Access to behavioral health services for women on TANF

描述：从收入维持津贴(AFDC)到以工作换取临时现金援助(TANF)的福利改革的主要特点是严格的工作要求、制裁和资格限制。这项改革的预期结果是通过就业实现自给自足。基本的福利改革是假设TANF接受者与一般人口中的妇女一样能够工作。越来越多的人认识到，由于严重精神疾病(SMI)导致的严重残疾，TANF人口中的一部分面临着工作和自给自足的障碍。由于福利待遇的变化和医疗补助登记人数的下降，这些高危人群获得行为健康服务的机会可能会受到威胁。通过获得有效的行为健康服务，可以促进这些妇女的就业。这项试点研究通过确定患有SMI的AFDC/TANF人群的服务使用模式，以及确定在离开福利之前接受过行为健康服务的SMI家庭的女户主在离开TANF后是否继续接受服务，来检验这些研究关注的问题。这项试验性研究的结果将被用来确定进行一项全面的纵向研究的可行性，即福利改革成果对目前或以前正在领取福利的有SMI的户主的影响。试点的具体目标是： 确定1997年至2000年期间在宾夕法尼亚州费城接受医疗补助报销行为健康服务的现任和前任女性户主的目标人口--接受AFDC/TANF的家庭的服务使用模式。 确定退出福利是否会减少在AFDC/TANF期间使用医疗补助行为健康服务的SMI女性获得治疗的机会。 制定一项研究设计，用于纵向研究福利改革成果对有SMI的现任和前任领取福利的户主的影响，以R01或职业发展奖励提案的形式提交。

DESCRIPTION: Key features of welfare reform from an income maintenance entitlement (AFDC) to temporary cash assistance in exchange for work (TANF) are strict work requirements, sanctions, and time limits on eligibility. The expected outcome of this reform is self-sufficiency through employment. Underlying welfare reform is the assumption that TANF recipients are as able to work as women in the general population. There is increasing recognition that a subset of the TANF population face barriers to work and self-sufficiency based on significant disability due to -serious mental illness (SMI). Access to behavioral health services by this at-risk population may be in jeopardy as a consequence of changes to welfare entitlements and declines in Medicaid enrollment. Employment for these women can be facilitated by access to effective behavioral health services. This pilot study examines these research concerns by identifying patterns of service use of the AFDC/TANF population with SMI and determining whether female heads of households with SMI who had received behavioral health services before leaving welfare continue to receive services after leaving TANF. Findings from this pilot study will be used to determine the feasibility of conducting a full-scale longitudinal study of the impact of welfare reform outcomes on heads-of-households currently or formerly receiving welfare that have SMI. The specific aims of the pilot are to: Identify patterns of service use of the target population of current and former female heads-of households with SMI receiving AFDC/TANF who used Medicaid reimbursed behavioral health services in Philadelphia, PA, between 1997 and 2000. Determine whether leaving welfare reduces access to treatment for women with SMI who used Medicaid behavioral health services while on AFDC/TANF. Develop a research design for a longitudinal study of the impact of welfare reform outcomes on current and former heads-of-households receiving welfare that have SMI, to submit as an R01 or a career development award proposal.