Providing Mental Health Services to TANF Recipients: Program Design Choices and Implementation Challenges in Four States. Funding Arrangements

08/01/2001

The study states primarily used their TANF block grant and state MOE (Maintenance-of-Effort) funds to pay for mental health services. These funds are distributed in two ways. Under the first model, the state welfare agency or state legislative body allocates TANF or MOE funds specifically for the purpose of providing mental health services. In Florida, the state legislature allocated $45 million in TANF/MOE funds to provide mental health and substance abuse treatment to welfare recipients and low-income families at risk for TANF involvement. The state welfare office in Tennessee designated $8 million for mental health and other services for welfare recipients. Programs for which funds have been earmarked in this way appear to have a distinct program identity with a centralized program administrator and some uniformity in how the program operates.

Under the second model for funding mental health services, which is used in Oregon, the money is part of a pool of funds designated for services designed to help TANF recipients find employment. In Oregon, the decision about the amount of funds to allocate to mental health services is made primarily at the local level.

Both approaches to funding have strengths and limitations. The first model guarantees that a certain amount of resources will be used to provide mental health services. It also requires strong centralized leadership at the state level to develop a service delivery structure and process. This model can be limited insofar as it makes it more difficult to integrate mental health and employment services. So while a program with an independent funding arrangement has more autonomy, it also requires more effort to integrate mental health and welfare policies and service delivery. Under the second funding model, integration of mental health and employment services becomes easier, as mental health services exist as one of a range of options to help welfare recipients become employed. The drawback is that mental health services compete with other services for funding, making the availability of funds more tenuous.

In addition to TANF and MOE funds, states may use funds from the Welfare-to-Work grants program to provide mental health services.(15) Washington County (St. George), Utah, is 1 of 11 counties participating in a competitive Welfare-to-Work grant. Part of the funding for this grant has been used to hire additional social workers and intensive case managers to expand social work services in the southern area of the state. The advantage of Welfare-to-Work funds is that they offer program administrators another way to pay for mental health services. These funds can be used to pay for client assessments and mental health treatment, and for supportive services while clients receive treatment. The drawback is that the narrow eligibility criteria for welfare-to-work programs restrict the types of clients who may participate in mental health services paid for with these funds.

Endnotes

9.  AFS operates Oregon's welfare programs, which have a strong emphasis on employment and work supports.

10.  DCF is responsible for the state's economic and self-sufficiency services, family safety system services, mental health and substance abuse services, and adult and developmental services.

11.  The Office of Economic Self-Sufficiency is responsible for determining eligibility for TANF and other public assistance programs for low-income families.

12.  Certified social workers have completed a master's degree in social work but do not have clinical licensure.

13.  Salaries range from $30,000 to $35,000 per year for a licensed mental health counselor compared to between $18,000 and $23,000 for bachelor's level staff.

14.  GROW stands for Gain immediate employment, Reach needed training, Opportunities for improved wages, and Work toward career goals.

15.  Welfare-to-Work funds were authorized by the Department of Labor in 1998. Competitive and state formula Welfare-to-Work grants are no longer available.

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