Researchers report differing findings regarding the financial status of TANF child-only relative care cases. For example, recent research indicates that child-only relative care cases typically are less disadvantaged and have more income than a standard TANF case (Wood and Strong, 2002; Farrell et al., 2000). Schofield and Fein (2000), however, found that while child-only relative caregivers report higher earnings than parental caregivers, their total earnings average well below the poverty line. These financial barriers, if present, may be serving as obstacles to obtaining and providing physical and emotional health care. While children in TANF child-only relative care are eligible for Medicaid, long delays can occur between the time a child is removed from his or her home and Medicaid approval, during which time the child may not be covered by Medicaid (Risely-Curtiss and Kronenfeld, 2002). Health care access may also be limited because not all providers serve Medicaid patients and some types of services are not covered. With reimbursement rates for TANF grants averaging less than half of the reimbursement rate for foster care in most states (Wood and Strong, 2002; Farrell et al., 2000; Schofield and Fein, 2000), covering the additional medical and behavioral expenses of a child can become overwhelming to a relative caregiver on a fixed income.
Relative caregivers also face expenses associated with school, including clothes, uniforms, books, supplies, and field trips (Edelhoch, 2002). These needs are especially critical as school engagement is reported to be poor among this population.
Since eligibility for TANF benefits is no longer a federal entitlement, states have the option of not offering child-only grants or imposing limitations such as waiting lists on child-only grants. However, all states are currently offering some type of child-only grant, without waiting lists. Benefit levels have always varied among states, even under the former TANF program, benefit levels varied among states. Under the current TANF program, however, states have greater flexibility to change benefit amounts or offer new combinations of benefits (e.g., without first having to submit a plan for approval to the federal government).
In summary, a substantial body of research has shown that children in relative care typically come from unstable environments and have often been exposed to multiple traumatic experiences (e.g., abuse, neglect, substance abuse). Compared to children in parental care, children in relative care have greater physical and emotional needs, perform more poorly in school, and experience economic hardship. However, even with these concerns, it is possible that these potentially damaging developmental risks might be moderated by the benefits (e.g., emotional attachment, permanency) of living with a relative (Altshuler and Gleeson, 1999).