Poverty Reduction: HHS Can Improve Information to Assist States and Localities in Adopting Approaches That Serve Whole Families
Released: 2020-05-07T00:00:00

Letter

Background

Federal Programs for Low- Income Individuals and Families

We previously found that there are more than 80 federal programs that provide aid to people with low incomes, which are administered by several federal agencies as well as state and local providers. We reported that the low-income programs were created at various times, to serve different populations, and in response to different policy issues. We also found that many of these programs provide assistance such as cash aid, food, shelter, and health care for those who have limited means or are disadvantaged in other ways, while other programs are designed to help low-income people move toward self-sufficiency through education, training, and employment services.

In their current strategic plans, some agencies include goals related to supporting individuals or families to help them move towards self- sufficiency. For example, HHS has a strategic objective to “encourage self-sufficiency and personal responsibility, and eliminate barriers to economic opportunity.” Officials from HHS’s Administration for Children and Families (ACF) said they are currently updating ACF’s strategic plan and it will likely include a vision of ending multigenerational poverty through primary prevention by using a whole family—or two-generation— approach that proactively connects families to services before they are in crisis.

Two-Generation Approaches to Poverty Reduction

Two-generation approaches are different from individual low-income programs because these approaches simultaneously address multiple areas, such as child and family economic supports, education, employment, health, well-being, and social capital, according to HHS. These approaches are based on findings that connect the well-being of parents to their children’s social, emotional, physical, and economic well- being. For example, research indicates that parents’ improved economic security is linked to improvements in children’s home environment, greater parental engagement in their children’s schooling, and stronger parenting skills, which may lead to improved child outcomes. Similarly, children’s well-being directly affects their parents’ ability to succeed in both school and the workplace. For example, if parents participate in a workforce training program, but cannot access safe and affordable child care, they may not be able to accept or keep the job for which they trained. Research developed by an ACF-sponsored project states that two-generation approaches are hypothesized to result in parents experiencing stronger labor force attachment or increased earnings, children improving their school readiness and academic achievement, and families increasing family functioning, community connectedness, goal-directed behavior, and executive functioning, among other potential outcomes.

This approach is not a new idea. For example, Head Start programs, which started in 1965, provide early education services to low-income children while offering support to families, such as services that promote housing stability, continued education, and financial security. In addition, federal programs have supported past efforts to improve service coordination for low-income families, such as the use of one-stop centers that deliver workforce, education, and other support services at a single location. These previous efforts, however, often prioritized one generation over the other, according to researchers. Researchers also found that these previous efforts tended to not provide the intensity or duration of services needed to create change for low-income families.

More recent two-generation approaches are intentionally meant to provide services for parents, children, and families in innovative ways by equally addressing the needs of children and parents using quality programs and interventions. For example, ACF is using a human- centered design approach to work across its programs to help families achieve economic independence. Human-centered design aims to create solutions from the point-of-view of families that are in need and the states that serve them and to design systems and service delivery to fit families instead of the other way around, according to ACF. These newer two- generation approaches, which aim to be higher quality and more intensive than previous efforts, are still being tested. ACF and others are currently evaluating the effectiveness of these two-generation approaches.

Selected State and Local Entities Most Commonly Reported Using 10 Federal Programs to Meet the Unique Needs of Local Communities

The 10 Most Cited Federal Programs Have Characteristics That Allow State and Local Entities to Address Multiple Aspects of Child and Parent Well- Being

Ten federal programs were most commonly cited by selected state and local entities as being used to serve whole families and reduce poverty (see table 1). These programs are administered by USDA, HHS, and DOL.

Federal officials have reported that the 10 programs have characteristics—including the target populations, purposes, and services provided—that allow state and local entities to address multiple aspects of child and parent well-being, and these have implications for their two- generation approaches. (See appendix I for the target population, purpose, and services provided by the 10 federal programs.) Specifically:

Target Populations. Consistent with two-generation approaches, many of the federal programs target low-income, needy, or at-risk families. However, we previously reported that eligibility requirements for some low-income programs vary significantly with regard to who may obtain benefits and services, how income is counted, and the maximum income applicants may have. As a result, state and local officials told us that some families who they would like to engage in two-generation approaches are not eligible for some of the federally- funded programs they use for these approaches.

Purpose. The purposes of Temporary Assistance for Needy Families (TANF) and the Community Services Block Grant (CSBG) are broad and can be used to support families in multiple ways. For example, CSBG’s purposes are, among other things, to reduce poverty, revitalize low-income communities, and empower low-income individuals and families to become fully self-sufficient. In addition, according to HHS, these two broad programs allow state and local agencies to cover costs that other programs do not allow, such as salaries for staff to design the two-generation approach. Among the 23 state and local entities, officials from the three entities that reported using CSBG and seven of the 11 that reported using TANF said that they used the programs in combination with other federal programs that have more limited purposes. The other programs can be used to provide more specific supports, such as developing child care programs, increasing employment and earnings, alleviating hunger, or improving maternal and child health.

Benefits or Services Provided. A range of benefits and services for both children and parents are available across the 10 federal programs, such as child care, food assistance, and job skills training. To create their two-generation approach, state and local entities can, to the extent permitted by law, combine services from multiple programs to provide a coordinated approach to addressing the needs of the entire family. In fact, according to HHS, combining services from multiple programs is common in two-generation approaches because single programs tend to cover only one type of service or may be for parents or children instead of both.

In addition to the 10 most commonly cited federal programs, state and local entities reported using over 40 other federal programs to support their two-generation approaches (see appendix II). For example, one entity has a housing complex for single parents and their children. The families receive HUD Section 8 Project-Based Rental Assistance, and the entity also provides support services such as child care, parenting classes, and financial counseling. Two entities reported using Medicaid— one of the nation’s largest sources of funding for medical and other health-related services for low-income individuals.

There may be additional federal programs beyond those cited that could be used for two-generation approaches that selected state and local entities did not report using. For example, HHS officials told us that the Social Services Block Grant could be used for two-generation approaches because it is one of the most flexible sources of social services funding. HUD officials said the Family Self-Sufficiency Program provides case management services and could be used for two-generation approaches. However, none of the 23 selected state and local entities reported using either program.

Selected State and Local Entities Combine Federal Programs with Other Resources in Multiple Ways to Support Their Unique Two-Generation Approaches

We found that selected entities leveraged the 10 most commonly cited federal programs in different ways to meet the unique needs of their individual communities. Officials from some entities reported using only one of the 10 programs, while one entity reported using as many as seven of the programs. In addition, all of the 23 selected entities reported using other resources, including state, local, and/or philanthropic funds, to create their two-generation approaches (see fig. 1). Some state and local officials said these additional resources were needed to provide flexibility in meeting the needs of families. For example, officials from one agency told us they used additional resources to provide services to families with incomes that exceeded the eligibility limits for federal programs, noting that some with higher incomes were still in need of assistance.

To create their unique two-generation poverty reduction approaches and address the needs of their communities, selected entities reported the significance of involving leadership, changing policies, expanding services, modifying service delivery practices, and/or serving specific populations. Specifically: Involving Leadership. In some states, the governor or state legislature encouraged state agencies to adopt two-generation approaches and/or staff were hired to lead the state’s efforts in implementing two-generation approaches, according to officials. For example, officials told us that Maryland’s governor and Connecticut’s state legislature created commissions with membership from state agencies, local organizations, and the public. The commissions made recommendations related to mitigating multigenerational poverty and developing local programs to pilot two-generation approaches. In addition, Colorado, Connecticut, Maryland, and Minnesota officials reported hiring a two-generation approach program manager within state government to coordinate the state’s efforts across agencies and programs to implement such approaches.

Changing Policies. Officials from some states said they changed policies to better support families as part of their two-generation approaches, such as modifying eligibility requirements for certain services. For example, officials from a Colorado state agency said they changed policies across a range of programs to be more family friendly, such as providing transitional food assistance to families no longer eligible for TANF. Officials from a Georgia state agency said they made a number of policy changes, such as increasing the income eligibility threshold for child care subsidies to help families retain this care as their income increases.

Expanding Services. Some officials also reported providing additional services to families that they had not provided in the past. For example, a Colorado state agency is piloting an expansion of its maternal and child home visiting program that adds employment, education, and child care to the supports the program already provides in order to improve family economic self-sufficiency. A Colorado local department now provides short-term housing with support services, in addition to its existing emergency shelters, for some families experiencing homelessness.

Modifying Service Delivery Practices. Selected state and local entities sometimes changed the methods they used to deliver services to families, according to officials. For example, families served by a local agency in Maryland complete an intake form and a strengths and needs assessment. A trained coach then helps the family complete a pathway plan with family goals and action steps. A Minnesota local department is implementing new tools to assess the health, nutrition, education, and employment needs of families and connect them to supports across the department. A Connecticut state agency is employing a family centered coaching model in its Jobs First Employment Services Program. The coaching goes beyond traditional job search assistance by identifying the needs of children and parents and providing financial literacy training.

Serving Specific Populations. Two-generation approaches by selected non-governmental organizations generally provided services to more specific populations, such as single parents or the families of children in certain schools. For example, a non-governmental organization in Minnesota serves single mothers and their young children by providing housing, on-site early childhood education, and weekly life skills training while mothers earn post-secondary credentials. Another non-governmental organization in Minnesota serves families of children in Minneapolis schools and assists families in accessing a variety of services, such as housing stabilization, health, career, and financial counseling. A non-governmental organization in Connecticut provides support services for the parents of children attending its preschool, including helping parents become certified child care workers and obtain full-time employment in a preschool program.

Selected State and Local Entities Reported Challenges Related to Data Sharing and a Lack of Information on Successful Two- Generation Approaches

Difficulties with Data Sharing Impeded Selected State and Local Entities’ Two-Generation Approaches

Officials from 14 of 23 state and local entities reported challenges related to sharing data across low-income programs. We found that some state and local entities have data sharing practices in place, while others are in the midst of designing or creating related systems. Sharing data across systems and programs serving low-income families could enhance state and local two-generation approaches. For example, officials in one county said that if more robust data sharing occurred across agencies and systems, they would have access to information that would help them make decisions based on the needs of the families they serve. Additionally, officials from one non-governmental organization said they wanted to share data with other relevant organizations in order to be able to measure the impact of their two-generation approach. We previously found that states and localities used data sharing to improve case management by helping caseworkers obtain client information more quickly and make more informed decisions.

Yet, state and local officials said that data sharing is difficult due to issues with linking data across low-income programs and concerns about how to protect participant privacy. Specifically, officials from five state and local entities reported issues related to linking data, including that a lack of common data fields across low-income programs made it difficult for the entities to share data. For example, officials at one state agency said they wanted to link mental health and substance abuse data systems. However, the officials have spent 6 years creating matching fields across these systems to allow the data to be shared, and the process is not yet complete. In addition, officials from seven entities said concerns about protecting participant privacy contributed to their data sharing challenges. For example, an official at a state agency noted it can be difficult to balance protecting an individual’s privacy while sharing enough data to be helpful to entities using two-generation approaches.

Federal agencies have taken steps to assist state and local entities interested in data sharing by providing related resources and guidance (see fig. 2). Although this information may not be specific to two- generation approaches, federal officials reported that it could be useful to entities utilizing these approaches.

Selected State and Local Entities Reported a Need for More Information on Two-Generation Approaches

Officials from 11 of 23 state and local entities reported a lack of information on two-generation approaches to be challenging. Specifically, they wanted more examples of successful two-generation approaches, opportunities to learn from peers, and information on federal funding sources that can be used to implement these approaches. For example, officials at one state agency said they had difficulties learning about federal funding sources that do not directly relate to the agency, but could be used to support two-generation approaches. In addition, officials at a non-governmental organization said they would benefit from federally sponsored peer learning so that they could gain knowledge from states and localities to build into their two-generation work.

We found that HHS has developed information memorandums and policy statements on two-generation approaches that address the topics desired by state and local entities. HHS also has hosted webinars and communities of learning to assist state and local entities that were interested in adopting two-generation approaches. For some of these efforts, HHS partnered with other federal agencies. Specifically, within HHS/ACF, at least seven offices have developed information related to two-generation approaches (see fig. 3 for examples). This information discusses a range of topics, from funding flexibility to options for building service models, that could assist state and local agencies in creating two- generation approaches.

According to federal internal control standards, managers should externally communicate the information needed to achieve their organizational goals. To help to ensure effective external communication, managers may want to consider whether the information is readily available to the intended audience when needed. While HHS has created resources relevant to two-generation approaches, it has not made this information readily available to all entities using two-generation approaches. HHS officials said that they disseminate guidance and other resources through existing program or office-specific mechanisms, such as separate email lists and websites for each office. Other federal agencies in our review also created information relevant to two- generation approaches that they distributed through existing program mechanisms. For example, DOL officials said information related to two- generation approaches is woven into technical assistance as relevant to various grant programs. Similarly, Education officials said they published guidance on its website and sent it to state educational agencies and other stakeholders through program specific email lists.

Given these current approaches to distribution, state and local entities using two-generation approaches may not have access to or be aware of all relevant resources if these resources are only available to recipients of certain federal programs or entities in contact with certain federal offices. Without access to all pertinent information, state and local agencies may be unaware of the breadth of information available on two-generation approaches and related topics and may be unable to use it to address challenges they face while designing and implementing such approaches.

HHS recently identified an interagency effort that officials said should address challenges faced by state and local entities, including their desire for information on two-generation approaches. The interagency Council on Economic Mobility was recently established and is led by HHS with participation from USDA, Education, HUD, DOL, Department of the Treasury, Social Security Administration, Office of Management and Budget, Council of Economic Advisers, and Domestic Policy Council. Its tentative mission is to “create an accountable and effective structure for federal interagency collaboration encouraging economic mobility and to use federal levers and tools to promote family-sustaining careers and economic mobility for low-income Americans.” Since the Council on Economic Mobility was only recently established, it is too early to determine whether it will make information readily available across federal programs that is relevant to state and local entities using two-generation approaches.

Conclusions

Poverty negatively affects many aspects of a family’s life, including a child’s education and a parent’s ability to participate in the labor force. Previous attempts to provide better service coordination for low-income families lacked the intensity and quality of services needed for parents and children to create effective change, according to researchers. Some state and local entities are attempting to use two-generation approaches to help families move towards economic self-sufficiency and alleviate the impact of poverty on children, adults, and families through quality programs that address the needs of both generations. State and local officials that we interviewed have implemented a variety of two-generation approaches, but some said they do not have sufficient information on these approaches to most effectively serve families. HHS and other agencies have taken steps to address these challenges, including providing webinars, information memorandums, and other assistance. However, most of these resources are shared through individual program and office mechanisms, potentially making them difficult to access by those not directly connected to certain programs and offices. Moving forward, readily available information and assistance could more effectively help state and local officials learn how to better serve families and help break the cycle of multi-generational poverty.

Recommendations for Executive Action

We are making the following recommendation to HHS: The Secretary of HHS, in consultation with the Council on Economic Mobility, should make information that would assist state and local entities in developing and implementing two-generation poverty reduction approaches readily available across federal programs and offices. (Recommendation 1)

Agency Comments

We provided a draft of this report to USDA, Education, HHS, HUD, and DOL for comment. We received written comments from HHS, which are reproduced in Appendix III. HHS concurred with our recommendation. The agency stated that through its coordination of the Council on Economic Mobility it will promote poverty reduction approaches that aim to provide more integrated, person-centered service delivery. In addition, HHS stated that it will work to identify opportunities for collaboration, promising practices, and successful models that promote economic mobility and will develop strategies for promoting them, such as through technical assistance. HHS also provided technical comments, which we incorporated as appropriate.

We are sending copies of this report to the appropriate congressional committees, the Secretaries of the Departments of Agriculture, Education, Health and Human Services, Housing and Urban Development, and Labor, and other interested parties. In addition, the report is available at no charge on the GAO website at https://www.gao.gov.

If you or your staff have any questions about this report, please contact me at (202) 512-7215 or larink@gao.gov. Contact points for our Offices of Congressional Relations and Public Affairs may be found on the last page of this report. GAO staff who made key contributions to this report are listed in appendix IV.

Appendix I: Characteristics of Federal Programs Most Commonly Cited by Selected Entities Implementing Two-Generation Approaches

Appendix I: Characteristics of Federal Programs Most Commonly Cited by Selected Entities Implementing Two-Generation Approaches To develop child care programs that best suit the needs of children and parents in each state, to empower working parents to make their own decisions on the child care that best suits their family’s needs, to provide consumer education to help parents make informed decisions, to provide child care to parents trying to achieve independence from public assistance, and to help states implement their child care regulatory standards. To enforce the support obligations owed by noncustodial parents for the support of their children through locating noncustodial parents, establishing paternity, obtaining child support, and assuring that assistance in obtaining support or order modifications will be available to all who request such assistance.

Community Services Block Grant (CSBG)

To reduce poverty, revitalize low-income communities, and empower low-income individuals and families in rural and urban areas to become fully self-sufficient.

Noncustodial parent location, paternity establishment, establishment of child support orders, review and modification of child support orders, collection of child support payments, distribution of child support payments, and establishment and enforcement of medical support. A wide range of locally determined services and strategies may be supported to help low-income individuals and families become self- sufficient; address the needs of youth in low-income communities; and effectively use and coordinate with related programs. Comprehensive child development services, including educational, dental, medical, nutritional, and social services to children and their families. Services may be center based, home-based, family child care, or a combination, and may be full- or part-day or full- or part- year.

To provide two-generation child development, family engagement, and family support services to pregnant women and young children from birth to age 5 and their families. The purpose of the program is to promote children’s school readiness by enhancing social and cognitive development and by providing educational, health, nutritional, social and other services for children and families. To improve maternal and child health, prevent child abuse and neglect, encourage positive parenting, and promote child development and school readiness.

Regular home visits and support services from a nurse, social worker, or other professional. Families are provided services that are tailored to their specific needs, such as teaching parenting skills, promoting early learning in the home, or conducting screenings and providing referrals to address caregiver depression, substance abuse, and family violence.

Program Supplemental Nutrition Assistance Program (SNAP)

To alleviate hunger and malnutrition and permit low-income households to obtain a more nutritious diet by increasing their food purchasing power.

Temporary Assistance for Needy Families (TANF)

To accomplish one or more of the following: (1) provide assistance to needy families so that children may be cared for in their own homes or in the homes of relatives; (2) end the dependence of needy parents on government benefits by promoting job preparation, work, and marriage; (3) prevent and reduce the incidence of out-of-wedlock pregnancies; and (4) encourage the formation and maintenance of two-parent families. To provide a combination of education and training services that help job seekers obtain employment and advance in the labor market, to emphasize the alignment and integration of Workforce Innovation and Opportunity Act (WIOA) programs, to emphasize that employers are also customers of the workforce system, and to involve employers in helping the system provide the skilled workers they need. To provide a combination of education and training services that help job seekers obtain employment and advance in the labor market, to emphasize the alignment and integration of WIOA programs, to emphasize that employers are also customers of the workforce system, and to involve employers in helping the system provide the skilled workers they need. To provide a combination of education and training services that help job seekers obtain employment and advance in the labor market, to emphasize the alignment and integration of WIOA programs, to emphasize that employers are also customers of the workforce system, and to involve employers in helping the system provide the skilled workers they need.

Benefit or service provided Benefits are provided through an electronic benefit transfer card to purchase food from authorized retailers. Allotments are determined on the basis of the thrifty food plan. TANF-funded services include: cash assistance (benefit levels and eligibility criteria defined by individual states); noncash services, including child care, work activities, work supports, and some child welfare services; and various other social services directed toward the statutory goals of family formation and reduced non-marital pregnancies. Employment services, including job searches and placement assistance, and referrals to employers.

Training and services, such as occupational skills training, career counseling, and job searches.

Educational supports, occupational skills training, counseling, and paid and unpaid work experiences.

Appendix II: Additional Programs Cited by Selected State and Local Officials

In addition to the 10 most commonly cited federal programs, state and local entities reported using over 40 other federal programs to support their two-generation approaches to poverty reduction. These programs are administered by the Corporation for National and Community Service and the Departments of Agriculture, Education, Health and Human Services, Housing and Urban Development, Justice, Labor, Transportation, and Treasury. See tables 3 through 11 below.

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

Appendix IV: GAO Contact and Staff Acknowledgments

GAO Contact

Staff Acknowledgments

In addition to the contact named above, the following individuals made key contributions to this report: Rachel Frisk and Danielle Giese (Assistant Directors), Andrea Dawson (Analyst-in-Charge), Gretel Clarke, Kelsey Kreider, and Kelly Snow. Also contributing to this report were Alex Galuten, Melissa Jaynes, Joy Solmonson, Almeta Spencer, Curtia Taylor, and Walter Vance.