To understand the effects of devolution and time-limited assistance on low-income individuals, the institutions that serve them, and the neighborhoods in which they live.

"The study found that within a relatively short time — and typically with little prior experience in putting major pre-PRWORA reforms in place — the welfare agencies in these counties made significant strides in communicating a new welfare message, changing over to a work-first approach, mandating participation in welfare-to-work services, and designing new institutional structures."

"Much remained to be done, however, in terms of changing the culture of welfare agencies, sharpening and clarifying welfare’s new messages, developing and carrying out plans for dealing with especially disadvantaged recipients, enhancing job placement efforts, ensuring ongoing benefits for former recipients who have made the transition to low-wage employment, and improving recipients’ ability to keep jobs and to move up to better ones."

"To date, the sites have not seen a fraying of their "social safety nets.""

"The participants in the ethnographic study were in favor of many of the welfare reform provisions but expressed anxiety about their consequences."

Drawing on 1998-1999 survey and ethnographic data from the Urban Change study (a multicomponent study of the implementation and effects of welfare reform in four large cities), this paper describes the food security of mother-headed families who were living in highly disadvantaged urban neighborhoods and who had received or were currently receiving cash welfare benefits. The families of four groups of women were compared: those who, at the time of the interview, worked and were no longer receiving welfare; those who combined welfare and work; nonworking welfare recipients; and those who neither worked nor were then receiving welfare. The survey results indicated that food insecurity in the prior year was high in all groups. Overall, about half the families were food insecure, and hunger was found in slightly more than 15 percent of the families. Moreover, in nearly one-third of the families there were food hardships that affected the children’s diets. Food insecurity was most prevalent among families where the mother had neither employment income nor welfare benefits. Food insecurity was lowest among the families where the mothers were working and no longer getting welfare, but even in this group 44.5 percent were food insecure, and nearly 15 percent had experienced hunger. Data from in-depth ethnographic interviews indicate that, in this population, women who are food secure nevertheless expend considerable energy piecing together strategies to ensure that there is an adequate amount of food available for themselves and their children.

What workers think:

Welfare agency personnel are aware that recipients are entitled to transitional Medicaid and Food Stamps, and they strongly endorse working-poor families receiving these benefits.

Staff members’ perceptions of the adequacy of their training on transitional benefits vary from site to site.

What workers do:

What workers say they are doing is generally what they are supposed to do according to policy. In general, whether or not a recipient continues to receive food stamps after her cash case closes is strongly associated with the closing reason; in particular, when a TANF case closes because the recipient has not attended eligibility redetermination, she loses both cash and food stamps at most sites.

Medicaid is handled differently. Since early 1999, all the Urban Change states have put in place measures to promote continued Medicaid coverage, whatever the reason for closing a recipient’s cash case — although there is reason to question whether all staff members are following the new procedures. When procedures are computerized and the new rules are built into the system, workers are more likely to handle cases properly.

Why recipients don’t attend redetermination appointments:

Attending an in-person redetermination is likely to be especially inconvenient for TANF recipients who have found daytime jobs.

“Doing the right thing” may well depend on knowing the right things.

Recipients who know that they may be eligible for Medicaid and food stamps when they get a job may be more motivated to look for work, and they may be more willing to take entry-level positions and jobs with limited or no medical coverage.

What workers tell — or don’t tell — participants:

The line staff workers we interviewed generally said that they conveyed in-formation about ongoing benefits to recipients on their caseloads, although problems surfaced in their descriptions of what they said and when they said it.

Observations suggest that workers say they talk to recipients about ongoing Medicaid and food stamps more than they actually do.

Even when staff do convey eligibility information clearly, this is only one of many topics they must cover during the course of any given interaction with a client; consequently, clients may not remember what they were told.

Printed materials explaining food stamp and Medicaid eligibility were not always available, and when they were, workers in most sites did not routinely give them to recipients.

What participants understand:

The majority of the ethnographic study participants who were interviewed either said that they didn’t know about the current rules for food stamps and/or Medicaid or referred to time limits for these benefits.

In both sites, women usually reported receiving their information about food stamps and Medicaid from one or two sources, although as a group they mentioned a wide range of sources. No particular source of information or combination of sources was generally associated with a better understanding of the local policies regarding food stamps or Medicaid than any of the other sources.

Agency staff were generally aware that major changes in welfare policy had occurred, but few expressed detailed knowledge of the policies.

The overwhelming majority of respondents expressed negative or mixed views of welfare reform.

Changes attributed to welfare reform began soon after the policies were implemented, but these changes have not yet been as dramatic as the critics of reform have predicted.

Changes in the demand for education and training services have been the biggest effect of welfare reform so far. Agencies’ experiences - whether demand increased or decreased - depended partly on the state and local welfare policies and how they were implemented.

Most basic needs organizations have not yet seen an increase in demand. Nor, however, have they seen increases in private donations as predicted by supporters of welfare reform. Moreover, the experiences of a few Cleveland agencies suggest that time limits or sanctioning policies that cause many people to lose benefits will significantly affect the demand faced by these private charities.

Despite the limited impact that the first year of welfare reform had on community organizations, respondents anticipate that the new policies will appreciably increase the demand for their services in the future. Many, however, have no plans for meeting the new needs or the possible rise in demand.

• Compared with national samples, women in the Urban Change survey sample had substantially higher rates of personal health and mental health problems and children’s health problems.
• The ethnographic data suggest that the survey data do not fully capture the severity of the health-related hardships the families faced.
• Health problems were strongly related to the women’s employment status.
• Health care access, however, was strongly related to the women’s welfare status.
• The four work/welfare groups, then, had appreciably different health profiles — and all four groups had distinct health-related vulnerabilities.
• Both groups of women still on welfare, especially those without paid employment, had a high prevalence of health problems that pose challenges to welfare agencies.
• Negative experiences with the welfare agency were more prevalent among women with health problems.

• The majority of women who were working at the time of their interview had worked in most of the prior 24 months. Full-time employment was the norm, whether that employment was stable or not.
• Even among women who had been working most stably, the majority had low-wage jobs with earnings that put their families below the official poverty level.
• Among the employed women, about two out of five held jobs that provided no fringe benefits. Even among those who had worked most stably, only about half had jobs that offered health insurance.
• In most cases, the mothers’ earnings were the primary source of household income. Most women and their families faced multiple material hardships, such as food insecurity, housing problems, and unmet health care needs.
• Nearly all the women who worked faced barriers or "challenges" to employment, such as their own or a child’s health problems, less than high school education, or depression. The women who worked most stably faced fewer such obstacles.
• Public safety net programs (food stamps, Medicaid, housing assistance, child care subsidies) were not used by the majority of the women, despite their apparent eligibility for them.

Welfare administrators in the counties supported PRWORA's emphasis on rapid employment. For many administrators and staff, looming time limits on cash welfare assistance lent new urgency to the goal of getting clients into jobs or job preparation activities.

Declining caseloads and the TANF block grant structure left the counties with substantially more money to spend on welfare-to-work activities than had been available in the past. They used the funds to hire more case managers and to expand program capacity, which enabled them to extend welfare-to-work mandates and services to a larger proportion of the caseload.

The most common welfare-to-work activity in all four counties in 1999/2000 was work itself, followed by job search and short-term vocational training. Few participants were engaged in basic or postsecondary education. Only two of the counties ran substantial community service or unpaid work programs.

One important factor behind the increase in the proportion of recipients who were employed is state earned income disregard policies that allowed recipients to raise their monthly income by combining earnings and benefits and that boosted the counties' welfare-to-work participation rates. It is important to note, however, that welfare recipients who combined work and welfare generally used up valuable months of welfare eligibility.

The counties' emphasis on job search and short-term activities made sense in the strong economy of the late 1990s. The recent economic downturn may call for more spending on training and subsidized jobs.

Although the counties adopted strikingly different sanctioning policies to address noncompliance with work requirements, participation rates were roughly similar regardless of whether enforcement was strict or lenient.

• Assisted and unassisted leavers differed with respect to demographic characteristics, work-readiness, and work history.
• While a clear employment advantage was not evident for any one of the housing assistance groups, leavers with tenant-based assistance were somewhat more likely to have the most positive employment-related outcomes.
• Regardless of housing assistance status, the majority of those who went off welfare in quarter 3 of 1998 did not return to welfare in the year of follow-up. Assisted leavers with no recent work history were more likely to return to welfare.
• Post-exit well-being did not vary by housing assistance status: assisted leavers, more so than unassisted leavers, were more likely to be living in poverty and to report experiences of food insecurity and hunger. Unassisted leavers, were more likely to indicate housing hardships such as excess rent burden and unmet medical needs.
• The mobility choice inherent in Section 8 housing does not necessarily place tenants in safer neighborhoods.

• Individuals who left welfare in 1998 were somewhat more advantaged with respect to pre-exit employment and earnings.
• Women leaving welfare in 1998 were somewhat more successful in finding and keeping work.
• Both groups of leavers generally had low earnings and little earnings growth in their first year off cash assistance.
• Women with less than stable work history were more likely to report the presence of barriers to work.
• Less than one-fifth of those with children under the ages of 13 years reported that they had received help from a government agency or other source for paying for child care costs since they left welfare.
• Most recipients who left welfare did not return within one year of exit. Welfare recidivism rates were lower for the post-CalWORKs leavers.
• Those returning to welfare were less likely to have worked steadily post-exit and were more likely to have relied on other government supports.
• Overall, between 1996 and 1998 there was a marked increase in the rates of post-exit participation in Medi-Cal.
• Fifty-four percent of families leaving cash assistance live in households with incomes below the poverty threshold.
• Reports of post-exit material hardship varied by respondents' work status.

• Philadelphia substantially changed its welfare system. The state focused its welfare-to-work program on employment, expanded and simplified provisions that allow welfare recipients to keep part of their welfare checks if they worked and instituted 2 time limits.
• In Philadelphia, between 1992 and 2000, employment increased and welfare receipt declined.
• A longitudinal survey of welfare mothers living in the city's poorest neighborhoods suggests that, over time, more worked and fewer received welfare, while household incomes increased.
• Between 1992 and 2000, social conditions in the city's poorest neighborhoods generally improved.

• Miami-Dade implemented a stringent program.
• Miami-Dade’s welfare rolls fell sharply, but how much of the decline was due to welfare reform is unclear.
• Welfare reform appears to have led to an increase in employment among welfare recipients.
• Over time, welfare recipients’ employment and economic circumstances generally improved.
• Neighborhood conditions remained stable or improved.

• Los Angeles County's caseload is large and diverse.
• The CalWORKs program added time limits and rigorous participation requirements.
• CalWORKs requirements are softened by protections for children.
• California's cash grants and financial work incentives are comparatively generous.
• Participation in the GAIN program begins immediately.

• Caseloads were declining in the mid-1990s.
• Both participation and sanctioning increased.
• CalWORKs appears to have encouraged long-term recipients in Los Angeles to exit welfare more quickly.
• Recipients in both poor and nonpoor neighborhoods increasingly got jobs.
• The circumstances of recipients who took part in a longitudinal survey generally improved over time.
• Despite improvements, most women in the survey remained poor.
• Los Angeles’s new welfare policies were comparatively lenient.
• Welfare exits accelerated in all Urban Change sites.
• Caseload declines were smallest in Los Angeles.
• Across the four sites, similarities were more prominent than differences.

Three of the Urban Change sites had begun to plan for hard-to-serve recipients.

Two of the Urban Change sites had embarked on major job development initiatives.

Three of the Urban Change sites planned to provide special job retention and/or skills upgrading services.

In general, the sites have not focused on issues related to respondents’ personal lives.

1. Increase the eligibility period for food stamp receipt to the six months permitted under federal regulations, in order to reduce the “hassles” associated with more frequent recertification.
2. Seek a federal waiver of the food stamp rules to adopt the quarterly reporting option for families with earnings (discussed below).
3. Stop terminating food stamp benefits when the cash case closes for failure to attend redetermination; instead, offer a temporary extension of food stamp eligibility, and notify clients that they may still be eligible for this benefit if they provide the necessary information.
4. Extend welfare office hours to accommodate the needs of working participants, as has been done in Cuyahoga and Philadelphia Counties, and make sure that recipients know about the extended hours.
5. Institute or expand home visits to conduct eligibility recertification/redermination for participants when an in-person meeting at the welfare office cannot be readily scheduled.
6. Experiment with permitting recipients to verify ongoing eligibility for food stamps and cash welfare by mail or by telephone, as is currently done in California for Medicaid. Allow documents to be transmitted to the welfare office via fax machine, as is common practice in Cuyahoga County.
8. Accept verbal statements about the amount a participant pays for rent and utilities, instead of requiring official documentation. California has relaxed food stamp eligibility verification requirements in this way, with positive results.
9. Where TANF workers and food stamp-only or Medicaid-only workers are not collocated, be sensitive to the possibility that cases will not be transferred smoothly from one group to the other, and establish procedures that facilitate such transfers.
10. Consider placing outstationed workers in hospitals, clinics, and other community settings — not only to accept initial applications for food stamps and Medicaid (as is currently done for Medicaid in Miami) but also to conduct redeterminations. Los Angeles mounted a successful campaign to enroll children in Medicaid by locating outreach stations in schools, churches, community service agencies, and other sites outside the welfare office.
11. Require workers to keep a log of all cases in which any benefit other than TANF is terminated.
12. Require written authorization from clients who request closing not only the cash case but also food stamps and Medicaid; require that staff inform such clients about their potential continued eligibility for these benefits.
13. Institute supervisory review of all cases in which food stamps and Medicaid are closed along with cash.

Steps to Improve the Information Flow:

1. Anticipate that the information will have to be repeated many times, and in many different ways.
2. Expect workers to provide the information in their first interactions with recipients.
3. Equip workers with a script to ensure that they cover the topic of eligibility in their meetings with recipients. Incorporate this script (or other prompts) as a screen in the computerized eligibility system.
4. Include mention of transitional Medicaid and possible continued food stamp eligibility in any “contract” or self-sufficiency plan the recipient is expected to sign; give the recipient a copy of the contract.
5. Back up the oral communication with printed materials that recipients can take with them.
6. Enlist the help of the media and community-based organizations in getting the word out.
7. Provide training on transitional benefits to staff of all the divisions of the welfare agency who work with recipients, and to staff of outside agencies that provide welfare- to-work services.
8. Inform staff at community agencies serving large numbers of welfare recipients, as well as at welfare advocacy organizations, about policies concerning continued eligibility for food stamps and Medicaid.
What the Food and Nutrition Service Can Do:

1. Take additional steps to promote information dissemination. To achieve this objective, we suggest that FNS:
a. Seek congressional authorization to increase the federal share of funding (now set by law at 50 percent) for continued outreach to TANF and working-poor families to inform them about their potential eligibility for food stamps.
b. Encourage states to experiment with innovative ways of publicizing information about benefit eligibility, and serve as a clearinghouse for such techniques.
2. Relax the food stamp quality control regulations. Accordingly, FNS may want to: a. Make quarterly reporting of income the norm rather than a waiver available to the states.
b. Seek congressional authorization to reduce the financial penalties imposed on states for overpayments made to working families.