New Directions in Social Policy
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Editor's Note: In the December 2000 issue of POLICY & PRACTICE, Elaine M. Ryan, APHSA's director of government affairs, presented an overview of some of the social benefits, programs, and services to be reauthorized in the next two years. In this issue we feature a summary of APHSA's official report to the Bush Administration in which we present program challenges and action items that require both congressional and administrative action. The complete publication, Crossroads: New Directions in Social Policy, can be accessed at APHSA's web site, www.aphsa.org.
The Bush Administration and the 107th Congress are presented with a compelling opportunity to eliminate outdated federal rules and programs, to achieve greater efficiencies, and above all, serve children, families, and adults in need with dignity. These goals can be achieved by streamlining administration, aligning program outcomes, and expanding state flexibility in several human service programs over the next two years. The Personal Responsibility and Work Opportunity Reconciliation Act of 1996, including the Temporary Assistance for Needy Families block grant, the Child Care and Development Fund, the Food Stamp Program, the Promoting Safe and Stable Families Program, the Child Abuse Prevention and Treatment Act, and the transitional Medicaid program are all pending reauthorization. In addition, Medicare reform and the proposed creation of a new prescription drug benefit also may have implications for the Medicaid program. Child support distribution and child welfare financing are topics likely to be on the congressional agenda as well.
The breath and scope of the programs pending reauthorization will touch the lives of millions of the most disadvantaged children, families, and adults in the United States. Yet, current federal program rules, funding sources, and requirements conflict or impede their ability to deliver critical services to families in need. For example, states share responsibility for covering persons eligible to receive both Medicare and Medicaid without being able to affect policy decisions that govern Medicare. The Medicaid and State Children's Health Insurance Program (SCHIP) statutes do not permit blending insurance coverage and continuity of care as children move between programs. Billions of dollars in Head Start funds flow to local govements without respect to the state allocation of the Child Care and Development Fund, missing the opportunity to effectively leverage limited funding sources to reach additional children. The more effective states are in moving families from welfare dependence to work, the fewer resources are available to them to fund their child support programs because the collections once retained by states to operate their programs are now distributed to families. Varying eligibility and data reporting requirements for Temporary Assistance for Needy Families (TANF), the Workforce Investment Act, and the Welfare-to-- Work Grant program are vexing for both participants and administrators. Flexible state TANF and Medicaid eligibility rules conflict with restrictive federal Food Stamp Program (FSP) rules, often resulting in declining program participation. Different federal funding streams financing child welfare, Tide IV-E, and Title IV-B result in the perverse incentive to remove children from their homes rather than preserve families. These are but a few examples of conflicting federal program rules that should be addressed by the Bush Administration and Congress.
Food Stamp Program
APHSA calls for a comprehensive overhaul of the federal FSP that supports work and preparation for work and expands access for low-income disabled and elderly adults. The time has come for major changes, not further incremental adjustments to existing law. Both state administrators and food stamp recipients have become extremely frustrated and support for the current program is rapidly weakening. …