency includes obligations and goals for the client and often includes a state or county agreement to provide services.

To help clients with different degrees of at different levels of employability get jobs, become and stay employed, and become move to self-sufficient, cy, welfare agencies are providing and purchasing an array of services for clients. The linkage function of case management is a key component in delivering multiple services to TANF clients. Monitoring is also is an important function under welfare reform because since workers need to keep track not only of client progress, but also of client participation in required activities, client compliance with the personal responsibility or employability plan, and time limits. Monitoring can help the workers become aware of barriers to employment that may arise.emerge over time.

Although While supportive counseling may not be an explicit part of a state or local agency’s case management approach, this service function can help clients improve their coping skills and foster their willingness to participate in activities and their motivation to work. Some case management approaches, such as the Michigan Family Independence Agency’s "strength-based, solution-focused" casework approach, (Seefeldt and Peters, 2000), include supportive counseling activities. (Seefeldt and Peters, May 2000).

Who is performing case management activities in welfare agencies? To meet the requirements and goals of welfare reform, many welfare agencies have changed the roles and responsibilities of their front-line workers. As welfare agencies provide more case management services to more TANF clients, front-line workers have taken on a range of case management asuch activities, as from assessments, and service planning, to service brokering, and case monitoring. Even in agencies where separate workers perform income maintenance and case management activities, are performed by separate workers, all front-line staff are expected to convey the message of welfare reform. Some welfare agencies use specialized staff to perform certain case management activities, such as in-depth assessments and service planning to address barriers to employment. In redesigning jobs and responsibilities, some agencies have shifted certain case management activities to other public- sector agencies or to private contractors. For more information, see the Welfare Information Network (WIN) Issue Note "At the Front Line: Changing the Business of Welfare Reform," available at http://www.welfareinfo.org/frontline.htm.

What models of case management are welfare agencies using? Welfare agencies are delivering case management services to clients in different ways. Integrated case management, a team-based approach, intensive case management, and contracting out case management services are models that have emerged under welfare reform. efforts. Each has distinct advantages, challenges, and utility. The fFactors influencing that may influence the choice of approach include the agency’s mission, the capacity of its staff, the populations being served, and the extent of interagency coordination.

The integrated case management approach combines case management activities and such income maintenance functions such as intake and eligibility determination. In implementing this model, states have expanded the roles and responsibilities of income maintenance workers. This approach can enhance the continuity and coordination of services within and outside the welfare agency. However, if income maintenance functions are time- and paperwork- intensive, they can overshadow case management activities. In addition, income maintenance and case management activities use different skills and knowledge. Some agencies have eschewed the integrated approach, maintaining different workers for these activities. In this case, it is important that income maintenance workers also convey an employment message and that there is good intra-agency coordination.

Some agencies use have a team-based approach under which where multiple workers are involved in case management activities. Agencies that have specialized staff internally or have access to staff through interagency coordination may use a team-based approach to take advantage of staff training and expertise in particular areas, such as assessments or employment and training. Because multiple workers must coordinate their activities, this approach may be more successful when it assigns one worker as a primary case manager who can facilitate oversight and monitoring.

Intensive case management is an approach that allows enables an agency to deliver more individualized services to clients that who may need additional help to become gainfully employed, such as long-term recipients, welfare "cyclers," and clients with multiple barriers to employment. The agency needs to ensure that workers providing intensive case management have smaller caseloads, sufficient training, and adequate resources to address clients’ needs.

Federal welfare reform legislation gave states new opportunities to shift welfare- related services, including core activities such as like benefits determination and case management, to other public- sector agencies and to private contractors (Meyers, June 1998). Welfare agencies that have outsourced case management services still need to track client activities and evaluate the impact of services. Information sharing is a critical component of this approach. The welfare agency needs to keep the contractor or other government agency abreast of changes in TANF policies and procedures. In addition, the welfare agency can support those practicing providing case management by, for example, providing support services like such as child care subsidies when clients are eligible, imposing sanctions in a timely way, and taking other needed actions.

What kinds of training do case managers need? Helping clients become employed and self-sufficient is a difficult task that front-line workers are undertaking in a complex policy and programmatic environment. Front-line workers now doing case management may have little training in or experience with this method of delivering services. Yet these workers have greater discretion under TANF than under the more rule-bound Aid to Families with Dependent Children (AFDC) program and need to use their professional judgment in providing case management (Meyers, June 1998). Providing training to case management staff can improve the effectiveness and consistency of case management services. The kinds of training that workers need depends on their experience, what case management activities they are doing, and the client population.

Agencies should avoid overwhelming staff with training, but there are several a number of areas where training may be needed or helpful. These areas include including TANF policies and procedures, screening and assessment practices, community resources, barriers to employment, case management skills, and career development. Case management is not only is about coordinating services, but also is also an effort aims to help clients change their behavior and situation. Consequently, it requires staff to have As such, it calls on interpersonal, organizational, and community-oriented skills. Front-line workers who have little experience with this approach to service delivery case management may benefit from training in case management skills and techniques, such as relationship- building, service planning and referral based on clients’ needs, and identifying and accessing resource agencies. With welfare reform’s focus on work, welfare case managers may also need training on career development skills to help clients obtain jobs, sustain employment, and advance in the workforce.

Training should be connected to workers’ roles and responsibilities and to the program’s mission and goals. Training can be provided on an ongoing basis and delivered in different forms. Teaming up staff with different areas of expertise, holding regular peer meetings, and conducting small- group activities such as role- plays are opportunities for learning and sharing information and skills. By inviting representatives from community agencies to give presentations or conduct training, welfare agencies can tap the experience of case managers working in the community (Seefeldt, Sandfort, and Danziger, February 1998). In designing training, program managers can consult with front-line staff about their needs and preferences (Marks, 1999). Organizational changes need to support the new roles and responsibilities for which that front-line workers are being trained. for.

How can automated information systems support case management activities? A successful information system under welfare reform works as a management tool and as a support for front-line workers (Brown, March 1997). For many states, the age and limited capacity of their information systems can make it difficult for systems to support the programmatic activities and goals of TANF. programs. Yet modifying older systems and developing new systems is a long and evolving process. A recent U.S. General Accounting Office report (April 2000) found that although automated systems in the states examined in the report examined in the report support welfare reform in many ways, a number a number of these systems have major limitations in several key areas, including case management. For example, the The inability to obtain data on individual recipients from some of the agencies serving them is a major shortcoming.

Automated systems can support workers’ administrative responsibilities and their case management activities, such as like service planning and referral, monitoring client activities, and evaluating participant outcomes and program performance. To do so, agencies can work together to develop in developing information systems that enable allow front-line workers to access client-specific information across multiple organizations and systems. As information technology (IT) progresses, new IT solutions are emerging that support client-specific decision-making. For more information on case management and information technology, see the report Welfare Reform Information Technology: A Study of Issues in Implementing Information Systems for the Temporary Assistance for Needy Families (TANF) Program (State Information Technology Consortium, October 2000). (The Welfare Reform Information Technology project is an effort by the Office of State Systems Policy of at the Administration for on Children and Families and its contractor, the State Information Technology Consortium, to examine information systems issues and develop technical assistance resources.)

States’ automated information systems initiatives are using different a range of approaches to address the information needs of front-line workers. Some states are replacing existing systems with new integrated systems. Other states are developing new links among between separate information systems. For example, Ohio and Texas are developing "common front ends" to provide workers with a single point of access to multiple systems and reduce duplication in of data entry (U.S. General Accounting Office, April 2000). Internet technology is opening the doors to developing electronic networks among between agencies and is to web-enabling web access to different systems. Vendors and systems integrators have developed packages to support case management. Local welfare agencies can develop databases of community resources to support service planning and referral. For more information, see the WIN Issue Note "Information Systems and Tools to Support Goals of Self-Sufficiency," available at http://www.welfareinfo.org/systems.htm.

What kinds of organizational changes can facilitate effective case management? Front-line workers who have taken on case management roles and activities need the support of their agencies to help clients reach the goals of sustained employment and self-sufficiency. Strategies and organizational changes to facilitate case management activities include the following.

Case management, as As an approach to managing the delivery of client services, to clients, case management is embedded in some of the research on welfare reform programs. Readers can visit the web site of the Research Forum on Children, Families, and the New Federalism at http://www.researchforum.org/and search the online database for studies that include information on case management practices.

Several programs designed to promote the employment, job retention, and career advancement of welfare recipients used a case management approach to support program goals. The Family Support Act of 1998 created the Jobs Opportunities and Basic Skills Training Program (JOBS) to foster the economic self-sufficiency of AFDC parents. States had the option to offer of offering case management services to JOBS participants. The report Implementing JOBS: Case Management Services (Hagen and Lurie, 1994) examines the use of case management services under the JOBS program in ten 10 states (Hagen and Lurie, July 1994). The U.S. Department of Health and Human Services sponsored an evaluation of seven JOBS sites, now the National Evaluation of Welfare-to-Work Strategies (NEWWS). The Columbus, Ohio, site directly compared two approaches to case management, an integrated approach and a traditional approach that separated income maintenance and JOBS activities. and an integrated approach. The evaluation suggests that integrated case management may lead to higher participation rates in program activities, lower monthly sanctioning rates, and better tracking and monitoring of participants (see Brown, March 1997). The Columbus integrated case management staff had sufficient resources and small enough caseloads to perform both JOBS and income maintenance sets of responsibilities. For more information on NEWWS, visit see http://aspe.hhs.gov/hsp/NEWWS/.

The Postemployment Services Demonstration (PESD) was the first major demonstration program to examine the effectiveness of providing case management to newly employed welfare recipients as a way to promote job retention. PESD operated in Chicago, Illinois; Portland, Oregon; Riverside, California; and San Antonio, Texas, between mid-1994 and mid-1996. Although Though the PESD evaluation found that overall, the program had little effect on increasing earnings, reducing welfare, or promoting the move toward self-sufficiency, the findings offer evaluation offers valuable lessons for program design and service delivery. Key lessons include: the need to target clients appropriately for different types of job retention services, simplify service delivery mechanisms to allow free more time for coordinating services coordination and meeting other client needs, of clients, and address gaps in program services (Rangarajan and Novak, April 22, 1999).

The Administration for Children and Families of the U.S. Department of Health and Human Services has launched the Employment Retention and Advancement Evaluation project that draws on the lessons of PESD. Several sites are testing case management models. For more information, visit the Lewin Group web site at http://www.lewin.com/.

Mathematica Policy Research, Inc., which conducted the PESD evaluation, recently completed an evaluation of the GAPS initiative, a Pennsylvania program designed to help newly employed welfare recipients bridge the gap between welfare dependency and self-sufficiency through case management and other support services. Supportive counseling was the most commonly provided case management service. The evaluation found that participants valued the counseling, moral support, and personal attention that a case manager can provide. However, supportive counseling alone may not improve employment outcomes. Supplementing case management with additional services to support employment may help improve participants’ outcomes and gain their trust (Wood and Paulsell, December 2000).

Readers may also want to review the literature on organizational culture change in the welfare system for research on the changing roles and responsibilities of front-line workers (visit the web site of see the Research Forum on Children, Families, and the New Federalism at http://www.researchforum.org/).

The Nelson A. Rockefeller Institute of Government’s Front-Line Management and Practice Study is examining front-line practices and their organizational context under TANF, (visit http://www.rockinst.org/quick_tour/federalism/index.html).

The American Public Human Services Association, through its Organizational and Professional Development Department (OPD), has provided training and consultation on around case management in welfare reform programs to a number of a number of states and local jurisdictions. OPD developed a competency-based case management curriculum that supports a strong labor market attachment approach. There is renewed interest in this training curriculum as welfare agencies work with more hard-to-serve clients. The curriculum helps case management staff to manage their own behavior effectively, manage relationships with clients to encourage and support change, and manage work. The training provides a structured approach to comprehensive client assessment and the development of individualized employment plans. For more information, contact Sue Christie, director, Organizational and Professional Development Department, at 202/682-0100.

In Arizona, staff of at the Family Assistance Administration determines TANF eligibility and refers clients to the Jobs Administration for case management and employment-related services. The Family Assistance and Jobs Aadministrations are part of the Arizona Department of Economic Security (DES). The majority of Jobs Administration offices are collocated co-located with Family Assistance offices, which facilitates cross-divisional communication. The Jobs Administration provides case management services to TANF clients, former TANF recipients who that are employed, and individuals who are at risk of becoming TANF- dependent. Services include client assessment, preparation of the employability plans, service referral, coordination of training and employment activities, provision of certain support services, and follow--up. Jobs case managers receive three weeks of basic skills training in policies and systems. Refresher training also is offered.

Jobs case managers use the Jobs Automated System (JAS) to record client information and track client activities. JAS interacts with other DES automated systems. Electronic referrals and referral files containing basic demographic information are transmitted from the eligibility system to JAS. Jobs case managers are able to view certain types of client information in other DES systems, such as for example they can view wage records in the employment security system. Worker classification determines what systems and information can be accessed. For more information, contact Liz Steele, program administrator, Jobs Administration, Arizona Department of Economic Security, at 602/542-5954.

The Division of Social Services (DSS) of at the Delaware Department of Health and Social Services uses a two-tiered system of case management under which where separate case managers perform income maintenance functions and employment-related activities. are done by separate case managers. DSS case managers determine and review eligibility for TANF, Medicaid, fFood sStamps, and cChild cCare; develop a family profile; prepare the contract of mutual responsibility; and refer TANF clients to employment connections case managers who help clients get and keep jobs. The employment connections case management is done under contract. Different kinds of organizations provide this service;, for example, the Delaware Technical and Community College, Maximus, and the Salvation Army are contractors. DSS and employment connections case managers communicate by telephone, and e-mail, and through a DSS automated system for employment and training available to contactors. When work-related sanctions are required, the employment connections case manager informs the DSS case manager who then imposes the sanction.

DSS case managers receive training on in the following areas: DSS programs and their corresponding policies, substance abuse and domestic violence issues, DSS computer systems, and interviewing skills and techniques. Case managers can practice interviewing skills through role- play in an on online, interactive setting. DSS case managers use the Delaware Client Information System II, an eligibility and case management system for DSS programs that includes including TANF, fFood sStamps, and Medicaid. among others. The system tracks eligibility and benefit issuance and enables case managers to record case comments and client sanctions. There is a separate system for Child Care. For more information, contact Roseanne Mahaney, executive assistant to the director, Division of Social Services, Delaware Department of Health and Social Services, at 302/577-4402.

In most Maryland local departments of social services, Family Investment Program (TANF) case managers determine eligibility, assess job readiness, develop the independence agreement, and refer clients to needed services, training, and other work activities. In some local departments, a team of staff from several programs—Family Investment, Child Care, Child Support Enforcement, and Social Services—deliver case management services to clients. The Family Investment Administration (FIA) provides training on policies and skills to case managers. The University of Maryland School of Social Work provides training under contract to FIA on case management skills, customer service, and other topics. FIA’s Office of Work Opportunities purchases training for case managers on providing employment and career assistance. Case managers use an automated eligibility determination system—the Client Automated Resource and Eligibility System—that determines client eligibility, collects benefit history, and issues benefits and reports. Efforts are underway to improve access to client information across FIA programs. For more information, contact Rosemary Malone, policy and training chief, Family Investment Agency, Maryland Department of Human Resources, at 410/767-7949.

The most common model of case management in the Oregon TANF program is the integrated approach, a where the case manager determines TANF eligibility and provides case management services. These services include assessing clients and families, family assessment, case planning, referring clients referral to employment and family stability services, monitoring progress and attendance, maintaining regular contact with the client and service providers, case staffing with other agencies for joint case planning, applying sanctions, and providing transition services for clients going to work. In a few Adult and Family Services (AFS) branches, case management is shared between TANF staff and contracted wWorkforce agency staff. In some AFS branches with a high concentration of specialized cases, such as teen parents, clients may receive specialized case management.

Training for case managers covers a range of topics including the agency’s mission, values, principles, and staff expectations; case management activities under the integrated approach; policies and procedures for food stamps, medical assistance, and employment- related day care; and staff use of the computer systems. staff use. Alcohol and drug abuse issues are covered in a three-day training workshop offered to all state employees. Optional workshops on career planning and mentoring, communication skills, time management, and other topics also are also offered.

AFS has two primary systems for tracking and managing caseloads. One is the JOBS Automated System (JAS), a mainframe system that contains basic client information from other data systems and that is used to record client activities and participation status. This system also issues supportive payments. The other system is the Transition, Referral and Client Self-Sufficiency System (TRACS), a client/server system designed with input from front-line staff to support case management. The heart of TRACS is a case narrative system where case managers can record their interaction with clients. The case narrative is centered on the client. The agency is completing the integration of data input with JAS. This will eliminate duplicative data entry since TRACS will automatically transfer client information to JAS. TRACS also serves as an information-sharing network. A number of workforce and community service partners use the TRACS system. For more information, contact Bob Proctor, program analyst, Oregon Adult and Family Servcies, at 503/945-6115.

The Texas Department of Human Services (DHS) is participating in the Employment Retention and Advancement Project (ERA) sponsored by the Administration for Children and Families of the U.S. Department of Health and Human Services. The evaluation sites—Corpus Christi, Fort Worth, and Houston—will test the effect of intensive, team-based case management, combined with a stipend for those who work part or full time in conjunction with another approved activity, on employment retention and advancement. The results will be compared with those of compared to a more traditional work- first program.

The Texas ERA model emphasizes longer-term career planning and resolution of employment barriers. Intensive, team-based case management begins directly after an individual applies for and is determined potentially eligible for TANF assistance. The team-based approach is designed to enhance coordination and continuity among between eligibility, workforce development, and community services. Each case management team includes a DHS eligibility worker, a worker from the TANF employment and training program (Choices), and the ERA case manager contracted by DHS and the lLocal wWorkforce dDevelopment bBoard. Teams will work with clients for at least 12 months. Services include assessment, goal-setting, pre- and post-employment service planning, service brokering, advocacy, and follow-up. Caseload size for ERA case managers ranges from 35 to -40 clients. Workers participating in the ERA project have received training on basic case management, employment planning, and retention and advancement strategies, and on identifying and addressing barriers to employment. DHS purchased case management software for the ERA project to facilitate tracking client and team activities. The Corpus Christi and Fort Worth sites have begun to assign individuals to ERA program and control groups. For more information, contact Debora Morris, assistant deputy commissioner for planning, evaluation, and project management, Texas Department of Human Services, at 512/438-3353.

Mathematica Policy Research, Inc., contact Anu Rangarajan, 609/799-3535; or visit http://www.mathematica-mpr.com/.

Nelson A. Rockefeller Institute of Government, Federalism Research Group, 518/443-5844; or visit http://www.rockinst.org/.

Research Forum for Children, Families, and the New Federalism, 212/304-7132; or visit http://www.researchforum.org/.

University of Michigan, Program on Poverty and Social Policy Welfare, contact Kristin Seefeldt, 734/998-8514; or visit http://www.ssw.umich.edu/poverty/.

U.S. Department of Health and Human Services, Administration for Children and Families, Office of State Systems Policy, contact Mark Graboyes, 202/401-7237; or visit http://www.acf.dhhs.gov/programs/oss/.

U.S. Department of Labor, Employment and Training Administration, Workforce Investment Act, visit http://www.usworkforce.org/. The Workforce Investment Act designates case management as one of the intensive services for adults in the one-stop system. Welfare-to-Work Grant programs are providing case management services to their clients. Visit the Office of Welfare-to-Work at http://wtw.doleta.gov/.

Brawley, Scott. APHSA Summary of Findings: Survey of State TANF Client Assessment Policies and Practices. Washington, D.C.: American Public Human Services Association, 2000. Available at http://www.aphsa.org/opd/events/1031execsummary.pdf.

Brown, Amy. Work First: How to Implement an Employment-Focused Approach to Welfare Reform. New York, N.Y.: Manpower Demonstration Research Corporation, March 1997. Available at http://www.mdrc.org/Reports/workfirst.htm.

Hagen, Jan L., and Irene Lurie. Implementing JOBS: Case Management Services. Albany, N.Y.: Rockefeller Institute of Government, July 1994. For information on ordering, contact the Rockefeller Institute of Government at 518/443-5258.

Marks, Ellen L. Changing the "Culture" of the Welfare Office: Report from Front-Line Workers. Calverton, Md.:MD: Macro International, 1999. Available at http://www.macroint.com/publications/culture.pdf.

Meyers, Marcia K. Gaining Cooperation at the Front Lines of Service Delivery: Issues for the Implementation of Welfare Reform. Albany, N.Y.: Rockefeller Institute of Government, June 1998. Available at http://www.rockinst.org/publications/rockefeller_reports/rr07.html.

Morgenstern, Jon, Annette Riordan, Barbara S. McCrady, Katharine H. McVeigh, Kimberly A. Blanchard, and Thomas W. Irwin. Intensive Case Management Improves Welfare Clients’ Rates of Entry and Retention in Substance Abuse Treatment. Washington, D.C.: U.S. Department of Health and Human Services, Assistant Secretary for Planning and Evaluation, January 2001. Available at http://aspe.hhs.gov/hsp/njsard00/retention-rn.htm.

National Association of Social Workers. NASW Standards for Social Work Case Management. Washington, D.C.: National Association of Social Workers, 1992. Available at http://www.naswdc.org/practice/standards/casemgmt.htm.

Rangarajan, Anu, and Tim Novak. The Struggle to Sustain Employment: The Effectiveness of the Postemployment Services Demonstration. Princeton, N.J.: Mathematica Policy Research, Inc., April 22, 1999. Available at http://www.mathematica-mpr.com/PDFs/strug-rpt.pdf.

Rothman, Jack. Practice with Highly Vulnerable Clients: Case Management and Community-Based Service. Englewood Cliffs, N.J.: Prentice Hall, 1994.

Seefeldt, Kristin S., and Jacqueline Peters. The Family Independence Specialist: Successes and Challenges. Ann Arbor, Mich.: MI: University of Michigan, Program on Poverty and Social Welfare Policy, May 2000. Available at http://www.ssw.umich.edu/poverty/success-challenge.pdf.

Seefeldt, Kristin S., Jodi Sandfort, and Sandra K. Danziger. Moving Toward a Vision of Family Independence: Local Managers’ Views of Michigan’s Welfare Reforms. Ann Arbor, Mich.: MI: University of Michigan, Program on Poverty and Social Welfare Policy, February 1998. Available at http://www.ssw.umich.edu/poverty/report.

State Information Technology Consortium. Welfare Reform Information Technology: A Study of Issues in Implementing Information Systems for the Temporary Assistance for Needy Families (TANF) Program. Washington, D.C.: U.S. Department of Health and Human Services, Administration for Children and Families, October 2000. Available at http://www.acf.dhhs.gov/programs/oss/WRITReport/Index.htm.

U.S. General Accounting Office. Welfare Reform: Improving State Automated Systems Requires Coordinated Federal Effort. Report to Congressional Committees, GAO/HEHS-00-48. Washington, D.C., April 2000. Available at http://www.gao.gov/new.items/he00048.pdf.

Wood, Robert G., and Diane Paulsell. "Employment Retention for TANF Recipients: Lessons from GAPS." Issue Brief, no. 1 (December 2000). , number 1). Mathematica Policy Research, Inc., Princeton, N.J. Available at http://www.mathematica-mpr.com/PDFs/WTWIsBr1GAPS.pdf