The federal welfare reform law (PRWORA, 1996) provided states with increased autonomy, and allowed them to impose their own conditions on receipt of cash assistance. Many states established goals related to maternal behaviors, such as work, immunization of children, pediatric health visits and school attendance, as well as discouraging maternal drug use and childbearing. Noncomplinace can be penalized by financial sanction. The objective of this study was to document whether recent changes in welfare policy have had an impact on maternal and child health (MCH) services. A telephone-administered survey of MCH directors in the 50 states, Washington DC, and Puerto Rico was conducted. Trainined interviewers administered a structured questionnaire to determine the impact of welfare (TANF) policies on MCH services. Analyses focused on the level of interaction between TANF and MCH agencies; the role that MCH is playing in implementation of state welfare reform goals; the impact of welfare changes on MCH service delivery; new initiatives, including safety net programs, specifically developed and/or needed to address TANF requirements; the impact that TANF requirements and sanctions may be having on the health of women and their children. This research provides empirical support regarding the level of interaction between administrators of state TANF and maternal and child health agencies, and whether policies directed at influencing a group in one way (eg, encouraging work, discouraging childbearing) have resulted in other unplanned or unintended effects (eg, decreased supervision of children, increased abortions) relevant to MCH providers.
Learning Objectives: Attendees will learn the major health-related components of the 1996 national welfare-reform legislation, and the findings of a national study of state MCH administrators. They will be better able to assess the myriad state and local evaluations of welfare-reform policies, and determine their relative strengths and weaknesses with regard to health outcomes
Keywords: Welfare Reform, Maternal and Child Health
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.