State Programs, Budgets

San Mateo County is one of a small number of innovative local jurisdictions that is expanding coverage for uninsured adults and at the same time undertaking a reform of its safety net primary care system. We evaluated the impact of the systems redesign by comparing outcomes for a group of people served at the largest county safety net clinic prior to systems redesign (2006) to those served at the clinic after systems redesign (2009). Use of any preventive care services in a year climbed from 25.9 percent to 33.3 percent. Continuity of care also rose significantly, and emergency room use declined. The county's experience provides an example for other communities to follow as they improve the efficiency of health care services for the most vulnerable members of society.

The Special Supplemental Nutrition Program for Women, Infants and Children (WIC) provides supplemental nutritious foods, nutrition education, and referrals to other health, welfare, and social services. WIC eligibility is restricted to infants, children age 1 through 4, and pregnant and postpartum women who are either income or adjunctively eligible.

This project extends WIC national eligibility estimates to single years of age for children, produces estimates for each State and the District of Columbia, and updates methods for estimating eligibility in the territories. The project also implemented calculation of standard errors of estimate for national, regional, State, and Puerto Rico estimates.

Safety net policies can dramatically reduce poverty. A full assessment requires use of a Supplemental Poverty Measure (SPM) that adds near-cash benefits and tax credits to cash income, deducts necessary expenses, and uses up-to-date, geographically-sensitive poverty thresholds. This analysis implements the SPM in Georgia, Illinois, and Massachusetts to examine the effects of the key safety net programs on poverty. The results show that safety net policies in these three states have substantially different effects on poverty, but federal programs narrow the differences across the states.

The Welfare Rules Databook, provides tables containing key Temporary Assistance for Needy Families (TANF) policies for each state as of July 2010, as well as longitudinal tables describing selected state policies from 1996 through 2010. The tables are based on the information in the Welfare Rules Database (WRD), a publicly available, online database tracking state cash assistance policies over time and across the 50 states and the District of Columbia. The Databook summarizes a subset of the information in the WRD. Users interested in a greater level of detail are encouraged to use the full database, available at http://anfdata.urban.org/wrd.

In 2008, safety net programs cut child poverty in half in Georgia, Illinois, and Massachusetts. Federal programs that provide the same benefit across the country reduce poverty more in lower housing cost states such as Georgia than in higher cost states such as Massachusetts. Massachusetts's generous TANF policy has a greater impact on child poverty than the TANF policies in the other two states. Estimates are produced using the Supplemental Poverty Measure.

Findings from the Center on Nonprofits and Philanthropy’s National Survey of Nonprofit-Government Contracting and Grants show that a majority of human service organizations in Washington, D.C. are struggling due in part to challenges posed by working with the government in providing programs and services to District residents. At a forum of nonprofit leaders and government representatives, participants confirmed the study’s findings, shed light on issues unique to the city, and proposed initial recommendations to address some contracting challenges.

The Welfare Rules Databook, provides tables containing key Temporary Assistance for Needy Families (TANF) policies for each state as of July 2009, as well as longitudinal tables describing selected state policies from 1996 through 2009. The tables are based on the information in the Welfare Rules Database (WRD), a publicly available, online database tracking state cash assistance policies over time and across the 50 states and the District of Columbia. The Databook summarizes a subset of the information in the WRD. Users interested in a greater level of detail are encouraged to use the full database, available at http://anfdata.urban.org/wrd.

States play an important role in serving children with a need for mental health services. In order to improve the mental health care system for this vulnerable population, it is necessary to better understand the need for mental health services, their availability, and their effectiveness across states. This report reviews the recent literature on children’s mental health services and examines a wide range of data sources for state-based analysis. It considers the feasibility of producing a comprehensive evaluation of state mental health systems for children and discusses the potential limitations of such an analysis.