Prepared for the Office of the Assistant Secretary for Planning and Evaluation and the Administration for Children and Families, Contract No. 100-95-0021 Task Order No. 6. Any opinions expressed in this report are those of the authors and do not necessarily represent the views of the Urban Institute, American Institutes for Research or the U.S. Department of Health and Human Services.
This report reflects the contributions of many people. Program staff in the eight programs that form the basis of this report played a crucial role in helping us to understand their approaches for helping families who face a wide variety of personal and family challenges make the transition from welfare to work. We owe a special thank you to the following staff who helped us to schedule our visits to the program or graciously agreed to be interviewed over the telephone: Chris Kunde from the Kearns office of Utah's Single Parent Employment Demonstration Project; Suzanne Nobles and Terri Fransen from the Nevada County, California GAIN/Employment Services Program; Sue Smit and Michele Wallace from the Oregon Department of Human Resources; Christa Sprinkle of the Mt. Hood Steps to Success program in Portland, Oregon; Linda Bell from the Kenosha, Wisconsin JOBS Center; Toby Herr, Director of Project Match, Chicago; Ginger Hemmingsen of Cornerstone, a Family Development and Self-Sufficiency program grantee in Cedar Rapids, Iowa; Todd Walker from Avance Family Support and Education Program in San Antonio, TX and Jenny Wittner of Chicago Commons' West Humboldt Employment and Training Center.
Table of Contents
States are currently shifting the emphasis of the Aid to Families with Dependent Children (AFDC) system away from providing ongoing cash assistance to families to providing assistance to help recipients enter the labor market. As states attempt to increase the percentage of AFDC recipients who leave welfare for work or are actively engaged in work-related activities, they are likely to encounter more and more families who face a number of personal and family challenges that make it difficult for them to seek employment or to sustain employment over the long-term. For these families, their ability to succeed may depend on obtaining assistance to overcome or cope with learning disabilities, substance abuse, depression and physical or mental disabilities, family responsibilities, including the responsibility to care for other family members with disabilities, histories of physical or sexual abuse and domestic violence, social isolation, absent and/or non-supportive mates or significant others, inadequate parenting and discipline skills, and proximity to criminal activity.
Currently, most families who experience many of these personal or family challenges are exempted or deferred from participation in employment or employment-related activities. However, there are a small number of states and some local programs that have expanded the Job Opportunities and Basic Skills (JOBS) program or have developed programs outside of the welfare system to address the needs of these families. This report summarizes information from case studies of eight of these programs, examining the issues that are important to consider when designing such programs. Several broad lessons can be learned from their experiences.
- Program flexibility is critical. A diverse array of personal and family challenges contribute to families' inabilities to find or keep employment. These families also have very different strengths on which they can draw to become self-sufficient. Consequently, while some families may need limited assistance for only a short period of time, others may need intensive assistance for far longer. Because these families' circumstances are so diverse, a broad range of services and approaches to strengthening families are needed to help them achieve self-sufficiency.
- A critical component of programs designed to address the needs of families who are experiencing personal or family challenges that make the transition from welfare to work difficult is the development of a trusting relationship. Program administrators repeatedly stressed the importance of hiring staff who were genuinely committed to helping families bring about change in their lives. One of the main roles staff provide is to celebrate small steps toward self-sufficiency and to push families to progress further.
- Forging partnerships with community agencies that provide substance abuse treatment, mental health counseling or specialized services for women in abusive situations is critical to help some of these families achieve self-sufficiency. Most JOBS case managers or eligibility workers do not have the specialized skills that are needed to address these issues. Even programs that have hired more highly skilled JOBS staff rely on these outside resources, both because staff are not necessarily skilled in these particular areas and because they do not have sufficient time to provide the intensive counseling and support needed to address these issues.
- Clear expectations reinforced with financial penalties are important. Financial sanctions are viewed as a mechanism to encourage families to participate in program activities. Staff repeatedly report that sanctions serve an especially important function in getting families who are fearful of change to begin to take the initial steps to become self-sufficient.
- The provision of supportive services to families who experience various personal and family challenges that make it difficult for them to find or sustain employment is not incompatible with a program model that emphasizes rapid entry into the labor market. For many families, assistance designed to help them overcome particular barriers to employment can be provided within a relatively short period of time. In some cases, employment itself or participation in community activities designed to increase a recipient's work-related skills or self-esteem may help recipients to take the steps they need to overcome their personal or family challenges.
This report is the second of a series of reports on AFDC families who face personal or family challenges that are likely to make the transition from welfare to work difficult. The first report, Personal and Family Challenges to the Successful Transition from Welfare to Work by Krista Olson and LaDonna Pavetti is also available from The Urban Institute. This report examines the prevalence of specific types of personal and family challenges AFDC families encounter as they attempt to make the transition from welfare to work and provides estimates of the portion of the AFDC caseload that is likely to need more assistance than traditional welfare-to-work programs generally provide to succeed in the paid labor market.
Designing Welfare-to-Work Programs fro Familiaes Facing Personal or Family Challenges: Lessons from the Field
States are currently shifting the emphasis of the welfare system from providing ongoing cash assistance to families to providing assistance to help recipients enter the labor market. As states attempt to increase the percentage of AFDC recipients who leave welfare for work or are engaged in activities to prepare them to enter the labor market, they are likely to encounter more and more families who face a number of personal and family challenges that make it difficult to seek employment or to sustain employment over the long term. For these families, their ability to succeed may depend on obtaining assistance to overcome or cope with substance abuse, depression and physical or mental disabilities; their family responsibilities, including the responsibility to care for other family members with disabilities; histories of physical or sexual abuse and domestic violence; social isolation; absent and/or non-supportive mates or significant others; inadequate parenting and discipline skills; and proximity to criminal activity.
Currently, most families who experience many of these personal or family challenges are exempted from participation in employment or employment-related activities. However, there are a small number of states and some local programs that expanded the Job Opportunities and Basic Skills (JOBS) program or designed program models to better address the needs of these families. This report summarizes information from case studies of eight of these programs, examining the issues that are important to consider when designing such programs. Specifically, this report addresses the following six questions:
1) What are the types of issues that recipients must overcome to achieve self-sufficiency?
2) How do these programs determine which families need more intensive services?
3) What services are provided to families once they are identified in need of more intensive services?
4) What role do sanctions play in these programs?
5) Are these programs successful?
6) What lessons can be drawn from the experiences of these programs?
This paper is organized into two parts. Part I examines the six questions outlined above, drawing information from each of the eight case studies and Part II provides the detailed case studies of each of the programs on which this analysis is based. The first part of this report begins with a brief summary of each of the programs.
I. Brief Program Descriptions
The eight programs that form the basis of this analysis do not represent a random sample of programs designed to address the personal and family challenges welfare recipients face as they make the transition from welfare to work. Rather, the eight programs examined here were selected because they represent a broad range of approaches to addressing these issues. Seven of the eight programs serve welfare recipients exclusively and one serves a majority of welfare recipients. The seven programs that serve welfare recipients exclusively all have a direct link to the JOBS program and are all operated within a mandatory setting. All of the programs provide or are directly connected to programs that provide employment-related activities. It is important to note that these programs were selected from a relatively short list of programs. While there are numerous programs that address specific problems that welfare recipients face (i.e., substance abuse treatment programs or shelters for battered women), most of these programs do not have a direct connection to the welfare department, do not emphasize employment and are not mandatory, elements that are all important components of current efforts to transform the welfare system into a more employment-focused program. A brief summary of each of the eight programs follows.
Utah's Single Parent Employment Demonstration. As a part of their welfare reform demonstration project, all AFDC recipients in Utah are required to participate in program activities. Acknowledging that personal or family circumstances do not make it feasible for all families to immediately find or sustain employment, Utah has expanded allowable JOBS activities to include participation in activities such as substance abuse treatment or mental health counseling. They have also hired specialized workers, generally workers with a Master's degree in social work or counseling, to work with some of the families who need additional assistance to make the transition from welfare to work and to work with case management staff who are working with these families. In some parts of the state, substance abuse and mental health counselors have been co-located in the welfare office. Recipients who do not participate in the activities outlined in their self-sufficiency plan are subject to a financial penalty and eventually face the loss of all cash assistance.
JOBS for Oregon's Future. Through a JOBS waiver received in 1992, JOBS participants in Oregon can be mandated to participate in substance abuse or mental health treatment to meet their JOBS participation requirement if there is evidence that these issues are keeping a recipient from fulfilling their plan for becoming self-sufficient. Without such evidence, recipients who have failed to follow through with required program activities may be given the choice to undergo an assessment to determine whether the recipient is in need of substance abuse treatment before the conciliation and sanctioning process begins. District offices in the state are required to include procedures for addressing these issues in their local JOBS plans, but have broad flexibility in doing so. Thus, the actual programs or services that are made available to recipients vary from office to office. In the Portland area, which has the largest AFDC caseload in the state, mental health professionals are co-located in nearly all of the JOBS offices and substance abuse professionals have been hired to conduct assessments, refer recipients to appropriate treatment programs and monitor participation in treatment programs. Other offices across the state have forged partnerships with community agencies to make it easier for recipients to access needed services. The information presented here is based on visits to two District offices, District 4, representing a rural part of the state and District 2, representing Portland.
Family Development and Self-Sufficiency (FaDSS) is an intensive services program that currently operates as a component of Iowa's Promise JOBS program. The FaDSS philosophy recognizes that families at risk of long-term welfare use face many barriers (poverty, illness, alcoholism, learning disabilities, low reading levels and violence), but with long-term, intense personal interaction with trained staff and voluntary participation in the array of services offered by FaDSS (home visits, case management and family support, motivation and life skills, education and employment and training services and group activities), these families can become strong, self-sufficient community members. Staff from FaDSS and Promise JOBS work jointly with a family to develop a Family Investment Agreement (FIA), a social contract required of all non-exempt AFDC recipients in Iowa. This FIA identifies the steps a family will take to achieve self-sufficiency. The FaDSS worker works directly with the family to develop a comprehensive system of support services that are provided in a manner that promotes, empowers and nurtures the family toward self-sufficiency and healthy reintegration into the community. The FaDSS worker monitors compliance with the plan and noncompliance can eventually result in complete loss of cash assistance for an extended period of time. The information presented here is based on a site visit to Cornerstone, the FaDSS program in Cedar Rapids, one of the more populous areas in the state.
Chicago Commons West Humboldt Park Employment and Training Center (ETC) provides a structured GED and vocational training preparation program for AFDC recipients in a very poor, mostly Hispanic neighborhood in Chicago. Support groups to address problems faced by many of the participants (i.e., domestic violence, parenting, depression) are integrated into the classroom schedule. Ongoing case management is also provided. This program is a Project Chance provider (Illinois' JOBS program), but is operated by a private organization with relatively loose ties to the welfare office. Program staff have devoted considerable time and energy to developing an educational curriculum for welfare recipients with especially low education levels. The GED curriculum and the educational program for recipients with low educational attainment are structured programs that are designed to address the particular learning styles of the population being served. Classes are held daily and attendance is monitored very closely. Welfare recipients who participate in ETC are all mandatory JOBS participants and are subject to the same sanctioning procedures applied to all JOBS participants. ETC is a JOBS contractor. Thus they help recipients to obtain child care and transportation assistance when it is needed. Child care, health care and parenting education are all provided on-site.
The Progress Information Directed Toward Employment (PRIDE) Social Contract System is a planning and tracking tool designed for AFDC eligibility workers or JOBS case managers and administrators of state welfare departments. Over the last year research staff from Project Match (a welfare-to-work program that provides long-term, individualized employment services to AFDC recipients from the Cabrini-Green community in Chicago) have been piloting the PRIDE system in a local welfare office in Chicago. The PRIDE Social Contract System consists of an Activity Diary and a Computerized Tracking System. It is designed to provide front-line workers with the tools needed to help recipients define and embark on an individualized path to self-sufficiency. PRIDE is designed to be responsive to the diverse needs of the welfare population and is grounded in a belief that the welfare system should have clear and reasonable expectations for each recipient. For recipients who are not prepared to participate in private sector employment or other structured JOBS activities, PRIDE relies on positive parenting activities and participation in activities within one's own community to build competencies needed to succeed in the workplace. The PRIDE Social Contract System is designed to be implemented in a mandatory setting with recipients being sanctioned for failure to meet their monthly obligations.
Nevada County, California's GAIN/Employment Services Program is a small program designed to work with recipients who are exempted from GAIN, California's JOBS program. This program provides more intensive case management services to support the "hardest-to-serve" AFDC families who have been deferred from mandatory participation in the GAIN program because of drug and alcohol problems, emotional/mental problems, severe family crises, or legal problems. Services are provided by a social worker with a Master's degree. An important belief underlying the Nevada County GAIN program, and of the intensive case management services component, is that people can make changes if they are treated with respect and offered opportunities and support. A second important belief is that the county cannot "fix" families' lives, thus, families must make changes for themselves. There is a strong emphasis on employment as the long-term goal for everyone. Services provided include home visits, referral to community resources, and crisis counseling and ongoing support. Recipients who refuse intensive services are given the choice of going back into the GAIN program or seeking a job directly. Those who refuse all of these options are sanctioned for non-participation.
Kenosha County, Wisconsin's Participation Support and Intensive Case Management Services are services provided to JOBS participants who are either still in the JOBS program after two years (Intensive Case Management) or are experiencing family issues that are making it difficult to participate in the program (Participation Support). Intensive Case Management is provided by a specialized JOBS case manager and Participation Support Services are provided through the Prevention Services Network, a network of agencies within the community that have established formal relationships with one another to better coordinate services to families. Through the Intensive Case Management Program, recipients are provided with individual counseling and additional vocational assessment and psychological testing services. The focus is on trying to develop a self-sufficiency plan consistent with the participant's needs and skill levels. Through the Participation Support Program, recipients have access to a broad range of services including case management; home-school-community liaison services, recreational and enrichment incentive programs; children and youth counseling and mentoring; life, domestic and parenting skills development; family empowerment support groups; child management skill-building groups; tutoring and work apprenticeships. All case management visits occur in recipients' homes. The focus of the program is to help families use their strengths to overcome barriers to participation. Families receiving services through the Intensive Case Management and Participant Support program are generally active JOBS participants. While families cannot be sanctioned for non-participation in activities outside of the JOBS program (i.e., participation in a counseling or substance abuse treatment program), they can be sanctioned for non-participation in scheduled JOBS activities.
Avance Family Support and Education Program is the only program included in this analysis that does not have a direct link to the JOBS program. Avance's main purpose is to strengthen and support families. The core of the Avance program is parent and child education for families with infants and children under three years of age. In addition to parent education, other services include social support, adult basic and higher education, early childhood education, youth programs, personal development, and community empowerment. Although not a job training or placement program, the Avance model, which focuses on bettering oneself in order to provide a better future for one's children, combined with the basic education services provided, has enabled many parents to obtain further education and employment. The program was included in this analysis to provide an example of how family-centered programs outside of the welfare department address the issues that make it difficult for some welfare recipients to make the transition from welfare to work. Avance was selected over other similar programs because it provides basic skills, GED, and ESL classes and helps recipients to pursue additional training in addition to parent-child education. It was also selected because its parent-child education program is a structured curriculum that requires a high level of attendance for participants to graduate from the program.
II. Types of Issues Recipients Must Overcome to Become Self-Sufficient
Staff in these programs report a broad range of issues that recipients must overcome to achieve self-sufficiency. Issues raised in nearly all of the programs include: learning disabilities; substance abuse; domestic violence; physical health problems; mental health problems --especially depression but also more serious mental health issues such as schizophrenia and character disorders; and difficulties with children ranging from medical and physical problems such as asthma to severe learning disabilities and behavioral problems. Staff also report that low self-esteem is a major issue that they must address. Many recipients do not believe that they are able to succeed at anything. They often have long histories of failure in school, failure in relationships and difficulties raising their children. Thus, the first step in helping this group of recipients to become self-sufficient is often convincing them that resources to help them succeed are available.
The presence of learning problems, mental health issues, substance abuse and domestic violence are strikingly high in many of these programs. For example, Avance reports that 80 percent of the parents they serve are high school dropouts. Forty-percent of the participants in the ETC read below the 6th grade level. In a more rural office in Oregon, 18 percent of program participants were learning disabled and 29 percent indicated they had been in some type of special education previously.
In one Avance site, 58 percent of parents were identified as having high levels of depression. In Kenosha, 37 percent of the parents referred to the Participation Support Program were referred for depression, often in combination with other personal and family problems. In Utah, 26 percent of recipients receiving assistance for at least 18 months had mental health issues. Staff also report that mental health issues are often intertwined with substance abuse problems. Thirty percent of participants in the ETC reported current or past substance abuse problems. Among FaDSS participants, 24 percent reported current substance abuse and 32 percent reported past abuse. In the JOBS program in the rural site visited in Oregon, two-thirds of program participants reported using illegal drugs, but only 13 percent reported having a substance abuse problem. However, 27 percent reported that other people were concerned that they had a substance abuse problem and 42 percent reported they had a family member with a substance abuse problem.
Violence is an issue that was raised repeatedly among staff as a major issue they must address. Current or past domestic violence is common as is sexual or physical abuse as a child. One-third of FaDSS's participants were sexually abused and 49 percent were physically or emotionally abused as a child; more than two-thirds reported being current or past victims of domestic violence. In Oregon, one-third of program participants reported being sexually abused and 62 percent reported being physically abused as a child; 63 percent reported being pushed, poked, punched, slapped or forced to have sex by a significant other. At ETC, 56 percent of program participants reported they were current victims of domestic violence and 26 percent reported being past victims.
III. Identification of Families in Need of More Intensive Services
These programs rely on a variety of different strategies to identify families in need of more intensive services. These strategies include the use of formal assessment tools (beyond those used to assess the general service needs of all families), non-participation in regular program activities and development of a trusting relationship with a recipient. In general, these programs relied on a combination of these strategies, with one being the most dominant. For example, the Kenosha JOBS programs relies on all of these strategies, but relies predominantly on a formal assessment conducted during the first month of participation in the JOBS program. In contrast, Oregon's JOBS program relies primarily on recipient's performance in JOBS activities and the development of a trusting relationship with participants. Formal assessments are generally conducted only after there is some indication that a recipient is unable to fulfill the requirements set forth in her self-sufficiency plan, although some offices are beginning to conduct formal assessments routinely during Oregon's up-front job search process to identify recipients who may be in need of substance abuse treatment. ETC relies primarily on the development of a trusting relationship with participants to identify who is in need of additional services. Formal assessments are used to determine a recipient's educational level, but not to identify their need for supportive services. The key strategies used to identify recipients in need of more intensive services are described in more detail below.
A. Use of Formal Assessment Tools
Formal assessment tools to determine the need for more intensive services were used by just two of the eight programs -- the JOBS programs in Kenosha and Oregon. These programs use different tools to conduct their assessments and use the results in different ways. The Kenosha uses a general screening tool to identify "high-risk" families while Oregon primarily relies on the use of formal assessment tools to identify participants who are chemically-dependent.
1. Parent-Child Risk Screening
In January of 1995, the Kenosha JOBS program implemented a Parent-Child Risk Screening as part of their normal front-end assessment process in the JOBS programs. All new JOBS Program registrants are offered the screening on a voluntary basis. The screening consists of two pencil-and-paper scales which are administered as part of the group testing process. The first is the Achenbach Child Behavior Checklist, which is designed to indicate concerns the parent may have regarding psychosocial development or behavior problems with one or more of their children. The second is the Parenting Stress Index, which is designed to detect stresses related to the parenting process and, in extreme cases, is predictive of a heightened risk of potential child abuse or neglect. The Parent-Child Risk Screening scales are administered by a counselor from Kenosha's Participation Support Program and are then reviewed by a psychologist who identifies high-risk families who should be offered more intensive services. These high-risk families are then contacted by the counselor from the Participation Support Program to schedule a more intensive assessment in their home. Receipt of more intensive services is voluntary. During the first three months after implementing the screening, fifty-nine percent of recipients with valid screen results were identified as high-risk families. Only 24 percent of those families (14 percent of those screened) accepted or later became involved in services. Due to recent changes in the way the assessment is administered (administering the screening later during the up-front assessment process and having the counselor who will be contacting families administer the assessment scales), staff believe they are engaging a higher percentage of families in the Participation Support Program.
The purpose of the Parent-Child Risk Screening is to identify early on those JOBS participants who may be at higher risk in parenting or child behavior issues and for whom abrupt life changes associated with participation in the JOBS program or employment may cause additional stress. The Kenosha JOBS center initially implemented the screening because they were concerned about the impact of participation in the JOBS program on very young children. Staff were concerned that the number of families identified as high-risk was artificially high because the assessments were conducted during the first week when they were engaged in the JOBS program, a time of transition that was likely to be more stressful for parents than after they had become acclimated to the program. However, when the screening was moved to the third week of the program, there was no appreciable difference in the results.
2. Substance Abuse Screening
Oregon specifically uses a formal assessment tool, the Substance Abuse Subtle Screening Inventory (SASSI) to identify chemically-dependent individuals. The SASSI is a short screening tool that uses objective decision rules to classify individuals as chemically dependent or non-chemically dependent. The SASSI is a one-page self-report that can be administered and scored in 20-25 minutes. The SASSI is especially effective in identifying early stage chemically dependent individuals who are either in denial or deliberately trying to conceal their chemical dependency pattern. In addition to its validity as a screening tool, the SASSI also provides clinical insights into a client's defensiveness and other characteristics. The SASSI is used in different ways in different offices. For example, one branch office in the Portland area requires all recipients to schedule an appointment with a substance abuse screener as a part of the up-front job search process. Another branch office is planning to administer the SASSI in a group setting during a workshop on alcohol and drug education to be held as a part of the up-front process. Other offices only administer the SASSI after a referral has been made by a case manager. In the Portland area, the SASSI is administered only by professional substance abuse counselors. However, in other areas, the SASSI is administered by case managers.
Staff indicate that it is difficult to know when the right time is for screening for substance abuse problems. A mental health worker who worked with recipients who had been required to undergo a urinalysis said that recipients were so angry when they met with her that it made it almost impossible to do any work with them. In offices where the SASSI is used as a screening tool, staff feel that the way the screening is presented makes all the difference. In general, staff try to present it as an opportunity for recipients to create a better life for themselves and for their children. Because the substance abuse counselors see so many recipients who are in the late stages of substance abuse, they support doing more screening up-front using the SASSI. However, staff note that it is hard to know how to strike the right balance between respecting a recipient's right to privacy and using public resources efficiently. Staff expressed concerns that money is being wasted if people go through the JOBS program and then can't find employment because they can't pass a drug screen for employment.
B. Development of a Trusting Relationship
In all of the programs reviewed for this project, staff note that developing a trusting relationship is often the key to identifying families who are in need of more intensive or specialized services to achieve self-sufficiency. Families often are only willing to acknowledge that they have a substance abuse problem, are living in an abusive situation or are having problems parenting after they have developed a relationship with a worker. One administrator in Oregon noted that staff were very dedicated and really were committed to helping families create a better life for themselves and for their children. One worker noted that sometimes, you have to "nurture" a recipient into treatment. Over time, recipients begin to believe that staff really care about them and their well-being.
Staff develop trusting relationships through a variety of mechanisms. Home visits were especially common among these programs. The social worker from Nevada County indicated that about 90 percent of the recipients she sees agree to a home visit. She noted that some of the willingness of clients to let her visit them is due to the "AFDC grapevine." Other clients may tell new referrals that "She's O.K. She came to my house." Even from the beginning, however, the social worker found that people were eager for help. Many of them seemed to be relieved to have someone listen to them, eager to have someone come along and try to bump them out of the circle in which they were trapped. Staff from Avance note that they often visit a family in their home several times before they agree to participate in the program. Utah uses home visits extensively to uncover reasons why recipients may not be following through with the requirements set forth in their self-sufficiency plan.
Life Skills, a group activity, which is the first formal activity in several of these programs, also provides an important venue for developing a trusting relationship with program staff. Life Skills programs are designed to help recipients increase their self-esteem, become aware of the education, training and other program options available to them, develop realistic goals and begin to identify for themselves the issues in their lives that may impede their progress towards self-sufficient. Staff describe Life Skills as very intense. Recipients are fearful of change and because they have failed so often in the past, they are afraid they will fail again. Life Skills often is a very emotional experience for staff and participants because it is often the first time recipients are willing to admit that they have serious personal and family problems that have kept them from succeeding in the past. Staff also use Life Skills to try and develop support systems for recipients among their peers. Staff acknowledge that they will not be able to "fix" recipient's lives, but that they can provide them with resources to draw on to support their efforts to change their lives. Life Skills play an especially important role in identifying recipients in need of more intensive services in Kenosha, Oregon and ETC.
C. Failure to Meet Program Expectations
1. Non-Participation in Required Program Activities
Close monitoring of recipients' participation in program activities is a characteristic of nearly all of these programs. When recipients fail to follow through with the self-sufficiency activities, staff find that it is often an indication that some personal or family challenges may be present and that additional assistance may be needed to overcome these challenges. Case aides in ETC monitor attendance very closely. Any recipient who is absent from the program for two consecutive days receives a phone call to identify why the participant has been unable to attend. If the case aide cannot reach a participant by phone she may conduct a home visit. Through this close monitoring of attendance, staff often become aware of personal or family crises that make participation in the program difficult. Avance, the only program that is not mandatory and is not directly connected to the welfare program also monitors attendance closely. Participants must attend 75 percent of the parenting classes to graduate from the program. Similar to ETC, staff from Avance follow-up with families who miss classes via the telephone or through home visits.
In Kenosha, participants who are having difficulty following through with the requirements of the JOBS program are referred to the Participation Support Program if there is any indication that personal or family issues may be contributing to a participant's attendance problems. Once this referral is made, counselors from the Participation Support conduct an in-depth assessment of the family's strengths and weaknesses to develop a plan to increase their ability to comply with the requirements of the JOBS program. In Oregon, mandatory JOBS participants who have established a pattern of non-compliance with program requirements may be offered the opportunity to undergo a substance abuse assessment before the sanctioning process is initiated.
Utah imposes full family sanctions (complete loss of cash assistance) for non-participation in program activities. As a part of the conciliation process that must precede the imposition of a sanction for non-participation, Utah requires home visits by a specialized worker to ensure that families understand the participation requirements and that the family is making an informed choice not to participate. After implementing these procedures, staff reported uncovering numerous personal or family challenges that were keeping families from participating in the program.
2. Failure to Make Progress Towards Self-Sufficiency
The JOBS programs in Utah, Oregon, Nevada County and Kenosha attempt to engage all or the vast majority of AFDC recipients in JOBS activities that will help them secure employment in a relatively short period of time. In Utah, Oregon and Kenosha, those families who do not secure employment within a specified period of time are referred for more intensive services or undergo a formal case review to determine whether there is a need to adjust the participant's self-sufficiency plan and to determine what factors may be impeding their progress. Nevada County uses the current JOBS exemption criteria to identify families in need of more intensive services. The goal is to help these families to address the personal and family issues so that they may find employment or participate in other JOBS activities, rather than remaining in a deferral or exemption status for an extended period of time.
Oregon, Utah and Kenosha all engage AFDC recipients in employment-related activities as soon as they apply for assistance. Kenosha starts with a month-long assessment process that includes the Parent-Child Risk Screening described above. Families who have been in the JOBS program for two years or longer are routinely referred to an Intensive Case Manager. The purpose of this referral is to provide more individualized contact with recipients to identify the issues that may be impeding their progress towards self-sufficiency. This group of recipients also undergoes more extensive aptitude testing and vocational screening to determine whether a recipient's plan for achieving self-sufficiency needs to be modified. Recipients who are experiencing personal problems may also be referred to a psychologist for formal testing and assessment.
Oregon's JOBS program is geared towards much quicker entry into the labor market. Most new applicants are required to participate in a month-long structured or semi-structured job search process. Recipients who do not find employment by the end of this process undergo a more in-depth assessment, often through a Life Skills format, to develop a plan for finding employment that may include participation in short-term education or training, additional job search and other activities to help a recipient develop the skills she needs to enter the labor market.
Although Utah's main focus is on getting recipients into the labor market quickly, they acknowledge from the outset that recipients will take different paths to self-sufficiency. Thus, there is no required sequence of activities. However, over time, staff have learned that recipients who do not find employment within six months have a high probability of becoming long-term recipients. Thus, in some offices, staff have instituted a formal procedure, "case staffings" to review those cases that have not found employment within this time period. Case reviews are designed to assess the actions that have been taken on a case and to determine whether there is a need to change the approach to achieving self-sufficiency. One option is referring the case to a specialized worker who is more skilled than the regular JOBS worker. The specialized worker carries a smaller caseload, making it possible to spend more time conducting home visits and undertaking other assessment activities to identify the personal or family issues that may be impeding a recipient's progress to self-sufficiency. Alternatively, a case manager may continue to work with the recipient with supervision from a specialized worker. This latter option is often preferred because it allows a family to continue working with the same case manager rather than having to build a relationship with a new worker.
IV. Services Provided to Families Who Need More or Different Support than the JOBS Program Generally Provides
Seven of the eight programs included in this analysis rely on case managers or social workers (with varying levels of training) to provide more intensive services or to refer recipients for specialized services within the community. The remaining program, PRIDE, relies on AFDC eligibility workers to monitor a family's participation in an individually-negotiated set of program activities.
A. Crisis Counseling and Ongoing Support
1. Intensive Case Management
In general, all of these programs provide crisis counseling and ongoing support to recipients, although they do so in a variety of different ways and with varying levels of intensity. Case managers in Oregon's JOBS program and Kenosha's Family Support program primarily monitor family's receipt of services from other agencies rather than providing services themselves. In these two programs, staff do very little ongoing counseling with families, although they do meet with families on a regular basis. In Kenosha, workers meet with families twice a month in their homes. In Oregon staff try to meet with recipients once a month, although they are not always able to do so. Staff in Oregon generally meet with recipients in their office rather than in their homes. Participants in Avance and ETC are involved in on-site structured program activities on an ongoing basis so much of the ongoing counseling and support provided to these families occurs through their participation in the program rather than through structured interactions with individual case managers. However, in both programs case managers or counselors are available to provide more individualized counseling and ongoing support to families when it is needed. In Nevada County, Utah and FaDSS, intensive services are provided by professional social workers or other licensed professionals.
The case managers that provide more intensive services for families generally carry relatively small caseloads. FaDSS workers carry just 20 cases. The specialized workers in Utah and the case managers in the Participation Support program in Kenosha both carry caseloads of about 30 to 35 families. The Intensive Case Manager in Kenosha indicated that while she currently was working with only about 25 to 30 families, she expected to build her caseload up to a total of 50 families. The social worker in Nevada County carries a caseload of between 40 and 50 families. Oregon does not rely on specialized case managers to work with families who need additional assistance. Referrals are provided for these families and the case managers monitor their progress just as they do for families participating in regular components of the JOBS programs. Case managers perform both eligibility and JOBS functions in Oregon and carry caseloads of about 160 families. Case managers at ETC and the counselor at Avance primarily work with families when the need arises so they do not carry an ongoing caseload. Rather, they are available to work with all participants in the program at any point in time.
Most of the more intensive work that is done with families is done one-on-one with individual recipients, although a few of the programs do offer some specialized groups and work with families, including co-habitating boyfriends when appropriate. Flexibility is one of the key elements of all of these programs -- staff are encouraged to use whatever resources they have available to them to help recipients become self-sufficient. They are encouraged to take risks and think creatively to help families solve or cope better with any personal or family issues that are keeping them from achieving self-sufficiency.
Staff in Utah, Nevada County and FaDSS provide more individual counseling and ongoing support than the other programs. In FaDSS each family has one primary "Family Development Specialist" who works with them and also serves as the case manager. The Family Development Specialist provides the majority of the support needed by the family, but does refer the family to other community resources when necessary. Whenever possible, families are taught how to advocate for themselves, and where to turn in the community for additional resources. The worker involves the entire family in the plan. Families develop short-term and long-term goals, and each accomplishment, however small, is recognized and celebrated by program staff. The one-on-one unconditional relationship and the persistence and dedication of the workers is a key element of FaDSS. Once a family is enrolled in the program, the workers "latch on" to families and will persist in working with them through any number of difficult times when clients may not always be receptive. Families are generally involved in FaDSS for long periods of time, often for two to three years. However, given the current shift to more transitional assistance workers are shifting their focus to work with families to achieve their goals in shorter periods of time.
Specialized case managers in Utah and the social worker in Nevada County work with families in very similar ways. In stark contrast to FaDSS, these programs work with recipients for relatively short periods of time, often for as little as three months, although some families do receive services for substantially longer periods of time than others. In both programs, even though staff are working with families who have been identified as having barriers to employment, the focus is working with families to obtain employment as quickly as possible. To this end, both programs are based on a model of brief, rather than ongoing, counseling. Underlying this model of intervention is a belief that change in one area of functioning may have important "ripple effects" in others. Thus, instead of focusing on "fixing" families' lives, interventions are designed to help recipients resolve a specific issue that is preventing them from finding or keeping employment.
Workers acknowledge that recipients may need more assistance in the future so whenever possible they try to connect families with supportive services within the community in which they live. Workers in both programs conduct home visits regularly. Rather than meeting with every family within specified intervals (every week, once a month, etc.) staff meet with families as often as they need to. Some families need frequent visits, especially in the early stages while other families need less support. In both programs, the workers work with families to develop a plan for achieving self-sufficiency. The social worker in Nevada County indicated that her attitude is that the recipient should set the goals and do the work and that she will be there in a supportive role. She tells the recipients that she'll be there "one inch behind you, so you can't back up."
2. Referral to Other Community Resources
In general, programs rely on community resources to provided specialized services such as substance abuse treatment or mental health counseling. In some offices in Utah and Oregon, substance abuse and mental health professionals are co-located in the welfare office. The lack of resources within a community makes it difficult to address some of the personal and family challenges recipients need to overcome to become self-sufficient. However, resources that are difficult to find in one community are not necessarily difficult to find in another community. For example, staff in most of the JOBS programs in the Portland area in Oregon have access to on-site mental health services. However, the social worker in Nevada County indicated that she has the most trouble working with recipients with mental health problems because it is so difficult to access mental health resources in the community. Staff in both Kenosha and Portland note that managed care has made it especially difficult for them to get recipients into substance abuse treatment programs. Staff at ETC noted that there are long waiting lists for substance abuse treatment in Chicago so it is difficult to get participants into programs. In Nevada County the social worker has a good working relationship with a substance abuse treatment program for women so she is generally able to help recipients get into treatment when it is needed. Nearly all of the programs report a shortage of programs for victims of domestic violence. Shelters are often full and other resources available to address this issue are limited.
The JOBS program in Portland has worked especially hard to help JOBS participants gain access to mental health and substance abuse services. However, the referral systems set up to address these two issues are quite different from one another, primarily because the service networks within the community are very different. Mental health services are all contracted to one provider in each county. Services are provided by professional therapists, all who have Master's degrees in Social Work or Counseling. In two of the three main JOBS locations, mental health counselors are on-site, an arrangement that allows counselors to provide ongoing education as well as counseling to recipients.
The availability of mental health services is initially explained to JOBS participants in Life Skills, the first formal component of the JOBS program. Case managers refer recipients to mental health services for a variety of issues including questions around their ability to participate in JOBS, attendance issues, anxiety or behavior problems, chemical abuse history, past child abuse (physical or sexual), concentration/attention problems, depression, domestic violence, grief, isolation, parenting, relationship issues, suicidal thoughts/plans and transitional issues. All mental health referrals are made through a central mental health coordinator who works directly for the JOBS program. The coordinator triages the cases and meets with mental health staff to discuss the referrals. Once a referral is made the mental health counselors maintain ongoing contact with the JOBS case manager to inform them of a participant's progress. Case managers are notified immediately if a recipient does not follow through with the mental health referral.
Substance abuse issues are handled quite differently. The Portland area includes 40 substance abuse treatment providers and recipients are enrolled in 12 pre-paid health plans that work in conjunction with the Oregon Health plan. To streamline the referral process, the District has hired two substance abuse clinicians to work on-site at each of the JOBS and welfare offices. Case managers are currently being trained on how to identify recipients who may benefit from substance abuse treatment and how to make appropriate referrals to the substance abuse clinicians. It is the responsibility of the substance abuse clinicians to assess recipients for chemical dependence, refer recipients to the most appropriate provider for the individual, monitor individuals in treatment, advocate for them if necessary and act as a liaison between the treatment agency and the JOBS case manager. If treatment is recommended by the substance abuse clinician, it is mandatory and recipients can be sanctioned for failure to follow through with the recommended treatment. Participation in other JOBS activities during or after treatment is determined by the recommendation of the substance abuse clinician.
B. Expanded Allowable JOBS Program Activities
Utah, Oregon and the PRIDE program all expand the activities that count as participation in the JOBS program. In Oregon and Utah, recipients participating in mental health or substance abuse treatment are considered to be meeting their JOBS participation mandate. In Utah, recipients may also participate in parenting classes or other activities designed to help a family make progress towards becoming self-sufficient.
PRIDE is built on a belief that active, ongoing participation in community activities can help recipients who have not succeeded in regular JOBS program activities to develop some of the skills they need to be successful in the paid labor market. In contrast to most of the other programs visited for this analysis, the centerpiece of PRIDE is not helping families to directly address personal or family challenges that may be keeping them out of the labor market. Rather, PRIDE focuses on involving recipients in community activities at a level where they can be successful as a way to increase their level of competency, initially as parents and eventually as workers.
Underlying PRIDE is a strong belief that many of the skills one needs to be a good parent are the same skills that one needs to succeed in the workplace and to address the personal or family challenges one may face on a day-to-day basis. Program options for recipients who are not ready to participate in education, training or employment include activities such as volunteering at Head Start, participation on a tenant management board or positive parental activities such as taking a child to the library. These alternative activities are viewed as starting points, not as ongoing activities that can substitute for employment over the long-term. Recipients are encouraged to take on increasing levels of responsibility each month until they are able to sustain unsubsidized employment. Recipients can be sanctioned for failure to follow through with these activities just as they can for failure to participate in regular JOBS program activities.
C. Support Groups
Support groups are provided in Oregon, Utah, FaDSS and ETC. In addition, the pilot of the PRIDE Social Contract System has been implemented totally through the use of a group format. In Oregon, groups are generally used only as a part of a structured program, primarily because of scheduling difficulties. In one office, one mental health counselor provides a support group for recipients with learning disabilities. In another office, the Life Skills instructor and a professional substance abuse counselor run a weekly support group for recipients participating in Life Skills and the GED program. The group was initiated to reduce some of the anxiety Life Skills participants felt around making the transition from Life Skills to the GED program. Utah offers a support group for recipients dealing with less serious mental health issues. The group lasts for 8 to 10 weeks and is always filled to capacity. The group was started because it was difficult to access mental health resources in the community. One or two weekly support groups are also facilitated by Family Development Specialists in the FaDSS program. These groups provide a forum for women to talk to each other about common issues they face and provides a time and place for them to develop peer relationships.
Even though the PRIDE Social Contract System is designed specifically to help recipients develop an individualized employment plan that can change from month-to-month, it has been implemented in a group setting in the Chicago office where it is being piloted. Each month, participants in the pilot are required to submit a completed "Activity Diary" and then develop a new plan for the next month. Participants are also required to attend a group meeting once a month unless they are participating in a program activity during the times when the group meets. The group provides both a monitoring and support function. During the group meeting, each participant presents her Activity Diary, identifying both what she was supposed to do during the month and what she actually did. Group members then vote on whether each participant achieved a high, medium or low level of participation. The group then helps each participant to develop a new plan for the next month. The group is intended to be supportive. It provides an opportunity for recipients to receive praise for the work they did and pushes them to do better when they fall short of their goals.
At ETC, the majority of support is provided to participants through groups. After Life Skills, based on their personal and family circumstances, participants have the option of participating in one of several support groups that focus primarily on a specific issue: bad relationships (primarily focuses on domestic violence); disability services (for learning or physically disabled participants who are trying to receive services through the Department of Rehabilitation services); parenting; depression and special needs children. These support groups were started primarily to reduce the burden on staff who were always moving from one crisis to the next. The groups meet once a week and are integrated into the class schedule. The groups are used by participants to work on explicit goals. Each person will talk about their goals and what steps they have taken to achieve them at the beginning of each group. Since the inception of the groups, staff report there have been fewer emergencies for case managers because participants know they have a set time to discuss their issues and problems. Fewer participants also have to be pulled out from classes to deal with personal issues The group format also allows participants to be more independent than in an individual case management relationship. Women are taught how to use community resources. Furthermore, the group format often results in the experiences or statements of one woman bringing out similar issues for other participants.
D. Specialized Services for Recipients with Low Educational Levels
Nearly all of these programs reported working with recipients with severe educational deficits. To address this issue, ETC recently developed a specialized educational curriculum for recipients with very low educational levels. This program was designed for recipients for whom the GED is not a realistic option. This curriculum was designed to help this group of recipients to gain access to high quality training programs that do not require a GED. The Center identified four training programs in the city that offer training for entry into careers that would allow recipients to eventually become self-sufficient. Then, the employment and training specialist talked with the training programs about the type of skills, knowledge and support that are necessary for successful participation in the program. The greatest barrier that was identified was not academic ability but problem-solving skills, interpersonal relationships and communication.
Using this information, the specialist and instructors worked together to develop a curriculum specifically designed to prepare participants for these training programs. For example, basic reading and writing is now taught in a "Reading, Writing and Role Playing" format based on narratives about people at work which is designed to teach participants how to solve conflicts and approach new situations. The first module will also include an introduction to the training programs to expose participants to their options and what it might mean to work in a non-traditional occupational setting. Math, study skills and a course designed to help recipients achieve at least a 6th grade reading level will also be offered. The second module offers more specific courses depending on which training course a participant chooses.
E. Follow-up and Transitional Services
In general, since most of the services provided by these programs are contingent on a family receiving welfare or participating in the JOBS program, follow-up or transitional services are provided to program participants through informal, rather than formal means. The exception is Utah that has a waiver to provide transitional case management for an unlimited duration. Other programs are restricted to providing services for only 90 days after a recipient leaves the JOBS program. The social worker in Nevada County indicated that she continues to provide less intensive crisis intervention to families whenever they need her assistance. She indicated that she generally provides some type of follow-up services to about 10 former participants in any given month. In Kenosha, families receiving services through the Participation Support Program often stop receiving services abruptly because they are no longer receiving cash assistance or they are deregistered from the JOBS program. Whenever possible, staff try to link recipients to other services within the community. ETC and Avance both continue to provide services to former participants whenever they request them. ETC provides tutoring and other support if it is needed to program participants who enroll in other training or education programs.
V. The Role of Sanctions
Sanctions play an important role in all of the programs, except Avance, which is a totally voluntary program. Staff repeatedly note that sanctions often provide the "hook" they need to encourage families, especially those who are fearful of change to participate in program activities. The actual sanctions for non-participation and their relationship to participation in activities outside of the JOBS program do, however, vary from program to program.
Utah and Oregon both have waivers that allow them to mandate recipients to participate in personal development activities such as substance abuse treatment or mental health counseling. (Oregon's waiver is specifically for substance abuse and mental health treatment whereas Utah's waiver is more general, allowing the state to mandate participation in a broad range of activities.) Consequently, sanctions play a unique role in Utah and Oregon's implementation of policies and programs to help recipients address these issues.
Oregon mandates substance abuse treatment only when staff have concrete evidence of a substance abuse problem (i.e., dilated pupils, attending meetings or classes while intoxicated or high, etc.). Mental health counseling is rarely mandated, primarily because staff feel that mental health counseling only works when a recipient is ready to use it. In general, Oregon's waiver is not necessary for most of the substance abuse and mental health services provided by the District offices in Oregon. Substance abuse and mental health counseling are provided to recipients as an opportunity to help them address issues that may be keeping them from moving from welfare to work. Most sanctions occur for failure to comply with a self-sufficiency plan. Whenever staff feel substance abuse may be an issue, recipients may be offered the opportunity to undergo a substance abuse assessment before the sanctioning process is initiated. If a recipient refuses these services, they are sanctioned for failure to comply with their self-sufficiency plan, not for failure to participate in substance abuse treatment. Oregon currently uses the JOBS sanctions but has a waiver pending that would allow them to impose full family sanctions.
Utah's mandate to participate in program activities is reinforced with strong financial penalties and incentives. Recipients who participate in program activities full-time receive a $40 incentive payment. Recipients who fail to participate in program activities have $100 deducted from their grant ($414 for a single-parent family with two children) for two months then lose eligibility for cash assistance, making it the most stringent financial penalty for non-participation implemented to date. Once a family loses eligibility for assistance because of non-participation, they can requalify for assistance only after participating in specified program activities (such as orientation or community work experience).
To ensure that recipients understand the participation requirement and that staff are available to assist with removing any barriers to participation, an extensive conciliation policy has been adopted which includes specialized workers, home visits, an agency hearing and other efforts to encourage participation and ensure an informed choice on the part of the participant. These efforts must be undertaken before placing a recipient in a non-participation status. The rigorous conciliation process required before a family's cash assistance can be eliminated has provided staff with an additional mechanism for providing families with the resources they need to be able to participate in the Single Parent Employment Program. While conducting the home visits required as a part of the conciliation process, staff have uncovered serious mental health problems, communication problems and other family and personal issues that were keeping families from participating.
In FaDSS, the Family Development Specialist works with a family to develop small goals and feasible participation activities in order to encourage family participation and decrease the need for negative sanctioning. As long as families are active in FaDSS, the JOBS worker cannot enact a Limited Benefit Plan (LBP), Iowa's sanction (three months of a reduced grant followed by six months of total ineligibility for cash assistance). However, if a family is not making any effort to participate in FaDSS, participants must exit from the program. Before this occurs, every opportunity is provided to the family to participate at some level. Before exiting the family, the head of household is sent a letter explaining that if the family continues to refuse services, they are at risk of losing their benefits unless they begin participating in other Promise JOBS activities after case closure. FaDSS provides a final opportunity for the family to come before a review board made up of community advisory board members, where the family must explain why they would like to continue in FaDSS and what steps they will take to increase their participation. At the Cornerstone FaDSS, 85 percent of families who have reached this point accept the invitation to come to the review board, and so far, all of them have remained in the program. The review board and the threat of the LBP provides a mechanism to engage the family and makes evident to the family that the onus of participation rests on themselves.
In Kenosha, Participation Support case management services are voluntary. Workers cannot sanction recipients if they choose not to participate. However, if a recipient is not following through with their JOBS activities, the JOBS case manager will notify the economic support worker to reduce benefits. The Participation Support case will close if a client is not participating in the service plan or if they have been terminated for JOBS for any reason. Thirty percent of all JOBS participants are sanctioned because they are not fulfilling their employment plan. Sanctions are implemented immediately but are intended to encourage participation. Ninety-one percent of those sanctioned return to full participation within a year.
In Nevada County, clients are referred for intensive services when they are placed on deferral status from the GAIN program. At the end of the deferral period (which is often three months, but can be longer or shorter), the social worker and the recipient evaluate the progress to date. The deferral status can be extended if the client is actively working on resolving personal or family problems and needs more time. Clients who refuse any counseling or referral are given the choice of going back into the GAIN program or seeking a job directly, activities that are both seen as having therapeutic value for the individual and family. Clients who refuse all three alternatives are sanctioned by a reduction in the AFDC grant, following the current rules for sanctioning JOBS participants.
Historically, ETC has been a voluntary program. However, now that ETC is a Project Chance provider, once a recipient volunteers to participate in the program, she becomes a mandatory participant and is subject to all JOBS sanctions. ETC has also developed its own procedures to address extensive absences. Participants with excessive absences are placed on probation for thirty or sixty days. At any given time, approximately seven or eight women are on probation. If they miss more than an agreed upon number of days during this period, the women will be asked to leave the program for sixty days. Very often the women will come back. Staff do not focus on sanctions as much as they do in other programs. However, staff did indicate that they believe if sanctions were harsher or applied more readily, fewer participants would drop out of the program.
The PRIDE Social Contract system is designed to be implemented in a mandatory setting. Recipients can be sanctioned for failure to meet their monthly obligations. However, the obligations are designed to promote family well-being and self-sufficiency and not to be punitive. The flexibility of the PRIDE system allows recipients to participate in other activities if those planned do not work out. Thus, only those people who refuse to try to improve their lives in any way are likely to be sanctioned. Because the system is designed to monitor a recipient's progress on a monthly basis, it has the potential to eliminate long periods of inactivity with no intervention.
VI. Are These Programs Successful?
Only two of these programs, Avance and FaDSS have been formally evaluated. Thus, it is not possible to say definitively whether these programs are successful or not. However, the program statistics available from some of these programs are encouraging.
A formal evaluation of the Avance program was conducted from 1987 to 1992 with support from the Carnegie Corporation of New York. The evaluation found that mothers had developed more positive attitudes about their role as effective teachers of their children and that they interacted in a more positive and stimulating way with their children. The evaluation also found that Avance was successful in promoting enrollment in ESL, ABE, GED preparatory, and college courses, with 58 percent of participants at one service location and 63 percent at another enrolling in a continuing education class. A control group of participants had much lower participation rates (22 and 33 percent, respectively).
The formal evaluation of the FaDDS program in several sites (including Cornerstone) found that, in comparison to a control group, FaDSS participants reported significantly greater gains in their ability to meet the concrete needs of their families and made significantly greater gains in educational attainment. More FaDSS participants than controls were in full-time jobs, but the difference was not statistically significant. Due to greater participation in educational programs, during the early months of the evaluation, a greater proportion of the control group was off AFDC. By the 60th month, a larger percentage of the FaDSS participants were off AFDC.
The intensive case management services program in Nevada County has been more successful than expected. After the first six months, 27 (47 percent) out of 57 in the original caseload had moved from deferral status to GAIN participation, 14 (25 percent) out of 57 had secured employment, and 11 (19 percent) were discontinued from AFDC, leaving just five (9 percent) in deferral status. The program manager has also identified a number of unanticipated benefits. Through her home visits and non-threatening presence, the social worker has been able to address some family crisis situations that might have otherwise involved child protective services. The social worker has also been able to assist clients to work with the School Attendance Review Board to resolve attendance problems of students in the family. Finally, the social worker has served as a resource person who is available to assist other GAIN counselors in working with difficult cases.
Program statistics for Kenosha's Participation Support cases that were closed during 1995 indicate that 55 percent of the terminations occurred for positive reasons (14 percent for employment and 41 percent for other reasons). Seventeen percent of the terminations occurred for negative reasons (generally non-participation) and 28 percent were forced closures. The forced closures occur either when a recipient is deemed exempt from the JOBS program or is no longer participating in the JOBS program or when they leave the AFDC program. The research and evaluation unit of the JOBS center is currently working on developing indicators to assess the JOBS Participation Support Program.
ETC has not undergone any formal evaluation of their program, but they do try and follow-up with participants over an extended period of time. ETC's goal is to have positive outcomes for 50 percent of its participants 36 months after entering the program. Follow-up on FY '94 participants showed that after 18 to 27 months, 29 percent of recipients were working, 12 percent were in a job training program, 14 percent were still on-site in classes and 45 percent had dropped out of the program. But attrition clearly does occur over time for program participants. For FY '96 entrants, after just three to six months in the program, four percent were working, two percent were in job training, 83 percent were still on-site in classes and 10 percent had been dropped from the program. After six to 15 months, 31 percent of the FY '95 entrants were dropped from the program, 10 percent were working, six percent were in job training and 53 percent were still on-site in classes.
VII. Major Lessons Learned
These programs are clearly at the forefront of trying to address the needs of families who need more assistance than traditional welfare-to-work programs generally provide to succeed in the labor market. As a result, most of these programs are growing and changing over time, learning from their own experiences and adjusting their programs to better address the needs of the families they are trying to serve. Even though these programs are in their infancy, there are several important insights that emerge from their experiences. These insights include:
- Flexibility is a critical component of these programs. A diverse array of personal and family problems contribute to families' inabilities to find or keep employment. These families also have very different strengths on which they can draw to become self-sufficient. Consequently, while some families may need limited assistance for only a short period of time, others may need more intensive assistance for far longer. In addition, a broad range of services and approaches to strengthening families are likely to be needed to help these families achieve self-sufficiency.
- One of the key components of each of these programs is the development of a trusting relationship. Program administrators repeatedly stressed the importance of hiring staff who were genuinely committed to helping families bring about change in their lives. One of the main roles staff provide is to celebrate small steps to self-sufficiency and to push families to progress further.
- Forging partnerships with community agencies that provide substance abuse treatment, mental health counseling or specialized services for women in abusive situations are critical to help families achieve self-sufficiency. Most JOBS case managers or eligibility workers do not have the skills to address these issues. Even programs that have hired more highly skilled staff rely on these outside resources, both because they are not necessarily skilled in these particular areas and because they do not have sufficient time to provide the intensive counseling and support needed to address these issues.
- Clear expectations reinforced with financial penalties are important to the success of these programs. Staff report repeatedly that sanctions serve an especially important function in getting families who are fearful of change to begin to take the initial steps they need to take to become self-sufficient.
- The provision of supportive services and/or participation in alternative program activities is not incompatible with a program model that emphasizes rapid entry into the labor market. For many families, assistance designed to help them overcome particular barriers to employment can be provided within a relatively short period of time. In some cases, employment itself or participation in community activities designed to increase a recipient's competency in work-related skills and self-esteem may help recipients to overcome their personal and family challenges.
I. General Program Information
Avance Family Support and Education Program is a private, non-profit organization whose main purpose is to strengthen and support families. The program in San Antonio was begun in 1973. The Houston site opened in 1988, and services began in the Rio Grande Valley in 1993. The core of the Avance program is parent and child education. Avance reaches out to parents of infants and children under three years of age. Family centered, community-based services are provided which aim to strengthen the family. In addition to parent education, other services include social support, adult basic and higher education, early childhood education, youth programs, personal development, and community empowerment. The Avance model (the word in Spanish means to advance or to progress) is integrated into all aspects of home, school, and community life. Although not a job training or placement program, the Avance model, which focusses on bettering oneself in order to provide a better future for one's children, combined with the services provided, has enabled many participants to obtain further education and employment.
The Avance organization consists of a national office and three chapters. The national office was established in San Antonio in 1991, in response to a growth in services as well as a growth in demand for the curricula and other teaching materials developed by the Avance program. The national office conducts research and evaluation of Avance programs, disseminates program information and training and technical assistance across the country, and provides curriculum development, staff development, fund development, and financial management for three chapters. The three area chapters, located in San Antonio, Houston, and the Rio Grande Valley, are the Avance service providers. Staff of the national office and the three area chapters totals about 200. In 1993-1994, over 6,000 adults and children received Avance services.
B. Context: Community/State Welfare Policy
San Antonio is characterized by significant rates of population and job growth, a young and poorly educated labor force, a large Hispanic community, low-paying jobs, and a high poverty rate. Wages are low in San Antonio, and, compared to other large cities, workers in San Antonio are more concentrated in low-paying industries and low-paying occupations, particularly service occupations such as private household workers and food preparation, health services, and cleaning and building service occupations. There is considerable anxiety about U.S. Department of Defense cutbacks and base closures, since there are five large military bases in San Antonio, which are an important source of employment.
The Texas welfare reform waiver which was recently approved by the U.S. Department of Health and Human Services will include a personal responsibility agreement that addresses issues such as child support cooperation, early medical screening for children, work requirements, drug and alcohol abuse, school attendance, and parenting skills training. AFDC benefits would be subject to time limits of 12, 24, and 36 months, depending on education and job experience. Although these provisions have not yet been implemented, and in fact, the waiver had not yet been approved at the time of our site visit, Avance participants were aware of the upcoming changes. Both participants and staff noted that participants who are eligible for AFDC have not applied for benefits because of the general impression that the program was going to become more restrictive and involve more rules. There is concern that the time limits will be too stringent. For example, there is a one-year waiting list to enter a two-year nursing program at a local college, which is incompatible with a two year time limit for welfare benefits.
For those participants currently on AFDC or receiving subsidized day care through the JOBS program, a number of rules and requirements already pose challenges to their personal advancement. Texas AFDC/JOBS requires 20 hours per week participation in work or structured community service. Since attending classes does not count towards fulfilling this requirement, participants who are in school find themselves overburdened trying to fulfill the 20 hour requirement in addition to their schoolwork. Avance staff have tried to alleviate some of this burden by arranging for participants to complete their work experience or community service in activities related to their participation at Avance or through structured and supervised study groups. The Avance Adult Education Coordinator expressed concern that participants will drop out of school if too many demands are placed on their time, and then they will not be a position to secure better employment.
Other changes are occurring at the state level which will impact on Avance and its participants. For example, Texas has established a Workforce Commission to consolidate employment and training programs, and there is talk of a requirement that AFDC recipients complete 10 job applications per week. The Avance Adult Education Coordinator advocates for the needs of program participants and is working to assure that participants who continue their education will be supported in their efforts.
C. Population Served/Major Barriers
Avance serves a low-income, mostly Hispanic population, although the population served varies in each of the sites. The Houston site, where 99 percent of the participants are Hispanic, is largely first generation families (immigrants from Mexico and Latin America). Most participants in Houston are two-parent families and not on AFDC. In San Antonio, where 98 percent of the participants are Hispanic, there is more long-term poverty, and 51 percent are single parents. Rio Grande Valley participants are mostly Hispanic (98 percent) and married or living with a partner (77 percent). In Houston, 16 percent of participants receive AFDC and 7 percent are living in a public housing project. Rio Grande Valley characteristics are similar, with 18 percent of participants receiving AFDC and no participants residing in public housing projects. In contrast, 50 percent of San Antonio participants receive AFDC and 63 percent live in a public housing project.
Barriers faced by participants include: low education levels (80 percent of parents are high school drop-outs); a high degree of stress and isolation; lack of knowledge of child growth and development; significantly high potential for child abuse and neglect; and lack of marketable job skills. A formal evaluation of the Avance program in San Antonio, conducted from 1987-1991, found a very high level of depression among mothers in the Avance program. Fifty-eight percent of participants at one service location and 47 percent at another service location scored in the elevated range on a standardized self-report depression scale. Participants felt burdened, isolated, and unappreciated. Over 50 percent of parents were abused as children or witnessed violence in their homes.
Another barrier that staff see is illnesses of children and or parents, especially asthma in children. Participants are always juggling doctor's appointments, appointments with specialists, and other appointments such as those scheduled to apply for food stamps and WIC. Other barriers reported by staff include violence, substance abuse, and single mothers with partners in prison. Parents with older children were especially concerned about youth violence and gangs. Child care is also a very important issue, since there is a shortage of subsidized child care slots
II. Key Service Components
The Avance Parent-Child Education Program has two stages. The first stage consists of weekly center-based parent education classes, which continue for nine months. Additional services include home visits, child care, transportation, information and referral, and advocacy. Graduates of the parent education program are then encouraged to continue on to the second stage, during which classes in Adult Basic Education, English as a Second Language (ESL), and GED preparation are offered. During this period, which may last for several years, some mothers also enroll in community college courses provided at Avance centers. The ancillary services of child care, transportation, information and referral, and advocacy continue to be available during the second phase. The goal of the first year is to enhance the child rearing skills of mothers and infants so that they are better able to foster the optimal development of their children. The goal of the second year is to provide mothers with the educational achievements that will put them in a position to seek employment in better-paying jobs and thus improve their families' standard of living. All Avance programs include the key service components described below. However, this section focuses on service delivery as implemented and observed at the San Antonio site. The Avance program in San Antonio provides parent-child education in five centers and eight schools.
Avance recruits participants into the Parent Child Education Program through semiannual outreach into the neighboring community, word-of-mouth, and voluntary and involuntary referrals. The program is open to all families residing within the designated boundaries who have children between the ages of 0 - 3.
- Door-to-Door. Recruiters visit homes with children less than three years of age to describe program components and to attract young mothers to Avance. It is typical for recruiters to perform multiple visits before participants go to the Avance sites on their own. The San Antonio site, in particular, where many participants reside in public housing and have limited experience outside of their neighborhoods, requires more door-to-door outreach.
- Word-of-mouth is especially effective in recruiting immigrant or isolated families that are not referred to Avance from other programs. More of the families in Houston hear about the program via word of mouth.
- Referrals. Other programs refer participants to Avance voluntarily, or involuntarily as part of a mandated court order. Significant numbers of men join the fatherhood program in San Antonio through the court system, usually in connection with family-related offenses such as child abuse or domestic violence.
When the newly recruited participants come to observe the program centers, they are asked to complete intake forms. They also complete a pretest on their knowledge of parenting skills and child development and are tested again after completion of the parenting class. At this time, Avance may learn of participants' special needs and refers them to the proper services. For instance, if the participant does not know English, she is encouraged to take ESL courses, or if the mother needs family counseling, she is referred to an on-site family therapist or a therapist in the community. However, no formal individual service plan is developed.
C. Eligibility Criteria
The only criteria for females' inclusion in the first stage of the Avance program is that the mothers have children less than the age of three. Since Avance believes in the continuity of families, only a family member of a mother who completed the parenting program can use other program components. This includes men who enroll in the fatherhood classes. Proficiency in English, legal residence in this country, or welfare status are not requirements.
D. Parent Education
E. Child Education
- Parent Child Education Program is a nine month core curriculum that includes one three hour class per week. The participants are provided with free transportation and on-site child care at Avance. The first hour is devoted to toymaking, the second hour to lessons on stages of the cognitive, physical and emotional development of the child, and the final hour includes visiting speakers on community programs or issues or field trips. WIC clinics are also provided on-site. A home visitor also goes to the participant's home once or twice per month to demonstrate the use of the toys in the home setting. The home visitor also observes the interaction between the mother and child and the physical conditions in the home; referrals are sometimes made accordingly.
- Adult Literacy and Higher Education is the second stage of the Avance program which teaches basic skills, GED, ESL and college courses. Participants can choose to do job training instead of literacy education. Advisors at Avance provide college-level students with financial aid information, college registration, and placement as well as assistance in coordinating the JTPA/JOBS requirements. With the help of one assistant, the Adult Education Coordinator works with about 350 participants per year.
- Fatherhood Classes include weekly two hour meetings held over a 33 week span that complements the women's curriculum. The purpose of the fatherhood component is to strengthen the role of the father and to preserve the family unit. The program teaches the participants that in order to be a good provider for their children, they must obtain stable employment. In an all male environment, Avance fathers can discuss topics such as domestic violence, child abuse, drug and alcohol abuse, Hispanic culture and family life. Avance works with fathers who are living with their families as well as those who are divorced or separated, addressing the role and influence of the noncustodial parent.
F. Monitoring Progress, Recognition, and Graduation
- Child care Program While the mothers attend the parenting and adult education classes, the day care facility provides lesson plans for the children. Many of the children first learn to speak English and the alphabet at Avance. Children also receive a nutritious lunch in the day care facilities.
- HIPPY stands for the Home Instructional Program for Preschool Youngsters, a curriculum developed and sponsored by the National Council of Jewish Women. This is the second full year that Avance has offered HIPPY as an option available to all families after graduation from the on-site day care program. This preschool preparation program is targeted at children that do not qualify for the Head Start program. Using the HIPPY program, Avance graduates home teach 4-5 year old children in the community. Teachers also attend weekly group meetings.
Attendance at parenting classes as well as home visits serve to monitor progress in the parent-child education component of the program. Participants must maintain a 75 percent attendance rate to graduate. At the end of the 9-month parenting class, a formal graduation ceremony is held at the auditorium of a local university. Over 500 people attended the last graduation ceremony in San Antonio. Both parents and children are recognized as graduates, receive a framed certificate, and children wear a cap a gown. Avance provides transportation to the graduation ceremony.
Near the end of the program year, a lesson is devoted to goal setting. They discuss the many options available after graduation from the parenting class, including literacy classes, adult basic education, the home instruction curriculum for children, practicum program in the Avance child care center, and work opportunities. Avance staff will try to link participants to job contacts if they are interested.
The adult education coordinator is responsible for assessing the progress of the participants in the Avance adult literacy and higher education program. This individual oversees whether or not participants complete 75 percent of their GED lessons and if they have more than three unexcused absences from GED classes. If a student does not complete the requirements, the slot is given to another student. The adult education coordinator also considers the participant's JOBS status and helps her fulfill the employment requirement.
G. Community Linkages/Collaborative Arrangements
As a "home-grown" community-based program, Avance has strong ties to other services and providers in the community. The parent education program includes one hour per week that addresses community resources, either through guest speakers or field trips. Outside speakers have included a local councilman; voter registration volunteers; a state trooper to discuss driver safety, car seats, and insurance; a representative of a consumer credit counseling agency; a representative of the American Red Cross to teach basic first aid; a representative of Planned Parenthood; a representative of the child support office; a police officer to discuss community policing; and speakers on the subjects of domestic violence, HIV, and diabetes screening. Avance staff also use the United Way Blue Book for referrals and train participants to access services and advocate for themselves, using their knowledge of community resources.
A number of Avance's collaborative arrangements are aimed at improving accessibility of services to Avance families. Collaborative arrangements include an agreement with a local WIC program to provide monthly clinics at each of Avance's San Antonio sites, and arrangements with the Metropolitan Health District to provide periodic immunization clinics on-site. There is a family therapist on-site at one of the San Antonio locations. Avance obtains food from a local food bank and maintains a pantry at Avance for participants. Avance children are given priority for the Head Start program, but there is a need for more Head Start slots in housing projects. For older children, Avance sponsors a scouting program in San Antonio and an after school program in Houston. Avance parents play active leadership roles on Head Start policy councils and school PTAs.
Avance has also developed strong relationships with the literacy community. The Texas Education Agency provides literacy teachers to Avance. Literacy classes are offered twice per week and literacy is evaluated and assessed monthly. Avance staff also work closely with Project Quest, an innovative job training program in San Antonio. Avance has a good working relationship with the local community college and with a small local private college in San Antonio. The community college offers classes at Avance sites. Avance's Adult Education Coordinator works with the community college's Dean of Extension Services to assist in registration of Avance participants. She also works with the college's academic advisors and financial aide officers to assist students in completing and submitting forms.
III. The Presence of Barriers and How They Are Addressed
A major barrier addressed by Avance is low self esteem. Staff stress the important role of being a parent. They tell participants that this is the most important job they will ever have because it will determine the future of their children. Participants are constantly reminded by staff and by signs in the classrooms that read "you are your child's first teacher," or "it's never too late to learn."
The most common problems staff encounter are the mothers who "need to ask permission from their husbands" to go to the program. When visiting a home, if the husband is there, Avance staff tell him that he is more than welcome to sit with them and that he is more than welcome to come to the classes. Husbands do come to look over the program and this usually helps in their acceptance. There is a counselor on-site in the San Antonio center, a family therapist who works with children and adults. Avance staff also have a good relationship with a dispute resolution center. If they feel it would be helpful, they suggest this resource to participants, but the choice to go is left up to the participant. Avance staff can call community agencies and set up appointments at the request of the participant. The Houston program has comprehensive in-home support and case management services for court-referred families in cases of child abuse and neglect.
Avance staff are trained to be sensitive and non-judgmental. They encourage participants by reminding them of their role as parents, saying "try to make a difference for your child." The staff is very persistent. They don't let participants give up and they celebrate milestones, however small. This approach is greatly facilitated by the program's hiring practices. Avance strives to hire staff whose backgrounds and experiences are similar to those of the service population. Most are residents of the community served by Avance. Approximately 75 percent of Avance's staff are graduates of the program. All staff are bilingual. Thus, the Avance graduates act as role models for the new parents.
In the program evaluation it was found that participation in the Avance program, which had no specifically designed therapeutic component to address depression, did not have a positive impact on depression scores. Based on this evaluation, Avance staff have considered the addition of specific depression intervention programs to their model, but as yet have not successfully procured funding for such a component. Their experience indicates that more comprehensive involvement and longer time in the program seems to improve depression/stress.
IV. Funding Structure
In Fiscal Year 1995, Avance's national offices and three service sites had total revenue of $4.4 million. Federal grants and contracts provided 41 percent of this revenue, 25 percent of revenue came from private foundations, and state/local grants or contracts provided 10 percent of revenues. Other sources of funds included donations and contributions, United Way, and fund raising drives. There is substantial variation between the three service sites in their funding sources. This is largely a reflection of local community resources. For example, donations and contributions and fund raising drives, and in-kind donations comprise 31 percent of revenues in Houston and only 12 percent in San Antonio and 4 percent in Rio Grande Valley. The San Antonio site visited for this study had fiscal year 1995 revenues of $1.8 million, 61 percent provided by federal grant or contracts. Avance staff indicated that a very rough estimate of the average cost per family in the parenting program is $1,500.
Over the years Avance has changed and adapted, seeking new funding sources and expanding its services. For example, in 1989 the agency applied for and received a grant to implement the Parent-Child Education Program with the literacy component, in a school setting, as part of the U.S. Department of Education's Even Start initiative. Also in 1989, Avance was selected as one of the grantees to participate in the Comprehensive Child Development Program sponsored by the Head Start Bureau. One of the reasons for pursuing this grant was to develop the agency's capacity to provide additional services to families. Service components relating
to physical and mental health, prenatal care and education, and job development and placement have been implemented under CCDP. The CCDP project has also enabled Avance to strengthen its child development component. The home visiting program has become more structured, with an emphasis on assessing the child's developmental level and using the information to develop an individualized service plan for the child.
A formal evaluation of the Avance program was conducted from 1987 to 1991 with support from the Carnegie Corporation of New York. The evaluation found that mothers had developed more positive attitudes about their role as effective teachers of their children and that they interacted in a more positive and stimulating way with their children. The evaluation also found that Avance was successful in promoting enrollment in ESL, ABE, GED preparatory, and college courses, with 58 percent of participants at one service location and 63 percent at another enrolling in a continuing education class. A control group of participants had much lower participation rates (22 percent and 33 percent).
In 1992, Avance held a 17-year reunion of its first graduating class. Of the 31 women who graduated the first year, 23 were located. In 1973, prior to their enrollment in Avance, most of these women had dropped out of school.
At the time of the reunion, the following information was compiled on these 23 women and their 32 children:
- 94 percent of children who attended Avance had either completed high school, received their GED or were still attending high school.
- 43 percent of children who graduated from Avance were attending college.
- 57 percent of mothers who had dropped out returned to complete their GED.
- 64 percent of mothers who completed high school or GED had attended college or a technical program.
VI. Highlights of this Model
- The Avance model reaches parents through their children and thus strives to serve two generations.
- The model is very community/neighborhood-oriented.
- While the family focus may make the program appear "soft," make no mistake about it--the parent-child curriculum is theory-based and highly structured, and the adult education message is clear and strongly supported.
- The use of program graduates is unique and key to the program's replications and longevity. Program graduates must meet high program standards and receive ongoing training.
- The program has a research component with an interest in tracking participant outcomes. This information is used by the program not only to apply for new grants, but to continually adapt the program to the needs of its population.
Program Contact: Dr. Todd Walker (210) 270-4630
West Humboldt Employment Training Center
The West Humboldt Employment Training Center (ETC) operated by Chicago Commons is located in the West Humboldt Park neighborhood of Chicago, IL. West Humboldt Park is an area where more than one-third of the residents live below the poverty line, over half of adults lack high school diplomas, and over 70 percent of the children ages 5 and younger living in mother-headed households live in poverty; 37.5 percent of the population in the community received public assistance in 1988.
The center provides comprehensive services to enable welfare recipients to work towards their high school equivalency (GED) and/or enroll in training programs to become self-sufficient. In addition to classes, the center provides the support necessary to identify and resolve personal and family barriers to employment. The program serves as a bridge to high-quality, intensive vocational training programs that participants would otherwise be unable to access.
The services provided at the center include literacy, GED, and English as a Second Language (ESL) classes; parenting classes and individual parent-child sessions; on-site child care and Head Start; case-management and counseling in both individual and group formats; on-site medical care and medical case management; and career counseling and job placement assistance. To provide these comprehensive services, ETC works with other experienced social service providers. Erie Family Health Center staffs the on-site clinic, National Lekotek works on-site to provide family literacy and child development services; and Chicago Commons Child Development division runs the two on-site Head Start rooms.
At any particular time, approximately 120 families (women and children only) are on-site. Any welfare recipient 21 years of age and older is eligible to enroll. During FY >95, the center served a total of 184, mostly minority, participants: 27 percent were African American and 67 percent were Latino. They have served nearly 400 participants since opening in 1991. The average length of time spent in the program varies depending on the participant's education level at the time of entry. Those who test at the 9th grade reading level or above tend to remain in the program for 6 to 8 months or less, those at the 7th to 9th grade level remain one to one and a half years, and those with a six grade reading level or below average 2 years or more in the program.
II. Prevalence of Personal and Family Problems
Because ETC accepts any AFDC recipient who meets the basic eligibility criteria into the program, the population served has many needs. The average length of time on welfare for their FY 1995 entrants was 6.23 years. At the time of entry, 40 percent of the participants read below the 6th grade level; 56 percent were current victims of domestic violence, and 26 percent were past victims. Thirty percent of entrants suffered from current or past addictions. Thirty-eight percent of the families had at least one child with a severe learning disability, behavior disorder, mental illness or depression. Case managers attested that the most severe and difficult problems their families face are low self-esteem, abusive relationships, co-dependency, child care, alcohol, parenting problems, and depression.
Participants who drop out of ETC prior to meeting their educational or employment goal experience current domestic violence and current drug and alcohol abuse in far greater percentages than those who succeed. Of 31 participants who dropped out of the program within their first year, 71 percent were current domestic violence victims and 50 percent were currently addicted to drugs or abusing alcohol. However, staff believe that both these issues can be overcome and do not serve as absolute barriers to success. Fifty percent of participants who remained in the program for at least a year were also current victims of domestic violence.
One of the goals of ETC is to prepare recipients to address the personal and family challenges they are likely to encounter as they begin to make progress towards becoming self-sufficient. Domestic violence is a challenge that many recipients in the program face when they come into the program, but for many women, the violence they experience escalates over time. The experience of ETC has shown that women in abusive relationships are often forced into continued dependency by their partners who will heighten their aggression whenever the woman takes any steps to become financially self-sufficient. According to one staff member, many of the women participants would not be allowed to come to ETC by their significant others if other men were allowed on-site. They believe that to be effective, welfare-to-work programs must directly address this issue in order to bring about successful transitions to self-sufficiency.
ETC also has spent significant time assessing and clarifying the role of learning disabilities and low educational attainment in long-term welfare receipt. From their experience, many existing job training and preparation courses do not adequately meet the needs of women with very low reading levels. The majority of training programs require at least a tenth grade reading level. The amount of time necessary for many women to obtain such a standard is at least two years, if not longer. In the face of time limits, staff realize that many recipients will not have the time to meet these standards. Thus, they have created an alternative educational program for recipients with the lowest educational levels.
III. Recruitment of Participants and Assessment of Their Strengths and Needs
The West Humboldt Employment and Training Center is a private, community-based program. Thus, staff are responsible for recruiting AFDC recipients to participate in the program. In the past, staff have undertaken significant outreach efforts to inform the community about their program -- they knocked on doors, sent flyers home from school with children, and approached people on the street. ETC staff occasionally held presentations at Project Chance (Illinois' JOBS Program) and some staff would refer people not ready for work to them. Recently, the Project Chance offices have been calling all welfare recipients into their offices to determine whether or not they will be mandated to look for work. Those who have a high school diploma or recent work experience must seek work and the others are generally sent home. However, several local offices have invited ETC to do a presentation at these meetings to inform those recipients who are not subject to the work mandate that there are other options available for them. ETC is hopeful that this new arrangement will continue because it substantially reduces the time that must be spent on outreach activities.
Assessment of participant's strengths and potential barriers to employment begins during orientation and an 80-hour Life Skills class that precedes enrollment in the GED program or other educational components. The class is taught primarily by one of the two case managers, with specific segments conducted by case assistants, the employment and training specialist, or the director of the GED program. The Life Skills class is offered several times a year in both English and Spanish. Both the orientation and the Life Skills class are geared towards motivating recipients to participate in the program and work towards becoming self-sufficient. The principle mission is to start the process of building self-esteem. Participants are encouraged by the session leaders and each other to explore their family histories and current personal and family issues.
Participants are educated about domestic violence, mental health issues, depression and alcoholism. The case assistant who is a former ETC participant and domestic violence survivor dispels stereotypes and myths about relationships and explains how kids are affected by violent relationships. Participants are informed of available off-site services, including domestic violence shelters, individual and family therapy, and alcohol and drug treatment. The clinic's Registered Nurse provides health education and awareness on such issues as sexually transmitted diseases, birth control, and the importance of check-ups for both the women and their children.
During Life Skills, numerous activities are conducted to begin to assess participants' skill levels and to identify any personal or family issues that may make it difficult to participate in a structured education program or employment. Several diagnostic tests are administered and participants begin to set goals and design preliminary employment plans. The TABE test (a standard test used by many education and training programs) is provided to all participants to determine reading levels. Those who score above 6.5 also take a practice GED exam. Those scoring below 6.5 undertake a screening for learning disabilities and discuss their education history and past experiences. Correctly assessing and addressing learning disabilities is considered critical. ETC purchased a learning disabilities screening program last year. Staff have received training and are screening all participants who test at or below the 6th grade reading level. ETC has also sought out in-service training to educate their teachers in ways of accommodating learning differences and difficulties in the classroom.
The employment and training specialist introduces career planning and attempts to expand participants' horizons by outlining various options during the Life Skills class. As many different options as possible are presented. Initial individual employment plans are developed in the class setting. After Life Skills is finished, the specialist meets with each participant individually to discuss her education and employment goals, a realistic time frame, and necessary courses.
Personal and family issues that may impede progress toward self-sufficiency are generally identified through both formal and informal means. Staff report that an important part of Life Skills is using the group process to help recipients realize that they have the potential to change their circumstances and create a better life for themselves and for their children. Staff aim to create a supportive environment where recipients feel comfortable sharing personal and family issues that may make it difficult for them to participate in the program and eventually become self-sufficient. Staff also try to create an environment that encourages program participants to be supportive of one another. Staff feel that by the end of Life Skills, they know the participants well and are aware of many of the personal and family challenges each participant is facing. In addition, the participant meets with her casemanager within a month of completing Life Skills for a one and a half hour conference to assess family needs, identify goals and develop a plan for helping participants address those issues. A health screening at the on-site clinic also occurs during Life Skills, making it possible to identify any medical problems that may need to be addressed. While participants are invited to use the clinic's RN as their primary care provider and many do, this effort is complicated by state initiatives to enroll Medicaid recipients into HMOs.
IV. Strategies for Working With Families
The primary focus of ETC is to facilitate the transition to further education or employment opportunities that these participants would not otherwise attain. These opportunities include obtaining a GED, enrolling in a vocational training program, continuing education, or employment. There are several features of ETC's program that differentiate it from other GED or Adult Basic Education Programs. First, ETC takes a holistic approach to preparing recipients to become self-sufficient. They not only provide educational programs, but also provide extensive support to help families address personal and family challenges that often make it difficult for recipients to be successful in their attempts to become self-sufficient. Second, ETC has taken an active role in developing alternatives for recipients with very low educational levels. Third, ETC provides a very structured program and monitors attendance closely to identify recipients who may need additional assistance to succeed in the program.
A. Education, Employment and Training Services
As noted above, the education and training component is a primary function of ETC. Together with the support services, the program facilitates enrollment of participants in training programs or college courses that these women would otherwise have been unlikely to be accepted and/or succeed. After the completion of Life Skills, participants go on to ESL, GED preparation and/or Adult Basic Education classes which are held on-site from 9:30 to 1:30 five days a week. There are two two-hour class sessions per day that each participant attends. During each class period several courses are offered simultaneously. Each student is expected to take certain required courses in addition to some electives. Staff report that the element of choice is very powerful. Classes are taught in two or four month long modules.
1. The GED Program
Classes in the GED program are designed around materials that are included on the GED exam. However, the instructors have also worked hard to find innovative, interesting ways of teaching fairly traditional material. The courses are produced especially for ETC and instructors have designed classes to maximize the interest and usefulness of information to students by focusing on areas of direct interest and use to students. Critical thinking is an integral component of all classes.
As a participant begins to meet certain milestones, the employment and training specialist helps them to start narrowing their choices, and helps guide them to worthwhile training programs, community college, or employers. A number of training programs that have guaranteed or extremely high rates of job placement have been identified. Traditionally, these training programs have been accessible primarily to those participants who pass the GED or have reading test scores at the tenth grade level or higher, criteria that is often set artificially high.
2. Educational Program for Recipients with Low Educational Achievement
To provide recipients with low educational levels with opportunities to increase their employability, ETC identified four high-quality training programs --woodworking training, the Chicago Manufacturing Institute, Certified Nurse's Assistant, and chef training-- that offer training for entry into careers that would allow recipients to eventually become self-sufficient and do not require a GED as a prerequisite. The employment/training specialist talked with the training programs about what type of skills, knowledge and support are necessary for successful participation in the program. The greatest barrier that was identified was not academic ability but problem solving, interpersonal relationships, and communication.
Using this information, the specialist and instructors then worked together to develop a curriculum specifically designed to prepare participants for these training programs. For example, basic reading and writing is now taught in a "Reading, Writing and Roleplaying" format based on narratives about people at work and how to solve conflicts and approach new situations. The first module will also include an introduction to the training programs to expose participants to their options and what it might mean to work in a non-traditional occupational setting. Math, study skills, and a course designed to help recipients achieve at least a 6th grade TABE test score are also offered. The second module offers more specific courses depending on which training course a participant chooses. A practical math and design class that includes blueprint reading and creation of a product based on the blueprints, a Certified Nurse Assistant biology class, a Certified Nurse Assistant measuring class, grammar and geometry are among the courses offered.
ETC staff are also working to design support systems to further ensure the participants' success in these programs. ETC has always offered tutoring and resume services to clients in training programs off-site. They may also attempt to facilitate entry of two or more participants in one training program so that they can support each other and they will arrange group homework sessions for those who need extra help at ETC once they are participating in the off-site training program.
3. The ESL Program
The ESL students are primarily on a different track. In order to participate in the full ETC program including life skills and case management, the client must be receiving welfare. Currently, only twenty percent of ESL students receive welfare although this percentage is expected to increase with the new referral system. The ESL classes are divided into four levels. Students in the higher levels of ESL are also encouraged to enroll in GED preparation in Spanish or other further education available off-site, or participate in the training preparation courses available at ETC.
B. Case Management and Support
Although some individual case management does occur, the majority of support is provided to clients through a group format. Case managers carry a heavy load -- only two full-time case managers and two half-time assistants are on staff to work with up to 120 families on site in addition to any families who may have dropped out of classes or are in off-site training programs or employment but still need assistance. Case managers also teach the Life Skills class and run the support groups. In addition, ETC now also acts as the Project Chance case manager for each participant. Supportive service payments, for example child care or transportation, can be authorized at ETC. Participants never have to go to the Project Chance office, and are able to continue with their ETC worker even after they have graduated from the program. This has clear benefits for the participants, most of whom live in the neighborhood, in terms of both convenience and continuity. While it has increased their workload with no additional compensation, ETC provides this service in the hopes that more stabilized funding will result and because of the clear benefits for participants, most of whom live in the neighborhood, in terms of both convenience and continuity.
After Life Skills, based on their personal and family circumstances, participants have the option of participating in one of several support groups that focus primarily on a specific issue: "Bad Relationships" (domestic violence), DORS (for learning or physically disabled who are trying to receive services through the Department of Rehabilitation Services), Parenting, Depression, and Special Needs Children. The groups meet once a week and are integrated into the class schedule. The groups are used by participants to work on explicit goals. Each person will talk about their goals and what steps have been taken to achieve them at the beginning of each group. Since inception of the support groups, there have been fewer emergencies for case managers because participants know they have a set time to discuss their issues and problems. Fewer participants have to be pulled out from classes to deal with personal issues now that a particular time has been set aside. The group format also allows participants to be more independent than in an individual case management relationship. Women are taught how to use resources themselves. Furthermore, the group discussions allow what one woman says or experiences to bring out similar issues for the other participants.
Although there is one primary case manager assigned to each group, the staff generally works as a team. Discussions about the issues a participant may be facing occur with input from anyone else in the program relevant to the situation, such as teachers, employment specialist, or nurse. Referrals are made to community resources whenever appropriate. However, it is very difficult to find treatment for substance abuse or therapy. Some outside support groups (e.g., one for incest survivors) are utilized for special circumstances.
Once a participant enrolls in ETC, their attendance is taken very seriously. A case assistant is responsible for checking the attendance, and if a participant misses more than two days in a row, the case assistant will attempt to reach her by phone. If the phone attempts are unsuccessful, or absences continue, either the case manager or her assistant will conduct a home visit. Each month, all program staff including case managers and assistants, teachers, parent-child aide, and the health provider, will meet to discuss the twenty participants who have the most numerous absences and develop a plan for working with those families.
C. Home Visits
Although case managers feel home visits are important, they do not have the resources to conduct visits unless it is evident that a participant has been absent for several days. Home visits are used as an important mechanism to reengage participants who are at risk of dropping out. In addition, home visits enable staff to determine whether recipients are in danger. Many participants do not own phones, and visits are the only way to check up on them.
The parent-child worker conducts home visits to work with the parents in building parenting skills. Although the purpose of the visit is to work on the parent-child relationship, this staff member can discuss with the case managers and teachers any issues apparent from being in the parent's home environment that may be affecting participation or performance.
D. Family Literacy
A family literacy worker is available to work with participants on their parenting skills. She is available to spend one hour every two or three weeks -- forty-five minutes is spent watching the parent and child interact and fifteen minutes is spent alone with the mother discussing parenting, development and discipline concerns. The worker helps parents teach their children the value of reading, and uses toys and activities to help parents foster the development of their children. A lending library for toys and books is available for parents participating in this program.
Historically, ETC has been a voluntary program. Participants with excessive absences are placed on probation for thirty or sixty days. At any given time approximately 7 or 8 women are on probation. If they miss more than an agreed upon number of days during this period, the women will be asked to leave for sixty days. Very often the women will come back. Now however, due to recent Illinois welfare reform changes, a recipient who currently volunteers to participate in the program becomes a mandatory participant and is subject to all JOBS sanctions. How the mandate will ultimately effect client motivation and participation is unclear.
The total annual budget for ETC is $530,000. The program tries to keep the cost of serving each participant down to $3500 for all services per year, including the education component. Case managers are paid $23,000 to $30,000 per year and half-time assistants are paid $10,000 plus benefits. Twenty percent of funding comes from JOBS, fifty percent from private sources, and the remainder from Even Start, Voluntary Literacy, child care reimbursement, and Medicaid.
VII. Program Outcomes
ETC has not undergone any formal evaluation of their program, but they do try and follow-up with participants over an extended period of time. ETC's goal is to have positive outcomes for 50 percent of its participants 36 months after entering the program. Follow-up on FY '94 participants showed that after 18 to 27 months, 29 percent of recipients were working, 12 percent were in a job training program, 14 percent were still on-site in classes and 45 percent had dropped out of the program. Attrition clearly occurs over time for program participants. For FY '96 entrants, after just three to six months in the program, four percent were working, two percent were in job training, 83 percent were still on-site in classes and 10 percent had been dropped from the program. After six to 15 months, 31 percent of the FY '95 entrants were dropped from the program, 10 percent were working, six percent were in job training and 53 percent were still on-site in classes.
VIII. Highlights of the Model
- Maximization of limited resources by using a combination of individual and group interactions to help families overcome personal and family challenges to self-sufficiency.
- Creation of a supportive environment so that participants can help one another to overcome personal and family challenges to self-sufficiency.
- Provision of comprehensive services so that participants can address personal and family challenges while attending classes.
- Attention to strengthening participant's parenting skills.
- Monitoring attendance closely to encourage ongoing participation.
- Development of career-focused educational opportunities for participants with the lowest achievement levels.
Program Contact: Jenny Wittner (773) 772-0900
Iowa's Family Development and Self-Sufficiency Program (FaDSS)
Cornerstone is a Family Development and Self-Sufficiency (FaDSS) grantee funded by the state of Iowa to provide family development services to welfare recipients who are at risk of long-term welfare dependency. FaDSS was established by the state legislature in 1988 to promote self-sufficiency and decrease out-of-home placements among the welfare population. Seven demonstration grants were initially awarded. In 1990, FaDSS became a component of the Iowa Promise JOBS system, and in 1993 it was established as an ongoing state program. There are currently 11 grantees providing services to 29 counties.
Iowa's welfare reform initiative is known as the Family Investment Program (FIP). The vast majority of FIP recipients are required to develop and implement a social contract called the Family Investment Agreement (FIA) through Promise JOBS, Iowa's JOBS program. This agreement details the steps a family will take to become self-sufficient and establishes a time frame for doing so. This time frame serves as a limit on the time a recipient can receive FIP. However, this limit can be renegotiated if it is unachievable. Families who choose not to develop an FIA or fail to follow through with the plan are placed on a Limited Benefit Plan (LBP) which, if not renegotiated, eventually leads to the complete loss of cash assistance for at least a six-month period. While a welfare recipient is actively enrolled in FaDSS, FaDSS staff have ultimate say over what the FIA entails and when a recipient who has not been participating can be placed on a LBP. In Cedar Rapids, Cornerstone staff work with the Promise JOBS worker to develop the family's FIA, and modify the plan as needed. While staff reported that sometimes an adversarial relationship develops between the Cornerstone family development worker and the Promise JOBS worker, this relationship has been evolving and Cornerstone staff are able to take the lead in identifying family needs and priorities.
A. Services and Setting
The FaDSS philosophy recognizes that families at-risk of long-term welfare use face many barriers (poverty, illness, alcoholism, learning disabilities, low reading levels, victimization and violence), but that with long-term, intense personal interaction with trained staff and voluntary participation in the array of services offered by FaDSS, these families can become strong, self-sufficient community members. FaDSS develops a comprehensive system of support services for each family that are provided in a manner that promotes, empowers and nurtures the family towards self-sufficiency and healthy reintegration into the community. A Family Development Specialist works with each family to build upon identified strengths and assists families to set and attain goals.
Beyond a number of core service components, each grantee is free to design a program to meet the specific needs of each family and the community it serves. The foundation for all FaDSS services are the home visits. Other core components include assessment, goal setting, ongoing family support, referral to community resources and development of other community linkages, family empowerment, special needs funding, and group activities.
The Cornerstone Program serves Linn County and is located in Cedar Rapids. It is a collaboration between two local human service agencies, Four Oaks and Alternative Services. Four Oaks, a family service agency that offers both residential and community-based programs, provides the family support component of the Cornerstone Program. Alternative Services, which focuses on education and employment services for adolescents and young adults, provides an employment specialist to work with FaDSS participants. The program is co-located with the Four Oaks agency in a new building on the outskirts of Cedar Rapids, close to the Kirkwood Community College. Other on-site services available to Cornerstone participants include full day Head Start, infant and toddler day care, and evening child care when necessary.
Cornerstone targets welfare recipients who are between the ages of 17 and 26 and who were teenagers at the time of their first child's birth. Programming is geared to working out the multiple issues that young parents in poverty face and recognizes that these parents are struggling with their own developmental issues as well as those of their children. Approximately 60 families are enrolled at any given point in time. 1995 program statistics for Cornerstone indicate an average age of head of household of 20.8, an average of two children per household, and an average length of involvement of two years for adults and three years for children. Other FaDSS grantees have chosen to target older, longer-term welfare recipients, recipients with older children or three or more children, recipients without a high school diploma or GED, or recipients with multiple spells on FIP. Caseloads vary in size across the grantees from 50 to 115 families.
Families end participation in Cornerstone once they have stabilized both emotionally and financially, or after they have been off FIP for 90 days. The average length of involvement is 3 years. More attention has been paid to the 90 day transitional assistance rule due to increased oversight on the part of the state, and because some transitional funding was lost that provided services to families who were not yet stable despite being off of FIP for 90 days.
B. Community Context
The Cedar Rapids community is rich in supportive resources for families. A network of neighborhood-based family resource centers has recently been established under an initiative funded by the Edna McConnell Clark Foundation. In terms of employment, there are many jobs available, but obtaining full-time jobs with benefits is a problem for the Cornerstone target population. Cornerstone staff and participants, as well as corporate representatives, stated that the need was not for more jobs, but for better jobs. In the past ten years, private investment has successfully attracted new business and created a vibrant economy in Cedar Rapids. For example, there is a very large telemarketing business in Cedar Rapids, which continues to grow. Salaries are going up in this industry, and it is hoped that benefits provided with these jobs will increase as well. There are also a lot of temporary employment opportunities in Cedar Rapids. The labor market is tight, with an unemployment rate of only 2.8 percent, which encourages employers to train entry level workers.
II. The Prevalence of Barriers to Employment
Finding day care and coordinating transportation remain large issues for families in Cedar Rapids. Bus service stops at 6 PM, which proves particularly detrimental for Cornerstone families, because many entry level jobs require evening and weekend hours. Affordable housing is also difficult to find. Other major personal and family barriers faced by the Cornerstone families include current and past sexual abuse and domestic violence, substance abuse, learning disabilities, and depression. Mental illness, disabilities of both parents and children, and lack of social skills were also mentioned. The Alternative Services employment specialist noted that adult attention deficit disorder is also a common problem seen in the Cornerstone population. The Iowa Department of Vocational Rehabilitation recognizes this as a disability. Testing and treatment for this condition is available at a hospital clinic in Cedar Rapids.
Information gathered from all grantees across the state on families served between July 1, 1994 and June 30, 1995 provides a snapshot of the barriers confronting FaDSS families. Thirty-three percent of all families include an adult survivor of sexual abuse or incest as a child; 49 percent of adults are survivors of physical or emotional abuse or neglect as a child. Eighteen percent of adults are current victims of domestic violence and 47 percent are past victims. Twenty-four percent of the adult recipients are currently abusing drugs or alcohol, and 32 percent are past substance abusers. Thirty-nine percent of adult recipients have mental health issues and 12 percent are chronically physically ill. Twenty-five percent of families have a child with special needs. Forty-four percent of families face two to four issues (from a list of sixteen) and 32 percent face 5 or more issues.
III. Identification and Assessment of Participants and Their Needs
Cornerstone was one of four FaDDS grantees included in an evaluation which utilized an experimental design. During the evaluation, the Cornerstone program received its referrals from a state-generated listing of eligible families. When AFDC recipients who met the legislative and program specific criteria agreed to participate, they were randomly assigned by the Iowa Department of Human Services (IDHS) either to the treatment group (the FaDDS program) or to the control group. Control families did not receive FaDDS services, but they were eligible for other welfare-to-work services available to AFDC recipients.
Since the demonstration evaluation ended last year, referrals are now made at the local level by Promise JOBS. Informal referrals are also made by other community providers such as the alternative high school or neighborhood family resource centers, or self-referrals are made by interested families. However, regardless of the initial source, the referral must at some point be made through Promise JOBS. Little outreach is necessary by Cornerstone--when openings exist, phone calls are made to Promise JOBS or other community providers for referrals. Usually, there are more families in need than spaces. In addition to Cornerstone eligibility criteria, organizations are asked to refer families that have multiple issues and need additional time and help before beginning the process to self-sufficiency; have difficulty parenting; have indicated that barriers to work or school exist but are reluctant to be specific, have indicators of past or current sexual abuse, physical abuse, domestic violence or history of substance abuse; have difficulty in keeping appointments; or have a child with special needs. Occasionally, Cornerstone staff will make presentations at Promise JOBS. Since the referrals are now generated at the local level, and since Promise JOBS and other agencies know the focus and expertise of Cornerstone, families referred to the program tend to be younger and in need of even greater support.
Once a family is identified, a family development worker will attempt to contact the family at home. Every effort is made to have at least an initial home visit with the family where the services of Cornerstone are explained. The family and worker determine whether FaDSS services would be of benefit to the family, and the family is asked whether or not they would like to participate. Participants noted repeatedly that it was the persistence of the family development worker at this stage that really got them to give the program a try.
Assessment is an ongoing process that occurs as trust is established with the family. The Family Development Specialists also use a variety of tools such as an ecomap (picture of their support system) and a genogram (family tree), as well as a listing of family strengths and basic needs to assess a family's overall situation. Additional tools to assess skills, interests, learning disabilities, alcoholism or health status can be accessed when necessary or at the family's request.
All FIP recipients are required to complete an FIA. Those enrolled in FaDSS develop their FIA with their Family Development Specialist in conjunction with the Promise JOBS worker during the first week of Cornerstone's involvement. While this may be too early to discover all of the potential issues which need to be confronted, the FIA can be modified over time as additional barriers surface. Those recipients not enrolled in FaDSS develop an FIA solely with the Promise JOBS worker. Because of the relationship between the FaDSS worker and the client, their FIA's tend to be much more detailed and individualized. While more generic plans with fewer short-term goals will be adequate for many recipients, particularly those able to find employment on their own, families facing multiple barriers appear to benefit from the more flexible plans that the FaDSS workers can take the time to develop.
IV. Strategies for Working with Families
The FaDDS grant requires that Family Development Specialists are either certified through the University of Iowa College of Social Work and the National Resource Center on Family Based Services, or demonstrate the knowledge and competencies required to receive this certification, gained through experience and education. The Cornerstone program staff includes a Family Development Manager and four family support workers, one of whom shares his time with a co-located U.S. Department of Housing and Urban Development (HUD)-sponsored leased housing and in-home services program. The Cornerstone staff have varying, but complementary backgrounds, which is a valuable resource in assisting families with multiple barriers. For example, The Family Development Manager has a background in special education and children's behavioral issues; and one of the family support workers has over ten years of experience in domestic violence services. Although participants are assigned to one family support worker, all staff try to get to know all of the families and they let participants know that they can approach any staff member for assistance. The core component services of Cornerstone are: home visits, case management and family support, motivation/life skills training, employment and training services, community linkages, special needs funding, and group activities and drop-in center.
A. Home Visits
Home visits are the key component of FaDSS. Visits occur at least weekly during the first six months, and no less than once a month until the family requests that they end or the family is no longer receiving cash benefits for 90 days. Home visits are the mechanism through which a trusting relationship is built, and they serve as a means of providing information to the family development worker about the family's situation.
B. Case Management and Family Support
Each family has one primary family development specialist who also serves as the case manager. However, all families know the entire Cornerstone staff and could turn to any of the family development workers if their worker is unavailable. The family development worker provides the majority of the support needed by the family, but does refer the family to other community resources whenever necessary. Whenever possible, families are taught how to advocate for themselves, and where to turn in the community for additional resources. The worker involves the entire family in the plan. Families develop short-term and long-term goals, and each accomplishment, however small, is recognized and celebrated by program staff.
The one-on-one, unconditional relationship and the persistence and dedication of the workers appeared to be critical elements to the program's success. Although participation in the program is voluntary, once a family is enrolled, the workers "latch on" to the families and will persist in working with them through any number of difficult times where clients may not always be receptive.
In working with a family on their various issues, flexibility is critical and the focus must be on long-term prevention planning rather than short-term crisis intervention. Workers tend to take on a more nurturing role to work through sexual abuse issues and a more directive approach to encourage participants to enroll in a residential treatment facility for substance abuse issues. Working with a client in an abusive relationship entails the development of safety plans, obtaining restraining orders, constant encouragement and self-esteem building, as well as referrals for crisis shelter as necessary. Some issues clearly take more direct involvement with the family more than others.
Cornerstone staff maintain caseloads of approximately 20 families each. The state FaDSS agency suggests that in urban areas, caseloads remain between 20 and 25 per full time specialist and in rural areas, where travel to home visits may reach 60 minutes, caseloads of 10 to 15 be maintained.
One or two weekly support groups are facilitated by family development specialists. These groups provide a forum for the women to talk to each other about common issues they face and provides a time and place for them to develop peer relationships. Although participation in support groups is voluntary, the staff encourages women to attend, especially those who complain of isolation. While there is usually a group of about seven regular attendees, participation is open to all and varies from week to week. Child care is provided during the group sessions.
C. Motivation/Life Skills
Alternative Services has recently begun a one-week, twenty-hour class called Breaking Barriers which focuses on challenging negative thinking and destructive habits, analyzing how attitudes affect behavior, accepting accountability, building self-esteem, and expanding one's horizons. The Breaking Barriers curriculum was originally designed to reduce criminal behavior and recidivism and is now also being used in community programming for homeless populations and substance abuse rehabilitation.
D. Education and Employment/Training Services
Alternative Services also runs a Cornerstone Career Class that all participants are expected to attend. Not all families are expected to enroll in the class right away. The class is three weeks long, and focuses on building computer skills, exploring career options on an individual level, filling out applications, and building interview and resume writing skills. The class includes tours of colleges and vocational schools, guest speakers, mock interviews, and transportation to and from job interviews. Alternatives also provides Cornerstone participants with a computer lab where they can develop their resumes, type applications or cover letters, develop basic computer and typing skills, and use computer programs to study.
Approximately 300 employers support the employment component and may provide work opportunities, job shadowing, workplace tours, and post-employment support. While finding employment does not appear to be a major issue for most families as evidenced by the low unemployment rate, jobs that pay a decent wage and that provide benefits are not in abundance.
All Promise JOBS participants are eligible to enroll in education and training but there is a significant waiting list for postsecondary education preventing that route as an option in most cases. FaDSS has traditionally put an emphasis on education prior to employment but have been criticized because this generally takes longer than an employment-first strategy. Cornerstone clients have no problem obtaining funds for GEDs but have had difficulty with those who need funding for postsecondary education. Cornerstone does work closely with the local community college -- a scholarship fund has been created and the college works hard to find funding for child care.
E. Community Linkages
While Cornerstone is itself a collaboration of two local human service agencies, the program has joined forces with additional programs as well. Cornerstone is an active member of the Family Resource Development Association, an interagency collaboration which began three to four years ago in an effort to change how services and supports to families are offered in the Cedar Rapids community. There are 34 organizations in the association and they meet every two weeks. The involvement of public entities such as schools and the Department of Human Services has been key to the effectiveness of this collaboration.
Cornerstone has a community advisory board that includes nonprofits who provide services to Cornerstone and referral organizations. Agencies represented on the community advisory board include Metro Alternative High School, a public high school for at-risk students; Promise JOBS; IDHS Income Maintenance Division; Linn County Day Care, the subsidized day care agency; and HACAP Head Start, the local Head Start grantee. Under an expansion grant, the local Head Start grantee has opened a full-day site in the Four Oaks building to serve only Cornerstone children. The collaboration has allowed the FaDSS family development worker to also serve as the Head Start social services coordinator to reduce overlap of services and the number of staff the family must interface with. Other family support programs that collaborate with Cornerstone are the HUD leased housing program; Sharp Kids, which focuses on at-risk first graders; and the four neighborhood-based family resource centers which are being developed with funding from the Edna McConnell Clark Foundation. These centers are aimed at preventing child abuse and neglect and the out-of-home placement of children.
Cornerstone is also unique among FaDSS grantees in its development of a very enthusiastic and involved corporate board. The board's 10-12 active members assist in fundraising and provide advice and direction. In addition, member corporations must actively sponsor one Cornerstone family. This sponsorship entails some financial support, in many cases helping to offset costs such as uniforms and car repairs that might otherwise be insurmountable for the family alone, as well as material and emotional support during the holidays and times of crisis. To be eligible to apply for a sponsor, a family must have been in the program for six months and be working actively towards goal completion. The corporate board provides a link between Cornerstone families and the broader Cedar Rapids community. Corporate sponsors indicated that their involvement was an educational experience for their employees. It changed their views about welfare families, the obstacles they face, and their willingness to work. As a side benefit, managers noted that involvement in the Cornerstone partnership resulted in an increase in other community service activities among their employees.
F. Special Needs Funding
Funds may be provided by the FaDSS program when no other resources exist in the community or resources are inaccessible to the family. Car repairs, school clothes, rent deposits, counseling sessions, gifts, transportation and child care have been purchased with these funds. These special needs funds are considered to be essential by the state in order to enable a client through a crisis that would otherwise set her back, or provide for an initial investment for school or work that may be too high for the client to undertake on her own.
G. Group Activities and Drop-in Center
In addition to support groups, FaDSS encourages its grantees to offer other group activities as a means to break isolation, encourage networking, and reintegrate families into communities. Child and adult tutoring sessions, a peer mentoring program, a bi-monthly newsletter, parties, and holiday events foster group involvement. Cornerstone also has a drop-in center with free laundry facilities, a kitchen, and sitting area. Group activities at Cornerstone have been more successful than at other FaDDS grantees because parents and children are within the same age range and they face many of the same issues and challenges.
The Council on Resources, Policies, and Procedures (CORPS) is made up of four to six families who assist in planning activities, reviewing any proposed changes, and developing and monitoring the dispersion of emergency funds. Cornerstone graduates or those who are near graduation can serve as peer mentors for other families. Peer mentors participate in six to eight weeks of training in listening skills, domestic violence, values clarification, and role playing. Mentors spend one to two hours per week with the family or work with families on as-needed basis (e.g., tutoring, emergency support, etc.). To obtain a mentor, a family must be in the program for six months and have a safe living situation.
Family support workers also work with fathers and/or partners, including individual and couples counseling. Decisions concerning the involvement of men are made on a case by case basis because there are concerns when there is an abusive relationship. The CORPS group is currently working on suggestions for ways to involve males in the program. More men have been coming to Cornerstone since the program moved to its new facility, either to use the laundry or bring children to Head Start. Staff suspect this is because the new location is less "public," so men aren't concerned about friends or co-workers seeing them.
V. Sanctions and Changes in the Policy Environment
The Family Development Specialist works with a family to develop small goals and feasible participation activities in order to encourage family participation and decrease the need for negative sanctioning. As long as families are active in FaDSS, the Promise JOBS worker cannot enact a Limited Benefit Plan (LBP). However, if a family is not making any effort to participate in FaDSS, Cornerstone must exit them from the program. Before this occurs, every opportunity is provided to the family to participate at some level. Before exiting the family, the head of household is sent a letter explaining that if the family continues to refuse services, they are at-risk of losing their benefits unless they begin Promise JOBS activities after case closure. Cornerstone provides a final opportunity for the family to come before their review board made up of members from the community advisory board, where the family must explain why they would like to continue in FaDSS and what steps they will take to increase their participation. Eighty-five percent of families who have reached this point accept the invitation to come to the review board, and so far, all of them have remained in the program. The review board and the threat of the LBP provides a mechanism to engage the family and makes evident to the family that the onus of participation rests on themselves.
Participants in the LBP will be eligible for three months of full FIP benefits, followed by a second three month period during which benefits reflect the needs of the children only. At the end of the six months, all cash assistance is terminated. Clients whose FIP grants are terminated will not be eligible for assistance for six months.
Cornerstone staff feel that recent changes in welfare reform are pushing them to move clients along more quickly. While staff feel this is sometimes in the client's best interest and staff should facilitate more rapid change, in other cases they find that the shorter time frames limit the staff's ability to form relationships with clients. Family support staff indicated that it often takes six to eight months to establish trust with a client. The push to move clients to self sufficiency sooner means the family support workers have to be more directive. For example, sometimes they help a family prepare an FIA when they have known them for only one week. Staff feel that the State pressure is changing the nature of the FaDDS program. To-date, the average family stays with the FaDDS program for three years. As of November 1994, the FaDDS grant will not fund post-AFDC follow-up beyond three months. Cornerstone has only begun to feel the impact of this change recently, because they had a separate grant for transition funding until last year. They find that transition funding is needed now more than ever because of the shorter time they have to work with clients. Staff are concerned that some families will need more than two years and will need other sources of support. They plan to refer those who need additional help to the neighborhood resource centers being developed under the Edna McConnell Clark initiative. The Cornerstone manager and staff described themselves as being in a state of "awareness" of the impact of the changing policy and funding environment. They are just beginning to analyze the impacts and consider how they can be more inventive and innovative in adapting to a more employment-focused, time-limited system.
VI. Funding Structure
The total budget of the Cornerstone program serving approximately 60 families for one year is $171,865. Seventy percent of the budget is devoted to staff salaries and benefits for 3 and 1/2 family development specialists, one quarter time of the program manager, and the employment specialist. Family development specialist salaries range from $16,452 to $24,507.
The base FaDSS grant from the state of Iowa accounts for $137,906 of the budget. Local funds for matching provide an additional $23,789, nearly half of which is derived from the corporate sponsors, and the remainder from United Way contributions and local tax levies. Federal matching funds amount to $10,170.
VII. Program Success
The FaDDS Annual Report for Fiscal Year 1995 reports the following outcomes for the 146 families enrolled in the Cornerstone Program since 1989: 99 entered training or adult basic education; 38 entered a GED program; 58 entered college; 89 entered employment; 63 reduced their FIP or AFDC payment; and 56 became independent of FIP or AFDC. The evaluation of the FaDDS program found that, in comparison to a control group, FaDSS participants reported significantly greater gains in their ability to meet the concrete needs of their families and made significantly greater gains in educational attainment. More FaDSS participants than controls were in full-time jobs, but the difference was not statistically significant. Due to greater participation in educational programs, during the early months of the evaluation, a greater proportion of the control group was off AFDC. By the 60th month, a larger percentage of the FaDSS participants were off AFDC.
VIII. Highlights of this Model
Relationship with Promise JOBS and involvement in preparing and monitoring the Family Investment Agreement.
Collaboration between family support and job counseling training organizations (Four Oaks and Alternative Services).
Active Corporate Board and Community Board.
Peer mentoring program.
Team approach of the staff that builds on their complementary experience and skills.
Program Contact: Ginger Hemmingsen (319) 364-0259
Nevada County (CA) GAIN/Employment Services Program
I. Background Information
The Nevada County (CA) GAIN/Employment Services program has developed a pilot project for providing more intensive case management services to support the "hardest-to-serve" families and individuals in its GAIN employment service program. These families and individuals consist of welfare recipients who are deferred from mandatory participation in employment and training services because of drug and alcohol problems, emotional/mental problems, severe family crisis, or legal problems. Under the new program, a social worker works intensively with these individuals and families to help them overcome barriers preventing them from participating in GAIN or entering employment.
In the past, the deferral status for some recipients had been renewed over and over. The program director was uncomfortable leaving individuals unserved month after month, which seemed to imply that they were hopeless cases or "throw-away people." County staff felt somewhat frustrated by state regulations that prohibited the use of GAIN funding for direct counseling services. Managers decided to hire a social worker for a six-month trial period, to provide referral and counseling services under an intensive services case management model. The initial six-month trial period was so successful in moving individuals into GAIN participation and into employment that the County Board of Supervisors approved its continuation as a two-year pilot project beginning January 1995.
The Nevada County GAIN/Employment Services Program, like each of the 58 county-operated GAIN programs in California, is administered by the County Department of Public Social Services (DPPS). The County DPPS has considerable flexibility to design and administer the employment program, which provides AFDC recipients in the county with a range of employment-related training and supportive services within the regulatory parameters of the State (GAIN) and Federal (JOBS) programs. The program must serve all AFDC applicants and recipients whose youngest child is at least three years, unless they are exempt or deferred from participation.
The GAIN/Employment Services program in Nevada County consists of one office, with six GAIN employment and training counselors, the social worker providing intensive case management services, a supervisor and clerical staff support. The social worker, who has an MSW, is assisted currently by an undergraduate level social work intern working 16 hours a week. None of the employment and training counselors have Master's degrees, and some of them do not have Bachelor's degrees. The employment and training counselors provide job search, job clubs, assessment activities, and other employment-related services. If a counselor determines that a client is unable to participate in GAIN activities because of drug or alcohol problems, emotional/mental problems or severe family crisis, the client is placed on deferral status and referred to the social worker. About 450-500 cases participate in the GAIN Employment Services program in an average month. Statistics from July 1995 through January 1996 indicate that the pilot project received an average of 12 new referrals each month, for an average caseload (including ongoing cases of 44 clients. Over a six-month period, the pilot project serve 184 recipients (unduplicated count).
The office is located in the western part of the county, at the county seat of Twin City, California. The county is a small, rural county, of about 90,000 people. AFDC recipients who live 60 miles to the east, in the county's other major population center near the Nevada border, are generally granted an exemption from GAIN participation because of remoteness. The AFDC caseload, like the county population, is largely Caucasian. There is little of the ethnic diversity found in other parts of California. Almost all of the clients in the pilot project caseload are Caucasian, with the exception of two Hispanics and four American Indians. The county has the second-highest divorce rate among counties in California.
Until a move occurring at the time of this interview, the GAIN Employment Services office was located in a separate building from the county welfare building. According to management staff, the off-site location helped the GAIN office avoid the stigma of the welfare office and the often negative climate between welfare recipients and workers. GAIN clients are treated with respect and dignity from the moment they walk into the waiting room, with its welcoming coffee and friendly receptionist. Staff hope that the warm environment of the GAIN program will not be unduly harmed by moving into the building housing the AFDC program.
One of the underlying beliefs of the GAIN/Employment Services Program, and of the intensive case management services component, is that people can make changes if they are treated with respect and offered opportunities and support. However, the county cannot fix things for individuals and families, the individuals must make the changes for themselves. There is a strong emphasis on employment as the long-term goal for everyone.
The economy in Nevada County is somewhat depressed because of declines in the county's traditional industries of mining and logging. Some of the mining work is coming back, but the logging mills have been closing. The county is viewed by some as a "bedroom" community to Sacramento, which is located 60 miles to the south. Although the county has attracted some new computer technology companies, one of these companies has recently decided to re-locate away from the county. Finding ways to continue to attract new companies is a pressing concern for county officials.
II. Prevalence of Personal and Family Problems
According to the social worker, the most common problem among families and individuals in her caseload was drug and alcohol abuse, followed by depression and emotional problems. For many individuals, these two problems were intertwined. Temporary homelessness was also a significant problem; the social worker had recently assembled data that showed that one-third of the families in her caseload had been homeless at one point in a recent six-month period. Affordable housing was scarce and the local shelter had a limited capacity of 20 beds. Two other significant problems include domestic violence and psychiatric illness. The social worker noted that domestic violence affects single-parent families as well as two-parent families, because of violence perpetrated by absent fathers who return to the home. Psychiatric illnesses, such as schizophrenia, paranoia, or obsessive/compulsive behavior, affect a relatively small proportion of the intensive services caseload (about 7 percent), but are the most challenging to serve because of the difficulty of securing adequate psychiatric services.
Many of the recipients in the social worker's caseload are long-term welfare recipients. The average length of stay on AFDC was 4 years, 3 months for the 57 clients in the original caseload served in the first six-month trial period. Their average deferral time was 2 years, 3 months.
III. Strategies for Identifying Recipients in Need of Specialized Services
GAIN employment and training counselors conduct "appraisal" interviews with new GAIN participants, generally after the participant has attended a group "orientation" meeting. The appraisal interview focuses on the recipients' employability and job-readiness. Although the interview does not include a specific assessment of personal or family problems, such issues frequently come up during the interview. The client may be candid in admitting to an alcohol or drug addiction, may mention other factors that are barriers to employment, or may exhibit tears and other signs of emotional distress that signal she is not ready to enter the regular GAIN program. In such cases, the counselor tells the client that she can be deferred, for periods varying from one month to six months, and that a social worker will work with the client during that deferral period.
IV. Strategies for Working With Recipients in Need of Intensive Services
The social worker in the Nevada County GAIN program provides intensive services that are adapted to the individual needs of each family. Her approach combines home visits with efforts to assist the client in accessing resources within the community. She also provides crisis counseling and on-going regular contact.
A. Home Visits
Services begin with a call from the social worker to the individual placed in deferral status because of alcohol and drug problems, emotional/mental problems, or severe family crisis. She tries to call each individual within one week of the referral. If the client agrees, she holds the first meeting in the client's home. About 90 percent do agree to an initial home visit. The other 10 percent prefer to meet on the more neutral territory of the office, although eventually, they, too usually invite her into their home.
Some of the willingness of clients to let the social worker visit them is due to the "AFDC grapevine." Other clients may tell new referrals that "She's O.K. She came to my house." Even from the beginning, however, the social worker found that people were eager for help. Many of them seemed to be relieved to have someone listen to them, eager to have someone come along and try to bump them out of the circle in which they were trapped.
The goal of the first visit is for the client to get to know the social worker and feel comfortable. The social worker does not use any formal assessment tools. The clients' issues usually come up, either in the initial appraisal interview with the employment and training counselor or in early conversations with the social worker. If not, the social worker feels comfortable asking the client directly whether she has problems with drugs, alcohol, domestic violence, etc., during a second or third visit.
The social worker and client work together to develop an interactive service plan. The social worker's attitude is that the client should set the goals and do the work, but that the social worker will be there in a supportive role. She tells the clients that she'll be there "one inch behind you, so you can't back up." She works with clients to set realistic goals and to figure out the steps needed to achieve the goals. Employment is always the long-term goal, but there may be a variety of short-term goals, depending on the needs and wishes of the individuals and family. Goals can include securing a restraining order to deal with an abusive boyfriend, having enough food at the end of the month, finding the energy to leave the house daily, entering a substance abuse recovery program, etc.
Flexibility is one of the key elements of the model. The social worker has the latitude to schedule home visits as she sees necessary, sometimes as often as once a day in the beginning. No time limit is placed on the number of visits or weeks of service a family may require, although there is a "natural" point for evaluating progress at the end of each deferral period. (The length of the deferral is set by the employment and training counselor under the guidelines of program regulations). During the first six months of the program, the average client spent three months working with the social worker.
B. Referral to Community Resources
The social worker does more than simply make a referral to community services. She personally knows most of the service providers and has close working relationships with many of them. After she gets a client into a program, she maintains contact with the person, providing supportive services around the main intervention, where needed. She usually has clients sign a release of information form, allowing the service provider to keep her informed of how a client is doing and to alert her to needs for additional encouragement or support.
One of the programs to which she refers many clients is the county mental health department's "Mothers in Recovery" program for women addicted to drugs and alcohol. The social worker has a close relationship with the woman running that program, who keeps her informed of a participant's progress or needs during the eight-week program. The program is well-designed to meet her clients' needs (for example, it can send a car to transport families and it provides on-site day care) and so the social worker has no hesitation referring women to the program. About three-fifths of her clients are either in the program, about to enter it, or recent graduates.
Other community resources include mental health services, child protective services, the domestic violence and assault coalition, a women's self-help center, legal aid, and low-cost counseling services. Appropriate referrals for psychiatric services have been difficult to secure. It is hard to get access to low-cost mental health services unless a patient is so ill as to be suicidal. Although the social worker can provide some counseling to individuals and families around certain issues, she does not have the background or credentials to work with patients with psychiatric illnesses such as schizophrenia, paranoia, obsessive/compulsive behaviors, etc. Individuals who need to receive psychiatric services often must wait to see the psychiatrist and are scheduled for only one appointment per month, which means considerable time may pass before the appropriate type and dosage of medication is found. One approach used by the social worker has been to take the recipient to a medical clinic where she has good connections with a medical doctor, who has the authority to prescribe medication while the recipient is waiting to see a psychiatrist. She often accompanies the recipient to facilitate the discussion of the recipient's symptoms. In some cases, individuals are encouraged to apply for Supplemental Security Insurance (SSI), if their mental illness seems to be permanently disabling.
C. Crisis Counseling and Ongoing Support
The social worker has the training and experience to work personally with clients on therapeutic issues, either individually or in family therapy. This is sometimes necessary if the counseling center costs too much or if the client cannot seem to move forward with any other alternative. This option is used very little, however, because it takes up a lot of time for the social worker and because she thinks it is important for the individuals to get out of the house and into the community. It can be therapeutic for an individual to "get on the bus and go somewhere."
The social worker also shares with clients her professional belief that employment is in itself therapeutic. Sometimes when an individual does not feel ready to engage in the therapy or recovery program needed to address some of the intense personal or family problems in her life, the social worker will recommend that the client go to work, in part for its therapeutic value. Entering GAIN is another alternative to continuing to work on the family dysfunctions. The social worker is available to support the client, but not to support the client in remaining in deferral status without making any effort or progress.
Much of the counseling provided by the social worker is crisis counseling and ongoing support, helping individuals deal with stressful situations. Many clients find it supportive to just have someone who listens, cares, and does not go away. The social worker is readily available in person or by telephone, and she continues to be available to clients after they move into the GAIN program or into employment. She can help them talk through situations, such as the loss of a babysitter or the problem of a difficult boss. Roughly five to 10 clients a month may receive some level of ongoing support, often over the telephone, in addition to the regular caseload of 40 to 50 who are formally in deferral status.
D. Absent Parent Involvement
About 85 percent of the social worker's caseload is female. The program does not work directly with many absent parents. One barrier is that the non-custodial parent who is not on AFDC has no direct motivation to talk with the social worker. Another barrier is that the absent parent (usually the father) is viewed by the mother and social worker as contributing to the family problems. A number of the absent fathers are subjects of restraining orders. In a few cases, the social worker has met with the absent father and the mother to try to work together to overcome barriers to the mother's participation in GAIN or employment in the community.
E. Other Services
Since the arrival of the social work intern, the intensive services caseload has expanded to include some individuals deferred because of transportation problems or legal problems. The intern has been able to work with the Department of Motor Vehicles and the courts to assist people with such matters as regaining drivers' licenses. In one case, an individual who had no drivers' license for ten years was able to regain his license by paying a $27 fine.
V. Role of Sanctions
Clients are referred for intensive services when they are placed on deferral status from the GAIN program. At the end of the deferral period (which is often three months, but can be longer or shorter), the social worker and the recipient evaluate the progress to date. The deferral status can be extended if the client is actively working on resolving personal or family problems and needs more time. Clients who refuse any therapy or referral are given the choice of going back into the GAIN program or seeking a job directly, activities that are both seen as having therapeutic value for the individual and family. Clients who refuse all three alternatives are sanctioned by a reduction in the AFDC grant. The first sanction can be "cured" instantly, the second sanction lasts for three months, and the third for six months.
The intensive case management services are funded out of the county's GAIN allocation, without any separate budget. The overall allocation for GAIN is $734,000, including employment services and supportive services (e.g., child care). These funds include the Federal Title IV-F funding and the matching funds provided by the State and county. In addition to the case management services provided by the social worker, the program depends heavily upon community resources, such as the Mothers in Recovery program run by the county mental health department. Costs for these services are not reflected in the GAIN allocation.
VII. Program Outcomes
The intensive case management services program has been more successful than expected. After the first six months trial period, 27 out of 57 in the original caseload had moved from deferral status to GAIN participation, 14 out of 57 had secured employment, and 11 were discontinued from AFDC, leaving just five in deferral status. According to a January 1996 report on the pilot project, the average starting wage for those employed was $5.95 per hour and the average hours worked per week was 24. Most jobs were in retail, secretarial work, housekeeping or food service.
In addition, the program manager has identified a number of unanticipated benefits. Through her home visits and non-threatening presence, the social worker has been able to address some family crisis situations that might have otherwise involved child protective services. The social worker has also been able to assist clients work with the School Attendance Review Board to resolve attendance problems of students in the family. Finally, the social worker has served as a resource person who is available to assist other GAIN counselors in working with difficult cases.
The program manager and social worker attribute the success of the program to several key elements. First is the attitude of the social worker and the underlying philosophy of the program. Individuals and families are viewed as having the ability to make changes in their lives, with support. A high value is placed on employment, both as an important long-term goal for all individuals and as an activity that itself has therapeutic value. Second, the program is very flexible. The social worker has considerable latitude to spend her time with families as she sees best. Although the program has numerical goals, she does not focus on quotas, but works with each client until thy are ready for GAIN or employment. Most of her caseload is back in GAIN or employment within six months, but she has two families she has worked with for the whole two years. Third, and related to program flexibility, the program is home-based. The social worker enters the home of individuals and families as a non-threatening person, who is not a CPS worker or an AFDC worker. Most people seem eager to find somebody help them out of the trap in which they find themselves. The social worker's role becomes a supportive role of brokering services and encouraging clients to take active steps toward the goal of employment and self-sufficiency.
VIII. Highlights of the Model
Flexibility to design an individualized plan and providing support after formal program enrollment has ended.
Strong emphasis on employment as the ultimate goal.
Use of community resources to connect the recipient to the neighborhood in which they live.
Use of home visits to develop a trusting relationship in a relatively short period of time.
Program Contacts: Suzanne Nobles (916) 265-7171 or Terri Fransen, MSW (916) 265-1760
Kenosha County, Wisconsin
Participation Support & Intensive Case Management Programs
The Kenosha County Job Center provides integrated services to public assistance recipients to assist them towards self-sufficiency. Integrated Service Teams, each sharing a common caseload, consist of 6 economic support (AFDC) specialists, two JOBS case managers, and one job placement specialist. The center also houses intake workers, on-site child care, a jobs resource room (that is available and can be used by any county resident), and classrooms for orientation and other group sessions and adult education. On-site services are provided by 20 different agencies. Staff are located by function, rather than by the agency to provide for maximum integration of services.
Of the current AFDC caseload of 1800 - 2000 families, approximately 850 are JOBS mandatory. One hundred percent of mandatory JOBS participants are served by the JOBS program. Recipients who are pregnant, incapacitated, or have children younger than one year old are exempt. Until September of last year, families with children younger than two were exempt.
Kenosha County is located in the southeast corner of Wisconsin just north of the Illinois state line. It is a mixed urban and rural county of 130,000 people. The area is rebounding from the closing of a major automobile manufacturing complex which at one time employed approximately one-third of the population in Kenosha. The current unemployment rate is 3.5 percent. While a broad range of manufacturing, retail and tourism businesses have begun to strengthen the area's economic base, many of the new jobs are in the service industry.
The Kenosha County Job Center has three different mechanisms through which they provide more intensive support services to the families and individuals they serve, two are for families participating in the JOBS program and one is offered to parents sanctioned through Learnfare who may or may not also be in JOBS. Welfare recipients who have been in the JOBS program for more than two years without making substantial progress are referred to an Intensive Case Manager for specialized services. JOBS participants who experience family problems that make it difficult for them to participate in the JOBS program can be referred to the Participation Support Program to receive additional services. Families with children who are experiencing school attendance problems can receive services through the Learnfare Case Management Program, a program that is not connected to the JOBS program, but is similar to the Participation Support Program. The Participation Support Program and Learnfare Case Management are both family-oriented programs while Intensive Case Management is focused specifically on the needs of the individual recipient. The Participation Support and Learnfare Case Management Programs are part of the Prevention Services Network, a network of family-oriented services within Kenosha that work together to maximize the use of community resources while the Intensive Case Management Program is a specialized component of the JOBS program.
At the time of our visit, Kenosha was preparing to implement two major statewide policy changes. First, beginning March 1, 1996, all AFDC applicants with children over the age of one were to be required to participate in 60 hours of program activities, including 30 hours of direct employer contact within a four-week period in order to be deemed eligible for assistance. Second, families participating in the JOBS program would be required to participate in activities for 30 to 40 hours per week and would be "paid for performance." For every hour of non-participation, recipients would have $4.25 deducted from their grant. While staff who worked with families needing additional services expressed concern over how these policies would affect these families, because the policies were still being clarified at the state level, no discussions had yet occurred on whether any changes would be made to the Participation Support or Intensive Case Management Programs to respond to these changes.
II. The Prevalence of Barriers to Employment
According to case managers, the major barriers faced by recipients who receive assistance through the Participation Support Program include single parent issues (lack of external resources and social networks), difficulties with a particular child, mental health problems, alcohol and drug abuse, and domestic violence. The more individual barriers faced by recipients in the Intensive Case Management Program include mental illness, physical disabilities, lack of a high-school diploma or equivalency, and low self-esteem.
At the time they were referred for services through the Participation Support Program, 37 percent of the 178 recipients referred were suffering from depression, 35 percent were experiencing difficulties around single parent issues, 34 percent were having parenting difficulties due to personal problems, 27 percent had children with behavioral, emotional or developmental issues, 25 percent were experiencing anxiety, 22 percent were experiencing other psychological problems. Smaller percentages reported substance abuse or domestic violence: 13 percent reported alcohol or drug abuse concerns and 11 percent reported domestic abuse. Relatively small percentages reported other issues such as child care or transportation difficulties, physical disabilities, suspicion of child abuse, or housing instability. Over half (57 percent) of participants were referred with multiple barriers. These numbers signify a lower boundary for prevalence rates because they are the reasons for initial referral only. They do not include issues which surface once more intensive case management begins.
Logistical barriers also exist in Kenosha that make it difficult for some recipients to look for work. There is very little low income housing and transportation services are very poor. Public transportation ends at 6 PM. There are not enough licensed child care facilities, but parents tend to select other types of care and do not request their subsidies. For JOBS participants, a waiting list exists only rarely. While the quantity of child care does not seem to be an issue, the quality of the care is of concern.
III. Identification and Assessment of Participants and Their Needs
At the time of our site visit, new applicants received an appointment for both AFDC and JOBS intake, and all mandatory JOBS Program participants were engaged in a work program activity, received their child care and transportation voucher authorizations within seven days of application. JOBS participants were scheduled for group orientation during the first two weeks of enrollment. With the implementation of the new job search requirement for applicants, applicants will submit job search logs and instructors will submit attendance records. Once the requirement has been fulfilled, they will be assigned to an Integrated Service Team and an economic support worker will approve the first check.
The group JOBS orientation that occurs within two weeks of application is the first point of contact with the JOBS program. This orientation is followed by a Life Skills program that lasts for four weeks. Life Skills includes motivational and job seeking skills workshops, group assessment, and vocational exploration. During group assessment a number of academic and vocational interest and aptitude tests are administered. Tests include the Adult Basic Learning Examination (ABLE), Career Orientation Placement and Evaluation Survey (COPES), COPS Interest Inventory, and Career Ability Placement Survey (CAPS).
One of the Participation Support case managers currently administers a Parent and Child Screening for all new JOBS participants during the up-front assessment phase of the JOBS program. The Parental Stress Index (PSI) and the Achenbach Child Behavior Checklist (CBCL) measure stress levels and family functioning. The Parental Stress Index has three subscales: difficult child, parental stress and parent/child interaction. At the time the test is administered, the Participation Support worker explains what the tests mean and that family support services are available to anyone who requests them. She also informs the participants that she may be in contact with them. Sixty percent of all JOBS participants scored in the at-risk range on one or both instruments (defined as borderline or clinical on the CBCL or in the 95 percentile on the PSI).
Upon hearing about Participation Support services, participants may request that their JOBS case manager refer them for services so that they may deal with additional family or personal barriers to employment. In developing the individual's employment plan or after working with a participant to engage them in various JOBS program activities, the JOBS case manager may become aware of issues that are hindering the participant's performance. The JOBS case manager may then refer the participant to Participation Support. Finally, if scores on either the PSI or the CBCL indicate high levels of stress for the family, the tests are reviewed by a psychologist. The psychologist determines whether a high, medium or low level or risk exists, and whether a family should be referred to Participation Support. If a family is referred, the Participation Support worker who administered the test will visit the recipient at home and explain the services in greater detail. Staff note that the services have been well received lately, at least in part because the recipients meet the Participation Support worker during Life Skills. Once a family has been referred to Participation Support, the Participation Support worker assesses the family's strengths and identifies areas of concern, then works with the family to develop a plan for addressing those needs.
Families are referred for case management services through Learnfare once a child has been identified as having attendance problems. Staff note that since younger children have become subject to the Learnfare attendance requirements, the families referred to them through Learnfare have problems similar to the families referred through the JOBS program. Participation in both the Learnfare and Participation Support programs are voluntary, however, staff note that the engagement of Learnfare families who are under the threat of being sanctioned or have already been sanctioned has been much more successful.
Recipients are referred for Intensive Case Management based on the amount of time they have spent in the JOBS program. Once they are referred, the Intensive Case Manager works with a vocational clinician and a psychologist, if necessary, to identify potential reasons why a recipient may not be making progress towards self-sufficiency. The Intensive Case Manager replaces the recipient's JOBS case manager and because of her smaller caseload, is able to work more intensively with the recipient to become self-sufficient. Only 10 percent of JOBS participants remain in the program for more than two years, half of whom are on longer educational tracks. The other half are referred to Intensive Case Management.
IV. Strategies for Working with Families
Both Learnfare and Participation Support workers are part of Kenosha's Prevention Services Network (PSN) and provide similar, family-focused services to their clients. The Intensive Case Manager focuses primarily on issues that the individual faces that are more personal in nature. If the issues involve the entire family, the Intensive Case Manager, like any JOBS case manager, can refer the family to Participation Support.
The primary services offered through PSN to Participation Support and Learnfare clients are: case management; home-school-community liaison services through school-based workers in nine schools; recreational and enrichment incentive programs; children and youth counseling and mentoring; life, domestic and parenting skills development; family empowerment support groups; child management skill-building groups; tutoring; and work apprenticeships. Families are referred outside of the network for health services, alcohol and drug abuse counseling and treatment, adult education, mental health services, and housing. Staff note that they have had difficulty accessing some of these services, especially substance abuse treatment, since managed care has been implemented. PSN also coordinates programs for adolescent parent self-sufficiency, crisis pregnancy counseling, and prevention of elementary school grade retention. A shelter and support program for women who are victims of domestic violence and their children is also affiliated with PSN.
A. Home Visits
Participation Support and Learnfare workers meet with their clients at least twice a month, often at home. Home visits are preferred because issues are more likely to be apparent or surface in the family's normal environment. If a family support worker from one of the PSN agencies is also working with the family, he or she will spend more time in the home.
B. Case Management and Support
The Participation Support and Learnfare workers provide case management for clients needing intensive services. The Participation Support worker carries a caseload of 30 to 35 families per month, in addition to administering the Parent and Child Screenings. Case management services include assessment of family functioning and needs, as well as youth risk factors; development of family service plans with the goal or reintegration into the JOBS program (or in the case of Learnfare the goal is improved school attendance); monitoring and updating of family service plans; and monitoring and tracking of outreach service provision and case plan compliance.
The Intensive Case Manager manages her participants' employment and training activities as well as any additional services the individual needs to meet her goals. She considers her current caseload of 28 very manageable and could handle 30 to 50 cases. The Intensive Case Manager is the only JOBS case manager with her own office. The ability to shut her door makes a big difference in being able to talk to participants about their personal problems. The Intensive Case Manager is responsible for providing the full range of case management services to JOBS program participants, i.e., brokering, assessing, referring, monitoring, planning and advocating for services. The Intensive Case manager is also expected to maintain excellent working relationships and effective communication with participants, other JOBS case managers, economic support specialists and other agencies providing services to the individual.
C. Referrals to Community Agencies
The Participation Support or Learnfare case managers coordinate referrals to other services within or outside PSN. The participant's JOBS case manager still manages any employment and training activities but does coordinate and discuss progress and changes with the Participation Support or Learnfare worker.
If more intensive contact is needed with the family than meeting once every other week, clients will also work with a family support worker. The Kenosha Area Family and Aging Services, Inc. (KAFASI) provides in-home family support services within PSN. Family Support Workers visit parents with young children, teen parents and teens who are pregnant. Based on the family service plans developed by PSN case managers, Family Support Workers help with prenatal care support, parenting education, life skills development and health care needs assessment and coordination, as well as school readiness and recreational/enrichment programming for whole families.
Participation Support, Learnfare and Intensive Case Manager workers can refer for mental health counseling with the Professional Services Group, another agency that provides services at The Kenosha County Job Center. The psychologist who assesses the initial screening resides in this group and is available to conduct psychological evaluations. A mental health therapist is also on staff. Currently, regular JOBS case managers cannot avail themselves of these services.
Of the 178 families who received services through the JOBS Participation Support Program in 1994, 40 percent received counseling or psychiatric evaluations; 30 percent received in-depth instruction and parenting help for their children and 27 percent of the recipient's children became involved in some type of recreational activity outside their homes.
D. Employment/Training Services
All Participation Support, Learnfare, and Intensive Case management clients have access to all of the employment and training resources available through the Job Center to any JOBS participant. Features of the Job Center include: coordination of all job training and employment opportunities and employer contacts made through JTPA, JOBS, Job Service registrants, and Gateway Technical College students and graduates.
E. School Liaison Support
For those families with children who have problems of attendance or other problems at school, three contracting agencies provide school-linked outreach services. School Liaison Workers link proactively with families in their homes, helping to resolve problems of school attendance and communication between school personnel, the parents or other caregivers, and the students themselves. Primary support services offered by School Liaison Workers include recreational and enrichment incentive programming, attendance monitoring, tutoring, counseling and mentoring, arranging work experience and facilitating support groups.
Participation Support and Learnfare case management services are voluntary. Workers cannot sanction recipients if they choose not to participate. However, if a recipient is not following through with their JOBS activities, the JOBS case manager will notify the economic support worker to reduce benefits. The Participation Support case will close if a client is not participating in the service plan or if they have been terminated by JOBS for any reason.
Learnfare families have already been sanctioned or are on the way to being sanctioned due to excessive absences at school. Kenosha County staff feel they have been able to turn what appears to be a punitive sanction into a method of helping families, and they have been successful at engaging these families because of the hook that Learnfare provides.
Thirty percent of all JOBS participants are sanctioned because they are not fulfilling their employment plan. Sanctions are implemented immediately but are used as an incentive for participation. Ninety-one percent of those sanctioned return to full participation within a year.
In 1996, $214,708 was allocated to the Participation Support Program for a six-month period. This budget includes the salaries for the Participation Support Case Managers and funds to purchase services (i.e., Family Support services from Kenosha Area Family and Aging Services, Inc.) from providers within the Prevention Services Network. The program has been funded through Federal Waiver Savings that will not be available at the end of the six-month period. Thus, staff were uncertain whether the program would continue and how it would be funded if it did continue. The Learnfare Case Management Program is funded at a higher level, $674,654, and is funded through a combination of state funds and Federal Waiver Savings. The Intensive Case Management and Assessment Program is funded through a combination of JOBS and Food Stamp Employment and Training funds, and currently consists of one full time case manager and the services of the vocational clinician up to full time as necessary. In 1993, when data for a full year of budget data is available for both the JOBS and the Participation Support Program, Participation Support accounted for 11 percent of the combined budget for these two activities. (The budget for Participation Support Case Management in this year was $352,485 and the budget for JOBS was $2,595,637 for a combined budget of $2,948,122.)
VII. Program Outcomes
Kenosha's programs for providing assistance to families who need additional assistance to become self-sufficient have not been evaluated but program statistics for Participation Support Cases that were closed during 1995 indicate that 55 percent of the terminations occurred for positive reasons (14 percent for employment and 41 percent for other reasons). Seventeen percent of the terminations occurred for negative reasons (generally non-participation) and 28 percent were forced closures. The forced closures occur either when a recipient is deemed exempt or is no longer participating in the JOBS program or when they leave the AFDC program. The research and evaluation unit of the JOBS center is currently working on developing indicators to assess the JOBS Participation Support Program.
VIII. Highlights of the Model
Creation of a network of services within the community to meet the needs of families.
Use of home visits to develop a supportive relationship with a family.
Use of up-front screening to identify families early on who may need additional assistance.
Program Contact: Larry Jankowski (414) 697-4552
JOBS for Oregon's Future
I. Background Information
In 1992, Oregon received waivers through the 1115 waiver process allowing them to require mandatory JOBS clients to participate in mental health and substance abuse diagnostic, counseling and treatment programs. District offices identify the specific strategies they will use to address these issues as a part of their JOBS plans. Thus, the strategies used to address these issues vary from one District to the next, just as strategies to implement other components of the JOBS program do. The information presented here is based on site visits to two local Districts. District 4 includes three rural counties south of Salem, the state capitol and District 2 covers the two most metropolitan counties in the state, including Portland, the state's largest urban area. While there are specific procedures guiding the use of substance abuse and mental health services, in both Districts, there is substantial flexibility in how and when these resources are accessed. Oregon's commitment to create a "learning organization" is evident in the evolution of the JOBS program in general, and in the delivery of substance abuse and mental health services within the JOBS program, in particular.
The substance abuse and mental health components of Oregon's JOBS program are provided within the context of a JOBS program that aims to move recipients into the labor market as quickly as possible and within the context of a welfare system that emphasizes job placements rather than the provision of cash assistance as its primary mission. Performance in the District offices is measured against specific goals for reducing the AFDC caseload and placing recipients in employment, with the primary emphasis on employment placements. The Director of the Adult and Family Services Branch of the Department of Human Services indicated that "Our focus is to keep our eyes on employment. You don't win by caseload reduction, you win by employment placements." Reimbursement in all of Oregon's JOBS contracts is tied to job placements and the total number of recipients served.
Oregon has relied on both administrative and policy changes to shift the emphasis of welfare from the provision of cash assistance to employment. Three administrative changes are especially important to the implementation of the waiver allowing substance abuse or mental health treatment to be mandated for JOBS clients. First, over time, Oregon has shifted from separate JOBS and income maintenance staff to a combined eligibility/JOBS worker in all of its offices across the state. Thus, one worker, a case manager, is responsible for authorizing cash assistance, helping a recipient to develop and implement a plan to find employment, monitoring compliance with the plan and imposing sanctions for non-compliance.
Second, believing that all time on welfare is "bad time", Oregon emphasizes up-front job search and self-sufficiency planning for all families applying for assistance. The actual content of this up-front process differs from office to office and is evolving over time, but the goal is to engage recipients in employment-related activities when they apply for assistance, emphasizing that welfare is only a temporary option. Beginning with the earliest client contacts, staff at these sites emphasize the value of self-sufficiency and stress that work is a better way of life than welfare. This up-front process is also designed to use the labor market to test who can find employment on their own or with minimal assistance and who needs additional assistance to make the transition from welfare to work. Staff in District 2 indicate that one-third of all of their job placements occur during this early intervention phase. Staff note that because they have been successful at moving many recipients into the labor market quickly, they are now working with recipients who need more assistance to find employment.
Finally, Oregon relies on a labor force attachment model in its JOBS program, aiming to move recipients into the labor market as quickly as possible. GED preparation or basic skills remediation and some short-term training is available, but, in general, recipients spend short periods of time in the JOBS program, generally no longer than 6 months.
II. The Prevalence of Substance Abuse, Mental Health Problems and Other Personal Difficulties
Staff in both Districts indicated that substance abuse and mental health problems are common among recipients and that it is often difficult to distinguish which is the primary problem. Domestic violence, sexual abuse as a child, medical problems, learning disabilities and involvement with the legal system are also problems commonly seen by case managers and/or JOBS staff.
A survey of recipients participating in the JOBS program in District 4 found that recipients experienced a vast array of personal and family challenges that could potentially affect their ability to find or sustain employment. Twenty-one percent of participants reported they did not have dependable, stable housing. Eighteen percent reported they had been told they had a learning disability and 29 percent had been in a special education or learning resource class when they were in school. Current or past abuse was extremely common: 62 percent reported being yelled at, called names, slapped, choked, hit or hurt in other ways as a child; 32 percent reported being sexually abused as a child and 63 percent reported being in a relationship (current or past) where they have been pushed, poked, punched, slapped or forced to have sex. Use of illegal drugs and involvement with the criminal justice system were also quite common. One third of the participants reported having been in jail and 26 percent reported being convicted of a criminal offense. Almost two-thirds (63 percent) reported having used illegal drugs, but only 12 percent reported having a drug or alcohol problem. Twenty-seven percent reported that someone else had suggested they had a problem with drugs or alcohol and 42 percent reported they thought a family member had a problem with alcohol or drugs.
III. Strategies for Identifying Recipients with Substance Abuse or Mental Health Problems
Staff in Oregon use a variety of techniques for identifying recipients who may need substance abuse or mental health treatment to succeed in the workplace. These techniques include: (1) ongoing monitoring of participation in JOBS and other self-sufficiency activities by case managers; (2) Participation in Life Skills; and (3) use of formal screening tools.
A. Ongoing Monitoring and Intervention by Case Managers
In Oregon, case managers have the responsibility for helping recipients to develop and implement a plan to find employment as soon as possible. While plans are generally developed quickly, they are often modified over time, as a recipients' strengths and personal challenges become clearer. Personal challenges often surface after a recipient misses several appointments or is otherwise having difficulty following through with the agreed upon activities. When these situations occur, case managers try to identify whether there are personal or family issues that may be contributing to this pattern of non-compliance, then explore options for helping them to address those issues. In some, but not all offices, workers conduct home visits to try and identify issues that may be keeping a recipient from participating in the program. Staff indicate that it often takes several weeks before a recipient is willing to admit to a worker that she has an alcohol or drug problem or is in need of mental health services. One worker noted that recipients often are in denial for at least the first few weeks of meeting with someone, then they start to open up and the denial starts to break down. She noted that many recipients have to be "nurtured" into treatment programs, especially when a long history of substance abuse is involved.
Case managers play a critical role in linking recipients with the resources they need to become self-sufficient. However, they are not trained as professional counselors and are not expected to function in this way. Rather, staff are trained to assess recipients' ability to succeed in the implementation of their self-sufficiency plan and to refer for professional services when needed. District 4 is currently in the process of training all case managers on how to identify recipients who may have a substance abuse problem. The goal of the training is to provide case managers with the information and skills they need to make appropriate referrals to trained substance abuse counselors. Similar trainings on how to identify recipients who may suffer from character or personality disorders are planned for the future.
District 4 has a shortage of resources, especially for families experiencing abuse or housing problems so case managers are receiving more training to try and help recipients deal with some of these problems. The District has focused on creating an environment that encourages staff to intervene with families in the ways that they think would be most helpful. Case managers are given lots of support for the decisions that they make and they also rely on communication with each other to identify the best strategies for working with families. A supervisor in one of the branch offices indicated that staff are very dedicated and could not do the job well if they were not because they deal with "nightmares" everyday. She also noted that staff are especially good at assessing a recipient's strengths and identifying potential barriers to employment, making it possible for them to develop appropriate plans for entering the labor market.
B. Participation in Life Skills
In both Districts, Life Skills, the first formal JOBS activity for most recipients, provides an important avenue for identifying recipients who may be in need of alcohol and drug or mental health services, for educating recipients on the dangers of continued use of alcohol or drugs and for teaching recipients to access community resources that will help them to become self-sufficient. Life Skills is a structured, four-week sequence of activities designed to build the self-confidence and skills necessary for success in subsequent JOBS components and the labor market. It is also designed to help recipients identify a career that is consistent with their skills and experiences. Instruction is provided in such areas as: developing effective communication skills, stress management, time management, budgeting, conflict resolution, decision making, parenting strategies, balancing work and family, anger management, decision-making, goal setting, assertion skills and strategies to finding and keeping a job.
Because Life Skills is often the first step of a longer-term process to help recipients find employment, it is often very emotionally charged. Staff note that it is a time when recipients are given positive affirmation and learn they are cared for. Because recipients begin to perceive staff as helpers, it is often the time when the problems that recipients deal with in their day to day lives surface. The staff person who leads the Life Skills class in District 4 indicated that the problems families are dealing with are "enormous." In her classes, she has found that recipients are stiff and silent during the first week of the class. Often they are angry because they are required to participate. By the second week, they start talking and bonding with their classmates. By the third week, they are scared and by the fourth week, they are "sweating it," because they are so fearful that they will not be able to make it in the GED/Basic Skills class (the next step for most participants).
C. Use of Screening Tools
Oregon's creation of a "learning organization" is evident in its use of specific tools to screen for alcohol and drug abuse, and to a lesser degree, the presence of mental health problems. Only one branch office in District 2 uses urinalysis as a way to identify recipients who are using drugs. Administration of the Substance Abuse Subtle Screening Inventory (SASSI), a short screening tool that uses objective decision rules to classify individuals as chemically dependent or non-chemically dependent, is much more common. Still, the SASSI is used in different ways in different offices. For example, one branch office in District 2 requires all recipients to schedule an appointment with a substance abuse screener as a part of the up-front screening process. Another branch office is planning to administer the SASSI in a group setting during a workshop on alcohol and drug education to held as a part of required up-front process. Other offices only administer the SASSI after a referral has been made by a case manager. In District 2, the SASSI is administered by professional substance abuse counselors and staff in this District feel strongly that the SASSI should be administered by a clinically trained individual with additional SASSI-specific training and certification. However, in other District offices, the SASSI is administered by case managers.
Staff indicate that it is difficult to know when the right time is for screening for substance abuse problems. A mental health worker who worked with recipients who had been required to undergo a urinalysis said that recipients were so angry when they met with her that it made it almost impossible to do any work with them. In offices where the SASSI is used as a screening tool, staff feel that the way the screening is presented makes all the difference. In general, staff try to present it as an opportunity to create a better life for themselves and for their children. Because the substance abuse counselors in District 4 see so many recipients who are in the late stages of substance abuse, they support doing more screening up-front using the SASSI. However, staff note that it is hard to know how to strike the right balance between respecting a recipient's right to privacy and using public resources efficiently. Staff expressed concerns that money is being wasted if people go through the JOBS program then can't find employment because they can't pass a drug screen for employment.
IV. Approaches to Providing Substance Abuse and Mental Health Treatment Services
Districts 2 and 4 have both developed flexible approaches to identifying and addressing substance abuse or mental health issues as well as other barriers to employment. While those approaches are similar in some ways, they are different in others. Both Districts have mental health and/or substance abuse staff co-located in most of their branch offices. They both try to focus on offering services when problems get in the way, worrying that the more one concentrates on barriers, the more barriers one sees. But staff acknowledge that this is a balancing act, trying to offer services to recipients when they need them while not paying undue attention to problems recipients have learned to cope with. They also try to make sure people are aware of the resources that are available to them in the community, acknowledging that some problems are long-term and can't be fixed. They try to use an empowerment model as much as possible, letting recipients know they are in charge of their life. They teach assertiveness in Life Skills as a way of helping recipients to get the services they need to sustain employment.
A. District 4
District 4 is relatively small. Thus, the majority of referrals for alcohol and drug abuse and mental health services occur through joint staff meetings that are held on a regular basis. As a part of their assessment, case managers try and identify other agencies that are involved with a family and try to work with the other agencies to develop a common plan. Their goal is to have all service providers sending the same message to the family.
To address some of the anxiety regarding the transition from Life Skills, four years ago, the Life Skills instructor and an alcoholism counselor from the community started a mandatory support group for recipients participating in the Life Skills class and recipients participating in the GED class. Recipients often complain about the group, saying it is a waste of time, but the group leaders indicate that recipients use the group to talk about their problems at home. Thus, it ends up serving as a problem-solving group with recipients confronting and supporting one another. When problems are raised it in the group, it often provides the group leaders with an opportunity to provide a recipient with the assistance she needs. But the process is not always easy. Substance abuse problems are especially difficult to deal with because recipients deny they exist. To deal with the problems, recipients have to be motivated to do something different. When recipients do indicate they are ready to participate in mental health counseling or substance abuse treatment, referrals are made to local providers.
B. District 2
District 2 is much larger than District 4 and has numerous service providers, especially in the area of substance abuse. Thus, this District has developed much more elaborate procedures for referring recipients to substance abuse and/or mental health services.
1. The Provision of Mental Health Services
Mental Health services are all contracted to one provider in each county. Services are provided by professional therapists, all who have Master's degrees in Social Work or Counseling. In two of the three main JOBS locations, mental health counselors are on-site, an arrangement that allows counselors to provide ongoing education as well as counseling to recipients. The availability of mental health services is initially explained to JOBS participants in Life Skills. Recipients are not generally mandated into mental health treatment, except in cases where it is believed that mandating services is in the best interest of the client. In general, services are provided as an option for recipients who are having difficulty progressing towards self-sufficiency. Case managers refer recipients for mental health services for a variety issues including: questions around their ability to participate in JOBS, attendance issues, anxiety, behavior problems, chemical abuse history, child abuse (physical or sexual), concentration/attention problems, depression, domestic violence, grief, isolation, parenting, performance, relationship issues, sexual abuse, suicidal thoughts/plans, and transitional issues.
All mental health referrals are made through a central mental health coordinator who works directly for the JOBS program. The coordinator triages the cases she receives and meets with the mental health staff to discuss the referrals. A clerical staff schedules initial appointments for those who are referred for services. To reduce the time the mental health professionals have to spend tracking down recipients who miss initial appointments, case managers receive notice of any missed appointments and they have the responsibility for following up with the recipient. Recipients who are referred for mental health assessments are generally seen within three weeks. On average, recipients who are deemed in need of mental health services are seen by the mental health counselors for about 12 weeks, although some may be seen for as long as a year. All cases are reviewed every 90 days.
The mental health counselors generally provide individual counseling to JOBS clients. They have tried to do groups and feel that they would be useful, but they don't generally work because of scheduling problems. One counselor does conduct an eight-week support group for all participants participating in a specialized program for recipients with learning problems. While working with recipients their goal is to (1) try to help recipients to change the perspective of who they are, especially by teaching them how to take care of themselves; (2) teach recipients how to manage the stress in their lives; (3) send a positive message; and (4) provide medical intervention when necessary.
The mental health counselors see the full range of mental illness among the JOBS clients they see. Substance abuse problems are very common as are personality or character disorders. Recipients with these disorders are especially difficult to work with because these individuals have problems developing relationships and they develop maladaptive ways of dealing with the world. Recipients are also often very anxious about leaving their children with anyone. For many of them, their relationship with their children is the only successful relationship they have developed.
The mental health counselors are concerned that the up-front requirements increase the stress/anxiety level for recipients with mental health issues that need to be addressed. They recommend more flexibility in this process, possibly allowing recipients to participate for fewer hours per week while using incentives to encourage recipients to participate for more hours. The mental health counselors feel it is especially important to present recipients with clear expectations and options and for recipients to feel they have choices and continue to have some control over their lives.
2. Substance Abuse
Substance abuse issues are handled quite differently. The Portland area includes 40 substance abuse treatment providers and recipients are enrolled in 12 pre-paid health plans who work in conjunction with the Oregon Health Plan. To streamline the referral process, the District has hired two substance abuse clinicians to work on-site at each of the JOBS and welfare offices. (Next year, District 4 will hire an additional substance abuse counselor to work with adult recipients and a half-time counselor to work with teen parents.) Case managers refer recipients to one of the clinicians. It is the responsibility of the substance abuse clinicians to assess clients for chemical dependence, refer recipients to the most appropriate provider for the individual, monitor individuals in treatment, advocate for them if necessary and act as a liaison between the treatment agency and the JOBS case manager. It is also their responsibility to work together with all parties to determine and support client transition activities from treatment to active JOBS participation. Professional alcohol and drug assessments are mandatory if there is any reason to believe there may be an alcohol or drug problem (i.e., self-report, erratic behavior, alcohol on the breath, etc.). Further participation decisions are determined by the assessment results. If treatment is recommended, it is mandatory, with no exceptions. Participation in other JOBS activities during or after treatment is again determined by the recommendations of the alcohol and drug provider. A case manager can offer a recipient with a pattern of non-compliance the choice to meet with a substance abuse clinician before beginning the sanctioning process. However, they cannot mandate an assessment or treatment if they do not have actual evidence of a substance abuse problem (i.e., suspicion of substance abuse is not sufficient for a mandatory referral).
In theory, recipients can be referred for the full range of substance abuse treatment options, depending on their needs. However, in practice, treatment options are generally dictated by the services offered by a recipient's health plan. (All recipients in Portland receive health care through one of 12 pre-paid health plans.)
V. The Role of Sanctions
Because Oregon has a waiver that allows them to mandate participation in substance abuse or mental health services as a condition of participating in the JOBS program, sanctions play a unique role in Oregon's implementation of policies and programs to help recipients address these issues. However, it is important to note that this waiver is not necessary for all of the substance abuse and mental health services provided by the District offices in Oregon. As noted above, mental health services are rarely mandated. Rather, they are provided to recipients as an opportunity for helping them to address issues that may be keeping them from moving from welfare to work. Similarly, even though alcohol assessment and/or treatment can be mandated, many workers present substance abuse treatment as an opportunity for recipients to change their life.
Similar to other states that have shifted to more employment-focused welfare systems, sanctions play an important role in getting recipients to participate in program activities. One branch office in District 4 noted that they sanction many recipients for not attending the initial orientation for JOBS. They believe that implementation of a full family sanction would increase participation in program activities.
Funding for mental health and alcohol and drug treatment services for welfare recipients is included in the overall budget for the JOBS program which is financed with State Lottery and General Fund dollars. These funds are allocated by the State Legislature and matched to federal funds. The Districts then decide how much of their overall allocation will be spent to provide substance abuse and mental health services, allowing local Districts to develop service systems that respond to the needs of their recipients and take into account variation in local service delivery systems. Districts 2 and 4 spend a very small portion of their budgets on these services (two percent in the last fiscal year). In general, these costs reflect services to designed to provide JOBS recipients with better access to available services, rather than the full cost of providing services. For example, in District 2, money from the JOBS budget covers most, but not all, of the Medicaid match for mental health services. The salaries for two professional substance abuse counselors and a part-time clinical consultant are paid for with JOBS funds, but actual treatment services for substance abuse are provided through the Oregon Health Plan.
VII. Highlights of the Model
Inclusion of substance abuse and mental health services as integral component of the JOBS planning process and service delivery system.
Ongoing commitment to refine service delivery components and procedures over time.
Strong commitment to staff training and clearly delineating staff roles and responsibilities.
Maximum use of community resources.
Strong emphasis on employment.
Clear expectations and consequences.
Program Contacts: Christa Sprinkle (503) 256-0432 or April Lackey (503) 945-6122
Project Match of the Erikson Institute
The PRIDE Social Contract System
The PRIDE (Progress Information Directed Toward Employment) Social Contract System is a planning and tracking tool designed for line workers and administrators of state welfare departments. Over the last year research staff from Project Match have been piloting the PRIDE System in a local welfare office in Chicago. The PRIDE Social Contract System consists of an Activity Diary and a Computerized Tracking System. It is designed to be implemented by front-line eligibility or JOBS workers, providing them with the tools needed to help recipients define and embark on an individualized path to self-sufficiency. For recipients who are not prepared to participate in private sector employment or other structured JOBS activities, PRIDE relies on positive parenting activities and participation in activities within one's own community to build competencies needed to succeed in the workplace. Project Match research staff believe that by legitimizing activities that are valuable contributions to society, PRIDE has the potential to strengthen institutions within poor communities as well as individual families.
The PRIDE Social Contract System is based on the principles learned from Project Match, a research and welfare-to-work program that has been working with welfare dependent families in Chicago's Cabrini-Green housing development since 1985. More specifically, PRIDE provides specific tools for implementing Project Match's "Incremental Ladder to Economic Independence" (Attachment A) within the context of a welfare office that is shifting its emphasis from the provision of cash assistance to employment. Built into the Ladder and PRIDE is an acknowledgement that families have different strengths and different needs. Thus, unlike most JOBS programs, the PRIDE system is explicitly designed to accommodate the needs of recipients who are not ready to sustain full-time employment or more structured employment and training activities or are not ready to sustain high levels of time commitment.
When recipients enter a typical JOBS program, Project Match research staff note, they are likely to step onto the "middle rungs" of the Ladder, including such activities as 20 hours of education, training, job search, and other work preparation activities. Once people are working, they are considered to be on the "upper rungs." Those not ready for education, training or employment are generally exempted from program participation or are placed on the middle and upper rungs, where many of them do not succeed. To address the needs of this latter group of recipients, Project Match research staff have created the "lower rungs" as alternative first steps. Activities for this group of participants may include such activities as volunteering at Head Start, participation on a tenant management board or positive parental activities such as taking a child to the library. Implicit in the inclusion of these activities on the Ladder is an assumption that activities such as these can be used as stepping stones and indicators of movement toward economic independence. It is important to note also that the Ladder assumes progression over time, making these lower rung activities starting and not end points.
The principles underlying Project Match's Incremental Ladder provide important insight into the spirit in which the PRIDE Social Contract System has been piloted and is intended to be implemented :
- Every AFDC recipient can and should be required to be moving toward steady employment, as long as expectations are realistic and supports are available.
- There is not one best route out of welfare; each person must be given the opportunity to create her/his own pathway.
- To make sure that each person can create this unique pathway, there must be a broad enough array of activities - steps on the ladder - so that the person can step onto the ladder at a starting point that is not so high that she/he falls off, but high enough that it represents a competency not yet mastered.
- Once people step onto the ladder, they must be allowed, encouraged, and pushed to move to a higher step when there is evidence they are ready.
- When a person is experiencing difficulty in a self-sufficiency activity, she/he should be helped to move to a different setting, or to a lower step on the ladder, at least temporarily.
- Since assessment tools in the welfare-to-work field do not predict well who will succeed in which component, it is important that the initial assessment be tied to the initial placement, rather than to a long-term goal. It should not lock a person onto a particular track.
- Allowing people to start with individually appropriate time commitments is critical to their ability to make progress.
- To facilitate movement up the ladder, there should be flexibility around the length of time someone remains involved in a particular work activity rather than adherence to a predetermined number of months. This flexibility is especially important with those in the lower rung placement where hours and activities can change from month to month.
- Problems such as emotional instability should not be viewed unilaterally as barriers to work. For some they are; for others they are not. And for those for whom such problems function as barriers to work, clinical treatment should not be viewed as the only solution.
- Regular feedback to participants, both positive and negative (along with rewards and predictable consequences), is critical to keeping people moving along a career track toward steady work.
II. How PRIDE Works
The purpose of PRIDE is to translate the concept of a social contract based on mutual obligations into a productive relationship between each individual welfare recipient and the welfare department. PRIDE is designed to be responsive to the diverse needs of the welfare population and is grounded in a belief that the welfare system should have clear and reasonable expectations for each recipient. PRIDE provides the tools and procedures to support these expectations.
A. The Activity Diary -- the Heart of the PRIDE Social Contract System
The activity diary is the heart of the PRIDE system. The diary is a booklet that is to be completed each month by a JOBS participant and sent to the local welfare agency. The booklet includes (1) a self-assessment section, (2) a list of a broad range of activity options, (3) a section for recording and verifying participation in up to four activities per month, (4) a special section for GED test taking information, and (5) a section to record supportive services used.
The Diary serves several different purposes. First, it provides the front-line worker with a concrete tool for helping a recipient to develop a month by month activity plan. The tool is extremely flexible, making it possible to tailor a plan to be responsive to an individual's situation as it changes over time. Second, it provides recipients with information on the broad range of activities they can participate in and provides them with a tool for tracking their own progress. Appropriate activities are determined jointly between the worker and the recipient. According to Project Match research staff, filling out the diary helps the participant to be more self-reflective about what she is doing, but it is also a very specific and manageable task that gives the participants "practice" in fulfilling responsibilities and adhering to a schedule. Third, the PRIDE system provides an easy way to monitor a recipient's progress on a month by month basis and over time. The booklet is to be completed each month by the JOBS participant and sent to the local welfare agency. If the PRIDE system is implemented as designed, the participant would be subject to a sanction if the diary was not received by the welfare agency or if a recipient fails to fulfill the activities she or he has committed to (or alternative activities if a recipient is unable to follow through with her planned activities).
In the pilot project currently being undertaken in Chicago, recipients can participate in employment, pre-employment, education and training, volunteer, parent/child and family development activities (i.e., substance abuse treatment or mental health counseling) to fulfill their participation obligation. Recipients are required to pick up a new PRIDE Diary by the first day of the month. During the month, they are required to track the activities they participate in and enter them under the correct date. By the end of the month, they are required to have each activity in their plan verified. They are also asked to fill out the Self-Assessment section before mailing it to their worker. Their worker must receive the diary by the 10th of the month. On the last Tuesday of each month, recipients are required to attend a two hour monthly group meeting. The meeting is an opportunity for recipients to report on the activities they have participated in, to get feedback from the worker and others in the group on her progress and to create a new plan for the next month. Monitoring progress in a group setting substantially reduces the time a worker must devote to meeting with individual recipients but also provides a supportive environment in which recipients can begin to prepare to enter the labor market.
B. The PRIDE Tracking System
The PRIDE system is designed to provide line workers and administrative staff with information quickly on recipients' activities and progress. Thus, the PRIDE Tracking System is an integral part of the PRIDE Social Contract System. When fully operational, all of the data in the Diary will be entered into the PRIDE computer program, then will be processed and stored in the PRIDE database. The PRIDE computer programs will then be designed to create a variety of reports, some providing longitudinal information for each recipient and some providing aggregate information for all PRIDE participants. The Tracking System is designed to provide individual workers and administrators with ongoing information that can be used to monitor individual and program progress, emphasizing individual achievements and setbacks.
III. The Role of Sanctions
The PRIDE Social Contract system is designed to be implemented in a mandatory setting. Recipients can be sanctioned for failure to meet their monthly obligations. However, the obligations are designed to promote family well-being and self-sufficiency and not to be punitive. The flexibility of the PRIDE system allows recipients to participate in other activities if those planned do not work out. Thus, only those people who refuse to try to improve their lives in any way are likely to be sanctioned. Because the system is designed to monitor a recipient's progress on a monthly basis, it has the potential to eliminate long periods of inactivity with no intervention.
The PRIDE Social Contract System is relatively inexpensive to implement. It is a tool that is designed to support efforts to redirect the work of income maintenance staff from processing checks to promoting family well-being and family self-sufficiency. The flexibility of PRIDE makes it possible to be used in a variety of different settings as a support to work that is already being done. Monitoring of participant progress can be done either individually or in a group. Thus, it is possible to use the PRIDE system within an already existing individualized case management system. Being able to implement the PRIDE system in group setting makes it feasible to implement the system in welfare offices where workers carry large caseloads. The pilot project in Chicago is being funded by the Annie E. Casey Foundation and three Chicago businessmen.
V. Highlights of the Model
Attention to "lower rung" activities.
Use of neighborhood and parenting activities to build work-based competencies.
Relatively inexpensive to implement.
Program Contact: Ria Majeske (312) 755-2250, ext. 2297
Utah's Single Parent Employment Demonstration Project
Utah's welfare reform project, The Single Parent Employment Demonstration Project (known in the state as the Single Parent Demo), approved in 1992, was one of the first welfare reform demonstration projects to be approved by U.S. DHHS. Central to Utah's effort to reform the welfare system is a requirement that all welfare recipients participate in work or work-related activities, a feature that distinguishes Utah's welfare reform effort from all other initiatives implemented to date. The only recipients exempt from participating in program activities are children under the age of 16 and persons not included in the AFDC grant (recipients of Supplemental Security Income (SSI), relatives caring for another family member's child or illegal aliens). This means that recipients with infants as well as recipients with various potential barriers to employment (i.e., medical problems, substance abuse or domestic violence issues) are all required to develop a plan for becoming self-sufficient. Over time, this requirement, along with a commitment on the part of administrators and staff to achieve full participation, has resulted in sustained attention to the problems and needs of harder-to-serve recipients.
Utah's emphasis on employment and identification of potential barriers to employment begins with a family's initial contact with the welfare office where families apply for self-sufficiency assistance rather than cash benefits. As a part of this up-front self-sufficiency planning process, families are "diverted" from assistance whenever possible. Families who are diverted can receive up to the equivalent of three months of cash assistance and are eligible for all transitional benefits available to AFDC recipients. To address the diverse personal needs and life circumstances of those recipients who are not diverted from AFDC, self-sufficiency activities are defined broadly. Activities such as mental health counseling, substance abuse treatment or parenting classes are included in the broad array of activities available to help recipients become self-sufficient.
Job-ready recipients are encouraged to enter the paid labor market immediately and are rewarded for doing so while recipients with significant barriers to employment are provided with more individualized attention over a longer period of time with the goal of facilitating sustained progress towards self-sufficiency. Recipients may participate in education or training, but are often required to combine these activities with part-time employment. A recipient who is unable to work or attend school may participate in activities such as mental health counseling or substance abuse treatment until they are able to seek employment. Underlying this approach to reform is a belief that some recipients have one or more barriers that make it impossible for them to immediately find or sustain employment, but that with the appropriate investment of resources these problems can be alleviated over time, making it possible for these families to eventually become self-sufficient. In short, Utah's approach to reform requires those recipients who can work to do so almost immediately, but it does not assume that all recipients can or will find employment if they are simply required to do so.
From its inception, Utah's approach to reform was designed to be responsive to individual needs and circumstances. Nonetheless, staff at all levels -- from state officials to line workers -- feel they were totally unprepared for how difficult it would be to address the problems faced by some of the families they are now working with, especially those families with multiple problems. In hindsight, staff are regretful that they converted the families from the ongoing AFDC caseload into the new program so quickly. Staff feel that in the rush to implement, the recipients who needed the most assistance to make the transition to the new program received the least amount of support. Even though data suggests that staff have been successful in moving longer-term recipients into employment, these cases have been the most difficult for staff to work with. Administrators report that staff find it extremely frustrating to work with these families because progress towards self-sufficiency is often measured in very small steps. Staff also feel like they are in uncharted territory, often having to rely on trial and error to identify the best strategy for helping a family overcome their barriers to employment.
II. The Prevalence of Barriers to Employment
Data from a case record review on the presence of barriers among recipients in Kearns, an office that serves one of Utah's most urban areas, shows that barriers to employment were common, especially among longer-term recipients. Multiple barriers distinguished longer-term recipients more than the presence of any one barrier. For the full sample (109 cases) of recipients, 62 percent experienced at least one barrier to employment including not having a work history, children's behavior problems, family violence, homelessness, temporary medical problems or pregnancy, chronic medical problems or a disability, chemical dependency or mental health issues. Among recipients who received assistance almost continuously for the first two years of the demonstration project, 71 percent experienced at least one of these barriers. These longer-term recipients were almost twice as likely to experience three or more barriers to employment: 35.5 percent of longer-term recipients experienced this many barriers compared to 18.4 percent of the full sample. Specific barriers that were common among longer-term recipients included no work history (25.8 percent), temporary medical problems (29 percent), chronic medical problems or disabilities (19.4 percent), chemical dependency (22.6 percent) and mental health issues (25.8 percent). With the exception of chemical dependency, all of these barriers were far more common among longer-term recipients than among the sample as a whole.
III. Strategies for Identifying Recipients in Need of Specialized Services
Self-sufficiency workers have the primary responsibility for working with a recipient to develop a self-sufficiency plan and for monitoring compliance with the plan. Workers note that it usually takes time for a recipient to develop a relationship with a self-sufficiency worker and often it is only after trust has developed that a recipient reveals personal or family issues that may be impeding their progress towards self-sufficiency.
To better address the needs of recipients who are not progressing towards self-sufficiency, Utah uses "case staffings," a formal team-oriented procedure for reviewing these cases. These cases may include families experiencing mental health problems, domestic violence, chronic physical and mental ailments who are likely to be eligible for SSI benefits and cases involved in child protective services. The case staffings provide a structured mechanism for a worker to receive input on different strategies that might be employed to help a recipient move toward self-sufficiency. In some instances, a case may also be transferred to a new worker (if there are personality conflicts between the client and the worker, if the worker is too involved in the case or if another staff has expertise in an area that may be particularly helpful) or to a specialized worker who is more skilled in addressing the problems of the case.
Staff are trying to do a better job of using case staffings to intervene in difficult cases as early as possible. Based on an internal analysis of their caseload, staff found that recipients who have not obtained employment by the end of six months have a high probability of becoming long-term cases. Thus, they are paying particular attention to these cases by routinely bringing them to a case staffing in the seventh month of receiving benefits.
IV. Services Provided to Recipients in Need of Additional Assistance
Even though staff would be the first to admit that they have a long way to go in identifying the best techniques for helping families with multiple barriers to leave the welfare rolls, over time, Utah has devoted considerable time and energy to try and understand the situations faced by the recipients who have not left the welfare rolls and have attempted to develop specific strategies for working with these recipients. These strategies include: (1) hiring specialized staff who carry smaller caseloads; (2) developing a short-term treatment program; (3) co-locating mental health and substance abuse treatment staff in the welfare office.
A. Specialized Staff
When Utah's demonstration project was first implemented in the Kearns office, the managers designated one of their new staff positions to be a "treatment worker" -- someone who would have more skills and training for addressing more serious mental health and family problems than the typical AFDC worker. (In general, these staff have a Master's in Social Work or the equivalent.) Over time, Kearns has increased the number of treatment workers (also referred to as specialized workers) and has tried to make better use of their skills. Other offices have also hired specialized workers when they have implemented the Single Parent Employment Demonstration Project. Because these staff work very intensively with recipients, they carry very small caseloads, no more than 30 to 35 cases. (Regular workers carry caseloads of about 65 to 70 cases). Treatment workers conduct home visits for recipients not participating in the program, provide one-on-one counseling and try to link recipients with resources in the community (i.e., mental health or substance abuse programs) that will help them to achieve self-sufficiency. They also act as a resource for other staff who may be having problems moving some of their cases into employment.
Specialized staff use a model of "brief therapy" to work with recipients who are in need of more extensive counseling and support. Brief therapy is designed to be time-limited, generally involving only eight to 10 sessions. Staff generally use brief therapy to focus on resolving one issue that is keeping a recipient from finding or keeping employment. Even though staff work with recipients in a counseling role, their focus is specifically on helping recipients to resolve issues that are hindering their progress towards self-sufficiency. They acknowledge they cannot "fix" their clients' lives and that part of becoming self-sufficient is learning to manage the personal or family challenges that make it difficult for them to secure or keep employment.
B. Group Counseling
Over time, staff in Kearns found that there were few resources they could draw upon in the community for help with the supportive service needs of their most difficult cases. Recipients in need of mental health services often must spend long periods of time on waiting lists before they can receive assistance. There are not enough shelters for women in abusive situations and the local centers for women in crisis are always full. There are very few in-patient programs for mothers with drug and alcohol addiction and the private facilities are too expensive. These are major barriers for women with little money and nowhere to place their children while they are in treatment. To provide at least some resources for recipients in need of these kinds of services, the regional office has developed a group counseling program to provide services to some of their harder-to-serve cases with mental health problems in a short-term (eight to 10 week) structured setting. The program focuses on reaching those who are not served by other mental health services and purposely avoids addressing long-term mental health issues. The program is always filled to capacity. Staff believe the program both is needed and valuable and would like to see it expanded.
C. Co-location of Substance Abuse and Mental Health Staff
Over time, Utah has been expanding the Single Parent Employment Program to additional offices across the state. As they have done so, they have started to co-locate substance abuse and mental health providers directly in the welfare offices. This co-location provides an important link to services already available within the community. Utah also co-locates staff from the Employment Service in all of its welfare offices. Co-location of mental health and substance abuse services is viewed as important as the co-location of employment services.
V. The Role of Sanctions
Utah's mandate to participate in program activities is reinforced with strong financial penalties and incentives. Recipients who participate in program activities full-time receive a $40 incentive payment. Recipients who fail to participate in program activities have $100 deducted from their grant ($414 for a single-parent family with two children) for two months then lose eligibility for cash assistance, making it the most stringent financial penalty for non-participation implemented to date. Once a family loses eligibility for assistance because of non-participation, they can requalify for assistance only after participating in specified program activities (such as orientation or community work experience). To ensure that recipients understand the participation requirement and that staff are available to assist with removing any barriers to participation, an extensive conciliation policy has been adopted which includes specialized workers, home visits, an agency hearing and other efforts to encourage participation and ensure an informed choice on the part of the participant. These efforts must be undertaken before placing a recipient in a non-participation status.
The rigorous conciliation process required before a family's cash assistance can be eliminated has provided staff with an additional mechanism for providing families with the resources they need to be able to participate in the Single Parent Employment Program. While conducting home visits required as a part of the conciliation process, staff have uncovered serious mental health problems, communication problems and other family and personal issues that were keeping families from participating.
VI. Cost and Funding
The assistance Utah provides to families who need more assistance to become self-sufficient is primarily provided through more intensive contact between a family and a case manager. Thus the costs associated with providing services to these families is primarily the incremental cost of hiring a professionally trained case manager and the cost of maintaining a smaller than average caseload. In general, Utah has been able to fund these positions by redirecting savings that have accrued through implementation of other components of the demonstration project.
V. Highlights of the Model
Ongoing commitment to engage the full AFDC caseload in self-sufficiency activities.
Strong emphasis on employment as the ultimate goal.
Willingness to continually reassess progress and make adjustments when necessary.
Emphasis on mutual responsibility.
Maximum use of community resources.
Program Contacts: Connie Cowely (801) 538-4337 or Helen Thatcher (801) 538-8231