Category Archives: Human Services

States Perform

Source: Council of State Governments, 2017

States Perform provides users with access to interactive, customizable and up-to-date comparative performance measurement data for 50 states in six key areas: fiscal and economic, public safety and justice, energy and environment, transportation, health and human services, and education. Compare performance across a few or all states, profile one state, view trends over time, and customize your results with graphs and maps.

“You are in a better position to protect people when you feel like you’re protected yourself” : to what extent does union membership and ethical clinical social work practice align? : an exploratory study

Source: Robyn K. Douglass, Smith College School for Social Work, Masters Thesis, 1705, Publication Date 2016

From the abstract:
The purpose of this study was to examine the question: “to what extent does union membership and ethical clinical social work practice align?” by interviewing Licensed Clinical Social Workers (LCSW) working within unionized environments. The study focused on the experience of these clinicians within their current working environment and how being a union member allowed them to be able to provide ethical clinical social work practice to their clients/patients. The most compelling findings from this research were that the clinicians felt that union membership did align with providing ethical clinical social work practice to their populations within their agencies or organizations. There were limitations and concerns when it came to union participation in the form of a strike. Participants had mixed responses regarding the ethical considerations that come about as a result of a strike and how it could potentially impact their clients/patients negatively. Implications for social practice and policy highlight the need for further research in how the values of both labor unions and the field of clinical social work are closely aligned and in turn how can that help clinicians provide the most ethical care possible.

Drug Testing Unemployment Insurance Applicants: An Unconstitutional Solution in Search of a Problem

Source: Rontel Batie, George Wentworth, National Employment Law Project (NELP), Policy Brief, February 2017

From the summary:
Historically, states have never drug tested applicants for unemployment insurance (UI), primarily because the Social Security Act prohibits states from adding qualifying requirements that do not relate to the “fact or cause” of a worker’s unemployment. In the aftermath of the Great Recession, however, some states, in a misguided effort to try to contain the high costs of their UI programs due to high unemployment rates, began clamoring to drug test UI applicants. Their hypothesis (without any facts or data to back it up) was that claims would somehow substantially decrease, either as workers tested positive for drugs or declined to apply because of their drug use.

Mindful of the goal of drug-free workplaces but also of the lack of any data that drug use was an issue among the unemployed, in 2012, Congress reached a narrow compromise on drug testing UI claimants, one that took into account the serious constitutional issues with suspicionless drug testing. Congress agreed to allow, not require, states to test UI claimants in two specific, narrow circumstances: (1) workers who had been discharged from their last job because of unlawful drug use, and (2) workers looking for jobs in occupations where applicants and employees are subject to regular drug testing. Consistent with the new federal law, the U.S. Department of Labor issued regulations that closely tracked the legislation, defining occupations subject to regular testing to mean occupations where testing is legally required (either now or in the future), and not merely permitted.

Congressional Republicans, unhappy with the compromise they agreed to in 2012, have criticized the Labor Department regulations since they were proposed, claiming they were too narrowly drawn even though they closely tracked the legislation. The House of Representatives is now planning to invoke the Congressional Review Act to invalidate these regulations; and presumably, proponents of drug testing are counting on passage of a bill introduced in the 114th Congress by Rep. Kevin Brady (R-TX) that would effectively allow states to drug test all jobless workers filing for unemployment insurance. This bill, which we expect will be reintroduced shortly, would allow states to define occupations that “regularly” drug test to include all occupations where testing (including pre-employment testing) is permitted. If passed, this bill would open the floodgates for states to arbitrarily and unconstitutionally drug test its citizens solely because they are applying for UI benefits.

No one should be so confident that this bill could pass the Senate. Proponents have been trying to build support for drug testing UI claimants for years; but for the very narrow compromise reached in 2012, there has been no wider bipartisan support for the policy. Indeed, that is because such drug testing is simply another humiliation piled onto unemployed workers—a hurdle designed to be so stigmatizing that it discourages people from even applying for a benefit that they have earned in the first place….

Report to the New Leadership and the American People on Social Insurance and Inequality

Source: Benjamin W. Veghte, Elliot Schreur, and Alexandra L. Bradley (eds.), National Academy of Social Insurance, January 2017

From the abstract:
Our nation’s social insurance infrastructure forms the foundation of economic and health security for American workers and their families. Like all infrastructure, it must be periodically strengthened and modernized if it is to continue to meet the needs of a changing economy and society. This Report presents the new Administration and Congress with a range of evidence-based policy options, developed by the nation’s top social insurance experts, for doing so.

The first part of the Report takes stock of the policy challenges facing existing social insurance programs: Social Security, the major health insurance programs, and Unemployment Insurance. The second part discusses potential new directions for social insurance in coping with emerging needs in the areas of long-term services and supports, caregiving supports, and nonstandard work.

Children’s health insurance, family income, and welfare enrollment

Source: Martin Saavedra, Children and Youth Services Review, Volume 73, February 2017
(subscription required)

From the abstract:
Children from wealthier families are more likely to have health insurance than children from poorer families on average. However, the relationship between family income and health insurance is non-linear, as children near the Federal Poverty Line (FPL) are less likely to be insured than children from both wealthier families (who obtain health insurance from the private market) and poorer families (who obtain government-funded health insurance). This health insurance dip has persisted even as Medicaid has been expanded to cover those above the FPL. One explanation for this is that families who are far below the poverty line are better connected to the welfare system, and consequently, are more likely to enroll in Medicaid. This study uses data from the 2001–2013 Current Population Surveys and finds that (1) controlling for many of the determinants of eligibility, those on other forms of government assistance are more likely to have health insurance, and (2) the relationship between family income and children’s health insurance status is strictly increasing after controlling for enrollment in other welfare programs

Highlights:

• Children near the poverty line are some of the least likely to have health insurance.
• Children on public assistance are more likely to have insurance.
• The insurance-income relationship is increasing after controlling for welfare enrollment.

What everyone should know about their state’s budget

Source: Urban Institute, 2017
[tool was funded by the Laura and John Arnold Foundation]

State and local governments educate schoolchildren, train the future workforce, care for the sick and elderly, build roads, patrol neighborhoods, extinguish fires, and maintain parks. In short, they’re pretty important. But few Americans understand where their state and local tax dollars go and to what effect. It’s not just the amount of money spent that matters, it’s why that money is spent the way it is.

Through this web tool, we aim to fill that knowledge gap. The tool allows users to get under the hood of their government and understand not only how much a state spends but also what drives that spending.

To do this, we apply a basic framework to all major areas of government spending. The framework says that state spending per capita is both a function of how many people receive a service and how much that service costs the state for each recipient. ….

…In this tool, you’ll see the spending per capita breakdown for all states and the District of Columbia across all major functional categories. It allows you to see how each state ranks, and you can sort by any factor you choose. (One frequent outlier is DC; though included in the rankings, it often functions more like a city than a state) We’ve included some annotations to guide you along the way. By exploring the tool, you’ll gain a sense of how much each state spends on any given area and why states spend what they do. ….

Child Welfare: An Overview of Federal Programs and Their Current Funding

Source: Emilie Stoltzfus, Congressional Research Service, CRS Report, R43458, January 10, 2017

Child welfare services are intended to prevent the abuse or neglect of children; ensure that children have safe, permanent homes; and promote the well-being of children and their families. As the U.S. Constitution has been interpreted, states have the primary obligation to ensure the welfare of children and their families. At the state level, the child welfare “system” consists of public and private child protection and child welfare workers, public and private social services workers, state and local judges, prosecutors, and law enforcement personnel. These representatives of various state and local entities assume inter related roles while carrying out child welfare activities, including
• promoting child and family well-being through community-based activities;
• investigating, or otherwise responding to, allegations of child abuse and neglect;
• providing services to families to ensure children’s safety in the home;
• removing children from their homes when that is necessary for children’s safety;
• supervising and administering payments for children placed in foster care;
• ensuring regular case review and permanency planning for children in foster care;
• helping children leave foster care to permanent families via reunification with parents or, when that is not possible, via adoption or legal guardianship;
• offering post-permanency services and supports to maintain families; and
• helping older children in foster care, and youth who leave care without placement in a permanent family, to become successful adults. ….

….This report begins with a discussion of the status of FY2017 appropriations, which had not been finalized as of early January 2017, and then reviews federal appropriations activity in FY2016. The remainder, and bulk, of the report provides brief descriptions of each federal child welfare program, including its purpose and recent (FY2012-FY2016) final funding levels……

Who Hires Social Workers? Structural and Contextual Determinants of Social Service Staffing in Nursing Homes

Source: Amy Restorick Roberts and John R. Bowblis, Health & Social Work, Advance Access, First published online: December 7, 2016
(subscription required)

From the abstract:
Although nurse staffing has been extensively studied within nursing homes (NHs), social services has received less attention. The study describes how social service departments are organized in NHs and examines the structural characteristics of NHs and other macro-focused contextual factors that explain differences in social service staffing patterns using longitudinal national data (Certification and Survey Provider Enhanced Reports, 2009–2012). NHs have three patterns of staffing for social services, using qualified social workers (QSWs); paraprofessional social service staff; and interprofessional teams, consisting of both QSWs and paraprofessionals. Although most NHs employ a QSW (89 percent), nearly half provide social services through interprofessional teams, and 11 percent rely exclusively on paraprofessionals. Along with state and federal regulations that depend on facility size, other contextual and structural factors within NHs also influence staffing. NHs most likely to hire QSWs are large facilities in urban areas within a health care complex, owned by nonprofit organizations, with more payer mixes associated with more profitable reimbursement. QSWs are least likely to be hired in small facilities in rural areas. The influence of policy in supporting the professionalization of social service staff and the need for QSWs with expertise in gerontology, especially in rural NHs, are discussed.

State Expenditure Report (Fiscal 2014-2016)

Source: National Association of State Budget Officers, 2016

Overview:
This annual report examines spending in the functional areas of state budgets: elementary and secondary education, higher education, public assistance, Medicaid, corrections, transportation, and all other. It also includes data on the State Children’s Health Insurance Program and on revenue sources in state general funds.

– The total state spending growth rate slowed in fiscal 2016, following a 10-year high in fiscal 2015.
– Medicaid continued to increase as a share of total state spending, while K-12 remained the largest category from state funds.
– Transportation led the way in spending growth from state funds in both fiscal 2015 and fiscal 2016, while Medicaid experienced the largest gains from all funds.
– Revenue growth slowed considerably in fiscal 2016 as states saw weaker collections from sales, personal income, and corporate income taxes.
Related:
Summary
Archives

Cycle of Crisis

Source: Megan O’Matz, Sun Sentinel, December 15, 2016

In Florida, the soaring number of forced hospitalizations of mentally ill reveals a broken health care system failing those who need it most…..

….The government closed or downsized many of the facilities, and efforts shifted to enable the mentally ill to live in the community, in their homes or elsewhere, with the help of local professionals. But the government never allocated enough money for services or housing. Now people with mental illness are confined in jails, cast adrift in the streets, or left to the care of families without the means to support them. There’s not enough help between a short hospitalization or being sent to a state mental institution such as Florida State Hospital in Chattahoochee, the state’s largest….

Related:
Dying for help
Source: Megan O’Matz, Sally Kestin and John Maines, Sun Sentinel, December 15, 2016

Families struggle with severely mentally ill relatives, then become victims of their violence. Florida’s health care system is too stressed to prevent the tragedies. ….

…. No government agency monitors the tragedies. But a six-month Sun Sentinel investigation determined that people with mental illness have killed or brutally assaulted at least 500 loved ones in Florida since 2000. During that time, Florida’s spending on mental health programs has declined significantly: When adjusted for inflation, the state last year spent one-third less per capita on mental health and drug treatment than it did in 2000, according to a Sun Sentinel analysis of data. ….

…. Jailing a mentally ill inmate in Florida costs up to three times more than treatment. One successful statewide program that provides social workers to visit the mentally ill, ensure they take their medication, go to the doctor and have adequate housing, costs $35 a day. By comparison, it costs $121 a day to house a person with mental illness at the Broward County Jail. ….
Related: