Performance Improvement 1996. Office of the Assistant Secretary for Planning and Evaluation

02/01/1996

Contents

Adolescent Time Use, Risky Behavior, and Outcomes: An Analysis of National Data

Beginning Too Soon: Adolescent Sexual Behavior, Pregnancy, and Parenthood

Case Management in Service Integration: An Annotated Bibliography

Child Support Enforcement

Evaluation of Transition To Work Demonstration Projects Using a Natural Supports Model

Exploratory Study of the Barriers and Incentives To Improving Labor Force Participation Among Persons With Significant Disabilities

Family and Community Violence Prevention Program: Evaluability Assessment and Technical Assistance Conference

Fifty-State Health Reform Database

Final Report of the Task Force on the Privacy of Private Sector Health Records

JOBS Evaluation: Early Findings on Program Impacts in Three Sites

JOBS Evaluation: How Well Are They Faring? AFDC Families With Preschool-Aged Children in Atlanta at the Outset of the JOBS Evaluation

JOBS Evaluation: Monthly Participation Rates in Three Sites and Factors Affecting Participation Levels in Welfare-to-Work Programs

Managed Care for People With Disabilities: Developing a Research Agenda

Minnesota Learning Readiness Initiative: Reforming the Delivery of Social Services to School-Aged Children and Families in Hennepin County, Minnesota

New Approaches To Evaluating Community Initiatives: Concepts, Methods, and Contexts

Noncustodial Parents' Participation in Their Children's Lives: Evidence From the Survey of Income and Program Participation

Options for Full-Day Services for Children Participating in Head Start

Patterns of Substance Use and Substance-Related Impairment Among Participants in the Aid to Families With Dependent Children Program

Performance Measurement for the U.S. Department of Health and Human Services, the Administration for Children and Families, and Its Other Operating Divisions

Report to Congress on Out-of-Wedlock Childbearing

Review of Family Preservation and Family Reunification Programs

Simulation of Trends in Employment, Welfare, and Related Dynamics

Sources of Support for Young Latina Mothers

Substance Abuse Among Women and Parents

Systematic Thinking About Government Programs for Children With Disabilities: Size, Participation, Benefits, and Expenditures

Child Support Payment Patterns Among AFDC Mothers in Massachusetts and Implications for TRIM2

Use of Administrative Data Kept by States To Study the Duration of Program Participation

TITLE: Adolescent Time Use, Risky Behavior, and Outcomes: An Analysis of National Data

ABSTRACT NUMBER: 109

ABSTRACT: This report uses several large-scale databases to examine the time-use patterns of United States adolescents in the late 1980's and early 1990's. The report compares these patterns with those exhibited by young people 10 to 20 years ago, and tests whether participation in extracurricular activities reduces the chances that they will engage in various risky behaviors. The report finds that (1) most teenagers have a lot of unfilled discretionary time; (2) teenagers use this time to watch television, talk on the telephone, gather with friends in malls or other local hangouts, or work at low-skill jobs; (3) compared with earlier cohorts from the mid-1970's or early 1980's, teenagers spend no more time doing homework--despite supposedly more rigorous courses--they read fewer books, do fewer household chores, attend fewer religious services, and participate less in traditional school-based activities; (4) students who spend no time in extracurricular activities are 57 percent more likely to have dropped out of school by senior year, 49 percent more likely to have used drugs, 37 percent more likely to have become teen parents, 35 percent more likely to have smoked cigarettes, and 27 percent more likely to have been arrested than those who spend 1 to 4 hours per week in extracurricular activities; and (5) the effectiveness of organized youth activities depends upon the extent to which the activities develop skills, create challenges, and provide fulfilling experiences for participants. (Final report 64 pages, plus appendixes.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Emily Novick

PHONE NUMBER: 202/690-5937

PIC ID: 6014

PERFORMER ORGANIZATION: Westat, Inc., Rockville, MD

TITLE: Beginning Too Soon: Adolescent Sexual Behavior, Pregnancy, and Parenthood

ABSTRACT NUMBER: 110

ABSTRACT: This series of three reports discusses trends in adolescent sexual behavior and fertility, as well as trends in adolescent pregnancy prevention programs. The reports discuss recent trends in sexual behavior among this population, its use of contraceptives, and outcomes of pregnancy. The reports highlight findings in the following areas: (1) sexual intercourse among teens; (2) contraceptive use; (3) pregnancy outcomes; and (4) prevention programs. The reports find that the rate of sexual intercourse among teens is increasing, but that contraceptive use is consistently low. The reports stress that the younger a teen is at the time of sexual initiation, the more likely the experience is to have been coercive, and the more likely it is that the teen will become pregnant or contract a sexually transmitted disease. The reports also note that many factors, such as race, family income, developmental characteristics, educational success and goals, and neighborhood mores, influence the age of first sexual intercourse. The reports indicate that contraceptive use among teens varies: older teens are more likely to use contraceptives than are risk-taking teens; contraceptive methods requiring male involvement, such as condoms and withdrawal, are more common at first intercourse, while female-based methods are more common in longer standing relationships. Furthermore, there is generally a lag time between first sexual intercourse and obtaining contraceptive services. The reports note that prevention programs emphasizing behavioral skills-oriented sex education and recommending abstinence and consistent contraceptive use are most effective, as are other programs that address alternate life options for teens. However, most of the prevention and intervention strategies designed to affect the teen birth rate are small, ad hoc, and poorly designed short-term projects lacking a useful evaluation strategy.

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Elisa Koff and Amy Nevel

PHONE NUMBER: 202/690-5880

PIC ID: 5877

NTIS ACCESSION NUMBER: PB 95-256475; PB 95-256483; PB 95-256491

PERFORMER ORGANIZATION: Child Trends, Inc., Washington, DC

TITLE: Case Management in Service Integration: An Annotated Bibliography

ABSTRACT NUMBER: 111

ABSTRACT: Case management is integral to many service integration projects and programs, which use case managers as the primary link between clients and services. While no standard definition of case management exists, some consensus on a case manager's functions is emerging. These functions include (1) assessing client needs; (2) creating an action plan; (3) brokering services; and (4) ensuring that appropriate services are accessed and delivered. This annotated bibliography includes information on (1) case management practices and case manager functions; (2) evaluations that consider the process and outcomes of case management; and (3) case management operations. The articles and books selected focus on practices that cross organizational boundaries and that generally include young children in the population served. Items included in the bibliography were published after 1983 and are currently in print and available through public libraries or for purchase. The bibliography excludes works dealing with geriatrics, mental illness, or medical care. The abstracts do not critique or analyze the works described. See also PIC ID 5307-5307.9 and 5307.B-5307.C. (Annotated bibliography 35 pages.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Richard Silva

PHONE NUMBER: 202/690-6805

PIC ID: 5307.A

PERFORMER ORGANIZATION: National Center for Children in Poverty and National Center for Service Integration, New York, NY

TITLE: Child Support Enforcement

ABSTRACT NUMBER: 112

ABSTRACT: This report examines the problem of child support enforcement and its impact on welfare reform. The report was prepared by the interagency Working Group on Welfare Reform, Family Support, and Independence. It presents information on the state of child support enforcement in the Nation and provides a rationale for reform of the system. The report finds that (1) a gap exists between current child support collections and the amount that, theoretically, could be collected (this amount is about $33.7 billion); (2) this gap exists because not all child support awards are paid, awards are generally inadequate, and many eligible custodial parents do not have a child support order or award in place; (3) the number of children potentially eligible for child support has grown, primarily because of out-of-wedlock births; and (4) there have been some improvements in collection of child support payments (for children eligible for AFDC) and in paternity establishment. However, the report also asserts that fundamental system reform is needed; children have the right to receive support from both parents, and reform will save welfare dollars. This reform should be effected through universal, immediate paternity establishment; standardization of child support awards throughout the Nation (regularly updated); and vigorous interstate enforcement of child support orders. (Final report 18 pages, plus appendix.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Paul Legler

PHONE NUMBER: 202/690-7507

PIC ID: 5777

PERFORMER ORGANIZATION: Working Group on Welfare Reform, Family Support, and Independence, Washington, DC

TITLE: Evaluation of Transition To Work Demonstration Projects Using a Natural Supports Model

ABSTRACT NUMBER: 113

ABSTRACT: This report describes and evaluates the methods used by six demonstration projects to help schools and adult providers obtain integrated employment using natural supports for students with very severe disabilities (severe mental retardation, autism, learning disability, or other condition). The major categories of service provided include (1) student-centered planning, which helps the student identify goals and interests and assesses the behavior and knowledge the student needs to attain them; (2) community-based job experience; (3) job placements, ideally before the client has left school; and (4) transition out of the school system, including long-term vocational support and locating jobs when needed. The report also finds that (1) almost 335 persons with disabilities were identified as having participated in the projects; (2) sites attempt to select those with the most severe disabilities for inclusion; (3) most participants work less than half-time; (4) jobs are usually located by using direct telephone calls to potential employment sites; and (5) costs increase for schools using this method, but not for most parents and employers. The report details barriers encountered by sites, including difficulty in locating jobs, complex and rigid funding procedures, transportation problems, and staff turnover. The report suggests several areas for consideration in the future expansion and improvement of the program. (Final report variously paginated, plus appendix.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Richard Silva

PHONE NUMBER: 202/690-6805

PIC ID: 5836

PERFORMER ORGANIZATION: Pelavin Research Institute, Washington, DC

TITLE: Exploratory Study of the Barriers and Incentives To Improving Labor Force Participation Among Persons With Significant Disabilities

ABSTRACT NUMBER: 114

ABSTRACT: In recent years, substantial interest has emerged in improving opportunities for people with disabilities to join, remain in, or return to the work force. Disability income support programs like Supplemental Security Income and Social Security Disability Insurance now have work incentive programs. The Americans With Disabilities Act has made it illegal for employers to discriminate against persons with disabilities. This report provides background information on the barriers and incentives to improving the work force participation of persons with significant disabilities. The report includes (1) a literature review on various aspects of the competitive labor market for persons with disabilities; (2) the use of personal assistance services and assistive devices by disabled workers; (3) the impact of welfare reform strategies on persons with disabilities; and (4) selected programs that offer comprehensive services to help persons with significant disabilities participate in competitive employment. The report also provides a research agenda, noting that a substantial amount is known about the employment of persons with disabilities, but much more information is needed to help the government analyze the impact of current policies on this population. More research would also assist in formulating policies that are designed to increase the participation of persons with disabilities in competitive employment. (Final report variously paginated.)

AGENCY SPONSOR: Office of Disability, Aging, and Long Term Care Policy

FEDERAL CONTACT: Kathleen Bond

PHONE NUMBER: 202/690-6443

PIC ID: 5757

PERFORMER ORGANIZATION: The Lewin Group, Fairfax, VA

TITLE: Family and Community Violence Prevention Program: Evaluability Assessment and Technical Assistance Conference

ABSTRACT NUMBER: 115

ABSTRACT: This report presents information about the Family and Community Violence Prevention Program workshop held in January 1995 in Washington, D.C., for a consortium of historically black colleges and universities (HBCUs). The consortium has been developing and demonstrating interventions aimed at curbing the incidence of family and community violence. Participants included 30 HBCU participants, 6 Federal personnel, and 8 members of the contractor's staff. Originally planned for HCBUs as a 1-day training session on evaluability assessment, the conference was extended to 1.5 days. The first day included a review of the goals of the training workshop, a viewing of antiviolence public service announcements, an overview of evaluability assessment, the identification of stakeholders and environmental factors surrounding the demonstration projects, and a review of evaluability assessment logic models. The second day offered an opportunity for HCBU participants to develop evaluability assessment action plans for use in their demonstration projects. After the conference, participants completed a process evaluation of the training workshop. Process evaluation results show that participants' expectations were reasonable and were met to their satisfaction. Participants gained an understanding of the need for evaluability assessments and were prepared to conduct them. After the conference, the contractor also offered technical assistance to all HCBUs, based on lessons learned during the conference.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Burke Fishburn

PHONE NUMBER: 202/690-7807

PIC ID: 5789

PERFORMER ORGANIZATION: Macro International, Inc., Silver Spring, MD

TITLE: Fifty-State Health Reform Database

ABSTRACT NUMBER: 116

ABSTRACT: This project constructed a database consisting of data elements related to health reform for all 50 States. This database supports the generation of customized State profiles for a variety of purposes. For example, Administration officials need information specific to each State in order to better support a State's health care reform efforts. The database will also allow comparison of individual State health care report efforts to the Federal effort and to each other. Some of the questions that can be answered by the database include (1) how many States have adopted small group market reforms or risk pools for uninsurables and (2) how Federal reform efforts might affect each State. The database has not been updated since the end of 1994, but can be updated for a small additional investment of resources.

AGENCY SPONSOR: Office of Health Policy

FEDERAL CONTACT: Sarah Jane Holcombe

PHONE NUMBER: 202/690-7804

PIC ID: 5394

PERFORMER ORGANIZATION: The Lewin Group, Fairfax, VA

TITLE: Final Report of the Task Force on the Privacy of Private Sector Health Records

ABSTRACT NUMBER: 117

ABSTRACT: The mandate of the Task Force on the Privacy of Private Sector Health Records was to examine the extent to which problems exist with the collection, storage, and use of health information in the private sector. The changing policy environment refocused the mission to include examination of ways to protect the privacy of all health care information within the context of health care reform and the development of electronic health information networks. The task force examined the social, legal, and economic issues affecting the privacy of people who use the health care system. It addressed several policy questions, including (1) the kinds of records to be protected; (2) the treatment of especially sensitive records; (3) the level of legislation that should enact privacy provisions; (4) the circumstances under which a record keeper should disclose health information; (5) the impact of automation on the privacy of health records; (6) the use of unique identifiers for health records; (7) the oversight structure needed to protect privacy, confidentiality, and security matters and violations; and (8) the training, education, and awareness programs needed for health care users and providers. The report recommends a coordinated Federal policy on the privacy of health care records; the use of universal identifiers; effective security standards and guidance; the establishment of a data protection entity; and an education program about the issue. (Final report 128 pages, plus appendix.)

AGENCY SPONSOR: Office of Program Systems

FEDERAL CONTACT: Joan Turek-Brezina

PHONE NUMBER: 202/690-6141

PIC ID: PIC 5879

PERFORMER ORGANIZATION: Kunitz and Associates, Inc., Rockville, MD

TITLE: JOBS Evaluation: Early Findings on Program Impacts in Three Sites

ABSTRACT NUMBER: 118

ABSTRACT: This report presents impact results of an evaluation of the Job Opportunities and Basic Skills Training (JOBS) program in three sites: Atlanta, Georgia; Grand Rapids, Michigan; and Riverside, California. The JOBS program examines two interventions: the labor force attachment (LFA) approach, emphasizing rapid job entry; and the human capital development (HCD) approach, which offers longer, skill-building education and training activities. Participants were randomly assigned to one of these approaches or to one of two control groups. The report is based on telephone and in-person surveys of 2,604 people in the three sites. The report finds that (1) the three sites successfully operated two distinct, well-run, and highly mandatory LFA and HCD versions of JOBS; (2) the LFA approach increased participation in job-search activities dramatically, slightly increased participation in other work-directed services, and resulted in a high rate of sanctioning (removal of a portion of welfare benefits because of nonparticipation); (3) the HCD approach also resulted in a high rate of sanctioning, and the basic services provided were primarily basic education and job search; and (4) the LFA approach substantially increased the number of people who found work and left the welfare rolls within 2 years, and the LFA's impact on AFDC receipts and payments and on earnings was substantial, while the HCD approach had not yet translated into higher earnings.

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Audrey Mirsky-Ashby

PHONE NUMBER: 202/401-6640

PIC ID: 5776.4

PERFORMER ORGANIZATION: Manpower Demonstration Research Corporation, New York, NY

TITLE: JOBS Evaluation: How Well Are They Faring? AFDC Families With Preschool-Aged Children in Atlanta at the Outset of the JOBS Evaluation

ABSTRACT NUMBER: 119

ABSTRACT: This report provides a descriptive summary of a Child Outcomes Study (a component of the larger JOBS program evaluation) in Fulton County, Georgia, near the start of the JOBS evaluation. The Fulton County JOBS evaluation uses a human capital development approach, a labor force attachment approach, and a control group. The descriptive sample included 790 respondents from the JOBS Child Outcomes Study in Fulton County. All respondents were mothers whose youngest child was between age 3 and 5 at the time of random assignment, all were 20 years of age or older, and 96 percent were African-American. The report finds that the mothers in the Fulton County sample are highly disadvantaged in many ways. Their reading and math literacy levels are low, they report minimal economic or other assistance from the fathers of their children, and they have high rates of depressive symptoms. On the other hand, most report social support from family and friends, have completed high school or the graduate equivalent degree, have positive attitudes about maternal work, and have taken steps toward limiting their childbearing. The children in the sample are also disadvantaged: their receptive vocabulary is substantially below the national mean and many lack the skills and knowledge needed for school readiness. Finally, the report notes that the heterogeneity of the sample mothers will lead to varied outcomes for their children.

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Audrey Mirsky-Ashby

PHONE NUMBER: 202/401-6640

PIC ID: 5776.2

PERFORMER ORGANIZATION: Manpower Demonstration Research Corporation, New York, NY

TITLE: JOBS Evaluation: Monthly Participation Rates in Three Sites and Factors Affecting Participation Levels in Welfare-to-Work Programs

ABSTRACT NUMBER: 120

ABSTRACT: The JOBS program provides an array of job search, work experience, education, and training services to families who receive AFDC. The program requires participation; those who do not participate are sanctioned with the loss of part of their welfare grant. The legislation authorizing JOBS also requires States to meet specific, and incrementally increasing, participation standards. This report uses data collected from the case files of 1,113 AFDC recipients in three JOBS evaluation sites (Atlanta, Georgia; Grand Rapids, Michigan; and Riverside, California) to examine participation rates. The report notes that the definitions of participation and the classes of people included in the measure greatly affect the feasibility of achieving a particular standard. The report finds that (1) only 5 to 10 percent of all single-parent AFDC clients participated in the JOBS program or worked the required hours during each week in a month; (2) including sanctioning in the definition of participation raises participation rates to between 9 and 21 percent; (3) using only JOBS-mandatory individuals in the measure increases the participation rate; and (4) if participation rates remained at 1992 levels at the sites, the rates would fall far short of the ultimate standards contained in the 1995 welfare reform bills, despite the JOBS program's tough standards, and its success compared with other programs. (Final report 59 pages, plus appendixes.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Audrey Mirsky-Ashby

PHONE NUMBER: 202/401-6640

PIC ID: 5776.3

PERFORMER ORGANIZATION: Manpower Demonstration Research Corporation, New York, NY

TITLE: Managed Care for People With Disabilities: Developing a Research Agenda

ABSTRACT NUMBER: 121

ABSTRACT: This report provides background information for a meeting held on the subject of managed care and people with disabilities, hosted by the Office of the Assistant Secretary for Planning and Evaluation's Office of Aging, Disability, and Long Term Care Policy. The purpose of the meeting was to (1) review the implications of the movement toward managed health care for people with physical and mental disabilities; and (2) flesh out a research and demonstration program to improve the understanding of the impact of managed care on people with disabilities. The report highlights critical policy areas and related research issues around managed care and disability. These policy areas include (1) functional and demographic characteristics of persons with disabilities who receive managed care; (2) the impact of managed care, including how participation affects access to needed services; (3) targeting managed care plans to people who are disabled; (4) financing and reimbursement; (5) service coverage and organization of the delivery system; and (6) quality assurance. For each of these areas, the report discusses the policy issues involved, research completed and under way on the subject, and suggested directions for research. The report stresses that little information has been generated about how any of these areas affect persons with disabilities. The report also notes that many persons with disabilities fear the role managed care will play in their access to services and the quality of those services, and that some of these fears are justifiable. (Final report 28 pages.)

AGENCY SPONSOR: Office of Disability, Aging and Long Term Care Policy

FEDERAL CONTACT: Mary Harahan

PHONE NUMBER: 202/690-6172

PIC ID: 4927

PERFORMER ORGANIZATION: Office of the Assistant Secretary for Planning and Evaluation, Washington, DC

TITLE: Minnesota Learning Readiness Initiative: Reforming the Delivery of Social Services to School-Aged Children and Families in Hennepin County, Minnesota

ABSTRACT NUMBER: 122

ABSTRACT: This report presents information on a major collaborative service integration initiative in Hennepin County, Minnesota. The two-track initiative was intended to mobilize community planning and collaboration around the development of school-linked services. The first track, the Learning Readiness Initiative, concentrated on research and development. The second track, the School Human Services Redesign Initiative, was a large-scale effort to reform delivery of social and other support services to families. The Learning Readiness Initiative began with a feasibility study, "When Kids and Systems Collide," which found that, despite over $1 billion spent on education and human services in Hennepin County, a massive policy collaboration was needed to make these services effective. The initiative used research and development-oriented grant making to develop new approaches and to foster collaboration. The School Human Services Redesign Initiative, begun while the Learning Readiness Initiative was still under way, had four goals: (1) to increase equity on all levels among students in school achievement, school service, and health outcomes; (2) to strengthen families' ability to support their children; (3) to enhance the responsiveness of human services and schools to the needs of students and families; and (4) to strengthen community bonds. (Final report 47 pages, plus appendixes.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Richard Silva

PHONE NUMBER: 202/690-6805

PIC ID: 5340

PERFORMER ORGANIZATION: Minneapolis Youth Coordinating Board, Minneapolis, MN

TITLE: New Approaches To Evaluating Community Initiatives: Concepts, Methods, and Contexts

ABSTRACT NUMBER: 123

ABSTRACT: This report examines issues in evaluating comprehensive community initiatives (CCIs). CCIs have their origins in the settlement houses of the late 19th century and the War on Poverty, among other influences. Most CCIs seek to provide social and health care services to low-income communities, as well as improve general conditions in the communities. Most operate under the belief that authority and responsibility must reside at the local level, rather than with the municipal, State, or Federal governments. The report's introduction addresses several factors that make CCIs difficult to evaluate, including horizontal and vertical complexity; contextual issues, such as the macroeconomic climate that is out of the control of CCIs; flexible and evolving interventions; the broad range of outcomes sought; and the absence of a comparison community or control group. The articles included in the report attempt to address some of these difficulties. The article titles are (1) "Evaluating CCIs: A View From History"; (2) "Nothing as Practical as Good Theory: Exploring Theory-Based Evaluation for CCIs for Children and Families"; (3) "How Do Urban Communities Affect Youth? Using Social Science Research to Inform the Design and Evaluation of CCIs"; (4) "Problems in the Evaluation of Community-Wide Initiatives"; (5) "Using Community-Level Indicators of Children's Well-Being in CCIs"; and (6) "The Role of the Evaluator in CCIs." (Final report 225 pages.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Barbara Bromar

PHONE NUMBER: 202/690-6461

PIC ID: 5895

PERFORMER ORGANIZATION: Aspen Institute, New York, NY

TITLE: Noncustodial Parents' Participation in Their Children's Lives: Evidence From the Survey of Income and Program Participation

ABSTRACT NUMBER: 124

ABSTRACT: This study examines the relationship between noncustodial parental involvement, child well-being, child support, custody and visitation arrangements, parental income, and family structure. In examining these interactions, the report focuses on father involvement and child well-being. The report includes (1) a literature review and annotated bibliography and (2) a secondary analysis using the Survey of Income and Program Participation. Because the majority of noncustodial parents are fathers, it is hoped that the findings from this report will provide new insights for promoting father involvement for children in divorced, separated, and never-married families.

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Anne Benson

PHONE NUMBER: 202/690-7409

PIC ID: 6158

PERFORMER ORGANIZATION: The Lewin Group, Fairfax, VA

TITLE: Options for Full-Day Services for Children Participating in Head Start

ABSTRACT NUMBER: 125

ABSTRACT: This study examines full-day services offered by eight Head Start grantees that fund extended hours by combining resources from a variety of sources. Data were collected during 2-day site visits to each grantee. The grantees provide services in one of three ways: (1) wraparound care, which uses funding from sources other than Head Start to expand services; (2) wrap-in care, in which Head Start grantees contract with another provider and fund the set of services needed to bring the contracted program up to Head Start standards; and (3) connected care, in which grantees contract with existing child care programs to provide children with supervised care before and after the Head Start day. The report examines program differences in full-day services, funding, fiscal management, and collaboration. The report finds that grantees (1) develop innovative ways to train staff and to integrate parent activities and home visits into the full-day programs; (2) develop ways to allocate funding from various sources, but also deal with several funding issues, including parental loss of eligibility for full-day funding, retroactive reimbursements, and funding shortfalls; and (3) encounter quality assurance problems using wrap-in or connected care. The report lists several issues for consideration by Federal policymakers and points toward needed research. (Final report 47 pages, plus appendix.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Laura Feig

PHONE NUMBER: 202/690-5938

PIC ID: 5333

PERFORMER ORGANIZATION: Pelavin Research Institute, Washington, DC

TITLE: Patterns of Substance Use and Substance-Related Impairment Among Participants in the Aid to Families With Dependent Children Program

ABSTRACT NUMBER: 126

ABSTRACT: This report was sponsored and performed jointly by ASPE, the Substance Abuse and Mental Health Services Administration (SAMHSA), and NIDA. This report provides data on substance use and substance-related impairments among participants in the AFDC program. The study uses data from the 1991 and 1992 National Household Surveys on Drug Abuse to gain information about the prevalence of substance abuse in the AFDC population and to investigate the rate of substance-related impairment in this population. Substance-related impairment is categorized as either "significant impairment," which may preclude participation in training or education activities, or "some impairment," which may require treatment concurrent with these activities. The report finds that (1) 4.9 percent of female AFDC recipients and 5.2 percent of all AFDC recipients report significant substance-related impairment; (2) an additional 10.6 percent of female AFDC recipients and 11.2 percent of all recipients report some impairment resulting from substance use; and (3) AFDC recipients have higher rates of substance use and substance-related impairments than the general population, but the vast majority of substance users and substance-related impaired people do not receive AFDC. See also PIC ID 5180 and 5180.1. (Final report 26 pages, plus appendixes.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Laura Feig

PHONE NUMBER: 202/690-5938

PIC ID: 5180.2

PERFORMER ORGANIZATION: Office of the Assistant Secretary for Planning and Evaluation, Washington, DC

TITLE: Performance Measurement for the U.S. Department of Health and Human Services, the Administration for Children and Families, and Its Other Operating Divisions

ABSTRACT NUMBER: 127

ABSTRACT: This report presents illustrative, candidate sets of outcome indicators for Child Welfare and Child Health Services, as well as recommendations to the Department of Health and Human Services (HHS) to further develop outcome indicators. Indicators in the area of child health include (1) increasing the number of insured pregnant women and insured children; (2) increasing access and reducing barriers to services; (3) coordinating and simplifying programs and systems; (4) establishing quality standards; (5) implementing public health education; and (6) increasing the numbers of women and children receiving appropriate services. The report also indicates end goals for children's health. The child welfare outcomes goals are grouped in the areas of safety, permanency, child development, and customer service. These goals relate to home-environment safety; permanent placement for children; school-based performance and age-appropriate growth and behavior; and State-, child-, and family-level satisfaction with services. The recommendations presented in the report are clustered around the major elements that should be included in a plan for a departmentwide or operating divisionwide performance measurement process. These elements are (1) establishing high-level policy and working committees to oversee the effort; (2) undertaking comprehensive implementation; and (3) providing training and technical assistance to programs. (Final report variously paginated.)

AGENCY SPONSOR: Office of Program Systems

FEDERAL CONTACT: Mike Herrell

PHONE NUMBER: 202/690-5739

PIC ID: 5081

PERFORMER ORGANIZATION: Urban Institute, Washington, DC

TITLE: Report to Congress on Out-of-Wedlock Childbearing

ABSTRACT NUMBER: 128

ABSTRACT: This report was prepared in response to the Violent Crime Control and Law Enforcement Act of 1994, which requires that HHS prepare an analysis of the increases in nonmarital births. A Department working group was formed of staff from ASPE, NCHS, and NICHD. The report examines the trends in, consequences of, and causes of out-of-wedlock childbearing. The report finds that (1) in 1993, nearly one-third of all births occurred outside of marriage; (2) less than one-half of nonmarital births were first births, but teenagers account for about one-half of all nonmarital first births; (3) nonmarital birth rates are highest during the ages of 18-29, and tend to be higher among disadvantaged and less-educated women and women in urban areas; (4) the proportion of nonmarital pregnancies that ended in abortion declined from 60 percent to 46 percent between 1980 and 1991; and (5) the consequences and causes of nonmarital births are difficult to determine because most of these parents are disadvantaged before the birth. The report examines the role of welfare; economic opportunities; neighborhood influences; individual and family characteristics; and attitudes, values, and norms in the increase in nonmarital births. See also Call Number DOC.HE 20.6202:C43/x in PIC book collection.

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Elisa Koff

PHONE NUMBER: 202/690-5880

PIC ID: 5910

PERFORMER ORGANIZATION: National Center for Health Statistics, Hyattsville, MD

TITLE: Review of Family Preservation and Family Reunification Programs

ABSTRACT NUMBER: 129

ABSTRACT: This report describes the state of the family preservation field and examines in greater depth the characteristics and operations of family preservation programs that are potential sites for future outcome evaluation. The report looks at placement prevention programs in 26 States. Of these States, 22 have one or more statewide models (Colorado, Florida, Iowa, New Hampshire, and Oregon use two family preservation models). Four of the 26 states do not have a specific program model; they make funds available to counties and allow the counties determine their own models. The report also analyzes these family preservation programs' characteristics, including (1) program models; (2) referral sources; (3) referral practices, including definition of imminent risk, decisionmaking processes, and exclusion criteria; (4) program maturity; (5) service providers; and (6) program statistics. The report also discusses family reunification programs. There were 26 such programs on the State and county levels in 15 of the 26 States contacted. Reunification programs that are part of a more general family preservation approach indicate that only a small percentage of cases served are reunification cases. These programs generally provide aftercare services and do not differentiate between preservation and reunification cases. (Final report 82 pages, plus appendixes.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Matt Stagner

PHONE NUMBER: 202/690-5953

PIC ID: 5337

PERFORMER ORGANIZATION: Westat, Inc., Rockville, MD

TITLE: Simulation of Trends in Employment, Welfare, and Related Dynamics

ABSTRACT NUMBER: 130

ABSTRACT: The Simulation of Trends in Employment, Welfare, and Related Dynamics (STEWARD) model was developed to inform the debate on welfare policy by simulating policy options that reflect several key questions: How will policies intended to encourage work affect the duration of welfare dependency? How will education and training programs reduce the duration of welfare receipt? How will AFDC costs and caseloads change as a result of reforms, and in what time frame? This report describes the STEWARD model, including (1) its development; (2) its unique features; (3) the kinds of policy options it can model; (4) the concept of the model; (5) how the concept is translated into an operational model; (6) the sources of key empirical estimates; (7) an overview of the impact measures routinely presented in the model output tables; and (8) the model database. The report describes three scenarios that are simulated by STEWARD: (1) a baseline case that simulates welfare caseloads, dynamics, and costs for a baseline period (here, 1992) under actual policies in effect at the time; (2) what welfare caseloads and costs would have been had the policy changes that have been enacted recently been implemented in the baseline year; and (3) what welfare caseloads and costs would be if welfare reform policies were enacted on top of current policies. (Final report 103 pages, plus appendixes.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Don Oellerich

PHONE NUMBER: 202/690-5877

PIC ID: 5882

PERFORMER ORGANIZATION: Mathematica Policy Research, Inc., Plainsboro, NJ

TITLE: Sources of Support for Young Latina Mothers

ABSTRACT NUMBER: 131

ABSTRACT: In 1992, the total Latina fertility rate was 3.04 births per woman, compared with 1.94 for all non-Latina women. Since 1980, Latina total fertility has risen by about 20 percent, and teen Latina birth rates have increased by 30 percent. These figures contrast sharply with fertility rates of less than 7 percent for all non-Latinas since 1980 and 6 percent for non-Latina teens. This report examines the support strategies used by young Latina mothers in the United States in order to identify Latina subgroups in greatest need of additional support. Using data from the 1990 census, the report considers (1) the young mother's living arrangements and (2) how she supports herself and her child (through employment and public assistance). The report finds that (1) Puerto Rican mothers are less likely to be married or to be living with parents or other adults and are more likely to be living in poverty and receiving welfare; (2) Cuban mothers have the highest household incomes and the lowest rates of receiving welfare; (3) Mexican and Central and South American mothers are similar to Whites in terms of their marriage patterns and living arrangements, but have much higher poverty rates; (4) foreign-born mothers are considerably more likely than their U.S.-born counterparts to use family or kin resources, and they appear to use this strategy rather than welfare; and (5) the most vulnerable mothers are teens raising children alone. (Final report 12 pages, plus appendix.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Elisa Koff

PHONE NUMBER: 202/690-5880

PIC ID: 5917

PERFORMER ORGANIZATION: Urban Institute, Washington, DC

TITLE: Substance Abuse Among Women and Parents

ABSTRACT NUMBER: 132

ABSTRACT: This report uses data from the 1991 National Household Survey on Drug Abuse and the 1991 Drug Abuse Warning System to examine the prevalence of substance abuse by women of childbearing age and by parents. The report also examines the number of children potentially at risk because of parental drug abuse. The report finds that (1) 5.7 percent of women age 15-44 years with children living in their households report past-month illicit drug use, compared with 11.2 percent of women in the same age bracket without children living in their homes, and the rates for men show similar patterns; (2) approximately 6 million children (9 percent) under age 18 have parents who have used illicit drugs in the past month, most commonly marijuana; (3) substance abuse varies little by urban/suburban/rural residency; (4) the prevalence of drug abuse among parents shows similar demographic patterns, as does drug use in the general population; (5) 4 percent of mothers and 13 percent of fathers report consumption of 5 or more alcoholic drinks at one time on at least 3 occasions in the past 30 days; and (6) children of drug-using parents tend to be younger than children overall--20 percent of children of both past-year and past-month drug users are under 3 years old, whereas 17 percent of all children are in this age group. See also PIC ID 5180 and 5180.2. (Final report 51 pages, plus appendixes.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Laura Feig

PHONE NUMBER: 202/690-5938

PIC ID: 5180.1

PERFORMER ORGANIZATION: CSR, Incorporated, Washington, DC

TITLE: Systematic Thinking About Government Programs for Children With Disabilities: Size, Participation, Benefits, and Expenditures

ABSTRACT NUMBER: 133

ABSTRACT: According to one source, about 4.5 million children in the United States have a disability. Furthermore, measures of the prevalence of disabilities among children and adolescents have been growing over time, possibly because of changes in data collection, increased survival of low birth-weight infants and children with terminal chronic illnesses; increased responsiveness to programs that provide assistance; and greater parental, educational, and medical awareness and detection of disability in children. This report attempts to provide a better understanding of how various Federal, State, and local programs serving children with disabilities have evolved and how they fit together. The report contains information on the participation, benefits, and expenditures of major programs serving this population. The report finds that (1) at the Federal level, the largest programs for children with disabilities are Supplemental Security Income (SSI) and Medicaid; (2) participation in SSI has increased 150 percent since 1989, and, since SSI recipients are automatically eligible for Medicaid in most States, the number of children with disabilities receiving Medicaid has also increased; (3) the largest State and local program serving this population is special education, which provides educational and other services (speech therapy, counseling, and physical therapy, among others); and (4) data on this population is limited and hampers policymakers' ability to serve the population. (Final report 119 pages, plus appendixes.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Barbara Broman

PHONE NUMBER: 202/690-6461

PIC ID: 5950

PERFORMER ORGANIZATION: Urban Institute, Washington, DC

TITLE: Child Support Payment Patterns Among AFDC Mothers in Massachusetts and Implications for TRIM2

ABSTRACT NUMBER: 134

ABSTRACT: AFDC and the Federal Child Support Enforcement Program (Title IV-D) are closely linked. In fact, the Title IV-D program was originally established to stem escalating AFDC costs. Two surveys, the Current Population Survey and the Survey of Income and Program Participation collect data on child support collections. However, these self-reported data are subject to limitations endemic to this kind of information. This report presents an analysis of data collected on the State level (in this case, Massachusetts) for a random sample of at least 2,400 AFDC cases covering 12 consecutive months and having at least 1 month in which child support was due during 1993. The sample was reduced to 2,364 cases because of data limitations for some cases. The report presents analyses of these data by ethnic/racial group; marital status and education of the mother; and amount of child support due, the amount paid, and the percent of amount due that was paid. The report then considers the implications of these analyses for the Transfer Income Model-Number 2 (TRIM2) microsimulation model. It describes how TRIM2 models child support awards and payments, and how Title IV-D/AFDC data might be used for TRIM2 validation and improvement. The report concludes that State-level Title IV-D/AFDC data provide a rich source of information on the child support characteristics of families receiving AFDC, and that additional analyses of State Title IV-D/AFDC data could prove very useful for validating and improving the child support simulation procedures in the TRIM2 model. (Final report 45 pages.)

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Linda Mellgren

PHONE NUMBER: 202/690-7507

PIC ID: 4942

PERFORMER ORGANIZATION: Urban Institute, Washington, DC

TITLE: Use of Administrative Data Kept by States To Study the Duration of Program Participation

ABSTRACT NUMBER: 135

ABSTRACT: This study assesses whether administrative data kept by States can be used to study the duration of program participation in the AFDC, food stamps, medical assistance, and Title IV-D programs. The need for longitudinal data is compounded by recent efforts to reform welfare that limit the duration of a welfare spell to 24 months. Two types of data may be obtainable: retrospective data that are currently available, including case histories; and prospective data that are assembled as events occur. Of 15 States contacted, 4 (California, Georgia, New York, and Texas) were selected for the collection of detailed information on their respective data systems. The report finds that California and Texas offer the best possibilities for collecting retrospective data, while New York and California offer the best possibilities for collecting prospective data. The report offers two options for assembling longitudinal data about program participation on the State level: (1) asking States to produce these files themselves and providing them the funding to do so and (2) asking States to provide administrative data in whatever form it exists to a third party, who will assemble the longitudinal files. The report considers the positive and negative aspects of each of these options and concludes that the second option is better from a research standpoint. Under this option, data are more likely to be usable to address relevant policy questions and to make State comparisons. Furthermore, economies of scale are expected to make this option more cost-effective over time. The report notes that if neither option is considered viable, California and Texas have data available that may be examined, but these data lack information about all programs. Finally, the report cautions that new longitudinal data will not be available for at least 9 months from the date of funding.

AGENCY SPONSOR: Office of Human Services Policy

FEDERAL CONTACT: Linda Mellgren

PHONE NUMBER: 202/690-7507

PIC ID: 4945

PERFORMER ORGANIZATION: Urban Institute, Washington, DC