Separate estimates of work-related disabilities, mental health issues, and substance abuse range from less than 10 to almost 30 percent of all welfare recipients. Estimates of recipients with learning disabilities range from 25 to 40 percent. States are beginning to consider the extent to which individuals with multiple or severe barriers to employment comprise the welfare caseload. Overall, these changes reflect an increased emphasis on moving recipients with disabilities and caregivers toward work and self-sufficiency. Thirty states have changed their policies so as to increase participation in work and self-sufficiency activities among individuals with disabilities.
Some states use staff more familiar with work program requirements to make participation decisions.
Still another approach is the review of disabling conditions by medical review teams or other agencies in an attempt to apply more consistent standards when determining whether or not the individual should be required to participate. States requiring universal participation among welfare clients use individualized service planning strategies that emphasize recipients' capabilities and acknowledge that the path to self-sufficiency may be long. Examples of activities in some states include substance abuse treatment, vocational rehabilitation, or mental health counseling. Eighteen states have chosen to retain JOBS participation policies and generally exempt individuals with disabilities. States in this category have not changed their processes for determining if individuals with disabilities are required to participate or are eligible for exemptions.