State Welfare-to-Work Policies for People with Disabilities: Changes Since Welfare Reform - Executive Summary


Terri S. Thompson, Pamela A. Holcomb, Pamela Loprest and Kathleen Brennan

The Urban Institute


This report was prepared under contract #HHS-100-95-0021 between the U.S. Department of Health and Human Services (HHS), Office of Disability, Aging and Long-Term Care Policy (DALTCP) and the Urban Institute. For additional information about the study, you may visit the DALTCP home page at or contact the ASPE Project Officer, William Marton, at HHS/ASPE/DALTCP, Room 424E, H.H. Humphrey Building, 200 Independence Avenue, SW, Washington, DC 20201. His e-mail address is:

The views expressed are those of the authors and should not be attributed to the Urban Institute, its trustees, or its funders.


The focus of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA) on work and temporary cash assistance is likely to have significant implications for welfare recipients with disabilities and individuals who care for recipients with disabilities (caregivers). Prior to welfare reform, disabled recipients and caregivers were generally exempt from participating in welfare-to-work programs and cash assistance was available for an unlimited period. The purpose of this study is to determine the extent to which states have used the flexibility provided under PRWORA to change their welfare-to-work policies as applied to individuals with disabilities and caregivers. States' decisions about policy changes must be balanced against two key challenges presented by welfare reform:

  1. States must consider the diverse needs of individuals with disabilities while meeting the work participation and other requirements established in federal law. States now have the latitude to design their welfare-to-work programs in ways they believe will best meet the needs of their clients. States may also decide who among the welfare population will be required to participate in these programs. However, states are required to meet increasing work participation requirements or face financial penalties. PRWORA specifically requires that states must continue to comply with the Americans with Disabilities Act of 1990 (ADA), Section 504 of the Rehabilitation Act of 1973, and other civil rights statutes.

  2. The imposition of state and federal time limits increases the immediacy of welfare recipients' need for help in overcoming their barriers to work and self-sufficiency. Welfare agencies have not historically been required to focus on the needs of many clients with serious barriers to employment or self-sufficiency--including individuals with disabilities--and now must develop service strategies that achieve this end within 60 months (or less in some states).

This study represents a first attempt to provide a nationwide overview of welfare-to-work policies for individuals with disabilities and caregivers. To obtain this overview of state policies, Temporary Assistance for Needy Families (TANF) plans and other relevant policy documents were reviewed and conversations were held with welfare agency staff in each of the 50 states and the District of Columbia. This report does not provide detail on local-level implementation or local pilot projects. Additional detail about policy implementation will be obtained through case studies of a small number of policy approaches to be conducted in the second phase of this project.

The major findings of this report are:

  • The majority of states have changed their work participation policies to require participation among some individuals with disabilities and caregivers who were previously exempt.

  • States are in the early stages of making decisions about who should be required to participate in welfare-to-work services, who should be expected to move off welfare within 60 months, and what services will best help recipients achieve this objective.

The summary below provides a more detailed overview of the policy context essential to the understanding of state policy decisions and findings related to state welfare-to-work policy decisions as of April-May 1998.



  • There is no single definition of "disability" used by the welfare community. Individuals considered "ill or incapacitated," the definition used under the Job Opportunities and Basic Skills Training (JOBS) program, face issues ranging from short-term illnesses to permanent disabilities. However, many of the most severely disabled individuals have traditionally been, and continue to be, referred to the Supplemental Security Income (SSI) program.

  • Little is known about the prevalence of disabilities among the welfare population. Separate estimates of work-related disabilities, mental health issues, and substance abuse range from less than 10 to almost 30 percent of all welfare recipients. Estimates of recipients with learning disabilities range from 25 to 40 percent.

  • Many early welfare-to-work strategies focus on moving the most job- ready clients into employment. Under JOBS, recipients who were "ill or incapacitated," caring for an "ill or incapacitated family member," or faced other significant barriers to employment were not required to participate in employment and training programs. Because of categori- cal exemptions allowed under JOBS, states have less experience working with less job-ready recipients, commonly referred to as "hard-to-serve."

  • States are early in the process of assessing their "hard-to-serve" clients--of which individuals with disabilities are commonly considered a subset--and establishing appropriate service strategies. States are beginning to consider the extent to which individuals with multiple or severe barriers to employment comprise the welfare caseload. To the extent individuals with disabilities are considered a subset of the hard-to-serve, state welfare agencies know relatively little about their specific circumstances and needs, and are early in the process of designing services to assist them in moving from welfare to work.



The majority of states are using the flexibility provided under PRWORA to increase participation in welfare-to-work programs among persons with disabilities. Overall, these changes reflect an increased emphasis on moving recipients with disabilities and caregivers toward work and self-sufficiency.

  • Thirty states have changed their policies so as to increase participation in work and self-sufficiency activities among individuals with disabilities.

  • Of these, 17 states have broadened their participation policies to require participation among some recipients who were previously exempt.

  • Another 13 states have adopted a "universal participation" approach that requires all recipients to participate in some type of activity.

States that have "broadened" participation requirements but have stopped short of requiring "universal" participation have done so in a variety of ways. The following are common approaches used by states to broaden participation by individuals with disabilities over what was required under JOBS.

  • One common way states have broadened participation requirements is by allowing for very few formal exemptions but still maintaining mechanisms (e.g., "deferrals," "postponements") to release some recipients with disabilities or other significant barriers to employment from their obligation to participate.

  • Another approach entails having caseworkers "take a harder look" at cases that would have been exempt in the past in order to more fully assess if the individual is capable of participating in any work or self-sufficiency activity. Some states use staff more familiar with work program requirements to make participation decisions.

  • Still another approach is the review of disabling conditions by medical review teams or other agencies in an attempt to apply more consistent standards when determining whether or not the individual should be required to participate.

States requiring universal participation among welfare clients use individualized service planning strategies that emphasize recipients' capabilities and acknowledge that the path to self-sufficiency may be long.

  • The activities required are varied and in many cases are not limited to work or work-related activities that can be counted toward federally-mandated work participation rates.

  • Examples of activities in some states include substance abuse treatment, vocational rehabilitation, or mental health counseling. Allowable activities may also include attending parenting classes, keeping scheduled appointments with doctors, or applying for SSI.

Eighteen states have chosen to retain JOBS participation policies and generally exempt individuals with disabilities. States in this category have not changed their processes for determining if individuals with disabilities are required to participate or are eligible for exemptions.

State policies vary with respect to whether individuals with disabilities are subject to time-limited benefits.

  • Slightly less than half of the states (24) exempt persons with disabilities from time limits.

  • Many states have not yet determined who will receive a hardship exemption to the time limit. For now, these states consider all recipients--including individuals with disabilities--subject to the time limit.

States are in the early stages of assessing who among those on welfare may need assistance beyond 60 months. Welfare caseload compositions are chang- ing as job-ready clients find employment and less job-ready recipients remain on welfare. States must also decide who among those remaining on welfare may be eligible for inclusion in the 20 percent hardship exemption allowed under PRWORA or if they will use state funds to provide additional services.

The overwhelming majority of states have chosen to apply parallel policies to individuals with disabilities and caregivers. Although individuals with disabilities and caregivers likely face very different circumstances, both populations were categorically exempt from participating in the JOBS program and most states continue to apply similar policies to the two groups.

  • Eleven states have broader participation requirements for caregivers. In some states, participation has been broadened by redefining who may be considered a caregiver.

  • Fifteen states now require all caregivers to participate in some activity. This does not mean all caregivers are required to work or participate in work-related activities. Some states allow caregivers to fulfill their participation requirements by continuing to care for a disabled household member.

  • All but one state have adopted the same time limit policies for caregivers as for individuals with disabilities.