Although in this report we focus on substance abuse and mental health problems, learning disabilities and domestic violence situations, states and localities must decide which health conditions, disabilities or personal circumstances (or combinations of these issues) that inhibit clients' transitions from welfare to work they wish to address in their screening or assessment efforts. As discussed in more detail in Question Two, some states receive guidance from the state legislature or from other organizations specializing in a particular issue area. For example, New York law requires that the TANF system screen for substance abuse problems. Several states we spoke with noted that state and local domestic violence coalitions actively encouraged the TANF agency to develop approaches to screening or assessing for domestic violence situations.
While states and localities often must respond to these influences, any data that states may have about prevalence of disabilities or barriers to work among the TANF population in their state, locality, or nationally may help them decide which barriers should be the focus of identification efforts. In addition to prevalence estimates and state or local data, anecdotal evidence from caseworkers or other front line staff about prevalence might provide useful guidance about what issues are preventing people from obtaining work within the required time limits.
In any case, states must proceed cautiously, being sure to consider how a new screening tool will fit into their TANF client flow and what necessary services must follow the identification of a barrier to work or a disability. Some individuals interviewed for this study indicated that screening for a particular barrier should only be conducted if the TANF agency can subsequently offer services to address the problem. The length and format of the tool should also be considered. For example, using shorter tools or interviews may save time and resources. On the other hand, caseworkers may find that taking the time to establish a rapport initially will save the system time in the long run by preventing client barriers from being identified later in the process of moving to work.