Where to Turn... Your Guide to Federal Disability Policies and Programs Authors Patrice Drew, Esq. Cathy Ficker Terrill Anne C. Parrette, Esq. Project Coordinator Janna Starr Editors Larry H. Hoffer Lisa Ward Monique Marino Brain Injury Association US Department of Health and Human Services HRSA Health Resources and Services Administration Maternal and Child Health Bureau Disclaimer The Brain Injury Association shall not be held liable for content changes made by unauthorized parties, including but not limited to: alterations of text, images or other information within Where to Turn: Your Guide to Federal Disability Policies and Programs (the Guide.) The Guide contains general information. It is not an authoritative legal document, nor shall it be construed as legal advice. The Guide shall not be relied upon as a legal authority for acting or refusing to act. The information contained in the Guide may change as Federal polices and programs are amended periodically. The Brain Injury Association is not responsible for notifying the Public of these changes. Welfare and Temporary Assistance for Needy Families (TANF) What is the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996? The Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) was passed by Congress in 1996 and is a comprehensive bipartisan welfare reform plan that dramatically changed the nation's welfare system into one that requires work in exchange for time-limited assistance. The law contains strong work requirements, a performance bonus to reward states for moving welfare recipients into jobs, state maintenance of effort requirements, comprehensive child support enforcement, and supports for families moving from welfare to work - including increased funding for child care and guaranteed medical coverage. What is Welfare-to-Work? Under PRWORA, recipients must work after two years on assistance, with few exceptions. In 1998, states were required to have 30 percent of all single parent families, and 75 percent of all two-parent families, engaged in a work activity for a minimum of 20 hours per week for single parents and 35 hours per week for two-parent families. The rates for all families started at 25 percent in 1997 and increase 5 percent each year, to 50 percent in 2002. Work Requirements: Recipients must work after two years on assistance Single parents must work for at least 20 hours per week Two-parent families must work 35 hours per week Are child care and medical assistance available? PRWORA provides over $14 billion over five years in child care funding to help more mothers move into and stay in jobs. PRWORA also guarantees that individuals who meet pre-welfare reform welfare-eligibility criteria continue to be eligible to receive Medicaid, including at least six months of transitional Medicaid assistance (TMA) when they leave welfare-for-work. Families leaving welfare because of increased income from work are entitled to TMA for six months. For the next six months, they remain eligible for TMA if their income is below 185% of poverty. In addition, families who qualified for Medicaid under Section 1931 but are not on welfare also are entitled to TMA if they become ineligible because of increased income from work. States should make clear to families that they should remain in contact with the welfare office-even if they find a job or get a pay raise-in order to get TMA. What kind of work is required? To count toward state work requirements, recipients are required to participate in unsubsidized or subsidized employment, on-the-job training, work experience, community service, up to 12 months of vocational training or provide child care services to individuals participating in community service. Up to six weeks of job search (no more than four consecutive weeks) can count toward the work requirement. States can count no more than 30 percent of work participants toward meeting the work requirement based on their participation in vocational training. Single parents with a child under age six who cannot find child care cannot be penalized for failure to meet the work requirements. States can exempt from the work requirement single parents with children under age one and disregard these individuals in the calculation of participation rates for up to 12 months. Is there a time limit on receiving assistance? Families who have received assistance for five cumulative years (or less at state option) will be ineligible for federally funded cash aid under the welfare reform law. States are permitted to exempt up to 20 percent of their caseload from the federal time limit, and have the option to provide state-funded assistance, non-cash assistance or vouchers to families who reach the time limit using Social Services Block Grants or state funds. States also can lower the time limit for receipt of assistance in their state. How can I determine what job I am best suited for? Under PRWORA, states are required to make an initial assessment of recipients' skills. States also can develop personal responsibility plans for recipients to receive the education, training and job placement services needed to move them into the workforce. Are there any subsidies or incentives available to employers? The law allows states to create jobs by taking money now used for welfare checks and using it to create community service jobs or provide income subsidies or hiring incentives for potential employers. A welfare-to-work tax credit. This provision gives employers an added incentive to hire long-term welfare recipients by providing a credit equal to 35 percent of the first $10,000 in wages in the first year of employment, and 50 percent of the first $10,000 in the second year, paid to new hires who have received welfare for an extended period. The credit is for two years per worker, to encourage not only hiring but job retention. How does PRWORA promote responsibility? PRWORA includes the child support enforcement measures President Clinton proposed in 1994 - the most sweeping crackdown on non-paying parents in history. Collections rose to a record high of $14.4 billion in 1998, an 80 percent increase since 1992. Under PRWORA, to be eligible for Temporary Assistance to Needy Families (TANF) block grants, each state must operate a child support enforcement program that meets federal requirements. Provisions include: National new hire reporting system. The law establishes a Federal Case Registry and National Directory of New Hires to track delinquent parents across state lines. It also requires that employers report all new hires to state agencies for transmittal of new hire information to the National Directory of New Hires. Approximately 2.8 million parents delinquent in child support payments were found last year by the National Directory of New Hires, which matches all employees, both newly hired and those already holding jobs, with a list of parents who owe child support. This builds on President Clinton's June 1996 executive action to track delinquent parents across state lines. The law also expands and streamlines procedures for direct withholding of child support from wages. Streamlined paternity establishment. PRWORA streamlines the legal process for paternity establishment, making it easier and faster. It also expands the voluntary in-hospital paternity establishment program, started by the Clinton Administration in 1993, and requires a state form for voluntary paternity acknowledgment. In addition, the law requires states to publicize the availability and encourage the use of voluntary paternity establishment processes. Welfare recipients who fail to cooperate with paternity establishment will have their monthly cash assistance reduced by at least 25 percent. Paternity establishments rose to more than 1.4 million in 1998, an increase of over 300 percent since 1992. Uniform interstate child support laws. PRWORA provides for uniform rules, procedures and forms for interstate cases. Computerized state-wide collections. PRWORA requires states to establish central registries of child support orders and centralized collection and disbursement units. It also requires expedited state procedures for child support enforcement. Tough new penalties. Under PRWORA, states can implement tough child support enforcement techniques. PRWORA expands wage garnishment, allows states to seize assets, allows states to require community service in some cases, and enables states to revoke drivers and professional licenses for parents who owe delinquent child support. "Families First." Under a new "Families First" policy, families no longer receiving assistance will have priority in the distribution of child support arrears. This new policy will bring families who have left welfare for work about $1 billion in support over the first six years. Access and visitation programs. In an effort to increase non-custodial parents' involvement in their children's lives, PRWORA includes grants to help states establish programs that support and facilitate non-custodial parents' visitation with and access to their children. Are there any provisions that address teenagers? Under PRWORA, unmarried minor parents must live with a responsible adult or in an adult-supervised setting and participate in educational and training activities to receive assistance. States are responsible for locating or assisting in locating adult-supervised settings for teens. In addition to requiring unmarried minor parents to stay in school and live at home or in a supervised setting, the law encourages "second chance homes" to provide teen parents with the skills and support they need and provides $50 million a year in new funding for state abstinence education activities. What are the potential barriers to accessing aid? The enactment of PRWORA and the Balanced Budget Act of 1997 (BBA) has had a profound effect on the Medicaid program. There have been problems facing TANF/Medicaid recipients in many states. Delinking Medicaid - One perplexing and disturbing problem is the failure to "delink" Medicaid from TANF. To preserve Medicaid eligibility for families formerly eligible for Aid to Families with Dependent Children (AFDC), the new welfare law delinked eligibility for Medicaid from the receipt of cash assistance. Specifically, a new section, Section 1931, the so-called Medicaid savings clause, requires that families who meet the AFDC income, resource, and family composition rules in effect on July 16, 1996, continue to be eligible for Medicaid even if they do not meet their state's new cash assistance requirements. The "delinking" of Medicaid eligibility from TANF eligibility was intended to ensure that poor families with dependent children would continue to have access to medical assistance. Yet reports from the field indicate that eligible families and their children are losing Medicaid coverage. Although section 1931 requires states to establish a new, separate category of Medicaid eligibility based on pre-welfare reform eligibility criteria, states are continuing to link Medicaid eligibility to eligibility for cash assistance. Many states report using a consolidated application form for both TANF and Medicaid. States also are aligning eligibility rules for their TANF and Medicaid programs to minimize administrative burden and complexity and foster coordination. However, absent a clearly established alternate route to Medicaid, these policies and procedures are endangering Medicaid eligibility for recipients who do not want to receive TANF benefits or are no longer eligible to receive them due to a time limit or sanction. Sanction for Refusal to Work - Another problem is the use of sanctions. The PRWORA gives states the option to terminate the Medicaid coverage of an adult who loses cash assistance provided under the state's TANF-funded program because he or she refused to work. The Health Care Financing Administration (HCFA) has interpreted this provision to mean that a state may terminate Medicaid coverage of an individual whose "cash assistance funded under TANF is terminated for failure to meet a work requirement (as defined by TANF)." The federal statute explicitly prohibits states from terminating the Medicaid coverage of a pregnant woman who fails to comply with a work requirement, or from terminating a child's Medicaid coverage because the child's parents' refuse to work. Preliminary results from a nationwide survey revealed that 16 states report opting to terminate Medicaid coverage as a sanction for violating TANF work requirements. Reports from the field, however, indicate that states are applying sanction policies more broadly than permitted under the law. Many states require TANF recipients to sign a personal responsibility agreement that requires recipients to agree to certain conditions in order to receive their benefits, such as ensuring that their children receive age-appropriate immunizations and are raised in a home free from violence. The agreement explicitly provides that the failure to comply with any of its provisions may result in the imposition of sanctions, including the loss of cash benefits and Medicaid. Sanction for Alcohol and Substance Abuse - In certain states, some applicants for public assistance and Medicaid who fail to participate in mandatory screening and assessment for alcohol and/or substance abuse are becoming ineligible for both public assistance and Medicaid. Even in states with a policy of not sanctioning Medicaid for TANF-related violations, recipients are losing their Medicaid benefits. Sanction for Failure to Obtain Medical Support for a Child - Recipients also may be losing Medicaid benefits due to the inappropriate application of sanctions for failing to cooperate in obtaining medical support. The new welfare law left intact the provisions of prior law allowing states to terminate the Medicaid benefits of a custodial parent who fails to cooperate in obtaining medical support. States, however, no longer are permitted to impose a Medicaid sanction for a failure to cooperate with child support enforcement unless that failure is simultaneously a failure to cooperate in obtaining medical support. Work Diversion - Another major problem is diversion into work programs. A number of states have implemented or are implementing work first (or job diversion) programs, which divert recipients from applying for or receiving cash assistance when they first seek assistance from the county welfare office. Recipients may be diverted to an employment security office for a job referral or be asked to participate in "up front" job search activities before receiving any assistance. Such programs run the risk of denying recipients Medicaid benefits because they are diverted from even applying for cash assistance. Lack of access to Medicaid in these circumstances violates the PRWORA provisions that make recipients eligible for Medicaid based on the July 16, 1996, requirements. Such a rule also likely violates the Medicaid Act provisions allowing recipients the right to apply for benefits. Moreover, delaying the Medicaid application pending work program requirements that apply only to AFDC would violate Medicaid recipients' rights to have their applications processed in a timely manner. To find out how to apply for assistance in your state, contact your local social services department. Endnotes Families USA www.familiesusa.org Children's Defense Fund www.cdf.org Administration for Families and Children, Department for Health and Human Services www.acf.dhhs.gov Family Resource Coalition of America: www.frca.org