oversight

Welfare Reform: Information on Former Recipients' Status

Published by the Government Accountability Office on 1999-04-28.

Below is a raw (and likely hideous) rendition of the original report. (PDF)

                 United States General Accounting Office

GAO              Report to the Chairman, Committee on
                 Finance, U.S. Senate, and the Chairman,
                 Subcommittee on Human Resources,
                 Committee on Ways and Means, House
                 of Representatives
April 1999
                 WELFARE REFORM
                 Information on Former
                 Recipients’ Status




GAO/HEHS-99-48
      United States
GAO   General Accounting Office
      Washington, D.C. 20548

      Health, Education, and
      Human Services Division

      B-281749

      April 28, 1999

      The Honorable William V. Roth, Jr.
      Chairman, Committee on Finance
      United States Senate

      The Honorable Nancy Johnson
      Chairman, Subcommittee on Human Resources
      Committee on Ways and Means
      House of Representatives

      In recent years, states have reformed their welfare programs for needy
      families with children by strengthening and strongly enforcing work
      requirements for adults and imposing time limits on the receipt of cash
      assistance. During the same time period, the nation has experienced
      strong economic growth, and cash assistance caseloads have declined by
      40 percent—from their peak of about 5 million families in 1994 to 3 million
      families as of June 1998. Many of the reforms, begun as demonstrations
      under the Aid to Families With Dependent Children (AFDC) program, were
      incorporated into federal welfare legislation—the Personal Responsibility
      and Work Opportunity Reconciliation Act of 1996 (PRWORA). PRWORA ended
      the federal entitlement to assistance for eligible needy families with
      children under AFDC and created the Temporary Assistance for Needy
      Families (TANF) block grant, which makes $16.8 billion available to states
      each year through 2002 and is overseen by the Department of Health and
      Human Services (HHS) at the federal level. Specified goals of TANF include
      providing assistance to needy families so that children may be cared for in
      their own homes or in the homes of relatives; ending the dependence of
      needy parents on government benefits by promoting job preparation,
      work, and marriage; preventing and reducing the incidence of
      out-of-wedlock pregnancies; and encouraging the formation and
      maintenance of two-parent families. To help states achieve TANF goals,
      PRWORA gives the states increased flexibility over the design and
      implementation of their welfare programs; however, states are required to
      impose work requirements and enforce a 5-year lifetime limit on the
      receipt of federal assistance.

      These changes in welfare programs, designed to decrease dependency,
      combined with the dramatic declines in welfare caseloads, have generated
      interest among program administrators, state and local policymakers,
      welfare advocates, and the public in general about the condition of




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                   families no longer receiving cash assistance under AFDC or TANF.1 Given the
                   importance of knowing what has happened to the parents and children of
                   families who have left welfare, and to better understand states’ progress in
                   meeting TANF goals, you asked us to report on what is now known about
                   families no longer receiving welfare. Because there are no federal
                   requirements for states to report on the status of former welfare
                   recipients,2 the only systematic data currently available on families who
                   have left welfare come from research efforts initiated by states to meet
                   their own information needs. As you requested, we (1) determined the
                   extent to which states have reported information on the condition of
                   families who have left welfare in the following key areas: economic status,
                   family composition, and family and child well-being; (2) determined from
                   generalizable state studies what is known about the status of former
                   welfare families in the key areas; and (3) identified federal and state
                   efforts to improve the usefulness of the data obtained through these state
                   efforts.

                   To do this work, we collected and examined reports—published by
                   September 30, 19983—that were based on studies conducted or sponsored
                   by states of families who left the AFDC or TANF rolls during or after 1995.
                   We also spoke with state officials in the states that had published reports
                   and with HHS officials, and we reviewed documents from several
                   organizations that are monitoring states’ efforts to study former welfare
                   families. We conducted our work between July 1998 and April 1999 in
                   accordance with generally accepted government auditing standards. (See
                   app. I for a more detailed discussion of how studies were identified,
                   assessed, and compared.)


                   Seventeen states have published information on the status of their families
Results in Brief   who have left welfare.4 Each of these states reported on the economic
                   status of former welfare recipients, and the majority reported on family

                   1
                    For the purposes of this report, the term “welfare” refers to cash assistance received under AFDC or
                   TANF.
                   2
                    PRWORA makes $1 billion available over 5 years to reward states that achieve high performance
                   levels in meeting TANF goals. HHS has determined that the fiscal year 1999 High Performance Bonus
                   will be based in part on job retention rates and the earnings gain rates of adults leaving welfare,
                   outcomes that require states that choose to compete for the bonus to follow up with former welfare
                   recipients who obtained employment.
                   3
                    For the states that had published reports by this date, we included additional information as it became
                   available, including more recent reports and data.
                   4
                    These states are Idaho, Indiana, Iowa, Kentucky, Louisiana, Maryland, Michigan, Montana, New
                   Jersey, New Mexico, Oklahoma, Pennsylvania, South Carolina, Tennessee, Washington, Wisconsin, and
                   Wyoming.


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composition and family and child well-being. The studies differed,
however, in important ways, including the categories of families studied,
geographic scope, the time during which families who had left welfare
were tracked, and the extent to which the families for whom data were
available are representative of all families in the sample. Taking these
factors into account, we determined that studies from only 7 of the 17
states had enough information on a sample of families to generalize
findings to most families who had left welfare in the state at the time of
the study.

These seven states’ studies reported that most of the adults in families
remaining off the welfare rolls were employed at some time after leaving
welfare. However, significant numbers of families also returned to the
rolls. In the three studies that reported the information, from 19 to
30 percent of the families who left welfare returned to the rolls at some
time during the follow-up period. Although the seven states’ studies
generally had limited data on total household income, five reported that
many families who had left welfare subsequently received noncash public
assistance such as Medicaid and food stamps, indicating that families’
incomes were low enough to keep them eligible for these forms of
government assistance. None of the studies reported on changes in family
composition resulting from marriage or pregnancy after leaving welfare.
Regarding measures of well-being, six states’ studies included data on
homelessness or separation of children from their parents and reported no
indication of increased incidence of these outcomes at the time of
follow-up.

Efforts are under way at both the federal and state levels to improve the
usefulness of the data being collected to assess the status of former
welfare families. Most states either are currently studying or plan to study
former welfare families, and HHS has recently funded 14 projects to track
and monitor families who have left welfare. The projects will cover
families who leave welfare in 10 states, five counties in 2 other states, and
the District of Columbia. These jurisdictions, which include three of the
states whose studies are reviewed in this report, will receive technical
assistance through HHS and from other states on developing their tracking
efforts. State officials in many of the states whose studies we reviewed
said they plan to continue studying former welfare families, in some cases
with additional HHS support, but also on their own. Maryland, for example,
plans to conduct a telephone interview of a sample of former welfare
families to get more in-depth information on such items as the factors that
helped families leave welfare, and Idaho is trying to locate additional



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             families who have left welfare in order to increase the ability of the data to
             support conclusions about the population of families leaving welfare in
             that state. In the future, these ongoing state efforts, many supported by
             HHS, should provide a more complete picture of the status of families who
             have left welfare.


             Under the AFDC program, many states received waivers from federal rules
Background   to strengthen work requirements for adults. In addition, some states began
             experiments with time limits on receiving cash assistance. Under TANF,
             states generally must impose work and other program requirements on
             most adults receiving aid and, when an adult does not comply, reduce a
             family’s benefit or, at state option, terminate the benefit entirely.
             Moreover, families receiving TANF face a lifetime limit of 5 years, or less at
             state option, of federal assistance. These reforms represent significant
             departures from previous state and federal policies for needy families with
             children and have been accompanied by large declines in the number of
             families receiving cash assistance, from an all-time high in 1994 of about
             5 million families to just over 3 million as of June 1998.

             While numerous efforts are planned or under way to assess welfare reform
             nationally, currently little information is available on the status of families
             who have left welfare. Although families have always left welfare for a
             variety of reasons, including increased household income due to
             employment or marriage,5 once their cases were closed and the families no
             longer received assistance, they usually were not routinely tracked or
             monitored.6 However, in the new environment in which eligible needy
             families are no longer entitled to cash assistance and the emphasis is on
             moving families off welfare into employment, concern about the condition
             of families no longer receiving aid has increased. The Congress and others
             are interested in the employment status of former welfare recipients,
             changes in family composition resulting from marriage and pregnancy, and
             the overall well-being of these families and their children. While the
             Congress has earmarked $5 million for HHS to study the outcomes of
             welfare reform and has taken other steps to monitor the status of poor
             families as discussed below, states are not federally required to report on
             the condition of former welfare families.

             5
              See, for example, Mary Jo Bane and David T. Ellwood, The Dynamics of Dependence: The Routes to
             Self-Sufficiency (Cambridge, Mass.: Urban Systems Research and Engineering, 1983) and LaDonna
             Pavetti, The Dynamics of Welfare and Work: Exploring the Process by Which Women Work Their Way
             Off Welfare (Cambridge, Mass: Ph.D. dissertation, Harvard University, 1993).
             6
              Families have been tracked in the past if they were involved in a program evaluation or other targeted
             research effort.



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States’ greater responsibility for welfare programs under PRWORA has
increased states’ need for information to support program management
and decision-making, as well as to respond to the information requests
from a variety of interested parties, such as service providers, advocacy
groups, and the media. For example, some state legislatures are requiring
state welfare agencies to report on outcomes from their reformed welfare
programs, including the status of former welfare families. Consequently,
many states have begun to track former welfare families.7 The data these
states are reporting are the major source of information currently available
on the condition of families who have left welfare.

Only those families who actually become welfare recipients and then leave
the rolls are included in most state tracking studies. However, the changes
in welfare can also have the effect of decreasing the number of families
coming onto the welfare rolls. For example, many states have diversion
strategies designed to prevent families from coming onto the welfare rolls
by providing a needed service, such as child care or transportation,
providing a one-time cash payment to overcome a barrier to employment,
or requiring that applicants conduct a job search before receiving cash
assistance.8 As a result, a comprehensive assessment of the postreform
status of poor families with children would include information on
TANF-eligible families who did not become welfare recipients as well as
former welfare recipients.

To provide information on the postreform status of all low-income
families, not just former welfare families, the U.S. Census Bureau at the
direction of the Congress is conducting a longitudinal survey of a
nationally representative sample of families, paying particular attention to
eligibility and participation in welfare programs, employment, earnings,
out-of-wedlock births, and adult and child well-being. Data from this
survey, called the Survey of Program Dynamics, will help researchers and
policymakers understand the impact of welfare reform on the well-being
of low-income families and children by providing information on whether
welfare recipients are finding jobs, what their earnings are, and what types
of support they need to make the transition from welfare to work. In

7
 In this report, we use the terms “track” and “tracking” to refer to efforts to collect information on
families who have left welfare, regardless of whether data have been collected one time only or over
time.
8
 See Welfare Reform: States Are Restructuring Programs to Reduce Welfare Dependence
(GAO/HEHS-98-109, June 18, 1998); Richard P. Nathan and Thomas L. Gais, Overview Report:
Implementation of the Personal Responsibility Act of 1996 (Albany, N.Y.: Federalism Research Group,
The Nelson A. Rockefeller Institute of Government, Oct. 1998); and Kathleen Maloy and others, A
Description and Assessment of State Approaches to Diversion Programs and Activities Under Welfare
Reform (Washington, D.C.: The George Washington University, Aug. 1998).



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                            addition, the Urban Institute is conducting a multiyear project monitoring
                            program changes and fiscal developments, along with changes in the
                            well-being of children and families.9 As part of this project, the Urban
                            Institute has surveyed nearly 50,000 people to obtain comprehensive
                            information on the well-being of adults and children as welfare reform is
                            being implemented in the states. A second survey is planned for 1999. Full
                            results from the Census Bureau and Urban Institute surveys may not be
                            available until the year 2000. In addition, a plethora of studies are under
                            way that will be providing information in the future on various aspects of
                            welfare reform.10


                            Seventeen states have collected data and reported on the status of some
State Studies               former welfare families in the key areas of economic status, family
Reported Some               composition, or family and child well-being. The state studies differed in
Information on the          important ways, such as categories of families tracked, the length of time
                            families were tracked, and the sources of follow-up data. Some of the
Status of Families          studies presented no information on a substantial portion of the sample
Who Have Left               families, limiting the usefulness of these studies for drawing conclusions
                            about the status of most former welfare families in the state. We
Welfare                     determined that studies in 7 of the 17 states had enough data on a sample
                            of families who had left welfare to generalize sample findings to the
                            population of former welfare families from which the sample was drawn.


Seventeen States Reported   We identified a total of 18 state-sponsored or -conducted studies in 17
Some Information on         states—2 studies in Wisconsin and 1 in each of the other states—that
Economic Status, Family     reported on the status of families who left welfare in 1995 or later. The
                            reports contain a broad range of information on economic status, family
Composition, or Family      composition, and family and child well-being. Figure 1 summarizes the
and Child Well-Being        kinds of information reported in each of the 17 states and classifies the
                            information according to the three major areas of interest. All of the
                            studies reported information on economic status, all but one reported on
                            family and child well-being, and most reported some information on family

                            9
                             The Urban Institute, a research organization located in the District of Columbia, is conducting a
                            multiyear project designed to analyze the devolution of responsibility for social programs from the
                            federal government to the states, focusing primarily on health care, income security, job training, and
                            social services. Initial results from the 1997 National Survey of America’s Families are available at the
                            Urban Institute’s Web site at www.urban.org. The survey is representative of the nonelderly population
                            in the nation as a whole and in 13 states: Alabama, California, Colorado, Florida, Massachusetts,
                            Michigan, Minnesota, Mississippi, New Jersey, New York, Texas, Washington, and Wisconsin.
                            10
                              For a list of completed and ongoing studies of welfare reform, see the Web site
                            www.researchforum.org, created and maintained by the Research Forum on Children, Families, and
                            the New Federalism, National Center for Children in Poverty, 154 Haven Avenue, New York, N.Y.
                            10032-1180.


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composition. Overall, 15 of the 17 states reported information in all three
areas. (App. II lists the 17 states and their study reports.)




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Figure 1: Categories of Information Reported in State Studies of Former Welfare Families




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                                   a
                                    The Louisiana study included information on families leaving welfare in metropolitan New Orleans
                                   only.
                                   b
                                       Two studies were conducted in Wisconsin.
                                   c
                                   Idaho measured this variable, but the variable was not discussed in its report.
                                   d
                                    South Carolina reported separately on this variable in “Child Maltreatment Among Former Clients
                                   of the South Carolina Family Independence Program,” Oct. 1998.
                                   e
                                    Tennessee performed an additional study of child well-being for a nonrepresentative sample of
                                   children whose parents had left the state’s welfare program between Dec. 1996 and Feb. 1997
                                   that includes information on emotional, economic, and motivational well-being.




Studies Differed in                Because states generally initiated tracking studies to meet their own
Coverage, Timing, and              information needs, the 18 studies in the 17 states differed in a number of
Data Sources                       important ways, including the categories of families tracked, geographic
                                   coverage, the time periods covered, and the timing and frequency of
                                   follow-up. The studies also differed in the sources of data used for
                                   tracking families who had left welfare. Table 1 summarizes key
                                   information on the studies, including the categories of families studied, the
                                   time periods involved, the frequency of follow-up, the time between
                                   leaving and follow-up, and the method of data collection.

Table 1: Key Ways in Which State
Studies Differed                   Categories of families
                                   and time periods                               Follow-up                    Data collection
                                   involved                         Frequency      Timing                      method(s)
                                   Idaho
                                   Families who left TANF           Twice          6 to 12 and 13 to 24        Mail survey
                                   July to Dec. 1997                               months after exit
                                   Indiana
                                   Families receiving AFDC          Once           12 to 18 months after       Telephone survey
                                   May 1995 to May 1996                            enrollment
                                   who subsequently left
                                   AFDC
                                   Iowa
                                   AFDC families assigned to Once                  8 to 12 months into         Telephone survey,
                                   or who volunteered for the                      assignment                  in-person interviews,
                                   Limited Benefit Plana Nov.                                                  case studies, and
                                   1994 to Apr. 1995                                                           review of
                                                                                                               administrative data
                                   Kentucky
                                   Families who left TANF           Once           1 to 11 months after        Telephone survey
                                   Jan. to Nov. 1997                               exit
                                                                                                                          (continued)




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Categories of families
and time periods                        Follow-up                Data collection
involved                    Frequency     Timing                 method(s)
Louisiana
Families in metropolitan    Once          1 to 4 months after exit Telephone survey
New Orleans who left
TANF Jan. to Mar. 1998
Maryland
Families who left TANF      Quarterly     Up to 12 months after Review of
Oct. 1996 to Sept. 1997                   exit                  administrative data
Michigan
Families whose AFDC       Biannually      3 and 6 months after   In-home interviews
benefits were terminated                  exit                   and review of
in Apr. 1996 because they                                        administrative data
did not comply with
program rules
Montana
Families who received or    Once            Up to 22 months after Telephone survey and
left AFDC or TANF Mar.      (survey) or     exit                  review of
1996 to Sept. 1997          monthly                               administrative data
                            (administrative
                            data)
New Jersey
Families whose TANF       Once            1 to 2 months after exit Telephone survey
benefits were terminated
Jan. to Feb. 1998 because
of failure to comply with
program rules
New Mexico
                                          b
Families who left AFDC      Once                                 Mail survey
July 1996 to June 1997
Oklahoma
Families who left or were Once            2 to 18 months after   Telephone survey
denied TANF Oct. 1996 to                  exit or denial
Nov. 1997
Pennsylvania
Families who left TANF      Once          1 week to 11 months    Telephone survey
Mar. 1997 to Jan. 1998                    after exit
South Carolinac
Families with a household   Once          9 to 14 months after   Telephone survey and
member required to seek                   exit i                 some in-person
employment who left                                              nterviews
TANF July to Sept. 1997
and had not returned at
time of follow-up
                                                                            (continued)




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Categories of families
and time periods                                Follow-up                    Data collection
involved                           Frequency     Timing                      method(s)
Tennessee
Families who lost TANF     Once                  Approximately 3             Telephone survey
benefits Jan. to Oct. 1997                       months after exit
because they did not
comply with program rules
and TANF families whose
head was employed full-
or part-time Feb. to Oct.
1997
Washingtonc
Single-parent families who Once                  2 to 4 months after exit Telephone survey and
left TANF Apr. to July 1998                                               review of
                                                                          administrative data
Wisconsin
Single, female-headed              Five times    Quarterly for 5             Review of
families who left AFDC                           quarters after family       administrative data
July 1995 to July 1996                           left welfare
Families who left                  Once          5 to 10 months after        Telephone survey and
AFDC/TANF Jan. to Mar.                           exit                        in-person interviews
1998 and did not return
prior to survey
Wyoming
Families who left TANF             Once          1 to 15 months after        Telephone survey
Dec. 1996 to Feb. 1998                           exit

a
 The Limited Benefit Plan was part of Iowa’s welfare reform initiated under waiver. It was a
short-term alternative assistance program for AFDC recipients who did not comply with program
rules and for some volunteers. Families in the Limited Benefit Plan received reduced cash
benefits that were subsequently terminated for a fixed period of time, after which the family could
reapply for benefits.
b
    Information not provided in report.
c
 South Carolina and Washington reported on groups of families who had left welfare earlier. We
included the most recent sample in our summary.

Source: GAO analysis of state studies.



Fourteen of the studies reported data on a statewide sample of families
who left welfare for a range of reasons, and one study reported on a
sample of families who left welfare in the state’s major city. The remaining
three studies focused primarily on families who left welfare because of an
adult recipient’s failure to comply with program requirements. These three
studies were conducted, at least in part, because of concerns about the
potential impact on family well-being of the loss of the entire cash benefit,




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rather than just a reduction in benefits, as was typically required under
AFDC for noncompliance.


None of the studies reported specifically on families who had left welfare
because of time limits. While there is great interest in the status of these
families, in most states few families have reached their time limits, and in
states where they have, few families have lost benefits as a result of the
time limits.11 However, as states’ programs mature and more families
reach the federal 5-year time limit on TANF benefits or state-established
time limits of shorter duration, more of these families will be included in
the tracking studies.12

The studies also differed in the time period during which families left
welfare and the length of time between the family’s exit and the study
follow-up. The time at which states initiated a study of families who had
left welfare depended in part upon when states’ reforms were
implemented and when they needed information on the status of families
affected by the reforms. The time periods of the 18 state studies ranged
from as early as 1995 (before federal welfare reform) to as late as 1998
(after TANF was implemented in most states). The amount of time between
leaving welfare and the follow-up also varied, ranging from 1 to 24 months.
There were also differences in the frequency of follow-up. At least one
state, Maryland, has been tracking families who have left welfare for a
number of years and plans to track monthly samples of families for 2 years
after they leave the rolls, whereas other states planned a one-time
follow-up effort.

In addition, the studies used different sources of data to locate and track
families. The Maryland study and the first Wisconsin study relied solely on
administrative data, while other states’ studies were based on surveys of
the former recipients using in-home visits, the telephone, or the mail.
Some states’ studies used both survey and administrative data.
Administrative data are case-specific information from the files of various
programs, services, or agencies, including state unemployment insurance,
food stamps, Medicaid, child welfare, child support enforcement, and


11
  As part of its overall evaluation of Florida’s Family Independence Program, the Manpower
Demonstration Research Corporation conducted interviews with 25 families 6 months after the
families lost benefits because of time limits. At least half of the 25 families reported that since their
benefits had expired it had become more difficult to make ends meet. In general, however, there was
no evidence of major changes in housing status or living arrangements, nor was there evidence that
most respondents lacked the means to buy food.
12
 The Manpower Demonstration Research Corporation is also conducting a cross-state study of
welfare time limits in Florida, Vermont, and Wisconsin.



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                           criminal and education agencies. Since administrative data are limited to
                           data collected for program management purposes, they may not be as
                           focused on the questions of interest as are the survey data. On the other
                           hand, administrative data may be less expensive to collect and more
                           accurate than the self-reported data and can more readily than a survey
                           provide information on large numbers of individuals.


Findings From Most State   We determined that eight tracking studies, covering seven states, (1) were
Studies Were Not           designed to include most families who left welfare in the state at the time
Generalizable to the       of the study and (2) had sufficient data on the sample of families tracked
                           for the sample to be considered representative of families studied.13 These
Population of Former       studies were designed to include families who left welfare for a range of
Welfare Families in the    reasons, although the studies varied in the specific category of families
State                      covered. For example, the Maryland study included all families who had
                           left welfare, while the South Carolina study included only families with a
                           household member required to seek employment who subsequently left
                           welfare and had not returned at the time of follow-up.

                           Although none of the 18 studies were able to locate all families included in
                           the samples to be tracked, eight studies had sufficient data on a sample of
                           families to conclude that the sample represented the population from
                           which it was taken. The nonresponse rates ranged from 15 to 88 percent
                           for the state surveys. For the two studies using administrative data only,
                           information about 8 percent and 18 percent of the families being tracked
                           could not be found in the data being used. (See app. I for the proportion of
                           families located in all 18 studies.)

                           Missing information for some members of a sample raises concerns about
                           the representativeness of the remaining sample and whether findings can
                           be generalized to the population from which the sample was drawn.
                           Families who left welfare and subsequently responded to a survey and
                           families about whom information was available in administrative data may
                           be different in important ways from families for whom no information is
                           available; thus, results based on such families are not generalizable to the
                           entire population of families who left welfare in a state. Some
                           policymakers and researchers are concerned that families who do not
                           answer surveys or whose current status is no longer reflected in
                           administrative data might be worse off than families for whom there are



                           13
                            While the Iowa study had an 85-percent response rate, results could only be generalized to families
                           assigned to Iowa’s Limited Benefit Plan, and not to families leaving welfare for other reasons.



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data.14 While the families who were not located may have fared quite well
in terms of employment or family formation, some missing families may be
experiencing hardship. For the purpose of summarizing findings, we either
included only those studies that had data on at least 70 percent of the
sample of families from the population of interest in the state or included a
nonresponse analysis that showed no important differences between
respondents and nonrespondents.

The seven states that we determined to have studies with results
generalizable to their welfare populations are Indiana, Maryland,
Oklahoma, South Carolina, Tennessee, Washington, and Wisconsin. We
estimated that these seven states accounted for about 8 percent of the
number of families who left welfare nationwide between October 1993 and
June 1997. Figure 2 highlights these 7 states, along with the 10 other states
that reported information on former welfare recipients.




14
  In five states, follow-up was done by telephone with no provision for families without telephones. In
one of these studies, only families for which the state had telephone numbers were included in the
sample to be tracked. Since it is reasonable to assume that families without telephones could differ in
important ways from families with telephones, findings based on a sample of families with telephones
are unlikely to be the same as findings based on a sample that includes families that have no
telephones.



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Figure 2: States That Have Reported Data on Families Who Have Left Welfare




                                         Studies in the seven states had either (1) data on a high enough percentage
                                         of the sample to reasonably generalize the results to the population from
                                         which the sample was drawn or (2) an analysis showing that the



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                             nonrespondents had some of the same key characteristics as the
                             respondents, providing greater assurance that the results from the limited
                             sample could be generalized to the population from which the sample was
                             drawn. (See app. I for a more detailed discussion of our assessment.)


                             Because the seven states’ studies differ in several ways, as discussed
Most Adults in Former        above, the results are not completely comparable across states. However,
Welfare Families Were        the studies provide an indication of the status of families who had left
Employed at Some             welfare in these states at the time of the studies and, to the extent that the
                             results are consistent, suggest a pattern of what is happening to these
Time After Leaving           families. The studies had consistent findings on employment and earnings.
Welfare; Little Else Is      Most former welfare families had an adult who was or had been employed
                             since leaving welfare. Although the studies indicated that former
Known About Family           recipients often worked at low-wage jobs, little information was available
Well-Being                   on families’ total household incomes, which could include child support or
                             earnings from a second worker. Some studies also reported that
                             significant proportions of the families had returned to welfare. In general,
                             the studies provided little information on family and child well-being.


Adults Had Employment        Employment rates ranged from 61 to 87 percent for adults in the families
Rates of 61 to 87 Percent,   who left welfare in the seven states; however, these employment rates
but Little Is Known About    were measured in different ways. Studies measuring employment at the
                             time of follow-up reported employment rates from 61 to 71 percent.
Household Income             Studies measuring whether an adult in a family had ever been employed
                             since leaving welfare reported employment rates from 63 to 87 percent. In
                             the four studies reporting both employment measures, the percentage
                             employed at some time since leaving welfare was considerably higher than
                             the percentage reporting employment at the time of follow-up. (Table 2
                             summarizes employment and earnings data in seven states.) These
                             employment rates generally exclude families who returned to welfare,
                             which can be a substantial portion of the families who leave welfare. In
                             the three studies for which such data were available, the percentage of the
                             families who initially left welfare and then returned to the rolls ranged
                             from 19 percent after 3 months in Maryland to 30 percent after 15 months
                             in Wisconsin. Removing families who return to welfare from the
                             employment rate calculations results in higher employment rates than




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when they are included, since many former recipients who return to the
welfare rolls are not employed.15




15
  For example, if 2,000 families leave welfare and, at a 3-month follow-up, 1,000 are employed, 500
remain off welfare but are not employed, and 500 have returned to welfare and are not working, the
3-month employment rate is 50 percent for the entire 2,000 families and 67 percent if only the 1,500
families remaining off welfare are included in the calculation.



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Table 2: Employment and Earnings Data From Studies in Seven States
State and period                                                                                  Average number of
during which families Employed at time Ever employed since Average hourly                          hours worked per           Average earnings
studied left welfarea       of follow-up      leaving welfare      wage rateb                                 week                 per quarterc
Indiana, 1995-96d                  64.3%                           84.3%                $6.34                        32                    $2,637
                                       e
Maryland, 1996-97                                                  63.0f                      e                         e
                                                                                                                                                2,384f
                                                                          e
Oklahoma, 1996-97                  64.5                                                  6.51                        34                         2,877
South Carolina, 1997               61.8                            85.6                  6.45                        36                         3,019
                   g                                                      e
Tennessee, 1997                    61.0                                                  5.67                        37                         2,727
Washington, 1998                   71.0                            87.0                  8.09                        36                         3,786
                       h               e                                                      e                         e
Wisconsin, 1995-96                                                 82.1                                                                         2,378i
               j
Wisconsin, 1998                    62.0                            83.0                  7.42                        36                         3,473i
                                           Note: Except where noted, these data include only families who did not return to welfare.
                                           a
                                            The year indicates the period during which the families studied left welfare. For more detailed
                                           information on the different time periods and frequency and length of follow-up in these studies,
                                           see table 1.
                                           b
                                           These figures represent the mean wage. While the mean wage tends to be higher than the
                                           median wage, we did not have the median wage for all studies.
                                           c
                                            For all studies except Maryland’s and the first Wisconsin study, we had to estimate quarterly
                                           earnings on the basis of reported average hourly wage and average number of hours worked per
                                           week. Because it is unlikely that all members of the sample worked all 13 weeks in a quarter, most
                                           of these estimates are likely to be somewhat higher than the actual average earnings per quarter.
                                           d
                                            Wage and earnings data for Indiana include those of recipients with earned income who were
                                           also on welfare. Because Indiana did report that average wage rates were significantly higher for
                                           former welfare recipients than for those combining work and welfare, the average wage rate for
                                           the combined groups may underestimate the wage rate for former recipients who are no longer
                                           on welfare.
                                           e
                                               Data were not available.
                                           f
                                               This figure also includes individuals who returned to welfare.
                                           g
                                            The Tennessee study reported separately for families who left welfare because of
                                           noncompliance and for those who were employed, whether on or off welfare. Employment rates
                                           presented here are for both groups, whereas wage data and earnings estimates are for the
                                           employed group only.
                                           h
                                            These data are based on a study using administrative data for families leaving welfare from
                                           July 1995 to July 1996.
                                           i
                                            Caution must be used in comparing these earnings figures because the earlier study used
                                           administrative data and the later one used survey responses. The administrative data may
                                           underestimate earnings because not all earnings were included. The survey data may be more
                                           inclusive of earnings but, because the data were self-reported, they could understate or overstate
                                           earnings.
                                           j
                                               These data are based on interviews with families who left welfare from Jan. 1998 to Mar. 1998.




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While all eight studies reported some information on former recipients’
earnings or wages, the studies did not provide a complete story on hourly
wages or number of hours worked.16 Average quarterly earnings for former
recipients ranged from $2,378 to $3,786 in the studies that either reported
quarterly earnings or for which we estimated quarterly earnings.
Extrapolating these quarterly earnings to a year results in average annual
earned incomes ranging from $9,512 to $15,144. These amounts of annual
earned income are greater than the maximum annual amount of cash
assistance and food stamps that a three-person family with no other
income could have received in these states.17 However, if these earnings
were the only source of income for the families after they left welfare,
many of them would remain below the federal poverty level.18

The question of whether a family is economically better off after leaving
welfare than when receiving cash assistance is quite complex. The answer
depends on many factors, including the amount of the cash benefit while
on welfare, which varies by state, family size, and earnings while on
welfare; family earnings and other sources of income; and aid after leaving
welfare, as well as any work-related expenses. For example, the 1995-96
Wisconsin study that tracked families for more than 15 months after they
left welfare compared postwelfare earnings of these families to the
maximum benefit they could have received under AFDC to see if families
were economically better off after leaving welfare. The study found that
whether postwelfare earnings exceeded the maximum AFDC benefit
depended in part upon the number of children in the family. Postwelfare
earnings exceeded the maximum AFDC cash benefit for 54 percent of the
families with one child and for 41 percent of the families with three or
more children. The study also noted that because some families combine
welfare and work, the combination of the cash benefit and earnings could
result in some families on welfare having more cash income than families
with earnings only. The study showed that during their first year off
welfare, less than half of the families had cash incomes higher than their
incomes had been while on AFDC, including both benefits and earnings.

16
 For another study of employment and earnings of families leaving welfare, see Sharon Parrott,
Welfare Recipients Who Find Jobs: What Do We Know About Their Employment and Earnings?
(Washington, D.C.: Center on Budget and Policy Priorities, Nov. 1998).
17
 In these seven states, for a single-parent, three-person family with no income, the maximum annual
amount of cash assistance and food stamps combined ranged from $6,000 in Tennessee to $9,744 in
Washington, as of Jan. 1997.
18
 For 1998, the federal poverty level for a family of three was $13,650. We estimated the average annual
earnings from the studies of the seven states as follows: Indiana—$10,548; Maryland—$9,536;
Oklahoma—$11,508; South Carolina—$12,076; Tennessee—$10,908; Washington—$15,144; and
Wisconsin—$9,512 and $13,892. In two of the studies estimated earnings were above the federal
poverty level.



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While the tracking studies provide information on individuals’ earned
incomes, much remains unknown about families’ total household income.
For example, the studies generally do not provide information on whether
others in a household have earnings or on other sources of household
income, such as child support payments or financial assistance from
relatives and friends. Moreover, most of the studies do not include
comprehensive information on the receipt of other noncash benefits, such
as food stamps, Medicaid, and child care or transportation assistance, or
what employment-related expenses, including child care and
transportation, households may have. Only three of the eight state studies
had some information on household income. In the Oklahoma study,
57 percent of the former welfare families reported household incomes at
or below the official poverty level. In the Indiana study, 57 percent of the
families off welfare at follow-up reported monthly household income
below $1,000. In contrast, Washington reported average total family
income, including child support payments, equal to 130 percent of the
federal poverty level for a family of three. According to the Washington
study, 35 percent of the families who left welfare and had children
received some child support, and 36 percent had at least one worker in the
family other than the respondent to the survey. The 1995-96 Wisconsin
study found that the proportion of families who had left and remained off
welfare for at least 1 year who had earnings above the official poverty
level varied by family size. While 35 percent of the families with one child
and 24 percent of the families with two children had earnings above the
poverty level, only 11 percent of the families with three or more children
did.

Although these studies do not provide a comprehensive picture of families’
financial situations, they consistently indicated that many of the families
leaving welfare were employed at fairly low-paying jobs. Our recent report
on TANF implementation in seven states and other studies indicate that
many states and localities are providing support services, such as case
management services and financial assistance with child care, to help
former welfare recipients maintain their employment. Several states and
localities have also undertaken efforts to help these low-wage workers
upgrade their job skills to improve their job prospects.19 Moreover, the
recently expanded earned income credit can increase the incomes of


19
 See Rebecca Brown and others, Working Out of Poverty: Employment Retention and Career
Advancement for Welfare Recipients (Washington, D.C.: National Governors’ Association and HHS,
1998); Mark Elliott, Don Spangler, and Kathy Yorkievitz, What Next After Work First? (Philadelphia:
Public/Private Ventures, spring 1998); and Brandon Roberts and Jeffrey D. Padden, Welfare to Wages:
Strategies to Assist the Private Sector to Employ Welfare Recipients (Chevy Chase, Md.: Brandon
Roberts and Associates, Aug. 1998).



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qualified low-income families by as much as $2,271 for families with one
child and $3,756 for families with two or more children.20 Information on
total household income and receipt of government supports is key to
understanding the condition of former welfare recipients and the extent to
which they continue to rely on government aid rather than becoming
economically self-sufficient.21

The studies in five states reported on the extent to which former welfare
families say they receive noncash public assistance.22 As shown in table 3,
in these states, between 44 and 83 percent of the families who left welfare
received Medicaid benefits, and between 31 and 60 percent received food
stamps. The Wisconsin study that tracked families who left welfare
between July 1995 and July 1996 for 15 months found significant decreases
in the use of noncash public assistance over time. Forty-six percent of the
former recipients who remained off welfare for at least 1 year received
both Medicaid and food stamps in the first quarter after leaving welfare,
and 28 percent received both in the fifth quarter after leaving cash
assistance. Four studies had information on the receipt of child care
subsidies.




20
  The earned income credit is a refundable tax credit for qualified working people who have earned
incomes below certain specified levels.
21
  Research conducted in 1996 by Cancian and Meyer using the National Longitudinal Survey of Youth
to trace welfare use, poverty status, and primary sources of income in the 5 years following an exit
from welfare reports that although 40 percent of the AFDC exiters do not return to AFDC within the
first 5 years, only 20 percent went the entire 5 years without using AFDC, food stamps, or
Supplemental Security Income. See Daniel Meyer and Maria Cancian, Life After Welfare: The
Economic Well-Being of Women and Children Following an Exit from AFDC (Madison, Wis.: Institute
for Research on Poverty, discussion paper no. 1101-96, Aug. 1996).
22
  While food stamp and Medicaid caseloads have declined recently, the reasons for these changes are
not fully understood. We do not know, for example, how many former welfare families that are eligible
for these benefits actually receive them. There is concern that some needy families no longer receiving
cash assistance may be unaware that they are still entitled to Medicaid and food stamps. While a
strong economy may also partially explain recent declines in food stamp and Medicaid caseloads, the
relative contributions of this and other such factors to these trends are unclear.


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Table 3: Percentages of Families Reporting Receipt of Public Assistance After Leaving Welfare
                                                                    Percentage receiving
State and period during                                                             Supplemental          Women, Infants,
which families studied left   Medicaid                                            Security Income           and Children                   Child care
welfarea                      coverage                  Food stamps                       benefits              benefits                   subsidies
                                                                                                                                                           b
Indiana, 1995-96              53                        38                                         11                       25
Oklahoma, 1996-97c            70                        50                                         17                          b
                                                                                                                                                     23d
South Carolina, 1997          80                        60                                         13                       27                       18
                                                                                                      b                        b
Washington, 1998              64 children; 44           45                                                                                           38e
                              adults
                                                                                                      b                        b                           b
Wisconsin, 1995-96            83 in first quarter       49 in first quarter
                              after leaving             after leaving
                              welfare; 56 in fifth      welfare; 31 in fifth
                              quarter after             quarter after
                              leaving                   leaving
Wisconsin, 1998               71                        49                                         17                       38                       17
                                             Note: Unless specified, the percentage is of all families in the sample. Except for the earlier
                                             Wisconsin study, all data are from surveys in which respondents self-reported their receipt of aid.
                                             a
                                              For more detailed information on the different time periods and frequency and length of follow-up
                                             in these studies, see table 1.
                                             b
                                                 This information was not reported.
                                             c
                                              Data include families that returned to work.
                                             d
                                              For respondents who are employed or in training and whose households include children, the
                                             percentage reporting the receipt of a child care subsidy increases to 34.
                                             e
                                              Families with children under 13 whose parent is at work.



                                             While receiving AFDC or TANF, families generally also receive Medicaid
                                             benefits to cover their health expenses. However, whether Medicaid
                                             benefits are retained after a family has left welfare depends on many
                                             factors, and health insurance coverage after leaving welfare varied in the
                                             states with these data.23 For example, about 9 percent of the children in
                                             families who left welfare in South Carolina, about 20 percent in Oklahoma,
                                             and 35 percent in Indiana did not have health insurance at the time of
                                             follow-up. For adults who left welfare in these states, 24 percent in
                                             Oklahoma, 32 percent in Washington, 48 percent in South Carolina, and
                                             54 percent in Indiana did not have health insurance.

                                             23
                                              To ensure continued Medicaid coverage for low-income families, PRWORA generally preserves the
                                             Medicaid entitlement, setting eligibility standards at AFDC levels in effect on July 16, 1996. In addition,
                                             under certain conditions, families that leave TANF for employment may continue Medicaid for 12
                                             months. Medicaid coverage is also available for many low-income children, even if their parents are
                                             not eligible. For more information, see Welfare Reform: Early Implications of Welfare Reform for
                                             Beneficiaries and States (GAO/HEHS-98-62, Feb. 24, 1998).



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                             While much attention is paid to welfare recipients who become employed
                             and stay off the rolls, there is also interest in how those who are not
                             employed and have not returned to welfare are faring. The South Carolina
                             and Wisconsin surveys asked nonworking former recipients what stopped
                             them from working for pay. In both states, the most frequently mentioned
                             reason was their own physical or mental illness, followed by the inability
                             to find a job, lack of transportation, and lack of child care. The Wisconsin
                             study attempted to determine how these families were supporting
                             themselves. Of the 142 former recipients not currently working, 18 percent
                             were living with employed spouses or partners. Sixty-five percent of the
                             families of the remaining nonworking former recipients were receiving
                             Social Security, state unemployment insurance, child support, or foster
                             care payments; 23 percent were not receiving cash assistance but were
                             receiving noncash assistance, such as free housing, rent subsidies,
                             Medicaid, or food stamps.


Studies in Seven States      The studies in seven states provided limited information on the family
Provided Limited             composition and well-being of former welfare families and the children in
Information on Family        these families. Although a major goal of welfare reform was the promotion
                             of two-parent families and the reduction of out-of-wedlock pregnancies,
Composition and the          the tracking studies report only minimal information on family
Well-Being of Children and   composition at the time of data collection, and no information on changes
Families                     that may have occurred just before or after leaving welfare. The studies
                             with surveys asked questions regarding family composition; however,
                             these surveys did not provide information on changes in the number of
                             children in a family, changes in marital status, or the formation of other
                             two-parent families since a family left the welfare rolls.

                             Further, beyond any inferences that could be drawn from the employment
                             and earnings of parents, the studies provided little information on how
                             former welfare children and families were doing relative to housing,
                             health, education, food security, substance abuse, crime, and
                             victimization.24 While some of the studies provided limited information on
                             some of these factors, there are no comprehensive data on family and
                             child well-being.

                             Three studies—from Maryland, Oklahoma, and Washington—reported on
                             the number of children in former recipient families that had ever been
                             involved with child protective services. These studies found few cases in

                             24
                               These and other factors are considered indicators of well-being. Fig. 1 lists a number of these items
                             reported in the state studies.



                             Page 23                                    GAO/HEHS-99-48 Status of Former Welfare Recipients
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which children had been involved with child protective services since
leaving welfare.25 For example, the Maryland study reviewed state data
from its foster care program to determine the number of children placed in
foster care after their families left welfare. This study reported that less
than one-half of 1 percent of the children studied entered foster care after
their families left cash assistance.

Two studies, South Carolina’s as well as Wisconsin’s recent survey of
families leaving welfare during the first quarter of 1998, asked former
recipients to compare several aspects of their general well-being after
leaving welfare with their situation when they were on welfare. Because
Wisconsin used a modified version of the interview schedule developed in
South Carolina, the data are comparable, even though the programs that
the recipients experienced are not. Table 4 shows the results from the two
states’ surveys. Former welfare recipients in both states were more likely
to experience some deprivations after leaving welfare than while on
welfare. At the same time, in South Carolina and Wisconsin, 76 and
68 percent, respectively, disagreed or strongly disagreed with the
statement that “life was better when you were getting welfare.”
Regarding housing status, an important aspect of well-being, the limited
information from the studies did not suggest increased incidence of
homelessness at the time of follow-up.




25
  South Carolina, in separate analyses, compared the number of incidents of maltreatment reported to
the Child Protective Services’ Central Registry for a sample of families who had left welfare with the
number of incidents for families still on welfare; it also compared the number of incidents of
maltreatment in a sample of former welfare families before and after leaving welfare. The differences
were not statistically significant for either comparison.



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Table 4: Recipients’ Comparisons of
Deprivations While on and After Being                                             South Carolinaa                      Wisconsinb
on Welfare                                                                    (percentage responding             (percentage responding
                                                                                      “yes”)                             “yes”)
                                        Question                               On welfare         Off welfare    On welfare   Off welfare
                                        Did you ever get behind in
                                        rent or house payments?                           13                15           30           37c
                                        Did you ever get behind on a
                                        utility bill?                                     16                18           49           47
                                        Was there ever a time when
                                        you could not buy food?                             6               9            22           32c
                                        Was there ever a time when
                                        you could not afford child
                                        care when needed in order to
                                        work?                                             11                9            22           33c
                                        Did somebody in your home
                                        ever get sick or hurt when
                                        you could not get medical
                                        care?                                               1               7c            8           11
                                        Did you have to go to a
                                        homeless shelter?                                   2               1             5               3
                                        a
                                        Based on a sample of 403 former welfare recipients.
                                        b
                                            Based on a sample of 375 former welfare recipients.
                                        c
                                        These differences are statistically significant at the .05 level.

                                        Source: South Carolina’s Survey of Former Family Independence Program Clients: Cases Closed
                                        During July Through Sept. 1997 and Wisconsin’s Survey of Those Leaving AFDC or W-2 Jan. to
                                        Mar. 1998, preliminary report.




                                        The number of states conducting or sponsoring studies that track the
State and Federal                       status of families leaving welfare has increased in recent years, and state
Efforts Are Under                       and federal efforts are under way to improve the usefulness of the data
Way to Improve the                      being collected. Thirty-nine states, including the 17 we identified in this
                                        report, and the District of Columbia already are tracking or plan to track
Usefulness of State                     families leaving welfare. In an attempt to improve the quality and
Tracking Studies                        comparability of these studies, HHS has funded several states and other
                                        jurisdictions to conduct tracking studies and is providing them technical
                                        assistance in conducting these studies.


State Tracking Efforts Are              We have identified 39 states and the District of Columbia that are either
Increasing in Number and                planning to study former welfare families or are already doing so. Most of
Expanding in Scope                      the 17 states that we discuss in this report are planning to continue their



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                             tracking and to enhance their efforts, in some cases with federal funds and
                             in other cases with state funds. Maryland, for example, plans to survey
                             former recipients to get the kind of detailed information about families’
                             lives that is not available in the program data upon which state officials
                             currently rely in their ongoing longitudinal studies. Among the topics to be
                             covered are how former welfare families are able to make ends meet; what
                             enabled them to leave the welfare system; and, in the cases of those who
                             returned to welfare, what brought them back. Idaho is trying to locate
                             families that did not respond to its survey. Maryland, Massachusetts, South
                             Carolina, Wisconsin, and Mecklenburg County in North Carolina have
                             received funds from HHS to support their efforts to link administrative data
                             systems for purposes of studying the effects of welfare reform on other
                             state and federal public assistance programs. A South Carolina official told
                             us that by linking TANF data to state unemployment insurance data, the
                             state was able to locate many of the families that did not respond to its
                             survey.


Federal Efforts Are          To increase the usefulness of state tracking efforts in providing a more
Helping States to Improve    complete picture of the status of former welfare families, HHS is supporting
the Usefulness of the Data   some states and counties with funds and technical assistance. As part of
                             its overall strategy to evaluate welfare reform, HHS has awarded grants to
Being Collected on           14 projects covering 16 jurisdictions—10 states, five counties in 2 other
Families Leaving Welfare     states, and the District of Columbia—to support efforts to track, through
                             administrative data, surveys, or other methods, former TANF recipients’
                             work transitions and receipt of other benefits, including supportive
                             services.26 Each of these tracking efforts plans to collect information on
                             one or more of the following: families diverted from welfare, eligible
                             families who do not apply for benefits, and families who have left welfare.
                             All 14 grantees will collect both administrative data and survey data on
                             former recipients. (See app. III for information on the 14 studies.)

                             In addition, HHS submitted its overall research plan for evaluating welfare
                             reform to the National Academy of Sciences for guidance on research
                             design and recommendations for further research.27 The National
                             Academy has convened a panel of experts on program evaluation
                             methods, survey design, administrative record analysis, state database


                             26
                               In May 1998, HHS announced the availability of funds and requested proposals from states for
                             research into the status of individuals and families who leave the TANF program and eligible families
                             who are diverted or who fail to enroll. Of the proposals received, 14 awards were made.
                             27
                               HHS has funded other related research efforts, including assessments of the impacts of welfare
                             reform on children and immigrants.



                             Page 26                                   GAO/HEHS-99-48 Status of Former Welfare Recipients
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               development and analysis, and welfare policy and evaluation to review
               data needs and methods. One of the panel’s first activities was to conduct
               a workshop to review and assess the HHS grantees’ study methodologies.
               The workshop provided a forum in which representatives from states and
               counties that had been awarded grants were able to talk with experts
               about their planned tracking studies. The panel plans a 30-month study on
               a broad range of issues related to evaluating welfare, with an interim
               report to be ready in June 1999.

               HHS expects to use data from the 14 funded projects to generate a picture
               of what is happening to families exiting welfare and families diverted from
               ever entering welfare. In recognition of the need for high-quality research
               and comparable findings, HHS is providing technical assistance to the
               states directly, and through the National Academy panel, and is
               encouraging grantees to share information with one another. The National
               Academy panel is providing advice on issues of data quality and
               comparability as well as policy relevance. Initially, the 14 grantees have
               agreed to work toward increasing comparability across studies by using a
               common definition of welfare “leaver.”28 They have also agreed to clarify
               which studies will be tracking only families with adults and which will also
               track welfare cases that only include children. Finally, with the
               encouragement of HHS and the National Academy, the grantees will be
               sharing common approaches to studying such areas as insecurity and
               deprivation, child well-being, and changes in household composition.29


               While we were able to learn about the status of former welfare recipients
Observations   in several states, we could conclude little about the status of most families
               that have left welfare nationwide. However, the limited information on
               economic status of the families being tracked indicates that many families
               who leave welfare find jobs that are low-paying. The low wages of these
               jobs emphasize the importance that income supports, such as subsidized
               medical and child care and the earned income credit, can assume in these
               families’ total financial resources. As we noted in our earlier report on
               TANF implementation in seven states, federal and state policies and
               programs for assisting low-income working families are likely to play a


               28
                 The grantees have agreed to define a “leaver” as a family that was off welfare for 2 months or
               longer.
               29
                 In addition, HHS has funded five states—Connecticut, Florida, Indiana, Iowa, and Minnesota—to
               assess the effects of different welfare reform approaches on child well-being. The state agencies and
               research organizations involved in these projects are attempting to ensure compatibility of outcomes
               and measures to promote the ability to compare outcomes among states.



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                  critical role in helping these families remain off cash assistance and move
                  toward economic self-sufficiency.

                  But much remains unknown about most families leaving welfare
                  nationwide. In our attempt to describe the condition of former welfare
                  families, we were constrained by the data currently available from these
                  early state tracking studies. More specifically, the high nonresponse rates
                  in many state studies limit the usefulness of the results because
                  generalizations cannot be made to all families of interest. Because those
                  families who do not respond to surveys, or who may not show up in
                  administrative data for other programs, may be the ones at greatest risk of
                  negative outcomes, some policymakers and program officials are
                  particularly concerned about not having enough information to determine
                  the status of these families. In addition, for policymakers to better
                  understand whether states are making progress in meeting the goals of
                  TANF, more comprehensive information is needed on household income;
                  receipt of government assistance; and changes in family composition,
                  including increases in the number of two-parent families and additional
                  births, especially to teens. And, finally, the data often are not comparable
                  among the states. Consequently, even if each state had collected
                  generalizable data on a comprehensive range of topics, it would often be
                  difficult to generate a national picture from such studies. More
                  comparable data would also be useful to individual states that want to
                  understand how former welfare families fare in their states as compared
                  with those in other states. In addition, comparable data among the states
                  could help policymakers and program administrators at all levels of
                  government identify promising approaches and practices for assisting
                  low-income families.

                  The limited nature of the information currently available emphasizes the
                  importance of additional state efforts, such as those funded by HHS. The
                  ongoing state efforts promise to provide a more complete picture in the
                  future. Many more states have tracking studies in progress or planned and
                  efforts are under way at the state and federal levels to improve the
                  usefulness of these efforts. As HHS continues to work with states to
                  support their efforts to collect data on families who have left welfare, it
                  has an opportunity to help states develop more generalizable,
                  comprehensive, and comparable data.


                  We obtained comments on a draft of this report from HHS, which stated
Agency Comments   that the report provides useful information on the status of former welfare



                  Page 28                        GAO/HEHS-99-48 Status of Former Welfare Recipients
B-281749




recipients and the varied efforts being made by states to follow up on the
impacts of welfare reform. HHS also noted, however, how difficult it was to
glean general results from such varied studies. It expressed concern that,
while the report appropriately discusses the issues that preclude
generalizing findings in many of the studies to the state level, the report
does not address other factors, such as differences in the definitions of the
populations studied and in states’ economic conditions, which make it
difficult to report general results from any of the studies. HHS further
suggested that rather than attempting to find areas of comparability in the
studies, we should focus on the crucial differences between studies and
emphasize the contribution that the HHS-funded state studies of families
leaving welfare will make. Finally, HHS had concerns about our reliance
upon studies with low response rates.

We agree with HHS about the difficulties involved in discussing general
results from the varied studies. We did not suggest, however, that results
from the eight studies could be generalized beyond the states from which
the study samples were drawn. We also pointed out that much remains
unknown about most families who have left welfare nationwide. In
addition, we were not attempting to report program impacts, which would
require controlling for other factors that could affect family status, such as
varying economic conditions. Rather, we focused on what is currently
known about the status of former welfare families given the extent to
which a particular state study was generalizable to the study population
within the state. We also agree with HHS’ concern regarding low response
rates, and this was the reason most of the studies were determined to not
be generalizable and no data from them were included in the report.
Finally, the report had already noted that we believe the HHS-funded state
efforts will make an important contribution toward improving the
usefulness of future studies and increase understanding of the condition of
former welfare families.

To address HHS’ concerns, we revised the report to place greater emphasis
on the studies’ differences by moving detailed information on the studies’
varied populations, time periods, and methodologies from the appendix to
the body of the report. We also added an additional caveat to the
discussion about employment and earnings information, pointing out the
lack of complete comparability among the studies. In addition, where
results from several states were displayed, we added information on time
periods and references to more detailed information on the studies’
populations and methodologies. HHS also made technical comments, which




Page 29                         GAO/HEHS-99-48 Status of Former Welfare Recipients
B-281749




we incorporated where appropriate. (See app. IV for the text of HHS’
comments.)

We also provided copies of the draft report to the 17 states whose studies
we reviewed and to an expert on welfare reform issues. We incorporated
their technical comments where appropriate.


As agreed with your offices, unless you publicly announce its contents
earlier, we plan no further distribution of this report until 30 days from the
date of this report. At that time, we will send copies to the Honorable
Donna E. Shalala, Secretary of the Department of Health and Human
Services; state TANF directors; and other interested parties. We will also
make copies available upon request.

If you or your staff have any questions about this report, please contact me
on (202) 512-7215. Other staff who contributed to this report are listed in
appendix V.




Cynthia M. Fagnoni
Director, Education, Workforce,
  and Income Security Issues




Page 30                         GAO/HEHS-99-48 Status of Former Welfare Recipients
Page 31   GAO/HEHS-99-48 Status of Former Welfare Recipients
Contents



Letter                                                                                                1


Appendix I                                                                                           34
Scope and
Methodology
Appendix II                                                                                          38
Reports From States’
Studies of Families
Who Left Welfare
Appendix III                                                                                         41
Information on
Selected Grants
Awarded by the
Department of Health
and Human Services
to Study Families
Leaving Welfare
Appendix IV                                                                                          44
Comments From the
Department of Health
and Human Services
Appendix V                                                                                           46
Major Contributors to
This Report
Related GAO Products                                                                                 48


Tables                  Table 1: Key Ways in Which State Studies Differed                             9




                        Page 32                       GAO/HEHS-99-48 Status of Former Welfare Recipients
          Contents




          Table 2: Employment and Earnings Data From Studies in Seven                  18
            States
          Table 3: Percentages of Families Reporting Receipt of Public                 22
            Assistance After Leaving Welfare
          Table 4: Recipients’ Comparisons of Deprivations While on and                25
            After Being on Welfare
          Table I.1: Response Rates for State Studies                                  35
          Table III.1: Selected Information on Grants Awarded                          41


Figures   Figure 1: Categories of Information Reported in State Studies of              8
            Former Welfare Families
          Figure 2: States That Have Reported Data on Families Who Have                15
            Left Welfare
          Figure III.1: Administrative Data Sources Grantees Planned to                43
            Use




          Abbreviations

          AFDC        Aid to Families With Dependent Children
          HHS         Department of Health and Human Services
          PRWORA      Personal Responsibility and Work Opportunity
                           Reconciliation Act of 1996
          TANF        Temporary Assistance for Needy Families


          Page 33                       GAO/HEHS-99-48 Status of Former Welfare Recipients
Appendix I

Scope and Methodology


                        This appendix provides more detail on how we (1) identified state studies
                        of families who had left welfare, (2) assessed the extent to which the
                        studies could support statewide generalizations of results, and
                        (3) summarized the findings on employment and income from the studies
                        with results generalizable to each state’s welfare population.


                        To obtain information to answer this request, we searched for state studies
Identifying and         of families who left welfare during or after 1995 that had published results
Assessing the Studies   by September 30, 1998. We began with a list of state tracking efforts
                        prepared by a joint effort of the staffs of the National Conference of State
                        Legislatures, the National Governors’ Association, and the American
                        Public Human Services Association.30 In addition, we talked to
                        representatives of the 10 states with the largest welfare caseloads
                        (California, Florida, Illinois, Michigan, New Jersey, New York, Ohio,
                        Pennsylvania, Texas, and Washington) and asked if they had any studies of
                        former welfare families for which results had been published. We also
                        talked to welfare experts and asked them if they knew of any ongoing
                        studies of former welfare recipients. Finally, we talked to representatives
                        of those states that we identified as having published reports on the basis
                        of their tracking efforts and asked what additional plans, if any, they had
                        for tracking former welfare families and if they had updated their work. If
                        a state had more recent information available, we included it in our
                        analysis when possible, in some cases using a report published after
                        September 30, 1998.

                        Through this process, we identified 18 separate tracking efforts in 17
                        states.31 The 18 studies varied in degree of data completeness and
                        statewide generalizability. We were interested in summarizing results that
                        could reasonably be generalized to most families who left welfare in the
                        state at the time of the study. We considered a study to be of an acceptable
                        level of statewide generalizability if the study successfully obtained data
                        on at least 70 percent of the sample of families for which it sought such
                        data, or if a nonresponse analysis of the data showed that were no
                        important differences between families represented in the data and those



                        30
                         This list appears in a document called “State Efforts to Track and Follow Up on Welfare Recipients”
                        and is updated periodically as additional studies are identified. The list we used was dated July 30,
                        1998. For the most recent list of state efforts to track welfare recipients, see the Web site
                        www.aphsa.org.
                        31
                         Wisconsin had two studies. The second surveyed a cohort of welfare recipients that left the welfare
                        rolls between Jan. and Mar. 1998. The results of this survey were issued on Jan. 13, 1999.



                        Page 34                                   GAO/HEHS-99-48 Status of Former Welfare Recipients
                                      Appendix I
                                      Scope and Methodology




                                      missing from the data.32 Except for this assessment, we did not
                                      independently verify the data included in the state studies. Using this
                                      assessment, we identified eight studies representing seven states. The
                                      proportion of families that responded to surveys or for whom data were
                                      located in administrative databases in each study is shown in table I.1.

Table I.1: Response Rates for State
Studies                                                                                                  Number of           Response rate
                                      State                 Population of interest                    respondentsa            (percentage)
                                      Idaho                 Families who left TANF July
                                                            to Dec. 1997                                          447                       17
                                      Indiana               Families receiving AFDC
                                                            May 1995 to May 1996 who
                                                            subsequently left AFDC                              1,589                       71
                                      Iowa                  AFDC families assigned to
                                                            or who volunteered for the
                                                            Limited Benefit Plan Nov.
                                                            1994 to Apr. 1995                                     137                       85
                                      Kentucky              Families who left TANF Jan.
                                                            to Nov. 1997                                          560                       17
                                      Louisiana             Families in metropolitan
                                                            New Orleans who left TANF
                                                            Jan. to Mar. 1998                                     349                       17
                                      Maryland              Families who left TANF Oct.
                                                            1996 to Sept. 1997                                  2,156                       82b
                                      Michigan              Families whose AFDC
                                                            benefits were terminated in
                                                            Apr. 1996 because they did
                                                            not comply with program
                                                            rules                                                  67                       53
                                      Montana               Families who received or
                                                            left AFDC or TANF Mar.
                                                                                                                                              c
                                                            1996 to Sept. 1997                                    208
                                      New Jersey            Families whose TANF
                                                            benefits were terminated
                                                            Jan. to Feb. 1998 because
                                                            of failure to comply with
                                                            program rules                                         453                       45
                                      New Mexico            Families who left AFDC July
                                                            1996 to June 1997                                     617                       12
                                      Oklahoma              Families who left or were
                                                            denied TANF Oct. 1996 to
                                                            Nov. 1997                                             292                       53
                                                                                                                                  (continued)


                                      32
                                       For other purposes, a different criterion may be more appropriate. For example, some program
                                      administrators believe that a major effort should be made to locate all families in the sample,
                                      especially if the purpose of a study is to ensure that families have not been adversely affected by
                                      program changes.



                                      Page 35                                    GAO/HEHS-99-48 Status of Former Welfare Recipients
                   Appendix I
                   Scope and Methodology




                                                                                   Number of          Response rate
                   State                 Population of interest                 respondentsa           (percentage)
                   Pennsylvania          Families who left TANF Mar.
                                         1997 to Jan. 1998                                  169                      47
                                   d
                   South Carolina        Families with a household
                                         member required to seek
                                         employment who left TANF
                                         July to Sept. 1997 and had
                                         not returned at time of
                                         follow-up                                          403                      76
                   Tennessee             Families who lost TANF
                                         benefits Jan. to Oct. 1997
                                         because they did not
                                         comply with program rules,
                                         and TANF families whose
                                         head was employed full- or
                                         part-time Feb. to Oct. 1997                     2,436                       51
                   Washingtond           Single-parent families who
                                         left TANF Apr. to July 1998                        592                      52
                   Wisconsin             Single, female-headed
                                         families who left AFDC July
                                         1995 to July 1996                              54,518                       92b
                   Wisconsin             Families who left
                                         AFDC/TANF Jan. to Mar.
                                         1998 and did not return
                                         prior to survey                                    375                      69
                   Wyoming               Families who left TANF Dec.
                                         1996 to Feb. 1998                                  200                      32

                   a
                   These are the families actually located for whom data are reported in the study.
                   b
                    Represents the percentage of families about whom information was located in program
                   administrative data.
                   c
                   Data not available.
                   d
                    Both South Carolina and Washington reported on groups of families who left welfare earlier. We
                   included the most recent sample in our summary.

                   Source: GAO analysis of state studies.




                   We summarized the results for the eight studies that we considered could
Summarizing Data   reasonably be generalized to the state level in the three major areas of
Related to         interest: economic status, family composition, and family and child
Employment and     well-being. This effort was constrained by the different sources of data
                   used by the state studies, different categories of families tracked, and
Income             different questions asked of respondents in the surveys. The area for
                   which each state study had somewhat comparable data was economic



                   Page 36                                  GAO/HEHS-99-48 Status of Former Welfare Recipients
Appendix I
Scope and Methodology




status. The state studies with surveys generally asked employment status
at the time of follow-up, hourly wage rate, number of hours worked, and
whether the respondent had ever worked since leaving welfare. The two
studies relying on state unemployment insurance program data to track
employment could report only whether an individual had worked at some
point during a 3-month period and total earnings for the period. Further,
since state unemployment insurance programs do not cover some
categories of employed individuals, program data would not have
information on these individuals. For example, self-employed individuals
and certain agricultural workers are generally not covered.

The two studies reporting average quarterly earnings based on state
unemployment insurance program data did not report average hourly
wage or average number of hours worked. In order to make earnings data
comparable among the eight studies, we estimated average quarterly
earnings for the other studies for which we had, or could calculate,
average hourly wage rates and average number of hours worked. We
multiplied the average hourly wage in each of these studies by the study’s
reported average number of hours worked in a week and multiplied by 13
to estimate a quarterly wage. This enabled us to compare estimated
quarterly earnings with the reported quarterly earnings. We also had to
make some adjustment to ensure that the employment rates were for
comparable categories of families. Although some of the studies reported
employment rates only for adults who left welfare and were still off the
rolls at the time of follow-up, others included all families who left the rolls
during the study period—even those who had returned to welfare at the
time of follow-up. To estimate comparable employment rates, we removed
from the calculation data on the individuals who returned to the rolls and
assumed that those who returned to the rolls were not employed.




Page 37                          GAO/HEHS-99-48 Status of Former Welfare Recipients
Appendix II

Reports From States’ Studies of Families
Who Left Welfare

               Project Self-Reliance TAFI Participant Closure Study (II), Idaho
Idaho          Department of Health and Welfare, spring 1998.


               The Indiana Welfare Reform Evaluation: Assessing Program
Indiana        Implementation and Early Impacts on Cash Assistance, Abt Associates,
               Inc., Aug. 1997.

               The Indiana Welfare Reform Evaluation: Who Is On and Who Is Off?
               Comparing Characteristics and Outcomes for Current and Former TANF
               Recipients, Abt Associates, Inc., Sept. 1997.

               The Indiana Welfare Reform Evaluation: Program Implementation and
               Economic Impacts After Two Years, Abt Associates, Inc., and The Urban
               Institute, Nov. 1998.


               Iowa’s Limited Benefit Plan: Summary Report, Mathematica Policy
Iowa           Research, Inc., and the Institute for Social and Economic Development,
               May 1997.

               A Study of Well-Being Visits to Families on Iowa’s Limited Benefit Plan,
               Mathematica Policy Research, Inc., June 1998.


               From Welfare to Work: Welfare Reform in Kentucky, Welfare Reform
Kentucky       Evaluation No. 1, Center for Policy Research and Evaluation, Urban
               Studies Institute, University of Louisville, Jan. 1998.


               Exiting Welfare: The Experiences of Families in Metro New Orleans,
Louisiana      School of Social Work, Southern University at New Orleans, June 1998.


               Life After Welfare: An Interim Report, University of Maryland School of
Maryland       Social Work, Sept. 1997.

               Life After Welfare: Second Interim Report, University of Maryland School
               of Social Work, Mar. 1998.




               Page 38                        GAO/HEHS-99-48 Status of Former Welfare Recipients
                 Appendix II
                 Reports From States’ Studies of Families
                 Who Left Welfare




                 A Study of AFDC Case Closures Due to JOBS Sanctions April 1996,
Michigan         Michigan Family Independence Agency, May 1997.


                 Montana’s Welfare Reform Project: Families Achieving Independence in
Montana          Montana FAIM, February 1998 Update, Montana Department of Public
                 Health & Human Services, Feb. 12, 1998.


                 WFNJ (TANF) Sanction Survey, New Jersey Department of Human Services,
New Jersey       July 2, 1998.


                 Survey of the New Mexico Closed-Case AFDC Recipients July 1996 to
New Mexico       June 1997, Final Report, University of New Mexico, Sept. 1997.


                 Family Health & Well-Being in Oklahoma: An Exploratory Analysis of TANF
Oklahoma         Cases Closed and Denied October 1996 to November 1997, Oklahoma
                 Department of Human Services, Sept. 1998.


                 TANF Closed-Case Telephone Survey, Pennsylvania Department of Public
Pennsylvania     Welfare, Mar. 1998.


                 Survey of Former Family Independence Program Clients: Cases Closed
South Carolina   During January Through March 1997, South Carolina Department of Social
                 Services, Division of Program Quality Assurance, Mar. 3, 1998.

                 Survey of Former Family Independence Program Clients: Cases Closed
                 During July Through September 1997, South Carolina Department of
                 Social Services, Division of Program Quality Assurance, Oct. 9, 1998.


                 Summary of Surveys of Welfare Recipients Employed or Sanctioned for
Tennessee        Non-Compliance, University of Memphis, Mar. 1998.


                 Washington’s TANF Single Parent Families Shortly After Welfare: Survey of
Washington       Families Which Exited TANF Between December 7 and March 1998,
                 Washington DSHS Economic Services Administration, July 1998.



                 Page 39                              GAO/HEHS-99-48 Status of Former Welfare Recipients
            Appendix II
            Reports From States’ Studies of Families
            Who Left Welfare




            Washington’s TANF Single Parent Families After Welfare, Washington DSHS
            Economic Services Administration, Jan. 1999.


            Post-Exit Earnings and Benefit Receipt Among Those Who Left AFDC in
Wisconsin   Wisconsin, Institute for Research on Poverty, University of
            Wisconsin-Madison, Aug. 17, 1998.

            Post-Exit Earnings and Benefit Receipt Among Those Who Left AFDC in
            Wisconsin, Institute for Research on Poverty, University of
            Wisconsin-Madison, Oct. 30, 1998.

            Survey of Those Leaving AFDC or W-2 January to March 1998, Preliminary
            Report, State of Wisconsin, Department of Workforce Development,
            Jan. 13, 1999.


            A Survey of Former POWER Recipients (Personal Opportunities With
Wyoming     Employment Responsibilities), Western Management Services, LLC, for
            Wyoming Department of Family Services, May 1998.




            Page 40                              GAO/HEHS-99-48 Status of Former Welfare Recipients
Appendix III

Information on Selected Grants Awarded by
the Department of Health and Human
Services to Study Families Leaving Welfare
                                       This appendix provides information on the study methodologies planned
                                       by the jurisdictions receiving grants from HHS to study families who have
                                       left welfare.

Table III.1: Selected Information on
Grants Awarded                                                                                               Timing of
                                                                                                                survey
                                                                    Award                                 (months after
                                       Grantee                     amount Population of interest                  exit)
                                       Arizona                    $249,824 Families leaving welfare                   12
                                                                           Oct. to Dec. 1996 and Jan.
                                                                           to Mar. 1998
                                       California—Los Angeles      250,000 Families leaving welfare                   12
                                       County                              Oct. to Dec. 1996 and Jan.
                                                                           to Mar. 1998
                                       California—San Mateo,       160,270 Families leaving or diverted        6 and 12
                                       Santa Clara, and Santa              from welfare Oct. to Dec.
                                       Cruz counties                       1996 and July to Dec. 1998
                                       District of Columbia        249,749 Families leaving welfare                    6
                                                                           July to Sept. 1997 and Oct.
                                                                           to Dec. 1998
                                       Florida                     274,719 Families leaving or diverted         18 to 20
                                                                           from welfare Apr. to June
                                                                           1997; families receiving
                                                                           food stamps or Medicaid
                                                                           who were eligible for, but
                                                                           not receiving, welfare Apr.
                                                                           to June 1997
                                       Georgia                     246,660 Families leaving welfare                    6
                                                                           Jan. to Oct. 1997 and July
                                                                           1998 to June 2001
                                       Illinois                    250,000 Families leaving welfare                1 to 9
                                                                           Oct. 1997 to June 1998 and
                                                                           Jan. to Mar. 1999
                                       Massachusetts               206,294 Families leaving welfare       3, 6, 9, and 12
                                                                           Jan. to June 1997 and Dec.
                                                                           1998 to Feb. 1999
                                       Missouri                    250,000 Families leaving welfare                   15
                                                                           Oct. to Dec. 1996 and Oct.
                                                                           to Dec. 1997
                                       New York                     80,476 Families leaving welfare                   12
                                                                           Nov. 1997 to Mar. 1998 and
                                                                           Jan. to Mar. 1999
                                       Ohio—Cuyahoga County        250,000 Families leaving welfare                   12
                                                                           Oct. to Dec. 1996 and Jan.
                                                                           to Mar. 1998
                                       South Carolina              200,000 Families leaving welfare              6 and 9
                                                                           Jan. to Mar 1997 and Jan.
                                                                           to Mar. 1999
                                                                                                             (continued)


                                       Page 41                        GAO/HEHS-99-48 Status of Former Welfare Recipients
Appendix III
Information on Selected Grants Awarded by
the Department of Health and Human
Services to Study Families Leaving Welfare




                                                                                Timing of
                                                                                   survey
                                      Award                                  (months after
Grantee                              amount Population of interest                   exit)
Washington                           244,965 Families leaving welfare                6 to 9
                                             Oct. to Dec. 1996, Oct. to
                                             Dec. 1997, and Oct. to Dec.
                                             1998
Wisconsin                            204,200 Families leaving welfare               5 to 10
                                             Oct. to Dec. 1996 and Jan.
                                             to Dec. 1998; families
                                             applying for welfare in
                                             Milwaukee Oct. 1998 to
                                             Mar. 1999

Source: Office of the Assistant Secretary of Planning and Evaluation, HHS.




Page 42                                  GAO/HEHS-99-48 Status of Former Welfare Recipients
                                          Appendix III
                                          Information on Selected Grants Awarded by
                                          the Department of Health and Human
                                          Services to Study Families Leaving Welfare




Figure III.1: Administrative Data Sources Grantees Planned to Use




                                          a
                                           This category includes other data sources, such as sources of tax, welfare-to-work, and health
                                          information.




                                          Page 43                                  GAO/HEHS-99-48 Status of Former Welfare Recipients
Appendix IV

Comments From the Department of Health
and Human Services




              Page 44    GAO/HEHS-99-48 Status of Former Welfare Recipients
Appendix IV
Comments From the Department of Health
and Human Services




Page 45                           GAO/HEHS-99-48 Status of Former Welfare Recipients
Appendix V

Major Contributors to This Report


               Gale C. Harris, Assistant Director, (202) 512-7235
               Margaret Boeckmann, Evaluator-in-Charge, (202) 512-6992
               Emily Loriso
               Regina Santucci
               Jay Smale




               Page 46                      GAO/HEHS-99-48 Status of Former Welfare Recipients
Page 47   GAO/HEHS-99-48 Status of Former Welfare Recipients
Related GAO Products


              Welfare Reform: States’ Experiences in Providing Employment Assistance
              to TANF Clients (GAO/HEHS-99-22, Feb. 26, 1999).

              Domestic Violence: Prevalence and Implications for Employment Among
              Welfare Recipients (GAO/HEHS-99-12, Nov. 24, 1998).

              Welfare Reform: Early Fiscal Effects of the TANF Block Grant
              (GAO/AIMD-98-137, Aug. 18, 1998).

              Welfare Reform: Child Support an Uncertain Income Supplement for
              Families Leaving Welfare (GAO/HEHS-98-168, Aug. 3, 1998).

              Welfare Reform: Many States Continue Some Federal or State Benefits for
              Immigrants (GAO/HEHS-98-132, July 31, 1998).

              Welfare Reform: Changes Will Further Shape the Roles of Housing
              Agencies and HUD (GAO/RCED-98-148, June 25, 1998).

              Welfare Reform: States Are Restructuring Programs to Reduce Welfare
              Dependence (GAO/HEHS-98-109, June 18, 1998).

              Welfare Reform: Transportation’s Role in Moving From Welfare to Work
              (GAO/RCED-98-161, May 29, 1998).

              Medicaid: Early Implications of Welfare Reform for Beneficiaries and
              States (GAO/HEHS-98-62, Feb. 24, 1998).

              Welfare Reform: States’ Efforts to Expand Child Care Programs
              (GAO/HEHS-98-97, Jan. 13, 1998).

              Welfare Reform: States’ Early Experiences With Benefit Termination
              (GAO/HEHS-97-74, May 15, 1997).

              Welfare Waivers Implementation: States Work to Change Welfare Culture,
              Community Involvement, and Service Delivery (GAO/HEHS-96-105, July 2,
              1996).




(116019)      Page 48                       GAO/HEHS-99-48 Status of Former Welfare Recipients
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