TANF: State Approaches to Screening for Domestic Violence Could Benefit from HHS Guidance
Published: 2005-08-16T00:00:00

Fast Facts:

Highlights:
section_title: Why GAO Did This Study
paragraphs: The Temporary Assistance for Needy Families (TANF) program introduced specific work requirements and benefit time limits. However, the Family Violence Option (FVO) requires states that adopt the FVO to screen TANF clients for domestic violence and grant waivers from program requirements for clients in domestic violence situations. TANF also allows the use of TANF funds for marriage and responsible fatherhood programs. Given states' broad discretion in implementing the TANF program, including most aspects of the FVO and marriage and responsible fatherhood programs, this report examines (1) how states identify victims of domestic violence among TANF recipients, (2) how states address domestic violence among TANF recipients once they are identified, and (3) the extent to which states spend TANF funds on marriage and responsible fatherhood programs, and how, if at all, these programs are addressing domestic violence.
section_title: What GAO Found
paragraphs: Forty-eight states have adopted the FVO or a comparable state policy. Most of these states actively screened clients by directly questioning them about domestic violence, whereas five states simply notified clients of domestic violence waivers without making a direct inquiry. Most states provide staff with a screening tool, but the detail and depth of these tools vary. State officials said that staff in local TANF offices often have limited skills in dealing with domestic violence issues, and policies regarding staff training vary. To address this issue, some state TANF offices employ domestic violence specialists. Although HHS has compiled and disseminated information about domestic violence screening, HHS has not issued guidance regarding best practices in domestic violence screening. State TANF programs help clients address domestic violence issues by granting waivers that exempt victims from TANF requirements, and by referring clients for domestic violence services. Most states will waive the TANF program's federal requirements pertaining to work, the 5-year lifetime limit on cash assistance, and the child support requirements. However, the conditions of these waivers vary from state to state. For example, 27 states required that clients participate in domestic violence services. Limited data on the number of domestic violence waivers indicates that a comparatively small portion of TANF recipients obtain such waivers. Most states have used TANF funds for marriage or responsible fatherhood programs or both. Specifically, 15 states reported funding marriage programs and 28 reported funding responsible fatherhood programs. States that provided usable data reported spending about 5 percent or less of their federal TANF budget on these programs. In addition, some states funded these programs through other funding sources or had programs in development. According to research and practitioners in the field, these programs generally do not explicitly address domestic violence, and HHS has stated that all future Healthy Marriage projects should include domestic violence protections.

section_title: Letter
paragraphs: The Temporary Assistance for Needy Families (TANF) program provided  about $17 billion in federal funds to states in fiscal year 2004 for cash  assistance and services to low-income families. This program includes  specific work requirements and a 5-year benefit time limit that some TANF  clients may be unable to meet. Recognizing that not all clients will be  ready to work and that some may need assistance beyond 5 years, the  program also offers various exceptions to these requirements. One  exception—the Family Violence Option—requires that states screen  clients for domestic violence and allows them to grant waivers from  program requirements for clients in domestic violence situations. Adopting  the Family Violence Option is not mandatory, and states that choose not to  do so may nonetheless adopt comparable policies. Although the  Department of Health and Human Services (HHS) oversees the TANF  program, states have broad discretion in implementing the program,  including most aspects related to the Family Violence Option.
Currently, the Congress is considering various changes to the TANF  program, including proposals that would establish matching grants to  promote marriage and discourage divorce, as well as measures  emphasizing responsible fatherhood. While spending TANF funds on these  activities is currently allowed under TANF, the amount states spend on  such program is relatively small compared to their total TANF budgets.
Concerned about these issues, you asked us to examine how state TANF  programs were addressing the issue of domestic violence and how, if at all,  these programs have funded or promoted marriage and fatherhood efforts.  As agreed with your offices, we responded to the following questions:
What are states doing to identify victims of domestic violence among  TANF recipients?
What are states doing to address domestic violence among TANF  recipients once victims have been identified?
To what extent are state TANF programs spending TANF funds on  marriage and responsible fatherhood programs, and how, if at all, are  these programs addressing domestic violence?
To answer these questions, we conducted a survey of the TANF programs  of the 50 states and the District of Columbia. In this survey, we asked  detailed questions about state policies regarding screening TANF clients  for domestic violence, how states addressed domestic violence situations  once clients have disclosed them, and the extent to which states have used  TANF funds for marriage and responsible fatherhood programs. To  supplement the data obtained through the survey, we conducted in-depth  visits to five states—Colorado, Georgia, New York, Oklahoma, and  Washington. We selected these states because their practices for screening  TANF clients for domestic violence have been in place for various  amounts of time; only one of these states, Oklahoma, has not adopted the  Family Violence Option. We selected one state—Oklahoma—in part  because of its TANF-funded marriage program, and another state— Georgia—because of its TANF-funded responsible fatherhood program.  During each of these visits, we conducted detailed discussions with state  officials about state policies, obtained documentation of state policies, and  visited two local service delivery offices in each state to discuss and  observe how the policies were implemented. We visited three states— Illinois, Iowa, and Wisconsin—while designing our study, and pre-tested  the survey with officials in Maryland, Michigan, and Pennsylvania. Finally,  we contacted researchers and policy analysts knowledgeable about the  TANF program, domestic violence, and marriage and responsible  fatherhood programs. We also reviewed pertinent literature concerning  each of these areas. A more detailed discussion of methodology is  contained in appendix I.
We conducted our work in accordance with generally accepted  government auditing standards between May 2004 and May 2005.
subsections: section_title: Background
paragraphs: The TANF program was established by the Personal Responsibility and  Work Opportunity Reconciliation Act of 1996 (PRWORA), and was  designed to provide cash assistance to needy families with children, while  at the same time ending the dependence of needy families on government  benefits by promoting job preparation, work, and marriage. As the  responsible federal agency, HHS provides an annual TANF block grant to  each state. In fiscal year 2004, states spent about $26 billion of federal and  state funds to assist low-income families, including providing monthly  cash assistance to about 2 million families as of June 2004.  States have  considerable flexibility in administering TANF programs, and in turn,  offices in localities throughout each state are responsible for interacting  with TANF clients and running the day-to-day aspects of the program.
The TANF program encourages recipients to work, places limits on the  length of time that a family can receive federal cash benefits and requires  that clients cooperate with child support authorities. Specifically, in  accordance with the authorizing legislation, TANF regulations state that all  clients must participate in work activities as soon as the state determines  they are ready to do so, or after 24 months of cash benefits, whichever  occurs earlier.  Further, clients may not obtain federal TANF cash  benefits for more than a total of 60 months during their lifetime. TANF  also requires that all families with children for whom paternity has not  been established or for whom a child support order needs to be  established, cooperate with child-support enforcement agencies. The  TANF program both gives states incentives to enforce these requirements,  as well as the flexibility to waive these requirements if necessary.  For  example, states must engage a certain percentage of their overall and two- parent caseloads in work activities, or face financial penalty. In practice,  states can waive the work and time limit requirements for clients in a  number of ways. For example, states can provide cash benefits beyond the  5-year time limit to for up to 20 percent of their caseload. Some states also  provide cash assistance with only state funds when a client has difficulty  meeting federal requirements.
States enroll applicants in the TANF program through a process that is  roughly comparable, though the particulars may vary from state to state  (see fig. 1). A TANF client may meet with a worker who verifies that the  cash assistance program is appropriate for the client’s needs and that the  client qualifies for cash assistance. The client is typically assigned a  caseworker who conducts a review of the client’s employment prospects,  including the client’s education, work history, skills, and aspects of the  client’s personal life that may affect their ability to hold a job. Based on  this review, the caseworker develops an individual responsibility plan that  outlines actions that the client is to take in order to obtain employment  and become financially self sufficient. This plan may require that a client  immediately begin a job search or that the client first take actions to  address aspects of the client’s life that pose a barrier to work. After this  plan is established, the caseworker meets with the client periodically, in  order to ensure that the client is making progress toward the goals  outlined in the plan. Some states also require a more in-depth,  comprehensive review of the client’s progress at regular intervals or if the  client is having difficulty meeting aspects of the individual responsibility  plan.
subsections: section_title: The Family Violence Option Gives States Incentives to Address Domestic Violence among the Client Population
paragraphs: The TANF legislation also established a provision known as the Family  Violence Option, under which states commit to screen clients for domestic  violence, and refer those who are identified as domestic violence victims  to domestic violence services. Further, states that have adopted the Family  Violence Option can waive program requirements—including those related  to work, the 5-year federal time limit, and cooperation with child support  authorities—if compliance would make it more difficult for clients to  escape domestic violence, or would unfairly penalize domestic violence  victims.
States that have adopted the Family Violence Option may also avoid  financial penalties related to the work requirements and the 5-year time  limit, if their failure to meet these requirements is at least partly  attributable to clients who have been granted federally recognized, good  cause domestic violence waivers. In order for the domestic violence  waiver to be federally recognized, it must specify which program  requirements are being waived, be granted based on need as determined  by a person trained in domestic violence, and be accompanied by a  services plan. States may report federally recognized good cause domestic  violence waivers to HHS, and HHS requires that such waivers not be  reported unless they meet the regulatory definition. As with other aspects  of the TANF program, states have broad flexibility regarding the detailed  implementation of the Family Violence Option.
section_title: Studies Indicated Domestic Violence Is Prevalent among Low- Income Women and Can Be a Barrier to Employment
paragraphs: Domestic violence affects a substantial percentage of low-income women,  according to existing research. Further, research shows that it can, in  some cases, pose a barrier to work and financial independence. In 1998,  we reported that studies indicated that between 15 percent to 56 percent  of welfare recipients are, or have been, victims of domestic violence.  Since that time, additional studies with similar findings have been  published. For example, a 2001 report summarized the prevalence of  domestic violence among a random sample of women in the TANF  caseload of an urban county in Michigan. This study found that about 51  percent of the women had been severely abused at some time in their life,  and about 15 percent had been severely abused by a partner at least once  in the preceding year. Further, 61 percent reported being threatened with  violence or other retribution at some point in their lifetime, and 24 percent  reported such an experience had occurred in the preceding 12 months.
Past research has also revealed that domestic violence can, in some cases,  be a barrier to work and financial independence. In our 1998 report, we  reported that various studies found that women who were or had been  victims of domestic violence were employed at about the same rates as  women who reported never having been abused. However, we also cited  one study that found abused women experienced higher job turnover and  more spells of unemployment than women who had never been abused.  Further, our 1998 report, as well as other research, has outlined how  domestic violence can impede successful employment for some women.  For example, several studies have shown that abusers may be threatened  by any steps a woman takes toward financial independence, and may  thwart a job search or employment by interfering with transportation to  work, or by making harassing phone calls to a woman while she is in the  workplace.
section_title: Prompting Disclosure of Domestic Violence Can Be Difficult
paragraphs: State TANF programs face significant challenges addressing domestic  violence, in part because it can be especially difficult to detect. Many  victims of domestic violence may be reluctant to disclose such a personal  and potentially humiliating aspect of their life. Researchers in the field of  domestic violence and state officials stated that domestic violence victims  may be unwilling to disclose domestic violence out of shame and  embarrassment. Victims may also fear retribution by the abuser.
TANF clients may be particularly reluctant to disclose abuse in the TANF  program setting. Advocates for victims of domestic violence explained that  TANF clients often see TANF staff as government officials who cannot be  trusted to keep the disclosure of domestic violence confidential. Further,  some clients may fear that any disclosure of domestic violence to  government officials could result in the loss of custody over their children.  As a result, disclosure may be thwarted, at least until a trusting working  relationship can be developed. Caseworkers may also lack specific skills  that facilitate disclosure. For example, according to some experts,  caseworkers may lack empathy for domestic violence victims.  Additionally, given the heavy workload that some caseworkers face—in  busy urban areas, some have over 100 clients—they may not effectively  screen for domestic violence. According to some researchers, some  caseworkers may see addressing domestic violence as conflicting with the  overall goal of ensuring that clients become employed. Finally, HHS  officials told us that the physical setting of domestic violence screening— which in many offices can occur in open cubicles or public spaces—may  not facilitate disclosure of domestic violence, as clients may fear being  overheard.
The difficulty of identifying domestic violence is compounded by a lack of  consensus about the best techniques for screening clients. Some state  officials and researchers reported the benefit of screening tools composed  of multiple questions asking about various aspects of domestic violence— such as physical abuse, verbal abuse, or stalking. They believe such an  approach helps clients who may not think of themselves as domestic  violence victims and yet may respond affirmatively to a question about a  specific behavior. On the other hand, some research has found that  detailed questions about specific aspects of domestic violence may be  considered overly intrusive, which can put clients on the defensive and  make disclosure less likely. A 1999 study on the state TANF programs’  efforts to assist victims of domestic violence found that screening  instruments should avoid intrusive questions about the specific actions of  an abuser, as such questions can be too personal or shaming.
section_title: Federal TANF Funds May Be Used to Fund Marriage and Responsible Fatherhood Programs
paragraphs: Because the TANF program includes a variety of goals, federal TANF  funds can be used for purposes other than cash assistance to needy  families. Because one of the purposes of the TANF program is to  encourage the formation and maintenance of two-parent families, some  states have opted to use TANF funds for marriage programs. Such  programs attempt to achieve these goals through various measures, such  as education. Similarly, some states have opted to use TANF funds for  responsible fatherhood programs. These programs are designed to  encourage the active and responsible involvement of non-custodial fathers  in the lives of their children.
State officials, practitioners, and the domestic violence services  community have stressed the importance of involving the domestic  violence services community in development and implementation of  marriage and responsible fatherhood programs. States that have used this  approach have indicated that the involvement of the domestic violence  services community was necessary to ensure that marriage and  responsible fatherhood programs address individual safety. HHS  Administration for Children and Families has echoed this sentiment in an  information memorandum that strongly recommends that states consult  with experts in domestic violence or with relevant community domestic  violence coalitions as they design marriage initiatives.  Further, HHS has  stated that its Healthy Marriage Initiative--which seeks to promote healthy  marriages though activities such as marriage and pre-marriage education-- requires grantees to develop domestic violence protocols that address  screening for domestic violence and referrals to local domestic violence  services.
section_title: Most States Have Adopted the Family Violence Option, and States’ TANF Programs Take Differing Approaches to Screening for Domestic Violence
paragraphs: While the large majority of states have adopted the Family Violence Option  or a comparable policy, states take a broad range of approaches to  identifying domestic violence. Most states require that clients be formally  screened for domestic violence, though techniques can vary significantly  from state to state. A few states do not actively screen, but require that  clients be notified of available domestic violence waivers. Comparatively  few states have policies regarding the privacy of screening, although  officials in most states we contacted acknowledged its importance.  Finally, most states reported that domestic violence screening is  performed by staff that may have little or no training in recognizing and  discussing domestic violence. To address this issue, some states have  employed domestic violence specialists.
subsections: section_title: Most States Have Adopted the Family Violence Option or an Equivalent Policy
paragraphs: Forty states have certified adoption of the Family Violence Option (see   fig. 2). Eight states reported that they had not certified the Family Violence  Option, but had adopted similar policies. Each of these states reported  that they make some effort to screen clients for domestic violence, refer  clients to domestic violence services, and offer waivers of certain TANF  program requirements.
Officials in only three states—Maine, Oklahoma, and Ohio—reported that  they had not adopted the Family Violence Option or a comparable policy.   According to Oklahoma officials, adoption of the Family Violence Option  was not seen as necessary because the state already required some of the  actions called for by the Family Violence Option, though the provisions  may not be precisely comparable.
section_title: States Take a Broad Range of Approaches to Screening for Domestic Violence
paragraphs: States screen for domestic violence using a broad range of strategies and  techniques. Some require that staff use formal screening tools at specific  points in the TANF process. Such tools vary in detail and depth of inquiry.  Five states notify clients of domestic violence waivers, but do not require  that staff specifically inquire about domestic violence. In addition, state  TANF program staff can at any time also use informal domestic violence  screening techniques, such as observing a client’s demeanor or interaction  with their partner.
subsections: section_title: Formal Screening at Specified Times
paragraphs: Officials in the large majority of states (43) reported that their state  actively inquires about domestic violence, and most of these states rely on  a mandatory screening tool. Specifically, 26 states responding to our  survey reported that they provide local offices with a specific screening  tool that must be used, while another 4 said the tool they provide is  optional. Eight states reported that they provide staff with guidance such  as regulations, staff manuals, or memoranda, in lieu of a specific screening  tool.
We learned during our visits to states that the breadth and technique of the  screening tools vary considerably. For example, the state of Washington  uses a nine-question, electronic screening tool that prompts TANF staff to  inquire about various aspects of domestic violence, including queries  about threats, angry outbursts or controlling behavior by the client’s  partner. This screening tool is administered by case managers, who  generally go through these questions verbatim, and record the client’s  responses in a data base. In contrast, the state of Iowa uses a tool designed  to be self-administered by the client that makes a single query about  sexual or physical violence in a table that covers a variety of health related  issues. This tool does not ask specific or probing questions about domestic  violence, but prompts the client to enter a checkmark if physical or sexual  violence is an issue for any member of the client’s family.
The large majority of states that require formal screening require it early in  the TANF process, with follow-up screenings at certain points. As figure 3  indicates, subsequent screenings occur either at regular intervals, or when  it becomes apparent that a client is having difficulty meeting program  requirements. For example, our survey data show that 24 states screen  during a TANF eligibility review that in some states, such as New York,  can take place every 6 months. Many states also screen when the client  exhibits difficulty in meeting TANF program goals or requirements. For  example, 20 states screen when a client fails to meet the conditions of  cash assistance. State officials told us that such follow-up screenings are  important because the client may be reluctant to disclose domestic  violence initially or because it may emerge as a problem after entry into  the TANF program.
Five states that have adopted the Family Violence Option or a comparable  policy reported that they do not actively screen TANF clients for domestic  violence. These states indicated that they have no screening requirements  beyond informing clients about available domestic violence waivers. An  official of one such state—Pennsylvania—referred to this process as  “universal notification” and explained that the policy was developed in  consultation with the state coalition that advocates for domestic violence  victims. The policy was developed in the belief that it is best not to probe  clients about domestic violence and risk putting them in an uncomfortable  situation, but to spell out the program flexibilities that exist for domestic  violence victims. This policy allows domestic violence victims to disclose,  if necessary, at a time of their choosing.
section_title: Informal Screening throughout TANF Process
paragraphs: Staff in local TANF offices can also conduct “informal” screening through  casually conversing with or observing clients. For example, a client’s  demeanor or physical appearance may provide evidence of domestic  violence. Several officials told us that such informal screening can occur  at any time in the TANF process and is especially important because a  client may not be ready to disclose a domestic violence situation at the  time of formal screening, and because a domestic violence situation may  arise after the formal screening. For example, caseworkers and other  officials in Wisconsin told us that disclosure of domestic violence often  occurred in the course of informal discussions and consultations between  clients and staff.
section_title: Fewer Than Half of States Reported Having Policies Regarding Privacy for Screening
paragraphs: Sixteen states reported that they have established policies regarding the  physical setting in which screenings occur. For example, Colorado  officials explained that, while screening will often begin in open cubicles,  the state’s policy is that the meeting will be moved to a private office if a  situation of domestic violence has been identified.
In our visits to TANF offices in seven other states, we learned that  screening often occurs in the course of much broader discussions that  occur in open cubicles near staff and other clients. During our site visits,  several state officials told us that although private, confidential settings  are important, many local offices would face constraints in providing such  settings. For example, an official in one state said that the degree of  privacy available varies considerably from office to office, and the setting  in some offices dictates that screening take place at desks near a lobby full  of clients. While this is not ideal, the local offices must work within the  constraints of the facilities in which they are located.
Ten states said that they have policies regarding individuals who may be  present during screening. For example, officials in the state of Washington  told us that, if a couple comes in to the TANF office to apply for benefits  together, it is state policy that they be separated before domestic violence  will be discussed. According to the Washington “Work First” handbook,  which provides written guidance for caseworkers and other staff in the  state’s TANF program, caseworkers are not to ask about family violence in  the presence of the partner, because this may endanger the client.  Similarly, the screening tool used in Illinois advises caseworkers to ask  questions regarding domestic violence at a later time if the client’s partner  is present. We also found that, although some states do not have policies  in this regard, some caseworkers in these states nonetheless ensure a  client is alone for domestic violence screening. A local office official in  New York, which does not have a privacy policy, said that before  questions about domestic violence are asked, they will separate couples  with a contrived reason, if necessary. For example, they may tell the  partner that he must meet with another staff member about another topic,  such as his job history.
In contrast, most states have no explicit policy about who can be present  during a client’s domestic violence screening. For example, an official at a  local office in Iowa said that the initial meeting with the caseworker takes  place with both partners present because it is important to see how a  couple interacts. If the caseworker suspects domestic violence, they may  try to separate the couple for a subsequent discussion. Other states  explained that they encourage a middle approach, explicitly relying on the  judgment of the caseworker. Similarly, in New York, state policy directs  that the domestic violence screening form can be mentioned with both  partners present, but that it not be addressed further if the clients are not  interested. However, the policy also advises that caseworkers may need to  be creative in finding a way to mention the domestic violence screening  form again in a private setting.
section_title: Screening Is Typically Performed by Caseworkers, but Some States also Use Domestic Violence Specialists
paragraphs: Forty-five states reported that caseworkers or intake workers are the staff  that typically conduct domestic violence screening, a fact acknowledged  by officials during our site visits. As figure 4 indicates, most state policies  require little training for these staff. Twenty states indicated that the state  either had no policy regarding domestic violence-related training, or may  provide training only once in caseworker’s career. Another 25 states  require training once in a staff members’ career and make additional  training optional.
Officials in each state we visited told us that the skills, abilities, and  inclinations of staff to conduct domestic violence screening vary  considerably. For example, one state official told us that the personalities  and style of caseworkers range across the board. This official said that  many staff are technical people who have spent their careers stressing  program qualifications, and addressing domestic violence and other “soft”  issues is difficult adjustment. An official of another state TANF program  said that even with the best of best training and screening policies,  screening effectiveness is dependent on the effectiveness of individual  caseworkers, and some caseworkers may simply skim the screening  questions and not ask the full range. These comments were reinforced  during our observations of domestic violence screening in several local  TANF offices. At one office, we observed one caseworker who stressed  certain aspects of the TANF experience, such as the need to obtain  employment or attend training services, but gave very peremptory  attention to other issues, such as domestic violence and mental health. At  another office, we witnessed screening performed by a social worker, who  paused at length over these issues, and sensitively asked follow-up  questions regarding the client’s home life, and took the initiative to gently  and patiently describe a local organization that could provide alternative  living arrangements, if this were necessary.
In order to supplement the skills of the caseworkers, three of the states we  visited—Georgia, New York, and Washington—employed domestic  violence specialists to conduct in-depth screening and assessment after a  client disclosed that domestic violence was an issue.  This practice is  implemented statewide in Georgia and New York, and has been  established for almost all of the TANF offices in Washington state. In all  three states, the domestic violence specialist serves to “backup” the  screening conducted by the regular caseworker. For example, New York’s  policy requires that a client be referred to a specialist—known as a  domestic violence liaison—as soon as a client discloses that domestic  violence is an issue. State officials told us that the meeting with the  specialist is scheduled as soon as possible and all further inquiry regarding  domestic violence is left to the domestic violence liaison. The specialist  then conducts a more in-depth inquiry and informs clients about options  for protective services and other assistance.
State officials told us that domestic violence specialists can play an  important role in addressing the needs of domestic violence victims and  are important given the limited skills of many caseworkers in dealing with  domestic violence. Officials in Washington, for example, said that the  presence of a domestic violence specialist increases the likelihood that a  domestic violence victim will attend counseling or other services to  address the problem. A caseworker can immediately walk a client over to  the desk of the domestic violence specialist, who then conducts an in- depth assessment, provides some degree of counseling, and makes  referrals to other agencies for ongoing services. They explained that if the  domestic violence specialist were not there, they believe that many clients  would ignore the referrals to outside agencies, and the domestic violence  issue festers. During one of our site visits, we learned firsthand of the  importance of effective interpersonal skills in domestic violence  screening. We interviewed an employee of a local TANF office who was a  former TANF recipient and a domestic violence victim. She explained that,  when she was screened for domestic violence, she was in a desperate  situation fleeing from her abuser and needed assistance right away.  Nonetheless, the attitude of the screening staff was so perfunctory and  indifferent that, had she not immediately been routed to a domestic  violence specialist, she said she probably would not have returned to that  office. The former victim further noted that many caseworkers are  overwhelmed by other demands, and felt that the caseworker she dealt  with was not equipped to handle domestic violence issues.
State officials also told us that domestic violence specialists can enhance  the ability of other office staff in dealing with clients’ domestic violence  issues. In Washington, caseworkers at a local TANF office stated that an  onsite domestic violence specialist serves as an important source of  technical assistance for caseworkers. For example, the specialist has  provided training for staff, and made them aware of the “red flags” that  may indicate domestic violence is an issue. The officials repeatedly  praised the domestic violence specialist for this “cultural” impact on this  TANF office.
section_title: HHS Has Taken Some Steps to Provide States with Guidance on Domestic Violence Screening
paragraphs: HHS has, since the establishment of the TANF program, taken a number of  measures to identify and disseminate information on what states are doing  to screen for domestic violence. For example, HHS funded a 1999 report  that summarized how states had implemented the Family Violence Option,  including the basic techniques each state used to screen for domestic  violence, and a number of detailed examples of how domestic violence  screening was conducted at specific locations.  Further, an HHS-funded  report published in 2000 provided in-depth descriptions how 7 counties in  different states identified domestic violence victims and assisted those  who disclosed. These reports also made observations regarding the  benefits and drawbacks of various screening practices. For example, the  report published in 2000 noted the usefulness of a more extensive  domestic violence screening tool—covering verbal, emotional, and sexual  abuse—that could be used once a worker has some indication that a client  may have domestic violence issues.
Although HHS has funded research on state TANF program approaches to  domestic violence screening, HHS officials also told us that the agency has  not provided state TANF programs with specific advice in the form of  policy guidance or memoranda regarding best practices in domestic  violence screening. Further, it has not specified minimal acceptable  standards for domestic violence screening. Agency officials explained that  the legislation establishing the TANF program gives states considerable  flexibility in implementing the Family Violence Option, and does not  provide HHS with authority to require particular approaches to screening.
section_title: To Address the Needs of Victims of Domestic Violence, Most States Use Waivers and Refer Clients to Local Service Providers
paragraphs: State TANF programs play an important role by offering victims of  domestic violence waivers from TANF program requirements and helping  them obtain needed services. Although most states will waive certain  TANF requirements, the provisions of these waivers vary from state to  state. Further, limited data from two states that we visited indicates that a  comparatively small portion of all TANF recipients obtain domestic  violence waivers. Although all state TANF offices rely on local service  agencies to provide domestic violence services, some also provide in- house domestic violence services and most actively monitor clients for  participation in services. While the full range of services is generally  available to victims in urban areas, services in rural areas are generally  less available.
subsections: section_title: Most States Waive Requirements for Work, Time Limits, and Child Support
paragraphs: Of the 48 states that adopted the Family Violence Option or an equivalent  policy, the majority will waive the requirement that TANF clients work or  engage in work-related activities, the 5-year federal lifetime limit on TANF  benefits, and cooperation with the child support authorities to collect  child support, as shown in table 1.
Some states will waive other requirements as well. Thirty-eight states  indicated that they will waive specific requirements included in a client’s  individual responsibility plan, which is intended to lead to work and  financial independence. For example, an Illinois official told us that the  individual plan of many clients requires them to meet with their  caseworker in order to continue receiving benefits. If a client misses a  meeting and can demonstrate that the failure to make the appointment  was due to domestic violence, the requirement can be temporarily waived  and cash benefits will not be interrupted. Another six states reported that  they will, if necessary, waive other program requirements in the event that  domestic violence makes them difficult to meet. For example, an Oregon  official reported that they will waive certain financial eligibility  requirements in the event of domestic violence. For example, if a domestic  violence victim must use part of her income to flee an abuser and pay for  temporary housing, this portion of the income will be temporarily  excluded from eligibility and benefit calculations.
section_title: Conditions for Receiving Waivers Varied by State
paragraphs: Federal TANF regulations allow states considerable flexibility regarding  the conditions for clients to obtain good cause domestic violence waivers.  For example, some states reported that they required recipients to provide  evidence of domestic violence before granting a waiver, while others  reported that the client’s word was sufficient. As table 2 indicates, 25  states do not require evidence beyond a client’s statement in order to grant  a waiver from work requirements. For example, a Washington official said  that additional evidence before granting a waiver was not needed because  officials expect clients to participate in domestic violence services, which  clients would not want to do unless such services are needed. In contrast,  Illinois requires that recipients provide additional documentation such as a  written statement from a third party, a police report, or documentation  from a domestic or sexual violence program.
Twenty-seven states reported that they also require domestic violence  victims to participate in domestic violence services in order to waive  program requirements. For example, officials in Iowa and Washington said  that clients must demonstrate that they are making an effort to address the  domestic violence by attending counseling or other services. In contrast,  an Illinois official explained that the state also requires that caseworkers  provide waiver recipients with information about available domestic  violence services and encourage them to attend; however, they cannot  require their participation. Officials said that some clients do not want to  participate in services provided through an agency but prefer to use an  informal network for support and assistance such as family, friends, or  church ministers.
Some states may also tailor waivers to fit a client’s particular  circumstances and will help clients maximize compliance with program  requirements. For example, New York offers “partial waivers,” which state  officials believe help to ensure a victim’s safety while still participating in  program activities. For example, a partial waiver could be granted to a  client who is taking job readiness classes but not actively searching for a  job because of safety concerns. In such a case, the partial waiver would  allow the client to fulfill part of the work requirement without interrupting  cash benefits. Similarly, a partial child support waiver would be granted if  it would put the client in danger to appear in court to pursue child support  (this is in contrast to a full child support waiver in which a client would  not be required to pursue child support at all if doing so would threaten  their safety).
section_title: Limited Data Indicates That a Small Portion of the TANF Population Use Domestic Violence Waivers
paragraphs: Reliable national data on the number of domestic violence waivers issued  by the states does not exist, according to an HHS official responsible for  tracking state data reporting. During our site visits, some of the eight  states were able to provide data on domestic violence waivers from the  work requirement. For example, Georgia officials reported that from July  2003 through June 2004, local TANF offices in Georgia granted 925 waivers  from the work requirement, which was less than 2 percent of the 52,515  clients who were receiving TANF benefits during that time. In contrast,  Washington officials reported that from October 2003 through September  2004, local TANF offices in Washington granted 5,162 waivers from the  work requirement, more than 9 percent of the 52,515 clients receiving  TANF benefits.
The number of waivers granted in some states may be relatively small  because clients may opt out of TANF requirements in other ways or  because domestic violence victims can comply despite their situation. For  example, some domestic violence victims may face multiple barriers and  could obtain a state “hardship” waiver that will extend the 5-year time  limit without coding it as a domestic violence waiver. Officials in most  states that we visited said that many victims prefer to work because they  consider financial independence as the best way out of an abusive  situation. For example, a caseworker in Colorado who works exclusively  with domestic violence victims said that she rarely grants a waiver for the  work requirement because most clients want to work, and even if they  only work part-time, the participation in domestic violence services is  included in the work plan as a work activity. She said that she only grants  a waiver from work requirements to individuals that are in such a critical  situation that they can only deal with their domestic violence issues.  Officials in New York also said that most domestic violence victims prefer  to work but that many also participate in the domestic violence services  that are offered.
section_title: Clients May Be Referred to Outside Service Providers or in Some Cases Obtain In-House Services, but Degree of Monitoring and Service Availability Varies
paragraphs: While all states reported that clients are referred to separate local agencies  for domestic violence services such as counseling, some offices also offer  such services in-house. During our site visits, some states reported that the  availability of services varied, with some states reporting that domestic  violence services were less available in rural areas. Further, some states  appear to be more active than others in monitoring the progress of clients  who obtain domestic violence services.
Thirty-eight states reported that their local TANF offices relied exclusively  on separate local agencies to provide services to their domestic violence  clients. These services generally include counseling, crisis intervention,  safety planning, support groups, legal and court advocacy, and emergency  shelter. In contrast, 13 states reported that they provided some domestic  violence services on-site in the local TANF office in addition to using  separate local agencies. For example, officials in Washington said that  most of the state’s local TANF offices have a Domestic Violence Advocate  (DVA) on-site who works exclusively with domestic violence victims  providing services such as safety planning and counseling. The benefit of  having this service located on-site is that it gives the victim immediate  access to services, and increases the chances that the clients will follow  through with services. Also, because the DVA is located at the TANF  office, the client may receive services without the knowledge of the  abuser. For other domestic violence services, such as shelter and legal  advocacy, clients were referred to a separate local service provider.
The kind of services offered to domestic violence victims is determined by  their need and the availability of such services in the community.  However, among the states that we visited, we found that the kinds of  services available varied—urban areas generally provided a full range of  services, while services in rural areas were less available. For example, a  Colorado official cited one area of the state that had only one shelter  serving five counties and officials in one rural county expressed a need for  more counseling services. New York officials also said that services were  less available in rural areas, but that it was simply not cost-effective to  have a full range of services in sparsely populated areas. In addition,  officials in several states that we visited said that transportation is less  available in the rural areas and access to services can be difficult for  victims living many miles from the nearest provider. For example, officials  in a rural office in Oklahoma said that the shelter serving their clients was  26 miles away and that caseworkers often have to call the local police to  transport domestic violence victims that are unable to transport  themselves.
While most states required that local TANF offices monitor client  participation and progress when referred for these services, some states  more actively monitor a client’s progress. In responding to our survey, 29  states reported that, in some or all cases, clients referred to a domestic  violence service provider must be monitored for progress. For example,  Washington officials said that communication with providers is required  monthly to monitor clients’ progress so that they can determine when they  are able to move into work activities that will allow them to become self- sufficient. In contrast, 16 states indicated that they had no such policy. For  example, New York officials said that they discourage communication  between the TANF office and the domestic violence service agency. An  official explained that the providers, who operate independently, want to  maintain confidentiality to ensure the victim’s safety.
section_title: Most States Used Federal TANF Funds for Marriage or Responsible Fatherhood Programs, but Take Differing Approaches to Addressing Domestic Violence
paragraphs: Thirty-one states reported using federal TANF funds for marriage or  responsible fatherhood programs, and limited research indicates that such  programs generally do not specifically address domestic violence. States  that reported funding marriage programs most frequently supported adult  and youth marriage and education programs. States that reported funding  responsible fatherhood programs most frequently supported programs  that deliver services to non-custodial fathers to enhance ability to meet  parental obligations. Data show that a relatively small portion of TANF  funds were used for marriage programs in 7 states and responsible  fatherhood programs in 21 states. While research indicates that these  programs do not explicitly address the issue of domestic violence, they  may nonetheless do so by emphasizing better communications and healthy  relationships, and constructive techniques for dispute resolution. Debate  exists as to the best approaches for marriage and responsible fatherhood  programs to address domestic violence.
subsections: section_title: Most States Used Federal TANF Dollars to Fund Marriage or Responsible Fatherhood Programs in the Last 3 Years
paragraphs: Thirty-one states reported using TANF funds for marriage programs,  responsible fatherhood programs, or both in the last 3 years. Specifically,  15 states reported funding marriage programs, and 28 states reported  funding responsible fatherhood programs from 2002 to 2004. Of these, 12  states reported funding both marriage and responsible fatherhood  programs. See figure 5.
States that funded marriage and responsible fatherhood programs with  TANF dollars in the last 3 years reported supporting various types of  efforts. Most frequently, states that funded marriage programs with TANF  dollars in the last 3 years reported funding adult and youth relationship  and marriage education programs. Such programs are generally based on a  standard curriculum, presented in a classroom-style format, and attempt  to change attitudes and dispel myths about marriage and to teach  relationship skills. For example, the Oklahoma Marriage Initiative works  to improve relationships through services that provide skill-based  relationship training. Workshop leaders are trained to teach Prevention  and Relationship Enhancement Program (PREP) courses, which are  designed to prevent divorce and enhance marriage, in their communities  and organizations across the states.  Most workshops are voluntary and  participants learn about the program through the Internet, referrals, word  of mouth, local advertising, and churches. One local TANF office required  participants to attend PREP or PREP-like courses. Similarly, youth  marriage education programs can be taught using one of several nationally  recognized curricula for building successful relationships and marriages.  Several states also reported funding activities such as media campaigns  and conferences relating to marriage.
States that supported responsible fatherhood programs using TANF  dollars in the last 3 years typically funded collaborative fatherhood  programs between government and private agencies or funded direct  services to non-custodial fathers to enhance their ability to meet parental  obligations. We visited one state—Georgia—that has fatherhood programs  in both these categories. These programs were initiated by the Director of  the Division of Family and Children Services, who believed some fathers  were not “deadbeats but dead broke” and appointed a special consultant  to develop fatherhood programs. Georgia’s Fatherhood Program is a  partnership with several state agencies and other organizations. The  program’s mission is to assist non-custodial parents in training and  educational opportunities leading to employment paying above minimum  wage and encouraging increased involvement in the lives of their children.  The program contracts with the Georgia Department of Technical and  Adult Education to provide job skills and placements for unemployed or  underemployed non-custodial parents. Georgia’s other responsible  fatherhood program, the Child Access and Visitation Program, is designed  to assist non-custodial parents with improving visitation with their  children and addressing the children’s relationship with the custodial  parent. This program is run through a contract with an outside service  provider and funded through a grant from HHS’ Administration for  Children and Families.
Two states that reported not using federal TANF funds for marriage  programs told us that they address factors that cause stress in marriages  without implementing marriage programs.  For example, Illinois chose to  emphasize direct support for low-income families by providing material  support, such as childcare, transportation, and cash assistance rather than  implementing marriage programs. An Illinois official also noted that a key  variable in successfully promoting marriage was increasing the economic  status of the couple so that they feel marriage is a viable alternative. New  Jersey also reported in its survey that the state funded programs that  address factors that can cause stress in marriages, as well as efforts that  indirectly promote and preserve marriage.
section_title: Limited Data Suggest States Use Small Amounts of Federal TANF Funds for Marriage and Responsible Fatherhood Programs and Some Rely on Other Funding Sources
paragraphs: States that reported using federal TANF funds for marriage or responsible  fatherhood programs did not report using a large proportion of their total  federal TANF budget for this purpose. Specifically, no state providing  usable data reported spending more than about 5 percent of its total  federal TANF expenditures on marriage or responsible fatherhood  programs for 2002 or 2003. While according to HHS officials more  complete national data does not exist, a Congressional Research Service  report also found that states were not spending large portions of TANF  funds on marriage programs. Similarly, according to another report,  states spend relatively small amounts of TANF funds on responsible  fatherhood programs.
Some states reported that they fund marriage and responsible fatherhood  programs with funding sources other than federal TANF dollars. Five  states in survey commentary and one state in a site visit indicated that  that they fund marriage programs with monies other than federal TANF  funds.  Two additional states indicated that they currently fund programs  with distinct marriage components, but they did not consider them  marriage programs per se. A Georgia official told us that the state will  soon be implementing a marriage program similar to the Oklahoma  Marriage Initiative. The program will use an ACF grant under the authority  of section 1115 of the Social Security Act and private funding rather than  federal TANF funds. Furthermore, since state fiscal year 2004, eight states  indicated in survey responses or during our site visit that they are  implementing or developing new marriage programs that may or may not  use federal TANF funds.
Similarly, some states are supporting responsible fatherhood programs  through other means. For example, some states also support responsible  fatherhood programs with monies other than federal TANF funds. The  state of Washington collaborated with Alaska and Oregon using non-TANF  funds to create public service videos to encourage fathers to be involved  with their children. One national fatherhood report also indicated that  responsible fatherhood programs remain largely funded through  foundations.
section_title: Generally, Marriage and Fatherhood Programs Do Not Explicitly Address Domestic Violence
paragraphs: According to research and practitioners in the field of marriage and  responsible fatherhood, domestic violence is generally not explicitly  included as a component of marriage and responsible fatherhood  programs. Recent research funded by HHS found that many of the widely  available marriage education programs were designed and tested with  middle income, college-educated couples, and do not assess for or address  a variety of issues—including domestic violence—that place considerable  stress on couple relationships. A researcher in the field of marriage  programs stated that such programs do not address domestic violence  because marriage education is an emerging field and developers did not  initially see the need for discussion of domestic violence within these  programs. Similarly, two representatives of national fatherhood advocacy  organizations indicated that most responsible fatherhood programs have  not addressed domestic violence or lack the resources to deal with  domestic violence. Furthermore, one found that this was because  practitioners in responsible fatherhood programs usually do not have  expertise in domestic violence issues.
Nonetheless, some marriage and responsible fatherhood programs do  address domestic violence implicitly through an emphasis on healthy,  egalitarian relationships and constructive conflict resolution. For example,  the Oklahoma Marriage Initiative program focuses on communication and  conflict resolution between couples without an explicit discussion of  domestic violence. The Oklahoma program covers danger signs of marital  problems, such as negative communication habits that can escalate into  anger and frustration, a pattern of constantly putting down or disregarding  the thoughts and feelings of a partner, or a habit of negative  interpretations of the actions and comments of a partner.
There is a range of opinions on how marriage and responsible fatherhood  programs should address domestic violence.  Some state officials  indicated that marriage programs that address domestic violence through  an emphasis on healthy relationships and conflict resolution alone can  reduce and help prevent violence in marriages by reducing the stress that  often leads to violence. For example, New York indicated that programs  designed to encourage healthy relationships will have the positive benefit  of reducing the likelihood of physical violence and emotional abuse. Some  practitioners have noted the need to address domestic violence explicitly  and have begun to take steps toward explicitly including domestic  violence in marriage programs and have sought program advice from local  domestic violence coalitions. For example, while the Oklahoma Marriage  Initiative does not explicitly cover domestic violence in its marriage  curriculum, it recently created a handout to assist clients in identifying  domestic violence and where to obtain help.
Nonetheless, other evidence suggests that domestic violence should be  explicitly addressed in marriage and responsible fatherhood programs.   The HHS-funded research on marriage and responsible fatherhood  programs found, for example, that many unmarried parents face a variety  of challenges that may impede their ability to form a stable marriage. It  further states that assessment of barriers—in particular domestic  violence—could point out the need for referral to other kinds of  appropriate help. State officials and advocates told us that addressing  domestic violence specifically is important to ensuring that programs  address the dangers of domestic violence.  Further, HHS has stated that all  future projects funded by its Healthy Marriage Initiative--which seeks to  promote healthy marriages through activities such as marriage and pre- marriage education—are to fully incorporate domestic violence  protections, including project specific policies regarding screening for  domestic violence.
section_title: Conclusions
paragraphs: The TANF program emphasizes that recipients move toward economic  self-sufficiency, but also recognizes that some recipients may face barriers  that may make it difficult or impossible for them to work immediately, or  meet specific timelines for attaining self-sufficiency. One of these  provisions—the Family Violence Option—requires states that adopt it to  screen clients for domestic violence, and offer other assistance to those  who need it in overcoming this potential barrier to self-sufficiency. The  Family Violence Option offers states considerable flexibility in how they  screen for domestic violence, and states have taken a range of approaches  to doing so. While this flexibility is consistent with the overall TANF  emphasis on allowing states latitude in designing and administering their  programs, guidance on effective approaches to domestic violence  screening could provide states with additional information on promising  screening practices.
Specifically, there may be certain practices that could benefit all state  programs, assuming they are affordable and practicable. For example, in  the states we visited, domestic violence specialists appear to offer multiple  benefits to local TANF offices, including offering greater expertise and  more refined skills in dealing with extremely personal issues than is  typical of many caseworkers. This is especially important, given the  limited domestic violence training and varying levels of skills and abilities  among the caseworkers. Some states also appear, more than others, to  stress privacy in conducting domestic violence screening. Although HHS  has taken a number of actions to provide states with information about  approaches to screening, it has not identified and encouraged the adoption  of certain best practices through official guidance or memoranda.
section_title: Recommendations for Executive Action
paragraphs: We recommend that the Secretary of the Department of Health and Human  Services: examine current domestic violence screening practices of states, and  determine whether certain practices—such as employing and training,  where possible, domestic violence specialists—are particularly  promising approaches to screening for domestic violence, and provide states with information on these practices, and, through  agency guidance or memoranda, encourage their adoption.
section_title: Agency Comments and Our Evaluation
paragraphs: We provided a draft of this report to HHS for its review. Overall, HHS  agreed with the report’s findings and provided some comments on the  report’s conclusions and recommendations. Regarding the report’s  conclusions, HHS correctly states that there is a lack of consensus among  domestic violence services professionals about the best techniques for  screening clients and that it would be reluctant to advocate particular  screening approaches over others.  It further states that its regulatory  authority is limited in this and many other areas of the program. We agree  that there is no documented consensus about which screening practices  are the most effective and, consistent with current TANF regulations, state  programs should retain flexibility in designing the approaches they believe  are most effective. However, we believe that there may be some practices  that are sufficiently promising that all states should be made fully aware of  their merits, so that they can choose to adopt them if practicable. While  some of these promising practices might not be applicable in each and  every situation, we continue to believe that state TANF programs would  benefit from HHS guidance on the advantages and limitations associated  with particular promising practices. Further, HHS’ advocacy of these  practices would continue to allow state TANF programs and local TANF  offices to retain the flexibility and latitude to select approaches that best  meet the needs of their programs. We have revised our conclusions and  recommendations to more clearly suggest that HHS should make  information on promising screening approaches available to states and to  encourage their adoption.
HHS also provided technical comments on the draft report, which we have  incorporated where appropriate. HHS’ entire comments are reproduced in  appendix II.
As arranged with your office, unless you publicly announce its contents  earlier, we plan no further distribution of this report until 30 days after the  date of this letter. At that time, we will send copies to interested  congressional committees and Members, and the Secretary of Health and  Human Services. We will also make copies available to others upon  request. In addition, our report will be available at no charge on GAO’s  Web site at http://www.gao.gov.
Contact points for our Office of Congressional Relations and Office Pubic  Affairs may be found on the last page of this report. GAO staff who made  major contributions to this report are listed in appendix III.
section_title: Appendix I: Objectives, Scope, and Methodology
paragraphs: The objectives of this report were to determine (1) what states are doing  to identify victims of domestic violence among Temporary Assistance for  Needy Families (TANF) recipients, (2) what states are doing to address  domestic violence among TANF recipients once they have been identified,  and (3) the extent to which states are spending TANF funds on marriage  and responsible fatherhood programs, and how, if at all, these programs  are addressing domestic violence.
To address each of these objectives, we:    conducted a survey of the TANF agencies in all 50 states and the    conducted site visits to state TANF agencies and local TANF service  delivery offices in 8 states; and  interviewed researchers and representatives of national organizations  with expertise in the issues of TANF and domestic violence, as well as  marriage and fatherhood programs.
More detailed information on each of these aspects of our research is  presented below.  We conducted our work in accordance with generally  accepted government auditing standards between May 2004 and May 2005.
subsections: section_title: Survey development and implementation
paragraphs: The survey addressed all three objectives, and included questions about  states’ adoption of the family violence option or similar state policies,  screening for domestic violence, and the use of waivers and domestic  violence services to address victim’s needs. In addition, we asked states  about their use of TANF funds to support marriage and responsible  fatherhood programs.
The survey was developed based on knowledge obtained during our  preliminary research. This included a review of pertinent literature and  interviews with members of academia and representatives of organizations  that conduct research and policy analysis on TANF, domestic violence,  and marriage and fatherhood programs. We also conducted visits to TANF  offices in Illinois, Iowa, and Wisconsin to obtain an understanding of their  state TANF programs, how they identify domestic violence victims and  address their needs, and the use of TANF funds for marriage and  responsible fatherhood programs. The survey was pre-tested with state  TANF officials in Maryland, Michigan, and Pennsylvania to determine  whether respondents would understand the questions the way we  intended. These states were selected to ensure that we pre-tested with at  least one state that (1) had adopted the Family Violence Option (FVO)— (Maryland and Pennsylvania); (2) had not adopted the FVO, but was  reputed to have adopted a similar state policy (Michigan); (3) administered  the TANF program through state offices (Pennsylvania and Michigan); and  (4) administered the TANF program through county offices (Maryland). In  addition, Maryland was known to have developed a responsible  fatherhood program and Michigan had both responsible fatherhood and  marriage programs. Revisions to the survey were made based on  comments received during the pretests.
We sent the first mailing of the survey in November 2004 followed by a  second mailing in January 2005; telephone call reminders followed each  mailing. The collection of survey data ended in February 2005 with a 100  percent response rate. We did not independently verify the information  obtained through the survey. We did not attempt to verify the respondents’  answers against an independent source of information; however,  questionnaire items were tested by probing pretest participants about their  answers using in-depth interviewing techniques. Interviewers judged that  all the respondents’ answers to the questions were correct. Answers to the  final questionnaire items on expenditures were compared to HHS ACF  data (form 196) for 2002-2003 and information we received from other  researchers in this area. These data are not directly comparable to data  obtained in our survey, but do indicate whether survey respondents’  answers were reasonable. We conducted follow-up phone calls to clarify  responses where there appeared to be discrepancies.
Although no sampling errors were associated with our survey results, the  practical difficulties of conducting any survey may introduce certain types  of errors, commonly referred to as non-sampling errors. For example,  differences in how a particular question is interpreted or differences in the  sources of information that participants use to respond can introduce  unwanted variability into the survey results. We included steps in both the  data collection and data analysis stages to reduce such non-sampling  errors. Specifically, we pre-tested three versions of the questionnaire,  social science survey specialists designed draft questionnaires, and edits  were performed to identify inconsistencies and other indications of error  prior to analysis of data. Data from the mail survey were double-keyed and  verified during data entry and we performed computer analyses to identify  inconsistencies and other indications or error. Finally, a second,  independent analyst checked all computer analyses. We conducted our  survey work from July 2004 to February 2005.
section_title: State site visits
paragraphs: To obtain a detailed understanding of states’ TANF programs’ efforts to  screen for and address domestic violence, we conducted visits to eight  states. We visited three states—Illinois, Iowa, and Wisconsin— during a  preliminary phase of our work, and another five states—Colorado,  Georgia, New York, Oklahoma, and Washington in a later phase. We  selected these five states in order to ensure we covered (1) states in  different regions of the United States; (2) states that had adopted the FVO  recently and a state that had not adopted the FVO; (3) a state in which the  TANF program is state administered, and a state in which TANF is county  administered; and (4) a state that had used TANF funds to support a  marriage program, and a state that had used TANF funds to support a  fatherhood program.
In each state, we interviewed officials at both the state-level policy setting  office, as well as officials in two local service delivery offices. During both  the state level, and local office interviews, we used a standard interview  protocol that enabled us to obtain more detailed—yet comparable—  information than states were able to provide in the survey. In all five state- level interviews, we discussed state policies for domestic violence  screening, and policies regarding how victim’s needs are met once  identified. In addition, we asked officials about marriage and responsible  fatherhood programs, how these programs were implemented, and the  sources of funding. During the interviews in local TANF offices, we  discussed the implementation of state policies, and toured the offices. In  addition, in seven local TANF offices in five states, we were able to  observe caseworkers interviewing a client applying for TANF benefits,  which included questions about domestic violence. In Georgia, New York,  and Washington we also interviewed domestic violence specialists who  were located at the local TANF offices specifically to identify and address  the needs of domestic violence victims. Finally, we interviewed officials  from each state’s coalition against domestic violence to obtain their views  about their state’s program for identifying domestic violence victims,  meeting victim’s needs, and the existence of marriage and/or responsible  fatherhood programs. Our site visit work was conducted between  December 2004 and February 2005.
section_title: Other
paragraphs: As part of our work, we reviewed pertinent literature and interviewed  representatives of the following organizations:    The Center for Law and Social Policy;    The Urban Institute;    The Center for Impact Research;    The Center on Budget and Policy Priorities;    The American Enterprise Institute;    The American Public Human Services Association;    The Brookings Institution;    MDRC;    The National Governors Association;    Public Strategies;    The National Fatherhood Initiative; and    The Center for Fathers, Families, and Workforce Development.
section_title: Appendix II: Comments from the Department of Health and Human Services
section_title: Appendix III: GAO Contact and Staff Acknowledgments
subsections: section_title: GAO Contact
section_title: Acknowledgments
paragraphs: David Lehrer, Assistant Director, Michael Hartnett, Analyst-in-Charge,  Deirdre Gleeson-Brown, Gale Harris, Alison Martin, Nancy Purvine, and  Amber Yancey-Carroll also made significant contributions to this report.
Important contributions were also made by Jen Popovic, Corinna  Nicolaou, and Daniel Schwimer.