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Building Bridges: States Respond to Substance Abuse and Welfare Reform

General Information

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Evaluator(s) National Center on Addiction and Substance Abuse at Columbia University
American Public Human Services Association
Investigator(s) Fay Gibson (National Center on Addiction and Substance Abuse at Columbia University)
Sponsor(s) National Center on Addiction and Substance Abuse at Columbia University
Funder(s) Robert Wood Johnson Foundation
Subcontractor(s) Eagleton Institute for Politics at Rutgers University
 
Domain Income Security/TANF
Status Completed (final report released)
Duration May 1997 - Aug 1999
Type Research and/or Program Evaluation
Policy Analysis
Goal To study all 50 states and territories with regard to their policies and practices concerning alcohol- and drug-dependent individuals who were formally served by Aid to Families with Dependent Children (AFDC) and who will now be served by Temporary Assistance for Needy Families (TANF). To study selected states in further detail.
Program/Policy Description State programs regarding substance abuse differ on several key issues: 1)how they integrate client substance dependence problems into the welfare intake process and the employment program; 2) Medicaid and other funding streams for substance dependence problems; and 3) structures for dealing with substance dependence problems. The study analyzed all states along these dimensions and developed case studies of selected sites.
Notes No notes reported.
 
Last Updated 10/18/99
Type of Summary Reviewed
External Reviewer(s) Audra Keitt (National Center on Addiction and Substance Abuse at Columbia University)
Contact(s) Fay Gibson (fgibson@casacolumbia.org)
National Center on Addiction and Substance Abuse at Columbia University
633 Third Avenue
19th floor
(T) (212)-841-5213
(F) (212)-956-8020
Publications Department CASA Publications (not reported)
National Center on Addiction and Substance Abuse at Columbia University
633 Third Avenue
19th floor
(T) (212) 841-5200
(F) (212) 956-8020

Populations Studied

Target Population Recipients/participants/clients
General population
Persons with substance abuse problems
Subgroups Analyzed Low-wage workers
Sample Size and Unit 50 state governments and territories.

Selected states for study in greater detail were selected.

Sites Studied

All 50 states and territories.

Program Components, Policies, and Activities Evaluated

Program requirements

  • Work requirement
  • Enrollment in substance abuse program
  • Drug testing

Social/Support services

  • Health benefits
  • Multiple services in single location
  • Substance abuse/dependence treatment

Administration/Implementation

  • Changes in welfare office environment/culture
  • Administration/Implementation - misc.

Financial disincentives/Sanctions

  • Denial of benefits to persons convicted of felonies
  • Reduction/termination of benefits for substance abuse

Employment activities

  • Employment policies linked to treatment

Time limits

  • Time Limits - misc.

Family caps

  • Family Caps - misc.

Eligibility

  • Eligibility - misc.
Variation in program components across sites? Yes
Notes on program components Employment activities: Integration of substance dependence problems in employment programs will be studied. Financial disincentives/sanctions: Denial, reduction or termination of benefits for substance abuse will be studied. Program operations: Differences in operations of welfare program with regards to substance abuse will be studied.

Program requirements: Drug testing, enrollment in a substance abuse treatment program, and work are required of all participants.
Social/Support services: Existence, availability, and structure of substance abuse treatment will be studied.

Outcomes Assessed

Employment

  • Job readiness/training

Income security

  • Medicaid receipt
  • Welfare receipt

Benefit termination

  • Due to substance abuse

Sanctions

  • Sanctions - misc.

Program implementation

  • Program Implementation - misc.

Health/ physical well-being (including prenatal health)

  • Health/ physical well-being - misc.

Substance abuse

  • Substance abuse - misc.

Types of Studies

Type Descriptive/Analytical Study
Aim To address the following issues: 1)the extent to which states integrate client substance dependence problems into the welfare intake process and the employment program; 2) Medicaid and other funding streams for substance dependence problems; and 3) state structures for dealing with substance dependence problems.
 

Data Sources

Source Survey
Title Self-administered mailed survey concerning practices regarding welfare, employment, and substance abuse services
Sample Characteristics/Data Collection 50 states governments and territories.
Mailed November 1997.
Sites 50 States and territories
Response Rate/Attrition Notes 51 out of 54 jurisdictions responded - 94% response rate
Additional Execution Notes No notes reported.
 
Source Interview
Title In-depth telephone interview
Sample Characteristics/Data Collection 12 states were selected because they appeared to be the most effective in dealing with problems of substance; 4 key personnel from each of these states were interviewed. Data collected 4/98 - 6/98.
Sites 12 states were selected
Response Rate/Attrition Notes N/A
Additional Execution Notes No notes reported.
 
Source Field Research
Title Key informant interview, observations, and site visits
Sample Characteristics/Data Collection Site visit and observation of 5 states (selected from the 12 that are surveyed by telephone).
Interviews with 6 key officials from each of the 5 states.
Data collected 6/98 - 5/99.
Sites 5 states were selected
Response Rate/Attrition Notes N/A
Additional Execution Notes No notes reported.
 
Source Focus Group
Title Focus groups with line workers
Sample Characteristics/Data Collection Interviews with 6-8 frontline workers in each of the 5 selected case study states. Data collected 6/98 - 10/98.
Sites 5 states were selected
Response Rate/Attrition Notes N/A
Additional Execution Notes No notes reported.
 

Findings Available

Final Descriptive/Analytical Findings

Findings

08/01/99: Building Bridges: States Respond to Substance Abuse and Welfare Reform
Final descriptive/analytical findings:

Substance use among TANF participants is a significant concern to state administrators.

A variety of state structures for meeting the employment and treatment needs of participants are in place.

Policies and practices to identify and track substance abuse are undeveloped.

Substance abuse counselors are rarely available to welfare or employment staff.

Specialized employment and treatment services for substance abusing TANF participants are just beginning to be instituted.

 

Recommendations

Building Bridges: States Respond to Substance Abuse and Welfare Reform (08/01/99)
Involve workers at all levels of relevant agencies, from front-line workers to top-level management.

Elicit the political support of top-level politicians and administrators, and other stakeholders in developing and implementing policies and practices to address substance abuse within the context of welfare reform.

Continually assess and improve data collection, staff training, substance abuse screening and assessment, and other systems to identify and address substance abuse among TANF participants.

Identify a mix of treatment and employment-related services that address the multiple needs of substance abusing TANF participants in all regions.

Involve local agencies in developing state strategies to address substance abuse in the welfare system, and clearly communicate these strategies.

 

Existing Publications

08/01/99 Building Bridges: States Respond to Substance Abuse and Welfare Reform CASA
06/01/97 Building Bridges: State Policies and Practices Regarding Substance Abuse, Medicaid, and Employment Needs of Welfare Recipients: Project Summary CASA

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