A third mode of decision-making was prominent when we examined choices about non-health social services in these states, including TANF non-assistance, child care subsidies, and child welfare. Although decisions about Medicaid funding were strongly affected by provider interests and state funding needs and decisions about the critical parameters in cash assistance were influenced by political ideologies, choices regarding non-health social services more likely reflected a sort of technocratic politics. Decisions were made on the basis of assessments by state administrators about the relative merits of different programs and their centrality in achieving major goals.
However, these decisions were constrained by the availability of resources, and in recent years, those resources have been limited. Administrators were given flexibility in deciding what services to support, but the flexibility often looked like a delegation by the legislature, and sometimes the governor, of difficult choices between competing needs. That is, in recent years, many of the social service agencies among these six states were instructed by their legislatures not precisely where to reduce services but how much they had to cut from their total budgets. There were exceptions: sometimes governors or legislators championed particular services or programs, and these programs served as additional constraints. In these six states, such programs were usually some relatively popular educational initiative, such as Louisiana's pre-K program.
This manner of decision-making in part resulted from the low political salience of these non-health social service programs. Although many of the services, such as child care or child welfare, involved private providers, the providers were rarely organized and active in advocating these programs in state legislatures. Nor were child and other advocacy organizations as involved with these programs as they were in Medicaid or CHIP.
This political flexibility was augmented in recent years by the availability of the TANF block grant and fairly loose constraints as to what service and benefit programs might be included under TANF non-assistance and the state's MOE. In fact, sometimes this flexibility was as much a "burden" as a "blessing," as one administrator told us. Because the state legislature viewed the social services agency as having so much discretion in managing the block grant, agency officials perceived the legislature as unconcerned about imposing major cuts in state funding of agency programs because "they thought we could cover critical shortfalls with our 'slush fund'" (i.e., TANF block grant).
As noted above, within these constraints, administrators often made decisions based on judgments about which services were critical to major agency goals, which programs were successful in terms of performance standards, which programs were needed to create or maintain a coherent package of benefits or services, which programs involved high stakes (e.g., life or death issues), and how and whether programs can be administered with fewer staff. These were unenviable decisions in most of the states because state funds were scarce, TANF surpluses declined rapidly, and some block grants that provided greater per capita support to poor states, such as SSBG, were reduced in size. But, unquestionably, state officials had more control over the mix of services the state could offer than they had just a decade ago.
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