The findings from these evaluations, along with the programs' implementation experiences and other research, suggest nine lessons for states implementing the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (PRWORA), as well as for programs serving teenage parents on welfare.
The first three lessons pertain to reaching teenage parents on welfare and engaging them in ongoing activities. The last six lessons address program operation issues, including the specific services that programs may want to consider providing.
- Identify Minor Parents. States may find it challenging to identify all minor custodial parents receiving TANF cash assistance. Universal identification of teenage parents may require changes in the information that welfare data systems collect and record.
- Clear Expectations. Clear expectations for participation in education or employment-related activities combined with financial consequences for not meeting them can increase rates of participation.
- Case Management and Support Services. Participation mandates should be accompanied by case management and support services, such as child care assistance.
- Hire Good Case Managers. Effective case management hinges on hiring case managers interested in and capable of working with teenage parents and on providing in-service training, skilled supervision, and support for case managers.
- MIS. Up-to-date management information systems can improve staff efficiency.
- Appropriate Educational Opportunities. The educational opportunities currently available to teenage parents are often inadequate for addressing their educational needs.
- Intensive Family Planning Services. Intensive, ongoing family planning services are needed to delay additional births.
- Out-of-Home Activities Not Harmful. Requiring teenage mothers of young children to participate in out-of-home activities such as school, job training, or employment for up to 30 hours a week is not likely to harm children.
- Add Child-Focused Services. By adding intensive, child-focused services, programs can significantly improve the well-being of children at the same time they are helping teenage mothers.
States may find it challenging to identify all minor custodial parents receiving TANF cash assistance. Universal identification of teenage parents may require changes in the information welfare data systems collect and record.
The TPD and LEAP programs, as well as other states such as Arizona, California, Massachusetts, and Virginia that have implemented teenage parent provisions under federal welfare waivers, encountered major challenges to identifying all teenage parents on welfare who met eligibility criteria. The greatest challenge was identifying teenage parents who were receiving welfare as a minor parent on another person's grant. Existing data systems tended not to include codes to identify minor parents or link them to their children, or, if they had such codes, data generally were incomplete.(13)
Identifying all teenage parents who are subject to the new teenage parent provisions of PRWORA, particularly those receiving cash assistance under someone else's grant, will require explicit procedures for identifying the parents of each dependent child in a case. When taking applications or conducting eligibility redeterminations, caseworkers may need to ask for and record more-detailed information about relationships between case members than has been required previously. Some agencies will need to add special fields to existing data systems. Others may simply need to use their existing fields more consistently or differently.
If new information on case member relationships is collected, adding data fields that identify the parents of each dependent child may be preferable to adding codes that flag teenage parents. Codes for minors' parental status will need to be updated continuously as individuals move in and out of cases. Codes identifying children's parents are permanent and can be used to identify cases that include minor parents and their children. Codes that identify parents of dependent children may also be used to help establish paternity and child support orders.
Clear expectations for participation in education or employment-related activities combined with financial consequences for not meeting them can increase rates of participation.
The New Chance experience suggests that clear expectations, backed up by support services, can increase teenage parents' attendance in activities geared toward developing their self-sufficiency. Among the voluntary New Chance programs, the ones with the clearest attendance rules and expectations that participants would follow them achieved the highest participation rates. The New Chance experience in client recruitment, however, underscores the limited reach of voluntary programs. In one site, for example, the program reached approximately five percent of eligible teenage parents.(14)
TPD and LEAP show that clear expectations for participation can be more effective when they are backed up by financial sanctions for nonparticipation. TPD, for example, reached nearly 90 percent of all eligible teenage parents and enrolled them in the demonstration. Once enrolled, 92 percent engaged in program activities (Figure 1).
In both TPD and LEAP, financial sanctions were used heavily to promote participation. For example, about 8 percent of the TPD parents were sanctioned for failing to complete intake. About 62 percent of those who completed intake were warned at some time of a possible sanction. Case managers worked hard to encourage those who received warnings to get back into activities and to address obstacles to participation. Nevertheless, more than one-third of participants had their grant reduced at least once for failing to comply with ongoing participation requirements.(15)
|"The first time they sent me a letter, I looked at it and threw it away. The second time, I looked at it and threw it away again. And then they cut my check, and I said 'Uh, oh, I'd better go.' I was like, 'Oh my goodness, these people really mean business, and I'd better go down there and see what this is all about.'"
In LEAP, case managers requested sanctions for 56 percent of the teenage parents at least once during their first 18 months in the program for failing to meet school attendance requirements. The mandatory LEAP and TPD programs also achieved high rates of ongoing participation relative to the voluntary New Chance programs. In LEAP, 58 to 78 percent of eligible teenage parents met the school attendance requirements in any given month during the period for which data were available. In TPD, 82 percent of mothers developed a self-sufficiency plan, and 70 percent engaged in some school, job training, or employment (Figure 1). Between 30 and 50 percent were participating in these activities in any given month while the programs were operating.(16) Participation in the voluntary New Chance programs was measured differently, but it appears to have been considerably lower. New Chance mothers participated for an average of 6 months (one-third of the planned 18 months of services); half participated for less than 5 months. Absences were frequent.
Even higher rates of participation might have been achieved in TPD and LEAP if sanctions had been applied more regularly and more quickly when clients were not meeting the participation requirements. In TPD, case managers issued one or two warning notices and worked hard to get teenage parents to meet participation requirements before requesting sanctions. After a sanction was requested, it took as long as two months for the grant to be reduced.(17) In LEAP, sanctions were supposed to take effect three months after the attendance requirements were not met, so participants had several opportunities to respond to sanction notices. Many sanctions that were requested were not implemented within this three-month period.(18)
Participation mandates should be accompanied by case management and support services, such as child care assistance.
Teenage parents view participation mandates that are backed by case management positively. Case managers monitor teenager's participation in required activities, implement sanctions when required, and authorize support services. Support services are especially important for enabling case managers to enforce the participation requirements.
Programs may want to consider more-intensive case management that goes beyond enforcing participation and paying for child care and provides enhanced, individualized services to address the varying needs of teenage parents on welfare. When they enrolled in TPD, many teenage parents were highly motivated to give their children a better childhood than they had experienced.(19) Beyond this motivation, however, the group was diverse. One-third of the teenage parents were in school, one-third had graduated, and one-third had dropped out. Half had weak basic skills. When they enrolled, about half lived in households with other adults who might be able to provide economic and/or social support. The majority had one or more barriers to employment, including health problems, limited English proficiency, child care problems, and transportation needs.(20)
|"When I go to Project Advance, they know me, they speak to me. Some of the people there were on a first-name basis. It's another part of home. If I do something stupid, they know it, they tell me. When I do something good, they all praise [me] for it."
Programs may also consider using more-intensive case management to build and maintain participants' motivation. More-intensive case management allows case managers to develop relationships with their clients, push them to identify and clarify the barriers they face, and demonstrate a commitment to helping overcome these barriers that may be as important as the support services themselves. TPD case managers assessed clients' need for education, training, employment, and support services; developed individualized self-sufficiency plans; provided encouragement and support; coordinated services and interceded with other agencies and employers on behalf of clients; and ensured access to child care and transportation. Many TPD participants reported that the personal and caring attention they received from their case managers was an important motivation to participate in school or work-related activities.(21) In LEAP, adding enhanced school-based case management to regular LEAP services increased the school completion rate for initially enrolled teens.(22)
|"Before I went there, I was like, 'Gee, I don't know if I want to go to school,' but now I have decided to go to school with their help. Because I was thinking, if I was to go to school, how in the world was I gonna be able to pay the babysitter. And now that I'm coming here, they're paying the babysitter and transportation."
Teenagers, who often lack experience and confidence in dealing with life's problems, need more help than adults in addressing barriers to self-sufficiency. Adequate child care assistance -- not only financial aid, but also help arranging child care and dealing with problems when they arise -- is essential to teenage parents' continued participation in activities. Public transportation subsidies and help arranging other transportation when public transportation is not available may be critical for allowing many teenage parents to get their children to child care and themselves to school, training, or work. Some teenagers also need housing, emergency assistance services, health care, and mental health care (including treatment for substance abuse problems, counseling for family problems, and help with conflict resolution). Too many teenage mothers, especially younger ones, have been sexually or physically abused and will need help addressing the resulting problems.(23)
Although support services are costly, they may not be as costly as generally assumed if teenage parents' access to informal child care by relatives does not change significantly in the new welfare environment. In TPD and LEAP, for example, the total costs of child care subsidies were not as high as expected. In TPD, about one-third of active participants obtained free child care, mostly from relatives. Only one-third of those in school, training, or work needed help from the program to pay for child care.(24) In LEAP, few teenagers used program-funded child care, primarily because they relied on informal care from relatives, which could not be paid for with public funds.(25) More teenage parents may need child care subsidies under the new welfare policies, if the type or amount of child care assistance offered is different from that offered by TPD and LEAP or if relatives who would otherwise provide child care must seek jobs themselves.
In the case of some support services, other systems are in place to cover the costs. For example, school-related transportation and medical care costs generally are covered by local educational agencies and Medicaid, respectively. Funding from other sources for behavioral health services, however, appears to be much more limited.
Effective case management hinges on hiring case managers interested in and capable of working with teenage parents and on providing in-service training, skilled supervision, and support for case managers.
TPD and New Chance underscore the importance to effective case management of strong personal skills and an interest in working with teenage parents.(26) Effective case managers are both tough and supportive; they set consistent expectations for their clients but also encourage and support them in their efforts to overcome obstacles to self-sufficiency. Effective case managers actively seek client contact, are open-minded, and are comfortable dealing with teenagers and their sexuality. They often benefit from having something in common with the clients they are helping (such as having a young child). It is vital, however, that they not have personal "baggage" that leads them to foster dependency rather than promote self-sufficiency. They need to be creative in helping clients develop goals and individual self-sufficiency plans. They need to work well in a team and be well-organized and goal-focused, so they can deal with large caseloads and unpredictable demands on their time.
Programs can help case managers do their job well by providing the following types of support:(27)
- Clerical support for scheduling group sessions, monitoring attendance, following up on sanction actions, processing child care vouchers, and entering data into the management information system
- Clear and accurate information on available services, which can be provided through briefings by community service providers, on-line resource listings, and in-house specialists
- Good program visibility in the community, which may require marketing the program to other agencies and encouraging other service providers to tailor their services to teenage parents
- Ongoing training to enhance knowledge and skills, provide opportunities for reflection, and demonstrate management recognition of the complex problems case managers encounter
- Strong supervision to develop and apply strong casework methods, including case conferences and troubleshooting as appropriate, and to promote consistent and adequate recordkeeping
- Ongoing communication with case managers to identify program needs and persistent efforts to improve program operations and services to meet the needs
- Recognition of effort and accomplishments, for example, by telling staff directly when a particular effort or accomplishment is appreciated, or planning formal occasions to recognize case managers' efforts and accomplishments, such as staff awards and visits by top agency officials
Up-to-date management information systems can improve staff efficiency.
A good management information system can facilitate the work of case managers, especially when caseloads are high. An effective management information system must contain accurate and up-to-date information on clients' needs, planned activities and services, ongoing participation and service receipt, and cash assistance status (including information on sanctions). It is especially helpful if the system generates "ticklers" and management reports that staff can use to track clients' participation and progress, identify those who are not meeting participation requirements, and implement timely sanction procedures.
The effectiveness of any system depends on staff members having a thorough understanding of it and how it can support their work. Making the system user-friendly is essential and quite easy with today's technology. Still, training and technical assistance are important for achieving maximum benefit from the system.
Developing and maintaining such an information system is no longer difficult or costly. Some states already have systems that could be used or adapted to track client activities and produce useful reports. At modest cost, new management information systems can also be developed using off-the-shelf software and hardware. (Developing proprietary or special purpose software and/or customized hardware is not likely to be cost-effective.)
The educational opportunities currently available to teenage parents are often inadequate for addressing their educational needs.
Simply requiring teenage parents to attend existing education programs is not likely to improve their employment prospects. All three programs increased school or GED attendance, but none succeeded in either increasing measured basic skills or improving later employment outcomes dramatically.
|"My baby's sick a lot and I'm out of school, and they don't give you make-up work or anything. So it's like a lot of my classes, I am failing, but I can't help it because I can't come to school on those days. They don't understand it."
Imaginative programs that combine academics, work experience, and intensive personal attention and can spark teenage parents' interest and commitment are needed. Regular schools and community Adult Basic Education (ABE) and GED programs often offer poor learning environments for young mothers. Many schools make no effort to accommodate teenage parents' needs for flexibility when their children are sick, their child care arrangements break down, or they face other crises. Others tend to accommodate teenage parents by lowering their academic expectations for the young mothers while offering child care and other support services.
Many young mothers feel uncomfortable in ABE and GED classes with older adults, and teachers accustomed to serving a broader adult population may be insensitive to teenage parents' problems. Many TPD mothers lacked interest in returning to a regular school program and had trouble fitting into available ABE and GED programs. For some, it was important that the educational curriculum be connected to real-life or job experiences.(28)
Developing special on-site classes to respond to perceived limitations in existing education and training programs is not necessarily easy. TPD developed in-house GED and ABE classes for participants, but program staff had difficulty getting participants to attend regularly.(29) New Chance also provided on-site GED classes tailored to teenage parents and experienced attendance problems.
A shift in focus, toward integrating education with job training and employment, may be helpful, especially under welfare reform. Immediate job-specific training to get trainees into jobs and improve the basic skills needed for employment may be more effective than strategies that seek to improve basic skills and garner receipt of a GED or diploma before job training is offered. This approach was successful for young minority single mothers in a demonstration program that served many individuals who had not graduated from high school.(30)
Many teenage parents have already failed in school and have large educational deficits (for example, very limited reading and math skills) when they enter programs like TPD and LEAP. Reengaging them in education and overcoming their deficits are difficult and highlight the importance of preventing school failure in the first place.
Intensive, ongoing family planning services are needed to delay additional births
Continued childbearing outside of marriage or a stable relationship intensifies barriers to economic self-sufficiency. It also strains limited economic resources further and makes child care needs more complex. Most teenage parents in the TPD programs wanted to delay having another child until they reached their goals or until their relationships, careers, living arrangements, or finances were more stable.(31) Few did so, however.
More intensive or different services are needed to help teenage parents delay subsequent births. The LEAP evaluation shows that simply keeping teenage parents in school is not enough to delay subsequent births. TPD and New Chance augmented their education and training services with family planning services to help teenage parents delay subsequent births. Although the services varied in intensity, they generally were inadequate. TPD provided initial workshops on contraception and sources of birth control, as well as counseling by case managers. New Chance planned more intensive family planning services, including two orientation workshops, group sessions at least monthly, routine individual counseling, and referrals to family planning providers, but the short duration of many teenagers' participation and difficulties implementing the planned services reduced the intensity of these services.
Only one of the three TPD programs and one of the New Chance programs led to delays in repeat pregnancies. The common features of these programs were:
- They conveyed clearer messages about the undesirability of having more children;
- Staff built on the teenagers' goals to delay childbearing and tended to be more aggressive in referring clients to family planning services;
- Tthey offered more extensive family planning services than the average site; and
- Staff had modest caseloads and were better able to provide individualized attention.
|"I might have [another] child years from now... I want to get my life together. I want to be married, have a good husband, a good home, and know I could afford another one."
To delay subsequent childbearing, programs may need to take a more active, ongoing role in helping teenage mothers define their family planning goals, understand their options for achieving their goals, gain access to family planning services, and follow through to achieve their goals. Programs can help teenage parents who want to delay having another child achieve this goal by convincing them that it is attainable (through abstinence or effective contraception), providing access to effective contraceptive methods, and following up to support their commitment to abstinence or effective contraception.
Research on two other programs suggests that it is possible to delay subsequent pregnancies when health care workers who are comfortable discussing sexuality, contraception, and related topics with teenagers build relationships with them and discuss these topics with them during regular home visits or health care visits. For example, programs that provided frequent home visits by nurses or trained paraprofessionals to improve mothers' health habits, infant caregiving, and personal accomplishments in the areas of work, education, and family planning reduced subsequent pregnancies and births. The home visitors in these programs showed women and their partners birth control devices, discussed the advantages of different methods of family planning in the context of the women's goals, and made referrals as needed.(32) In connection with visits for well-baby care, a program that provided family planning counseling, referrals to family planning clinics when appropriate, and follow-up discussions about using birth control was also effective.(33)
Several new highly effective contraceptive methods requiring less vigilance by the user are now available. Teenagers wanting to postpone another birth should be informed about them and encouraged to consider them. Information about these methods, which include hormone implants, hormone injections, and pills prescribed as emergency contraception, is not always readily accessible. Programs can play a vital role in informing clients about the full range of birth control options and helping them gain access to their selected methods.
|"I didn't plan it, and then again I kind of knew that it was going to happen because I wasn't really taking the pills like I was supposed to. I couldn't remember every day to take a pill. And I still don't."
Strategies for preventing teenage pregnancy also need to build on clear values about teenage childbearing. Programs that have been most successful in preventing teenage pregnancy have been the most directive or authoritarian and sent the clearest messages about expected behavior.(34) It may be important to communicate clearly to teenage parents that having another child soon after the first one, before reaching economic self-sufficiency, can have a negative effect on their children. Programs should not send mixed messages about future childbearing. Participants in New Chance may have received mixed signals, because the program celebrated their roles as mothers at the same time it hoped to encourage them to delay having a second child. The evaluators concluded that an emphasis on postponing additional births so parents can create a better future for existing children would have conveyed a clearer message.
Requiring teenage mothers of young children to participate in out-of-home activities such as school, job training, or employment for up to 30 hours a week is not likely to harm children.
The TPD evaluation showed that requiring teenage mothers to participate in education or employment-related activities when their children were very young, and providing child care assistance when necessary, did not adversely affect children's well-being in early elementary school. Increases in mothers' participation in school, training, and employment and accompanying increases in their use of child care did not lead to poorer developmental outcomes for their children. Neither did the increases help the children. For children whose mothers were subject to the participation requirement, scores on cognitive development, social-emotional development, and health assessments were similar to those of children whose mothers were in the control group.
Simply adding developmentally appropriate child care to program service offerings is not likely to improve child outcomes measurably. The New Chance programs offered free, developmentally appropriate child care at the program site or helped participants arrange it, but they did not enhance children's development. Poor attendance and high program dropout rates limited use of the child care and may account for the lack of positive impacts.
By adding intensive, child-focused services, programs can significantly improve the well-being of children at the same time they are helping teenage mothers.
Programs may want to expand their goals to promote healthy development in the children of teenage parents. Research shows that these children are at higher risk of poor health and development than children of older parents.(35) Consistent with this research, the children of the young parents in TPD and New Chance (both those who participated in the programs and those in the control group) performed poorly on assessments of their cognitive and social-emotional well-being compared with children from the same racial and ethnic backgrounds nationally. Designing programs to promote more positive health and development of children (in addition to promoting self-sufficiency among young parents) could improve school readiness and help prevent teenage childbearing in the next generation.
Recent research on early intervention programs shows that programs with intensive, child-focused services are more likely than those with primarily parent-focused services to enhance children's development. The Abecedarian Project, which provided full-time high-quality child care together with pediatric care and family support services until children were five years old, significantly improved children's cognitive development.(36) The Infant Health and Development Program, which provided child development services to low birthweight infants during home visits and in high-quality child care centers until the children were three years old, improved the cognitive development of the heavier low-birthweight children.(37) In contrast, the Comprehensive Child Development Program, which provided services to enhance parenting skills and ensured that low-income families received comprehensive social services to help them achieve economic self-sufficiency and to address their children's health and development needs, did not significantly improve children's well-being. The evaluators concluded that intensive, focused services provided directly to children and linked to well-defined outcomes are critical to success in improving children's well-being.(38)
Programs that lack the resources to provide intensive child-focused services may be able to collaborate with existing programs, such as Early Head Start, Head Start, or other high-quality child care programs, to arrange priority enrollment for welfare-dependent teenage parents and their children. Depending on the availability of existing programs, state and local agencies may want to encourage and support the development of programs for young children in communities where the need for them exceeds the supply.
|"Right now, I can't trust nobody with my baby because she can't tell me if somebody doing this or that to her because she's only 10 months. And I hear about this and that happening to little kids. I cannot trust them. Until I get somebody I trust to watch my baby, I will not be working or going to school."
Educating teenage parents about the features of high-quality child care and their options for arranging it may help promote its use. Education can also help them become comfortable with using nonrelative child care. Many teenage parents do not trust people they don't know to care for their children, especially when a child is very young.(39) Teenage mothers also need adequate subsidies to purchase high-quality developmental child care.