Report to Congressional Requesters

United States General Accounting Office

GAO

December 2002 WELFARE REFORM

Former TANF

Recipients with

Impairments Less

Likely to Be Employed

and More Likely to

Receive Federal

Supports

GAO-03-210
Recipients of Temporary Assistance for Needy Families (TANF) who had

impairments were found to be half as likely to exit TANF as recipients

without impairments, and recipients caring for children with impairments

were found to be less than half as likely to exit TANF as recipients not caring

for children with impairments, after controlling for demographic differences

such as age, race, and marital status. Although impairments affect exits,

other factors, including family support and personal motivation, as well as

local TANF policies, may also affect whether recipients exit TANF.

After leaving TANF, people with impairments were one-third as likely as

people without impairments to be employed, according to a statistical model

that controlled for demographic differences, and they were more likely to

receive federal supports. Forty percent of leavers with impairments

reported receiving cash assistance from Supplemental Security Income

(SSI), a federal program designed to assist low-income individuals who are

aged, blind, or disabled. Leavers with impairments were also more likely to

receive non cash support in the form of Food Stamps and Medicaid than

their counterparts without impairments.

These findings underscore the challenge states face in ensuring that

recipients with impairments and those caring for children with impairments

receive the supports they need to meet the work-focused goals and

requirements of TANF.

Employment and Receipt of SSI among Leavers with and without Impairments, July 1997

through July 1999

82% Employed (no SSI)

18%

Not employed (no SSI) Not employed (no SSI)

•

Employed

(no SSI)

6%

Both employed and

receiving SSIa

Receiving SSI

(not employed)

•

Leavers with impairments Leavers without impairments

• 27% 33%

34%

73%

Source: GAO's analysis of SIPP data on disability.

a

Employment and receipt of SSI are not necessarily concurrent.

WELFARE REFORM

Former TANF Recipients with

Impairments Less Likely to Be Employed

and More Likely to Receive Federal

Supports

www.gao.gov/cgi-bin/getrpt?GAO-03-210.

To view the full report, including the scope

and methodology, click on the link above.

For more information, contact Cynthia M.

Fagnoni at (202) 512-7215 or

fagnonic@gao.gov.

Highlights of GAO-03-210, a report to the

Ranking Minority Member, Subcommittee

on Human Resources, Committee on

Ways and Means, House of

Representatives and another

representative

December 2002

Debates surrounding the

reauthorization of welfare reform

legislation have involved some

discussion regarding outcomes for

TANF recipients with physical or

mental impairments. To inform this

discussion, GAO was asked to report

on (1) whether recipients with

impairments were as likely to exit

TANF as their counterparts without

impairments and (2) the sources of

income reported by leavers with and

without impairments. To obtain this

information, GAO analyzed selfreported data for the most recent

years available from the Census

Bureau’s Survey of Income and

Program Participation (SIPP) –- a

national survey of households that

includes questions about TANF status

and functional impairments.
Page i GAO-03-210 Welfare Reform

Letter 1

Results in Brief 2

Background 3

Impairments Were Relatively Common Among TANF Recipients 8

Recipients with Impairments Were Less Likely to Exit TANF Than

Recipients without Impairments 10

After Leaving TANF, People with Impairments Were Less Likely to

Be Employed and Were More Likely to Receive Federal Supports

Than Were People without Impairments 14

Concluding Observations 19

Agency Comments 20

Appendix I Scope and Methodology 22

Data Source: Census Bureau’s SIPP Data 22

Logistic Regression Analyses 23

Appendix II Comments from the Department of Health and

Human Services 28

Appendix III GAO Contacts and Staff Acknowledgments 30

GAO Contacts 30

Staff Acknowledgments 30

Bibliography 31

Related GAO Products 32

Tables

Table 1: Results of Logistic Regression Model of TANF Exits 25

Table 2: Results of Logistic Regression Model of Post-TANF

Employment 26

Contents
Page ii GAO-03-210 Welfare Reform

Figures

Figure 1: Prevalence of Impairments among TANF Recipients and

Non-TANF Population, July 1997 through July 1999 9

Figure 2: Demographic Differences between Adult TANF

Recipients with and without Impairments 10

Figure 3: Employment and Receipt of SSI among Leavers with and

without Impairments, July 1997 through July 1999 16

Figure 4: Proportion of Leavers with and without Impairments

Reporting Receipt of Income from Personal Earnings,

Household Earnings, or SSI in First Month after Leaving

TANF 18

Figure 5: Proportion of Leavers Receiving Food Stamps and

Medicaid, July 1997 through July 1999 19

Abbreviations

ADA Americans with Disabilities Act of 1990

AFDC Aid to Families with Dependent Children

DI Disability Insurance

HHS Department of Health and Human Services

MDRC Manpower Demonstration Research Corporation

MOE maintenance of effort

PRWORA Personal Responsibility and Work Opportunity

Reconciliation Act of 1996

SIPP Survey of Income and Program Participation

SSA Social Security Administration

SSI Supplemental Security Income

TANF Temporary Assistance for Needy Families
Page 1 GAO-03-210 Welfare Reform

December 6, 2002

The Honorable Benjamin L. Cardin

Ranking Minority Member

Subcommittee on Human Resources

Committee on Ways and Means

House of Representatives

The Honorable Pete Stark

House of Representatives

With the enactment of the Personal Responsibility and Work Opportunity

Reconciliation Act of 1996 (PRWORA), the Congress made sweeping

changes to federal welfare policy for needy families. PRWORA created the

Temporary Assistance for Needy Families (TANF) block grant to states,

which emphasizes work and responsibility over dependence on

government benefits. Under TANF, states are to impose work

requirements on most adults receiving TANF cash assistance and place a

lifetime limit of 60 months on the receipt of federal cash assistance. Some

policymakers have expressed concerns about the ability of TANF

recipients with physical or mental impairments to comply with program

requirements, which has contributed to a heightened interest in what

happens to people with impairments after they exit TANF. Although the

TANF block grant program was due to expire on September 30, 2002, the

Congress provided for an extension of the program until January 11, 2003.

By that time, the Congress must either reauthorize the program or provide

for an additional extension. As of September 30, 2002, the House of

Representatives had passed reauthorization legislation and the Senate

Committee on Finance had passed a reauthorization bill, although the full

Senate had not yet voted on this bill.

To provide you with information on how people with impairments are

faring in the current welfare environment and what issues may need

attention as welfare reform evolves, you asked us to determine (1) how

prevalent impairments are among TANF recipients; (2) whether recipients

with impairments are as likely to exit TANF as recipients without

impairments; and (3) what sources of income people with impairments

have after leaving TANF, compared with people without impairments.

To address all three questions, we analyzed self-reported data for the most

recent years available from the Census Bureau’s Survey of Income and

United States General Accounting Office

Washington, DC 20548
Page 2 GAO-03-210 Welfare Reform

Program Participation (SIPP)—a survey of households nationwide that

asks respondents questions about their TANF status and functional

impairments and uses categories of impairments comparable to those

covered by the Americans with Disabilities Act of 1990 (ADA).1

 Because

these data are self-reported, they may not accurately reflect the size of the

population with impairments. We used a cross section of responses given

between July 1997 and July 1999 and relied on a definition of impairments

developed by Census that includes both severe and nonsevere physical

and mental impairments. Our analyses included both descriptive statistics

and multivariate analyses. We used appropriate techniques to weight the

data to make population estimates. The sampling error for these estimates

varied but did not exceed plus or minus 8 percentage points. For more

information, see appendix I. We also reviewed findings of other studies to

supplement the SIPP data. We conducted our work from March to October

2002 in accordance with generally accepted government auditing

standards.

Impairments were relatively common among TANF recipients, with

44 percent reporting having at least one impairment, caring for a child with

at least one impairment, or both, compared with only 15 percent of the

non-TANF population. The term impairments encompasses both mental

and physical conditions. For instance, impairments could be physical

conditions that hinder movement or require a cane or other mobility

device, cognitive impairments, or mental conditions such as chronic

depression. Adult recipients who had impairments were more likely to be

over age 35 and white than adult recipients without impairments.

Recipients with impairments were less likely to exit TANF than recipients

without impairments. Specifically, controlling for certain demographic

characteristics, such as age, race, and marital status, adult recipients with

impairments were half as likely to exit TANF as were adult recipients

without impairments. Likewise, recipients caring for children with

impairments were less than half as likely to exit TANF as all other

recipients. Although impairments affect exits, other factors, such as family

support, personal motivation, and local TANF policies, may also affect

whether recipients exit TANF. For example, in a previous study, we found

 1

The ADA defines persons with disabilities as those who have a physical or mental

impairment that substantially limits one or more major life activities, such as walking,

hearing, etc.; those who have a record of such impairment; or those who are regarded as

having such an impairment.

Results in Brief
Page 3 GAO-03-210 Welfare Reform

that local TANF agencies sometimes exempted recipients with

impairments from requirements to participate in work or work-related

activities. While in some cases this may be appropriate because of the

level of severity of an impairment, in other cases it may mean that

recipients may not get the encouragement or opportunity to acquire work

skills that could help them exit TANF.

After leaving TANF, people with impairments were less likely to be

employed and more likely to receive federal supports than were people

without impairments. Controlling for demographic characteristics and

other factors, we found that leavers with impairments were one-third as

likely to be employed as leavers without impairments. Although they were

less likely to be employed, many leavers with impairments (40 percent)

received income support from Supplemental Security Income (SSI), a

federal program providing cash assistance to low-income individuals who

are aged, blind, or disabled. Among those who did have earnings from

employment or other sources, the amount of these earnings was similar

for leavers with and without impairments and averaged around $1,000 per

month. Leavers with impairments were more likely than leavers without

impairments to report having no income—from personal earnings,

household earnings, or SSI benefits—in their first month after exiting

TANF. Specifically, 36 percent of leavers with impairments reported

having no income from these sources compared with 23 percent of leavers

without impairments. However, leavers with impairments also were more

likely to receive non-cash supports from Food Stamps (77 percent versus

62 percent) and Medicaid (89 percent versus 71 percent) than their

counterparts without impairments.

In commenting on a draft of this report, the Department of Health and

Human Services (HHS) noted our analysis, while possibly the best

available approach, does not provide information on the extent to which

outcomes differ for recipients with different types or severity of

impairments, nor does it provide information on how local employment

services may affect these outcomes. We acknowledge that while our

analysis provides important descriptive information on outcomes for

TANF recipients with impairments as a whole, much remains unknown

about how best to help people with different types of impairments to

become self-sufficient.

PRWORA built upon and expanded state-level welfare reforms to

transform federal welfare policy for needy families with children.

PRWORA replaced the individual entitlement to benefits under the

Background
Page 4 GAO-03-210 Welfare Reform

61-year-old Aid to Families with Dependent Children (AFDC) program

with the TANF block grant, which provides family assistance grants to the

states, and emphasizes the transitional nature of assistance and the

importance of reducing welfare dependence through employment, among

other goals. HHS administers the TANF block grant program, which

provided grants to states totaling up to $16.5 billion each year through

September 2002. To receive its grant, each state must also spend at least a

specified amount of its own funds, referred to as state maintenance of

effort (MOE) funds.

While states have had flexibility to design programs that meet their own

goals and needs, they also have been required to implement federal work

requirements and time limits designed to promote employment among

those able to work. First, TANF established stronger work requirements

for those receiving aid than did the AFDC program. Specifically, to avoid

financial penalties, states had to meet federal participation rate

requirements, under which states were to ensure that an increasing

percentage of adult recipients were participating in federally defined

activities each year through fiscal year 2002. Second, states have been

required to reduce the cash assistance benefit of an adult who did not

participate as required by the state, referred to as a sanction, and could

opt to terminate cash aid for the entire family. Third, states also have had

to enforce a 60-month limit (or less at state option) on the length of time a

family may receive federal TANF assistance.

However, the law also provided states considerable flexibility in how they

implemented work requirements and time limits, and some states and

localities have used this flexibility to exempt recipients with disabilities

from these requirements. For example, in our 2002 report on states’

implementation of work requirements and time limits,2

 we noted that

states have generally faced greatly reduced federal participation rate

requirements. This resulted from the law’s “caseload reduction credit”

which adjusted downward the federally required rate if a state’s caseload

declined, which is exactly what occurred in most states—dramatic

caseload declines from 1996 through at least mid-2001. In fiscal year 2000,

these caseload reduction credits reduced required rates from 40 percent

 2

U.S. General Accounting Office, Welfare Reform: With TANF Flexibility, States Vary in

How They Implement Work Requirements and Time Limits, GAO-02-770 (Washington

D.C.: July 5, 2002).

State Flexibility on TANF

Work Requirements and

Time Limits
Page 5 GAO-03-210 Welfare Reform

(the required rate) to 0 in 31 states. These lower participation rate

requirements gave states more flexibility in exempting TANF recipients

considered hard to employ from meeting work requirements. We found

that while almost all states met or exceeded their adjusted required rate in

that year, the federal participation rates that states actually achieved

before adjustment ranged from about 6 percent to more than 70 percent.

Regarding time limits, we found that states generally excluded from time

limits families with a parent or caretaker with a disability or caring for a

family member with a disability. States could do this by using the

20-percent federal time limit extension established in the law or by using

state maintenance of effort funds, as also allowed by the law.3

 Our work

also showed that most families had not yet reached their federal or stateimposed cash assistance time limit as of fall 2001.

While recipients with impairments may sometimes be exempted from

work requirements and time limits, they may be at risk of having their

benefits reduced or terminated through sanctions. A study in four urban

areas conducted by the Manpower Demonstration Research Corporation

(MDRC) found that recipients with a greater number of health problems

were more likely to be sanctioned for noncompliance with program

requirements than their healthier counterparts.4

 Over 50 percent of former

recipients with at least one health problem left welfare due to sanctions

compared with 39 percent of recipients without health problems. Our

earlier report on sanctions under the TANF program found that families

who left welfare due to sanctions relied on support from family and

friends after TANF payments stopped, rather than on income from

employment, to a greater extent than families who left the program for

other reasons.5

TANF often serves, as did AFDC, as a temporary stopping point for lowincome individuals with physical or mental impairments that may be

 3

A state may exempt up to 20 percent of its average monthly caseload for hardship or

having been subjected to domestic violence.

4

Denise F. Polit, Andrew S. London, and John M. Martinez, The Health of Poor Urban

Women: Findings from the Project on Devolution and Urban Change, (New York:

Manpower Demonstration Research Corporation, 2001).

5

U.S. General Accounting Office, Welfare Reform: State Sanction Policies and Number of

Families Affected, GAO/HEHS-00-44 (Washington, D. C.: Mar. 31, 2000).

The Relationship between

TANF and SSI
Page 6 GAO-03-210 Welfare Reform

considered severe enough to make them eligible for the federal SSI

program. SSI, administered by the Social Security Administration (SSA),

provides cash assistance to low-income individuals who are aged or who

are unable to work because of a severe long-term impairment and who do

not have sufficient work history to qualify for SSA’s Disability Insurance

(DI) program.6

 To qualify for SSI, an applicant’s impairment must be of

such severity that the person is not only unable to do the kind of work that

he or she engaged in previously, but is also unable to do any other kind of

substantial gainful activity that exists in the national economy.7

 In most

states, SSI eligibility also entitles individuals to Medicaid benefits. As

distinct from TANF, SSI for adults has federally established eligibility

requirements and benefit levels and a nationwide disability determination

process.8

Some individuals who apply for TANF may have impairments severe

enough to make them eligible to receive SSI. Even before welfare reform,

states had been actively identifying and referring potential SSI-eligible

welfare recipients to SSI. In these cases, individuals may be on TANF

while they are waiting for their SSI eligibility to be determined.9

 In recent

years, receiving an initial disability determination took an average of about

4 months from the date of SSI application. For claims that are denied and

appealed, it may take over a year to reach a final decision. Generally,

except for more temporary conditions, TANF recipients who have

impairments but are not eligible for SSI or DI may be expected to work, as

their impairments have been deemed not severe enough to preclude

substantial employment.

Title I of the ADA prohibits discrimination against such persons who have

impairments but who are nonetheless able to perform the essential

 6

Cash assistance and services for persons with disabilities who have worked long enough

and recently enough are also available from the DI program. Other programs, which may be

available, include private disability insurance or pensions and state workers’ compensation

programs.

7

Work activity is generally considered substantial and gainful if the person’s earnings

exceed a particular level established by statute and regulations.

8

Some states provide supplemental payments to the federal benefit level.

9

Federal rules for TANF and SSI do not explicitly prohibit individuals from receiving cash

assistance from both TANF and SSI simultaneously. However, in effect, states’ income

eligibility rules for TANF generally preclude individuals from doing so.
Page 7 GAO-03-210 Welfare Reform

functions of the job they seek or hold.10 Under Title II of the ADA, no

qualified individual with a disability shall be excluded from participation

or be denied the benefits of the services, programs, or activities of a public

entity, or be subject to discrimination by such entity. TANF, as a federal

program, is subject to this requirement.11

Identifying and measuring impairments or disabilities is a complex

undertaking, and no single survey instrument has been accepted or

generally agreed upon as the preferred method for identifying impairments

within a population. Census believes the extensive set of disability

questions contained in the SIPP make it a preferred source to examine

most impairment-related issues.12 Nevertheless, SIPP data should be

interpreted with care. For instance, the SIPP relies on self-reports of

impairments and, therefore, may not accurately reflect the size of the

general or TANF population with impairments. This can result in the

overreporting or underreporting of impairments. For example, although

some impairments, such as the inability to walk, missing or impaired

limbs, or severely impaired vision, are easy to identify, many impairments

are not. Individuals may not report less obvious impairments because of

certain stigmas surrounding them or because they may not know of their

existence. Some examples of these impairments include learning

disabilities, depression, and mental illness. Other surveys use different

approaches to measure impairments. The National Household Survey of

Drug Abuse and the University of Michigan’s Women’s Employment

Survey, for example, use nonclinical in-depth diagnostic questioning to

identify certain psychiatric disorders that may be overlooked by other

survey techniques.13

 10The ADA was enacted, in part, to remove barriers to employment and receipt of public

services for people with disabilities by prohibiting discrimination. In the area of

employment, the ADA requires employers to make reasonable accommodations to persons

with disabilities (e.g., by providing a magnified computer screen for a vision-impaired

person), unless such accommodations would impose undue hardship on employers.

11On January 19, 2001, HHS’s Office of Civil Rights issued “Summary of Policy Guidance

Prohibition Against Discrimination on the Basis of Disability in the Administration of

TANF” to all entities involved in the administration and operation of TANF programs.

12The SIPP data reported do not include impairments related to substance abuse.

13Rukmalie Jayakody, Sheldon Danziger, and Harold Pollack, “Welfare Reform, Substance

Use, and Mental Health,” Journal of Health Politics, Policy and Law (Aug. 2000).

Identifying and Measuring

Impairments
Page 8 GAO-03-210 Welfare Reform

Physical and mental impairments were reported to be relatively common

among TANF recipients and, to a lesser degree, their children, compared

with their prevalence among the non-TANF population.14 National survey

data from the SIPP show that a total of 44 percent of TANF recipients

reported in both 1997 and 1999 that they either had one or more physical

or mental impairments as defined by Census or that they were caring for a

child with such impairments.15 Specifically, in 29 percent of the TANF

cases, only the adult recipient was reported to have impairments; in

7 percent of the cases, only the child was reported to have impairments;

and in 8 percent of the cases both the adult and child were reported to

have impairments.16 The prevalence of impairments among TANF

recipients is greater than among the U.S. non-TANF population, among

whom a total of 15 percent of individuals reported that they or their

children had impairments. (See fig. 1.) Appendix I lists the specific criteria

developed by Census that individuals must meet to be considered

impaired as applied in the SIPP. We considered individuals to be impaired

if they met the Census criteria in both 1997 and 1999.

 14“TANF recipients” are defined as those SIPP respondents who reported receiving TANF in

any month during the period of July 1997 through July 1999.

15In an earlier study (GAO-02-37), we reported that SIPP data showed that in 1999, a total of

44 percent of TANF adults aged 18 to 64 reported having one or more physical or mental

impairments as defined by Census. This figure differs from our current finding that SIPP

data show a total of 44 percent of TANF adults either had impairments themselves or

were caring for a child with impairments in both 1997 and 1999. The fact that both

numbers are “44 percent” is purely coincidental.

16These data capture individuals who reported functional or other activity limitations

generally covered by the ADA.

Impairments Were

Relatively Common

Among TANF

Recipients
Page 9 GAO-03-210 Welfare Reform

Figure 1: Prevalence of Impairments among TANF Recipients and Non-TANF Population, July 1997 through July 1999

As shown in figure 2, SIPP data show some demographic differences

between TANF recipients aged 18 to 62 who have impairments and those

who do not have impairments. Two-thirds of adult recipients with

impairments were over 35 years old, while fewer than a quarter of adult

recipients without impairments were older than 35. Age differences

between individuals with and without impairments exist not only among

TANF recipients, but among the non-TANF population as well. Among the

non-TANF population with impairments, 81 percent were aged 36 to

62 compared with 54 percent of those without impairments. Figure 2 also

shows that TANF recipients with and without impairments differed by

race. Forty-three percent of adult recipients with impairments were white

compared with 28 percent of adult recipients without impairments. Among

the non-TANF population, roughly equal percentages of people with and

without impairments were white. Finally, as shown in figure 2, we found

that SIPP data indicated no significant differences between recipients with

and without impairments in the percentage who were married or the

Neither adult nor 

child has

impairments

29%•

Only adult has

impairments

8%

Both adult and child

have impairments

7%

Only child has

impairments

•

•

Neither adult nor 

child has

impairments

11%

•

Only adult 

has impairments

1%

Both adult and child

have impairments

3%

Only child has

• impairments

TANF recipients Non-TANF population

85% •

56% •

Source: GAO's analysis of SIPP data on disability.
Page 10 GAO-03-210 Welfare Reform

percentage who had no more than a high school education. Regardless of

impairment status, about one-quarter of adult recipients were married and

two-thirds to three-quarters had no more than a high school education.

Figure 2: Demographic Differences between Adult TANF Recipients with and

without Impairments

a

Differences between recipients with and without impairments are statistically significant.

Impairments, whether they affected either adults or children, were

associated with a decreased likelihood that a family would exit TANF. In

particular, adult recipients with impairments were half as likely to exit

TANF as adult recipients without impairments, after controlling for

demographic differences, such as age, race, and marital status. Recipients

caring for children with impairments were less than half as likely to exit

TANF as others, after controlling for demographic differences. Different

types of impairments or impairments of differing severity could have

different effects on TANF exits, although we were not able to measure

these effects. Furthermore, factors other than impairments may also affect

whether recipients exit TANF.

Recipients with

Impairments Were

Less Likely to Exit

TANF Than

Recipients without

Impairments

Percentage of recipients with characteristic

0

10

20

30

40

50

60

70

80

Age 36-62a Married Whitea High School 

diploma or less

All recipients

With impairments

Without impairments

67

28

43

33

26

23 25

39

23

33

69

77

72

Source: GAO's analysis of SIPP data on disability.
Page 11 GAO-03-210 Welfare Reform

Using a statistical model to control for basic demographic factors (gender,

race, age, marital status, and education) and state-level differences,17 we

found that adult recipients with impairments were half as likely to exit

TANF as recipients without impairments. That is, an individual with an

impairment who received TANF at some point between July 1997 and July

1999 was less likely than an individual without an impairment to have

exited TANF by July 1999, all else being equal. For example, among

whites, those with impairments were less likely to exit TANF than were

whites without impairments. Likewise, among nonwhites, those with

impairments were less likely to exit TANF than were nonwhites without

impairments. If demographic factors are not taken into account,

approximately equal proportions (about 3 out of 4) of recipients with and

without impairments exited TANF.18

Among those recipients who did exit TANF, a number of them returned to

the TANF rolls at some point. SIPP data show that among individuals who

received TANF and subsequently exited TANF between July 1997 and July

1999, about 1 in 4 had returned to TANF before the end of that period. This

was true both of individuals with impairments and those without

impairments. Other studies of TANF leavers that have included various

time periods, populations, and methodologies have found similar results.19

For example, a recent study using data from the National Survey of

America’s Families found that 21.9 percent of families leaving welfare in

1997 returned within 2 years. They also found that almost half of those

who returned originally left welfare to work and that return rates were

higher for former recipients with little education, limited work experience,

and poor health.20

 17A variable is included in the model to control for any differences among states, although

the model does not evaluate the specific effects of different state policies. See appendix I

for model results.

18This helps to explain why the proportion of the caseload that had impairments did not

increase between 1997 and 1999, as we found in our October 2001 report, even though one

might expect the proportion of recipients with impairments to increase if recipients with

impairments were less likely to exit TANF than those without impairments.

19See U.S. General Accounting Office, Welfare Reform: Progress In Meeting Work-Focused

TANF Goals, GAO-01-522T (Washington, D.C.: Mar. 15, 2001).

20Pamela Loprest. Who Returns to Welfare? Policy Brief B-49 (Washington, D.C.: The Urban

Institute, Sept. 2002).

Adult Recipients with

Impairments Were Half as

Likely to Exit TANF as

Adult Recipients without

Impairments
Page 12 GAO-03-210 Welfare Reform

After using a statistical model to control for demographic factors, we

found that recipients caring for children with impairments were less than

half as likely to exit TANF as their counterparts not caring for children

with impairments.21 A variety of complicating factors related to their

children’s impairments may contribute to the decreased likelihood that

this population of TANF recipients will pursue and maintain employment.

For instance, parents of children with impairments may face demands on

their time related to their children’s impairments in the form of special

therapies, the administering of medications, regular medical appointments,

and hospitalizations. Furthermore, the chronic and unpredictable nature

of many impairments, such as severe asthma and seizures, may cause

parents to be absent from work frequently and with little or no advance

notice to their employers. This may be particularly problematic for TANF

leavers, many of whom enter into low- or unskilled entry-level jobs that

offer limited flexibility and benefits, such as vacation time, sick leave, and

health insurance.

Finding child care and maintaining adequate health insurance coverage

can be particularly challenging for parents caring for children with

impairments. Children with impairments may need child care providers

with the specialized training and equipment to accommodate their needs.

In earlier work, we found that child care providers for children with

special needs are sometimes in limited supply, especially in low-income

neighborhoods.22 In addition to the difficulty in obtaining child care,

families may be less likely to leave TANF if they are concerned about

losing health care coverage. While the Congress established provisions to

ensure that adults and children would continue to be eligible for Medicaid

after leaving TANF, in our 1999 report we found some evidence to suggest

that the reforms of 1996 initially contributed to confusion on the part of

both beneficiaries and caseworkers about the criteria for maintaining

Medicaid coverage after TANF benefits have been discontinued. Increased

awareness of the need to ensure continued Medicaid enrollment for

families exiting welfare has given rise to outreach efforts designed to

promote awareness and maximize enrollment among eligible families.

 21See appendix I for model results.

22See U.S. General Accounting Office, Child Care: States Increased Spending on LowIncome Families, GAO-01-293 (Washington, D.C.: Feb. 2, 2001); and Welfare Reform:

States’ Efforts to Expand Child Care Programs, GAO/HEHS-98-27 (Washington, D.C.: Jan.

13, 1998).

Recipients Caring for

Children with Impairments

Were Less Than Half as

Likely to Exit TANF as

Others
Page 13 GAO-03-210 Welfare Reform

Although recipients with impairments were less likely to exit TANF than

recipients without impairments, SIPP data did not provide reliable data on

several other factors that may also affect whether recipients exit TANF.

For example, there were insufficient data to differentiate among

individuals based on the severity, type, or number of their impairments.

However, it is possible that these factors might affect whether individuals

exit TANF, as evidenced in a study of SIPP data from the early 1990’s that

suggested that respondents with more severe disabilities were less likely

to exit welfare than respondents with less severe limitations.23

Furthermore, intangible factors such as family support and personal

motivation might also lead to very different experiences with TANF for

otherwise similar individuals. In our 1997 survey of individuals receiving

Social Security Disability Insurance, encouragement from family and

friends and high self-motivation were identified to be among a range of

factors that enabled these individuals with impairments to return to

work.24

In addition, local TANF policies, which are not measured by the SIPP

questionnaire, may affect whether recipients with impairments exit TANF.

For example, local TANF policies regarding screening, assessment, and

work requirements may affect whether recipients with impairments

receive assistance that could help them move toward employment. In a

national survey of county TANF agencies conducted for our October 2001

report, almost all the counties reported that they screened and assessed

TANF recipients for impairments, but many used methods that may not

accurately identify all impairments.25 In some cases, this may not be a

problem because recipients may find jobs and leave welfare without

special assistance. In other cases, recipients may need assistance targeted

 23Gregory Acs and Pamela Loprest, Do Disabilities Inhibit Exits from AFDC?

(Washington, D.C.: The Urban Institute, Aug. 1994).

24U.S. General Accounting Office, Social Security Disability Insurance: Multiple Factors

Affect Beneficiaries’ Ability to Return to Work, GAO/HEHS-98-39 (Washington, D.C.: Jan.

12, 1998).

25U.S. General Accounting Office, Welfare Reform: More Coordinated Federal Effort Could

Help States and Localities Move TANF Recipients With Impairments Toward

Employment, GAO-02-37 (Washington, D.C.: Oct. 31, 2001). The terms screening and

assessment are often loosely applied and can have different meanings in various treatment

and service communities. We defined screening as “any means of gaining information about

an individual that can be used to detect warning signs that suggest that some form of

impairment might exist.” If there is an indication that an impairment may exist, the next

step is to perform an assessment. We defined assessment as “a comprehensive examination

of an individual that is used to identify the specific impairment(s) he or she has.”

Factors Other Than

Impairments May Also

Affect Whether Recipients

Exit TANF
Page 14 GAO-03-210 Welfare Reform

to their special needs to help them take steps toward employment or to

transition to SSI.

We also found that many counties reported exempting from state work

requirements TANF recipients who had impairments or were caring for a

child with an impairment. While exemptions from work requirements may

be appropriate in some cases, in other cases it may mean recipients may

not be getting the help, direction, or encouragement they need to take

steps toward employment and increase their chances of exiting TANF.

Exemptions from work requirements could also leave them more at risk of

reaching a time limit without getting the assistance they need to find

employment or alternative means of support such as SSI. Our previous

work and other research makes clear that recipients exit TANF for a

variety of reasons—increased income, time limits, sanctions, and

voluntary exits—and that the reason that a family exits TANF could have

an effect on the family’s outcomes or circumstances. However, SIPP data

did not provide reliable data on the reasons families exited TANF.26

TANF leavers with impairments were less likely to be employed and more

likely to receive federal supports than were leavers without impairments.

Although we found, after controlling for certain factors, that leavers with

impairments were less likely to be employed than leavers without

impairments, many of the leavers with impairments received income from

SSI. Leavers with impairments also were more likely to receive Food

Stamps and Medicaid.

 26The survey did ask respondents about their reasons for exiting TANF, but 81 percent did

not answer the question.

After Leaving TANF,

People with

Impairments Were

Less Likely to Be

Employed and Were

More Likely to

Receive Federal

Supports Than Were

People without

Impairments
Page 15 GAO-03-210 Welfare Reform

Leavers with impairments were one-third as likely to be employed as

leavers without impairments, after controlling for basic demographic

factors, state-level differences, and receipt of SSI.27 In other words, for

those not receiving SSI, leavers with impairments were one-third as likely

to be employed as leavers without impairments, all else being equal.

Leavers caring for children with impairments were equally likely to be

employed as others, after controlling for demographics and other factors.

In addition to estimating the probability of employment, we determined

the actual percentages of adults who reported being employed at some

point after leaving TANF between July 1997 and July 1999. Thirty-nine

percent of adult leavers with impairments were employed at some point

after leaving TANF, including 6 percent who also received SSI at some

point after leaving TANF.28 (See fig. 3.) In contrast, 82 percent of leavers

without impairments reported being employed at least at some point after

leaving TANF between July 1997 and July 1999. In addition to the

6 percent of adult leavers with impairments who reported both

employment and receipt of SSI, 34 percent reported receipt of SSI but not

employment, indicating that a number of TANF recipients had

impairments severe enough to qualify them for SSI and presumably also

severe enough to limit their ability to sustain regular employment. Figure 3

shows that the proportion of leavers with impairments who reported

either employment or SSI receipt, or both, is about the same as the

proportion of leavers without impairments who reported employment.29

The fact that many recipients with impairments seem to have impairments

severe enough to qualify them for SSI suggests that many recipients are

relying on TANF while awaiting determination of their eligibility for SSI.

Again, it may take over a year from the time that an individual applies for

SSI to the time that a final eligibility decision is made. During this time,

individuals on TANF may or may not be exempted from work

requirements.

 27The model analyzed employment status for the period spanning July 1997 through July

1999 and controlled for gender, race, age, marital status, education, and receipt of SSI. A

variable was included in the model to control for any differences among states, although

the model did not evaluate the specific effects of different state policies. See appendix I for

model results.

28Employment and receipt of SSI were not necessarily concurrent.

29There is no statistically significant difference between the proportions of leavers with

impairments and without impairments who are neither employed nor receiving SSI.

Leavers with Impairments

Were Less Likely to Be

Employed, but Many

Received SSI
Page 16 GAO-03-210 Welfare Reform

Figure 3: Employment and Receipt of SSI among Leavers with and without Impairments, July 1997 through July 1999

Notes: For comparison, among the non-TANF populations, 52 percent of people with impairments

were employed, while 93 percent of people without impairments were employed during the same time

period.

“Employed” and “Receiving SSI” include people who reported being employed or receiving SSI,

respectively, in any month after leaving TANF and before the end of July 1999. “Not employed” and

“no SSI” include people who reported not being employed or not receiving SSI, respectively, the

entire time after leaving TANF and before the end of July 1999.

a

Employment and receipt of SSI were not necessarily concurrent.

Leavers with impairments were not only less likely than those without

impairments to be employed at any time after leaving TANF, but not

surprisingly, they were also less likely to report having personal earnings

from employment or other sources in any single month. In each of the

first 6 months after exiting TANF, about 20 percent of leavers with

impairments reported having personal earnings, compared with about

60 percent of leavers without impairments. For those who did report

personal earnings, though, the average amount of earnings for members of

both groups was essentially equal, at about $1,000 per month.30 About

35 percent of leavers in both groups also reported household earnings.

Regardless of their impairment status, their household earnings amounted

on average to about $2,000 per month in addition to any personal earnings

they may have had.

 30Estimates are based on small numbers of respondents, so differences too subtle to

measure could exist.

82% Employed (no SSI)

18%

Not employed (no SSI) Not employed (no SSI)

•

Employed

(no SSI)

6%

Both employed and

receiving SSIa

Receiving SSI

(not employed)

•

Leavers with impairments Leavers without impairments

• 27% 33%

34%

73%

Source: GAO's analysis of SIPP data on disability.
Page 17 GAO-03-210 Welfare Reform

Leavers with impairments were more likely than those without

impairments to report having no income—from personal or household

earnings or SSI—in any single month, although they may have received

Food Stamps or Medicaid.31 In their first month after leaving TANF,

36 percent of leavers with impairments reported having no personal or

household earnings, or SSI, compared with 23 percent of leavers without

impairments. (See fig. 4.) These proportions remained relatively constant

in each of the first 6 months after leaving TANF. Over the course of the

entire 24-month observation period, 10 percent of all individuals who left

during that period reported never having income from personal or

household earnings or SSI at any point after leaving TANF. This means

that 90 percent of leavers had income from at least one of these sources at

some point after leaving TANF. There were insufficient data to examine

whether there were any differences between people with and without

impairments on this measure.

 31There were insufficient data to determine how many recipients who reported no income

also did not receive Food Stamps or Medicaid.
Page 18 GAO-03-210 Welfare Reform

Figure 4: Proportion of Leavers with and without Impairments Reporting Receipt of

Income from Personal Earnings, Household Earnings, or SSI in First Month after

Leaving TANF

a

Differences between recipients with and without impairments are statistically significant.

A greater proportion of leavers with impairments reported receiving Food

Stamps and Medicaid than did leavers without impairments. Specifically,

77 percent of leavers with impairments received Food Stamps compared

with 62 percent of leavers without impairments. Similarly, 89 percent of

leavers with impairments reported receiving Medicaid in contrast to

71 percent of leavers without impairments. (See fig. 5.)

Leavers with Impairments

Were More Likely to

Receive Food Stamps and

Medicaid

Percentage of leavers 

0

10

20

30

40

50

60

70

80

90

100

Reported at least one of these sources of income

Reported none of these sources of income 

64

77

23

36

Leavers with 

impairmentsa

Leavers without 

impairmentsa

Source: GAO's analysis of SIPP data on disability.
Page 19 GAO-03-210 Welfare Reform

Figure 5: Proportion of Leavers Receiving Food Stamps and Medicaid,

July 1997 through July 1999

a

Differences between leavers with and without impairments are statistically significant.

The 1996 welfare reform legislation enacted by the Congress clearly

emphasizes the importance of welfare recipients taking steps toward

employment and self-support. At the same time, the legislation provides

states some flexibility to design programs that meet the needs of families

affected by serious physical and mental impairments who may need

special attention to facilitate the transition to work or to SSI. As states

move beyond the first 5 years of the TANF program, a key challenge will

be to ensure that recipients with impairments and those caring for

children with impairments receive the supports they need to meet the

work-focused goals and requirements of TANF.

Our findings underscore the magnitude and complexity of this challenge.

Our findings that both adult recipients with impairments and recipients

caring for children with impairments are less likely to exit TANF, and that

adult leavers with impairments are less likely to be employed, suggest that

in the early years of welfare reform at least, these families were not as

Concluding

Observations

Percent

0

10

20

30

40

50

60

70

80

90

100

Received

Food Stampsa Received

Medicaida

77

62

89

71

Leavers with impairments

Leavers without impairments

Source: GAO's analysis of SIPP data on disability.
Page 20 GAO-03-210 Welfare Reform

successful as those without impairments at leaving welfare through work.

Our finding that 40 percent of families with impairments who did leave

welfare received SSI after leaving TANF shows that SSI is an important

source of support for many of these families. This finding raises the

difficult question of how best to use their time on TANF while awaiting SSI

eligibility determination, such as what work expectations to have for these

recipients. These findings also raise the more general question for

policymakers about how best to promote work and personal

responsibility—through work requirements and time limits—while at the

same time taking into consideration the particular needs of recipients with

impairments and those caring for children with impairments. While our

analysis provides descriptive information on outcomes for TANF

recipients with impairments, much remains unknown about how best to

help people with different types of impairments become self-sufficient.

In commenting on a draft of this report, HHS said that the topic of TANF

recipients with impairments is an important one. HHS also noted that our

analysis, while possibly the best available approach, has limited

application in providing information on the extent to which different types

of impairments, impairments of varying severity, or local employment

services may affect outcomes for individuals with impairments. We

acknowledge that our analysis focuses on describing outcomes rather than

identifying explanations for these outcomes, in part because information

is not readily available to look at the more complex picture of each

individual’s needs and the particular services received. However, our

analysis provides important information on what is happening in the early

years of welfare reform with regard to recipients with impairments as a

whole. We added language to our concluding observations to state that

much remains unknown about how best to help people with different

types of impairments to become self-sufficient. HHS also noted that an

analysis that excluded recipients who moved onto SSI would be useful.

We added language to the report to clarify that our finding that recipients

with impairments are one-third as likely to be employed as recipients

without impairments refers to recipients who did not receive SSI. HHS’s

written comments are included in appendix II. HHS and two welfare

experts also provided technical comments, which we have incorporated

where appropriate.

We are sending copies of this report to the Secretary of Health and Human

Services, relevant congressional committees, and other interested parties.

Agency Comments
Page 21 GAO-03-210 Welfare Reform

We will also make copies available to others upon request. In addition, the

report is available at no charge on GAO’s Web site at http://www.gao.gov.

If you have any questions about this report, please contact me at

(202) 512-7215 or Gale Harris at (202) 512-7235. Other contacts and

acknowledgments are listed in appendix III.

Cynthia M. Fagnoni

Managing Director, Education, Workforce

 and Income Security
Appendix I: Scope and Methodology

Page 22 GAO-03-210 Welfare Reform

To describe the role of physical and mental impairments in the lives of

families leaving Temporary Assistance for Needy Families (TANF), we

developed estimates of the number of TANF recipients with impairments

and investigated the differences between TANF recipients and leavers

with and without impairments, using a 2-year cross section of data from

the Census Bureau’s Survey of Income and Program Participation (SIPP).

The SIPP is a national household survey conducted by the U. S. Census

Bureau in which panels of individuals representative of the nation,

including those receiving TANF, are interviewed over a period of 2 years

or more. At 4-month intervals, panel participants are asked a set of “core”

questions involving such subjects as their labor force activity, welfare

program participation, and demographic characteristics. Periodically, the

survey also asks a detailed set of questions called “topical modules” on a

variety of topics not covered in the core section, such as disabilities. For

our purposes, we selected panels starting in 1996 and sampled TANF and

non-TANF adults between the ages of 18 and 62. Data from the topical

modules on disability that we analyzed were from interviews conducted

from August 1997 to November 1997, and August 1999 to November 1999,

in which respondents were asked about their status in recent months,

including July of that year. We included respondents who were in the

sample in both July 1997 and July 1999 and analyzed their responses

during this time period.

During these interviews, panel members were asked an extensive set of

questions about their physical or mental impairments, including questions

on a range of functional or other activity limitations. To be identified as

having a disability or impairment in the SIPP, individuals must meet

specific disability criteria developed by the U. S. Census Bureau.1

 That is,

they must meet any of the following criteria:

1. Had difficulty performing one or more functional activities, including

seeing, hearing, speaking, lifting, and carrying, using stairs, and

walking.

2. Had difficulty with one or more activities of daily living, such as getting

around inside the home, getting in or out of a bed or chair, bathing,

dressing, and eating.

 1

Children were identified as having an impairment or not based on the questions in the

SIPP disability module related to children’s disabilities. These questions differed somewhat

from the questions related to adults’ disabilities.

Appendix I: Scope and Methodology

Data Source: Census

Bureau’s SIPP Data
Appendix I: Scope and Methodology

Page 23 GAO-03-210 Welfare Reform

3. Had difficulty with one or more instrumental activities of daily living,

including going outside the home, keeping track of money or bills,

preparing meals, doing light housework, and using the telephone.

4. Had one or more specific conditions, including a learning disability,

mental retardation or another developmental disability, Alzheimer’s

disease, or some other type of mental or emotional condition.

5. Had an other mental or emotional condition that seriously interfered

with everyday activities, including frequently depressed or anxious,

trouble getting along with others, trouble concentrating, or trouble

coping with day-to-day stress.

6. Had a condition that limited the ability to work, including around the

house.

7. Had a condition that made it difficult to work at a job or business.

8. Received federal benefits based on inability to work.

9. Used a wheelchair, a cane, crutches, or a walker.

For our purposes, we considered individuals to have impairments if their

survey responses indicated they had impairments at both times that the

disability topical module was administered (i.e., in both 1997 and 1999).

We considered individuals to not have impairments if their survey

responses indicated they did not have impairments at both times that the

disability topical module was administered. Individuals whose impairment

status differed between the first and second modules were excluded from

the analyses. (We excluded 12.5 percent of respondents for this reason).

We used appropriate techniques to weight the data to make population

estimates for 1999 as well as to take into account the complex sampling

design when estimating variances. Because the estimates we reported

from the SIPP were based on samples, they are subject to sampling error,

which varied but did not exceed plus or minus 8 percentage points at the

95-percent confidence interval. Therefore, the chances are 95 out of

100 that the actual population percentages are within no more than plus or

minus 8 percentage points of our estimates.

In addition to descriptive statistics, we used logistic regression models to

examine the effects of recipients’ having impairments, and of recipients’

caring for children with impairments on the likelihood of leaving TANF

and of being employed after leaving TANF, after controlling for age,

Logistic Regression

Analyses
Appendix I: Scope and Methodology

Page 24 GAO-03-210 Welfare Reform

gender, marital status, race, and educational attainment.2 Recognizing that

TANF policies may vary across states, we controlled for state in the

models as well. The models of post-TANF employment also controlled for

receipt of Supplemental Security Income (SSI).3

The results from the models we used are odds ratios that estimate, in table

1, the relative likelihood of leaving TANF for each factor and, in table 2,

the effect of each factor on the likelihood of being employed after leaving

TANF. If there were no significant differences between two groups, their

odds would be equal, and the ratio of their odds would be 1.00. The more

the odds ratio differs from 1.00 in either direction, the larger the effect it

represents.

The odds ratios in each table were computed in relation to a defined

reference group. In table 1 an odds ratio that is greater than 1.00 indicates

a greater likelihood of leaving TANF than the reference group while a ratio

under 1.00 indicates a lesser likelihood of leaving than the reference

group. In table 2 an odds ratio that is greater than 1.00 indicates a greater

likelihood of being employed after leaving TANF than the reference group

while a ratio under 1.00 indicates a lesser likelihood of being employed

after leaving TANF than the reference group. Both tables also show the

95-percent confidence intervals around the odds ratios. If these intervals

contain 1.00, the difference is not statistically significant.

 2

The purpose of our model is only to examine the effects of recipients or their children

having impairments on the likelihood of leaving TANF and of being employed after leaving

TANF. We are not attempting to explain TANF exits or post-TANF employment generally.

3

In developing our model, we examined the effects of all of the reasonable variables

available to us in the SIPP. In addition to those included in the final model, we tested the

effect of the number of children in a household and found that this variable had no

significant effect on the results.
Appendix I: Scope and Methodology

Page 25 GAO-03-210 Welfare Reform

Table 1: Results of Logistic Regression Model of TANF Exits

Model of adults with impairments Model of adults caring for children with impairments

Variable Odds ratio

95-percent

confidence interval Odds ratio

95-percent

confidence interval

Have a disability?

Disabled 0.49a(0.29-0.85) b b

Not disabled 1.00

(reference group)

b b

Have a child with a disability?

Child with

disability

b b 0.44a

(0.28-0.69)

No child with

disability

b b 1.00

(reference group)

Age

18-35 as of

7/97

0.85 (0.53-1.35) 1.09 (0.72-1.65)

36-62 as of

7/97

1.00

(reference group)

1.00

(reference group)

Gender

Male 2.21 (0.88-5.59) 1.89 (0.76-4.68)

Female 1.00

(reference group)

1.00

(reference group)

Marital status

Currently

married

1.24 (0.78-1.99) 1.40 (0.86-2.28)

Not currently

married

1.00

(reference group)

1.00

(reference group)

Minority status

Minority 0.40a(0.23-0.70) 0.44a(0.27-0.73)

White 1.00

(reference group)

1.00

(reference group)

Education

More than

high school

1.01 (0.59-1.71) 1.06 (0.63-1.81)

High school

or less

1.00

(reference group)

1.00

(reference group)

Note: The models also included a set of dummy variables to allow for effects of unmeasured state

characteristics. We have omitted the coefficients associated with the dummy variables to simplify

presentation.

a

Odds ratio is statistically significant at p<=0.05.

b

Not applicable.

Source: GAO’s analysis of SIPP data on disability.
Appendix I: Scope and Methodology

Page 26 GAO-03-210 Welfare Reform

Table 2: Results of Logistic Regression Model of Post-TANF Employment

Model of adults with impairments Model of adults caring for children with impairments

Variable Odds ratio

95-percent

confidence interval Odds ratio

95-percent

confidence interval

Have a disability?

Disabled 0.28a(0.13-0.60) b b

Not disabled 1.00

(reference group)

b b

Have a child with a disability?

Child with

disability

b b 0.72 (0.33-1.58)

No child with

disability

b b 1.00

(reference group)

Age

18-35 as of 7/97 1.45 (0.72-2.92) 2.27 (1.37-3.73)

36-62 as of 7/97 1.00

(reference group)

Gender

Male 4.90a (1.45-16.51) 1.41 (0.68-2.95)

Female 1.00

(reference group)

1.00

(reference group)

Marital status

Currently

married

0.31a(0.16-0.60) 0.51a(0.30-0.86)

Not currently

married

1.00

(reference group)

1.00

(reference group)

Minority status

Minority 0.70 (0.33-1.50) 1.00 (0.58-1.73)

White 1.00

(reference group)

1.00

(reference group)

Education

More than high

school

1.93 (0.89-4.18) 2.26 (1.29-3.95)

High school or

less

1.00

(reference group)

1.00

(reference group)

Receipt of SSI

Not receiving

SSI

28.18a(5.66-150.37) b b

Receiving SSI 1.00

(reference group)

b b

Note: The models also included a set of dummy variables to allow for effects of unmeasured state

characteristics. We have omitted the coefficients associated with the dummy variables to simplify

presentation.

a

Odds ratio is statistically significant at p<=0.05.

b

Not applicable.

Source: GAO’s analysis of SIPP data on disability.
Appendix I: Scope and Methodology

Page 27 GAO-03-210 Welfare Reform

TANF recipient: Respondents who reported receiving TANF in any

month during the period (July 1997 through July 1999).

TANF leaver: Respondents who reported receiving TANF in some month

during the period and subsequently not receiving TANF at some point for

at least 2 consecutive months.

Non–TANF population: Respondents who did not receive TANF benefits

in any month during the time period.

Employed (leavers): Respondents who reported employment in any

month after leaving TANF during the time period.

Age: Categorized as 18-35 and 36-62 and defined as the respondent’s

reported age in July 1997.

Education: Categorized as either having more than a high school

education or not. For models of TANF exits, education is defined as the

reported level of education in July 1997; for models predicting

employment among leavers, education is defined as the reported level of

education in the month the respondent reported leaving TANF.

Marital status: Categorized as either married or not. For models of TANF

exits, marital status is defined as reported status in July 1997; for models

predicting employment among leavers, marital status is defined as

reported status in the month the respondent reported leaving TANF.

Received Food Stamps/Medicaid (leavers): Respondents who reported

receiving Food Stamps/Medicaid in any month after leaving TANF during

the time period.

Received SSI (leavers): Respondents who reported receiving SSI in any

month after leaving TANF during the time period.

Definitions of Other

Variables
Appendix II: Comments from the Department of Health and Human Services

Page 28 GAO-03-210 Welfare Reform

Appendix II: Comments from the Department

of Health and Human Services
Appendix II: Comments from the Department of Health and Human Services

Page 29 GAO-03-210 Welfare Reform
Appendix III: GAO Contacts and Staff

Acknowledgments

Page 30 GAO-03-210 Welfare Reform

Sigurd Nilsen (202) 512-7003

Gale Harris (202) 512-7235

Heather McCallum (202) 512-2890

In addition to those named above, Tiffany Boiman, Wendy Ahmed, and

Grant Mallie made important contributions to this report.

Appendix III: GAO Contacts and Staff

Acknowledgments

GAO Contacts

Staff

Acknowledgments
Bibliography

Page 31 GAO-03-210 Welfare Reform

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Related GAO Products

Page 32 GAO-03-210 Welfare Reform

Welfare Reform: Tribes Are Using TANF Flexibility to Establish Their

Own Programs. GAO-02-695T. Washington, D.C.: May 10, 2002.

Welfare Reform: Federal Oversight of State and Local Contracting Can

Be Strengthened. GAO-02-661. Washington, D.C.: June 11, 2002.

Welfare Reform: States Are Using TANF Flexibility to Adapt Work

Requirements and Time Limits to Meet State and Local Needs.

GAO-02-501T. Washington, D. C.: March 7, 2002.

Welfare Reform: More Coordinated Federal Efforts Could Help States and

Localities Move TANF Recipients with Impairments Toward

Employment. GAO-02-37. Washington, D. C.: October 31, 2001.

Welfare Reform: Moving Hard-to-Employ Recipients Into the Workforce.

GAO-01-368 Washington, D. C.: March 15, 2001.

Welfare Reform: Work-Site-Based Activities Can Play an Important Role

in TANF Programs. GAO/HEHS-00-122. Washington, D. C.: July 28, 2000.

Welfare Reform: Means-Tested Programs: Determining Financial

Eligibility is Cumbersome and Can Be Simplified. GAO-02-58.

Washington, D.C.: November 2, 2001.

Welfare Reform: Improving State Automated Systems Requires

Coordinated Federal Effort. GAO/HEHS-00-48. Washington, D. C.: April 27,

2000.

Welfare Reform: State Sanction Policies and Number of Families

Affected. GAO/HEHS-00-44 Washington, D. C.: March 31, 2000.

Welfare Reform: Assessing the Effectiveness of Various Welfare-to-Work

Approaches. GAO/HEHS-99-179. Washington, D. C.: September 7, 1999.

Welfare Reform: Information on Former Recipients’ Status.

GAO/HEHS-99-48. Washington, D. C.: April 28, 1999.

Welfare Reform: States’ Experiencs in Providing Employment Assistance

to TANF Clients. GAO/HEHS-99-22. Washington, D. C.: February 26, 1999.

Welfare Reform: Status of Awards and Selected States’ Use of Welfare-toWork Grants. GAO/HEHS-99-40. Washington, D. C.: February 5, 1999.

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