April 25, 2002
The Child Welfare League of America welcomes this opportunity to submit testimony in behalf of our more than 1,175 public and private nonprofit child-serving member agencies nationwide regarding barriers to employment that affect the hardest-to-employ individuals, as part of the reauthorization of the Temporary Assistance for Needy Families program (TANF). We applaud the Subcommittee for recognizing the importance of eliminating barriers to employment in the context of TANF reauthorization.
If we are serious about helping families move from TANF to self-sufficiency, we must address the barriers they face and provide them with the supports they need. This year presents the first real opportunity for Congress, the Administration, and the nation to review and evaluate the significant decision made in 1996 to replace Aid to Families with Dependent Children. We have an opportunity to evaluate what has worked and to improve the program, eliminate barriers to employment, and positively impact the lives of millions of low-income children and their families.
TANF and Barriers to Employment
Families receiving TANF assistance face a number of barriers. As a result, some recipients are unable to move from welfare to personal responsibility and work. These barriers may include substance abuse, mental illness, domestic violence, or disabilities. For those families who come to the attention of the child welfare system-a good portion of them TANF recipients-alcohol and other drug (AOD) use is a major contributing factor for remaining unemployed for long periods of time. Families with substance abuse problems need appropriate and comprehensive treatment to overcome obstacles and move to self-sufficiency.
Estimates of the prevalence of substance abuse among TANF recipients range from 16% to 37%. In a survey of CWLA member agencies, caseworkers reported that up to 80% of the families that come to the attention of the child welfare system have an AOD problem. The U.S. Department of Health and Human Services estimated in August 2000 that at least 460,000 families on welfare-about 1.2 million parents and children-were affected by substance abuse. Several studies have suggested a high prevalence of substance abuse among women receiving TANF, with rates as high as 39%. The 1991 National Household Survey on Drug Abuse found that alcohol and drug use was more prevalent among the welfare population than the general public. TANF caseworkers, in particular, identify substance abuse as the most inflexible of the barriers facing people who are trying to make the transition from welfare to permanent employment. All of the studies make clear that substance abuse is a problem for many families receiving TANF and that it poses a barrier to employment and self-sufficiency.
In keeping with the philosophy of removing obstacles to work to achieve the overall goals of personal responsibility and self-sufficiency, CWLA supports changes and improvements in screening and assessment, sanctions, and work requirements for those needing substance abuse treatment and applying for TANF benefits.
Family Screening and Assessment
Families seeking cash assistance often face many other stressors in their lives that can become barriers to completing TANF successfully and that can jeopardize child safety and well-being. These include the need for adequate housing and transportation, substance abuse and behavioral health treatment, and assistance in addressing domestic violence. The purpose of a family assessment is to learn about and engage a family in identifying their needs, strengths, and current resources. Family screening and assessment is a key ingredient in helping families achieve self-sufficiency. It is also a vital tool for helping families improve their parenting abilities and ensuring child safety and well-being.
Many jurisdictions have initiated screening and assessment for families who are eligible for TANF. Some conduct an assessment with all new families requesting assistance. A personal responsibility plan, based on the assessment findings, sets forth the services the family will receive to address barriers and includes recommendations such as substance abuse or behavioral health assessments. Assessments may be conducted “midcourse” to determine client progress and make any necessary corrections to the service plan. Some jurisdictions also require a full assessment with the family prior to imposing sanctions.
These steps can prevent problems for families down the road-both the failure to meet work requirements and the increased risk of child abuse or neglect. For those families already involved with the child welfare system, joint TANF-child welfare assessments provide an opportunity to implement a coordinated service and work plan with the family. This ensures the family will receive a single plan for accomplishing both their work and family goals.
CWLA recommends that all families seeking TANF assistance participate in an initial screening by a trained caseworker to identify and screen for barriers to work, such as substance abuse. This initial screening should identify potential barriers that might interfere with the family’s ability to work requisite hours and otherwise comply with program requirements. If the screening identifies potential barriers for the parents or safety risks for the children, the caseworker should conduct a full family assessment and, where necessary, refer the family member for a professional evaluation to assess substance abuse, behavioral health, or other concerns beyond the worker’s expertise.
TANF workers should be trained to screen for barriers to work, including substance abuse, physical and behavioral health, and domestic violence, and for risks to child safety. Workers should also receive training in family assessment, enabling them to assess the needs, strengths, and resources of families as a tool for developing a plan that will lead to successful work and promote a safe environment for the children. Finally, for families already involved with the child welfare system, workers should be encouraged to conduct joint assessments and planning with child welfare so that both systems support families in their efforts to succeed in the workplace and as parents.
Substance Abuse and Sanctions
Families in need of services, such as substance abuse treatment, must receive the assistance they need to overcome barriers to employment. CWLA recommends that states conduct a presanction review before sanctioning parents who are considered noncompliant. Parents should not be subjected to sanctions and case closures because of the state’s limited substance abuse treatment capacity. If substance abuse treatment services, as specified in the individual responsibility plan, are not available to the parent, states should refrain from sanctions or case closures.
Substance Abuse and Work Requirements
Under TANF, substance abuse treatment is considered work activity and job preparation. Comprehensive, family-focused treatment programs, either residential or outpatient, require that parents engage in intensive therapy sessions, group counseling, parenting classes, and education or job training services. A 1998 Legal Action Center study, Helping Women with Alcohol and Drug Problems Move from Welfare to Work, looked at 20 women’s treatment programs and found that 60% included work and vocational training as part of treatment, whereas 75% required work and vocational training during the substance abuse treatment process.
The Americans with Disabilities Act (ADA), Section 504 of the Rehabilitation Act, and state laws require welfare programs to provide meaningful access and accommodation to people with disabilities. ADA covers parents in drug treatment programs. Reasonable accommodation and individualized assessment are key entitlements accorded to people covered by ADA. Substance abuse treatment as a work activity can constitute reasonable accommodation for parents. CWLA asks the Subcommittee to provide substance abuse treatment as a work activity as a reasonable accommodation for parents. Successful transition from treatment to work is necessary to ensure that states provide reasonable accommodation for people in treatment.
Improving Access to Comprehensive Treatment for Families
With the reauthorization of TANF, Congress is taking a long, hard look at the characteristics shared by those who remain on TANF. The hardest-to-employ will be those who have been unable to gain work. Clearly, behavioral changes will be critical to move those who have not been able to find and keep jobs because of existing barriers, particularly those confronting substance abuse.
As we have pointed out, AOD use and abuse is a major barrier to economic self-sufficiency. If left untreated, it can interfere with the ability to find and keep employment. The Substance Abuse and Mental Health Services Administration, Center for Substance Abuse Treatment’s report, A Look at State Welfare Reform Efforts to Address Substance Abuse, states that substance abuse treatment is effective in reducing illicit drug use, improving physical and mental health, and reducing criminal activity. Most importantly for the welfare population, substance abuse treatment also results in improved financial self-sufficiency. Studies of the effects of substance abuse treatment programs “have consistently shown that employment rates improve among individuals who participate in substance abuse treatment.” The National Treatment Improvement Evaluation Study (NTIES) indicated that employment increased 19% following treatment.
Substance abuse treatment programs can be instrumental in moving individuals off welfare. After participation in treatment, substance abuse clients show a significant decline in receipt of TANF. Among women in the NTIES study, welfare receipt decreased 11%. In another study of substance abuse treatment in California, Alcohol and Other Drug Treatment for Parents and Welfare Recipients: Outcomes, Costs, and Benefits, found a 22% decrease in welfare receipt after treatment. It also reported that
- the number of women with children who received welfare income decreased by 39% among cocaine users, 48% among amphetamine users, 14% among heroin users, and 26% among alcohol users;
- the benefit of substance abuse treatment exceeded the cost by 2 to 1 for women with children who were on welfare;
- the estimated cost saving was $7.00 for every $1.00 spent on treatment, due largely to reductions in drug-related crime.
The National Center on Addiction and Substance Abuse at Columbia University study, Shoveling Up: The Impact of Substance Abuse on State Budgets, revealed that, in 1998, states spent conservatively $81.3 billion dollars on substance abuse and addiction-13.1% of the $620 billion in total state spending. Of each such dollar, 96¢ paid for the consequences of substance abuse and addiction, and only 4¢ for prevention and treatment.
A recent National Institute on Drug Abuse report indicated that when savings related to health care costs are added to the savings due to crime, total savings could exceed costs by a ratio of 12 to 1. The value of providing treatment services to individuals with AOD problems cannot be ignored. A recent analysis indicated that every American pays more than $1,000 each year to cover the costs of untreated substance abuse. It would cost each American $45 per year to provide comprehensive treatment services-less than 5% of the current per-person toll for lack of treatment.
The importance of substance abuse treatment in promoting economic self-sufficiency is clear. For welfare reform to succeed, substance abuse treatment must become a component of welfare-to-work strategies. CWLA is encouraged by the Administration’s proposal, contained in the House TANF reauthorization bill (H.R. 4090), which gives work credit to families engaged in short-term substance abuse treatment. Although we feel that three months is not nearly long enough to effectively address a substance abuse problem, the recognition of treatment as a work activity is extremely important.
CWLA recommends that reasonable accommodation be given to treatment as a work activity to take into account the parent’s particular circumstances and needs as part of the individual responsibility plan. Aside from the needed improvements of screening and assessment, sanctions, and work requirements, substance abuse treatment services must be available for this to work. If treatment capacity is not accessible for those individuals most in need, family assessment and reasonable accommodation will not be successful.
Given what we know about treatment options that work, it is critical that collaborations be developed. A new collaborative infrastructure between TANF agencies, AOD agencies, and, we would argue, child welfare agencies, must be encouraged to effectively meet the needs of TANF families, many of whom are also families that come to the attention of child welfare.
Legislation currently before the Senate Finance Committee, S. 484, the Child Protection/Alcohol and Drug Partnership Act, would provide comprehensive substance abuse treatment for the most vulnerable families-those who come to the attention of child welfare. Introduced by Senators Olympia Snowe (R-ME) and Jay Rockefeller (D-WV), and cosponsored by a number of members of the Senate Finance Committee, S. 484 would provide what is needed-comprehensive substance abuse treatment that includes job preparation.
CWLA believes we have a real opportunity with the reauthorization of TANF to change behavior-a goal in both welfare reform and treatment for substance abuse. We encourage the Subcommittee to consider these recommendations.
The reauthorization of TANF affects millions of children and families. Now is the time for Congress to provide the resources, flexibility, and direction needed to help adults receiving TANF, particularly those dealing with substance abuse and who remain hardest-to-employ, with the tools they need to move from poverty to self-sufficiency and to better help their children. CWLA looks forward to working with members of this Subcommittee to ensure the needs of these hardest-to-employ families are part of any final TANF reauthorization considered this year.