Program operations/implementation: Operations and implementation of state diversion programs are studied.

Social/Support services: The effects of state diversion programs and activities on safety net providers is studied.

To study how diversion programs are being implemented and what the effects are on participants, particularly with respect to Medicaid enrollment.

To determine whether and how local communities and institutions, particularly the traditional safety net providers, might be affected by diversion programs and activities, in particular by changes in Medicaid enrollment rates.

To determine whether potential strategies for monitoring changes in Medicaid enrollment rates as well as the effects of these changes over time can be developed based on existing databases.

The authors find that more than half of all states have implemented formal welfare diversion programs that provide families with a one-time lump-sum payment for expenses and/or require up-front job search before being allowed to apply for cash assistance. Their analysis indicates substantial variation among states with regard to program conditions and requirements. In particular, the study examines the possible effects of diversion on an individual’s access to Medicaid, focusing on whether or not diverted families are ever linked with Medicaid even though they do not apply for cash welfare. Finally, it identifies areas of need for further research in monitoring the impact of diversion on Medicaid receipt and information on strategies to ensure access for Medicaid eligibles.

“Questions about mandatory applicant job search include: 1) how do workers determine who is and is not required to look for work as a condition of eligibility, 2) what fraction of applicants find employment before their application for assistance is processed, 3) how do the non-cash benefits available to families differ depending on whether an applicant finds employment before or after his or her application for assistance is approved, 4) what is the relationship between the level of job search activity required and/or the amount of job search assistance provided and the proportion of applicants who find employment, and 5) what happens to applicants who get discouraged and do not complete the application process.”

“A common set of data elements about the diversion program and the state=s Medicaid program is needed to fully document and analyze the effects. However, most states do not collect common data. In the case of applicant job search, for example, diverted cases generally would be coded as incomplete or denied with no specific reference to participation in and the outcome of participation in an applicant job search program. Most states report that they would measure the success of the diversion programs in terms of the number or percentage of total applicants diverted and if or for how long they then stay off the TANF rolls, but little data of this type are available.”