Screening and Assessment in TANF\Welfare-to-Work: Local Answers to Difficult Questions. Formal Approaches


Many who are interested in identifying unobserved barriers to employment—such as substance abuse and mental health problems, domestic violence situations, and learning disabilities—among the TANF population, are in search of a formal tool or instrument to identify barriers. However, few tools have been developed for use with TANF clients or designed to address the multiple barriers many TANF clients face.17 Where instruments are available, they are often state or locally-developed and have rarely been validated for use with the TANF population.

While many still seek an instrument that would accurately and reliably identify a wide range of issues faced by TANF clients, the reality is no such tool currently exists, or arguably, may ever exist. Those working in the trenches on this issue are far more concerned with developing a process that helps identify the likelihood that a barrier exists. Their challenge extends beyond the selection of a specific instrument, to determining how to integrate identification efforts into the existing TANF eligibility determination and service planning process, how best to utilize existing staff and partner agencies in this endeavor, and how to establish new partnerships where existing expertise or capacity is insufficient.

Within this larger process, formal tools do have a role and the study sites use a variety of tools or instruments to assist in identifying barriers.18 Tools used in the study sites can be divided into two categories—validated tools and non-validated tools. We define validated tools as those which were developed for use with a specific population and have been rigorously tested to determine their validity and/or reliability. Non-validated tools refer to those tools which are state or locally-developed and have not been rigorously tested.

Minneapolis, Minnesota is an example of a study site that is making a concerted attempt to use tools to specifically identify mental health and substance abuse barriers. At the time of our visit, the Minnesota Department of Human Services was in the process of attempting to validate a screening tool. This tool, which was being piloted in several areas around the state, including with some employment service providers in Minneapolis, is intended to guide TANF case managers’ decisions to refer clients for mental health and/or substance abuse assessments. This self-administered screening tool consists of sixteen “yes” or “no” questions—12 questions relating to mental health and four questions about substance abuse. The latter questions are similar in wording to those found in the CAGE, a substance abuse tool. Once a client completes the screening tool, the case manager scores the results. A client receives one point for every ‘yes’ response to questions, one through six of the mental health questions and a score of two points for every “yes” response for questions seven through 12. Clients that score a two or higher are recommended for referral. For the substance abuse questions, a client receives one point for every ‘yes’ questions and is recommended for substance abuse assessment if she scores one point or higher. The implementation of the mental health and substance abuse screening tool pilot was still in progress and the tool had yet to be validated at the time of our site visit.

17  For a more detailed discussion of the availability of tools, see Question Five in Ten Important Questions.

18  Although below we highlight several tools that the study sites use, this is in no way intended to promote the use of any instrument.

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