Welfare Policy and Substance Abuse in The United States (Encyclopedia of Drugs, Alcohol, and Addictive Behavior)
Generally speaking, the American income maintenance system is divided into two "tracks" based on the relationship of beneficiaries to the labor force. For the so-called "insurance-like" programs, notably Old Age and Survivors Insurance (what Americans refer to colloquially as "Social Security"), Social Security Disability Insurance, and Unemployment Compensation, eligibility is linked to an applicant's history of payroll deductionsontributions from wages to the public fund that supports the program. The so-called "welfare" programs, on the other hand, are "means-tested." That is, eligibility hinges on meeting strict limits on current earnings and accumulated wealth. Welfare programs are for very poor people and their benefits are substantially inferior to those paid by the insurance-like programs.
As well, the American income maintenance system is "categorical." For the most part, eligibility is based on membership in a particular category defined by administrative rules: Old age benefits are for those who meet the administrative definition of aged status; disability benefits are for those who meet the medical and vocational standards defining that category, and so forth. Except as discussed below in connection with General Assistance, there are no welfare programs for hale, nonelderly adults without children.
Finally, the income maintenance system in the United States is funded and administered by federal, state, and local (primarily county) governments. Insurance-like programs are usually funded and administered by the federal government, thus creating a significant degree of uniformity in benefits and eligibility rules. Welfare programs, however, usually are funded and administered by two or more levels of government, and benefit levels and eligibility rules vary considerably among political jurisdictions.
This article concerns the intersection of substance abuse and initial and continuing eligibility for welfare programs in the context of policy changes made during the 1990s. It focuses mainly on Temporary Assistance for Needy Families (TANF) and, to a lesser extent, General Assistance (GA). Supplemental Security Income (SSI), a federally funded and administered welfare program for the elderly, blind, and disabled, is the subject of a serparate entry concerned with addiction as a disabling impairment in the disability programs administered by the Social Security Administration (see ELIMINATION OF DRUG ADDICTION AND ALCOHOLISM AS QUALIFYING IMPAIRMENTS IN SOCIAL SECURITY DISABILITY PROGRAMS).
Temporary Assistance for Needy Families.
For 60 years after the enactment of the Social Security Act of 1935, America's cash assistance program for impoverished families was Aid to Families with Dependent Children (AFDC; Aid to Dependent Children until 1961, when a parental or caretaker grant was added). As the result of liberal court rulings in the 1960s and the separation of casework from the financial administration of recipients' grants in 1972, AFDC became substantially free of the punishing moralism that characterized an earlier era when social workers raided the houses of welfare mothers to search closets for evidence of a "man in the house" who might be made to support the women and their children. Although various work incentives were tried over the years, particularly during the 1980s, they had indifferent results and affected relatively few recipients. Even so, only a small percentage of AFDC families remained on the rolls for years at a time, and most AFDC heads of household, the great majority of them women between 18 and 35 years old, worked part-time or intermittently while raising their children.
However, the ascendancy of the Republican Party following the November 1994 elections yielded the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) of 1996 (P.L. 104-193). The PRWORA was based on premises laid out succinctly in Contract with America, the 1994 campaign manifesto drafted by Republican leaders in the House of Representatives. Contract opined that the liberal welfare regime dating from the 1960s "had the unintended consequence of making welfare more attractive than work" (p. 67). Moreover: "Government programs designed to give a helping hand to the neediest of Americans have instead bred illegitimacy, crime, illiteracy, and more poverty." Welfare reform should thus "change this destructive social behavior by requiring welfare recipients to take personal responsibility for decisions they make" (p. 65).
The PRWORA's countermeasures are a complicated combination of incentives and punishments directed at both welfare recipients and the states. The act creates a lifetime limit of 5 years's welfare receipt for TANF families. Further, its funding mechanism requires that each year the states move progressively greater numbers of TANF parents into jobs or face cuts in the overall federal grant to the state (known as a "block grant"). Each state may exempt 20 percent of its caseload from job placement, but in the long run the states are faced with the formidable task of making work-ready and placing in employment thousands of mothers with little work experience and few marketable skills. At the same time, the PRWORA permits the states a great deal of flexibility in using various funds to create training programs, support childcare, and even fund alcohol and drug treatment.
The PRWORA also requires or permits the states to enforce a variety of "behavioral requirements" for continuing eligibility for full TANF benefits. Among these is the PRWORA's permitting states to mandate treatment for alcohol and drug abusers as well as to require random drug testing under the threat of forfeited benefits. (A failed provision of the original legislation would have forced the states to implement these provisions.) However, recent research on TANF parents in some states has produced the startling (to some) finding that the prevalence of substance-abuse disorders in the adult TANF population, as measured by a rigorous standard, is very similar to that in the population at large: about 8 to 10 percent. To date, only Louisiana, Michigan, Nevada, and New York have expressed serious interest in drug testing and any implementation plan will face a court test. However, a number of states, including California, are exploring mechanisms for mandatory treatment and the use of "representative payees," a third party who receives and manages a recipient's benefits.
A further drug-related provision of the PRWORA is both more stringent and more common. The act provides that unless a state passes contrary legislation, any person with a felony drug conviction for conduct after August 22, 1996 (the date PRWORA was signed into law), will be banned for life from TANF benefits. This provision, it should be noted, reflects a negotiated compromise on the House of Representatives version of the act that would have extended the ban to those convicted of misdemeanors. At this writing, nine states (Connecticut, Kentucky, Michigan, New Hampshire, New York, Ohio, Oklahoma, Oregon, and Vermont) have passed the legislation required to opt out of the ban. Eighteen other states have passed legislation to soften it.
In 1996, about sixty-one thousand women were convicted of drug felonies in the United States. A 1997 Legal Action Center survey of seventeen drug and alcohol treatment programs for women with children located in different parts of the country found that 21 percent of the welfare mothers in those programs had felony drug convictions. In the only study to date relevant to the TANF ban's likely effect on single mothers, attorney Amy E. Hirsch interviewed twenty-six affected women in Pennsylvania, a state that has not modified the ban. Most were convicted of possessing small amounts of drugs valued from four to one hundred dollars. Before entering treatment (where Hirsch found them), all had been heavy users, typically of crack cocaine, and most had been charged with possession with intent to deliver. In fact, they were for the most part intermediaries and small-time corner girls bagging and transporting crack and engaging in sex work to subsidized their habits. Often, they were allowed (if not encouraged) to plead guilty to a felony because only by court stipulation could they receive a residential treatment bed.
Two-parent families may also qualify for TANF and the drug-felony ban may have an important and negative cumulative impact on them, perhaps by discouraging drug-felon fathers from living with their families so as not to jeopardize the TANF benefits of the mother and children, At this writing, there are no data on this subject.
General Assistance (known in some places as General Relief) is a form of welfare financed and operated entirely by state, county, or municipal governments. Many states do not have GA programs, or GA exists only in some local jurisdictions. GA benefit levels and eligibility rules also vary from state to state, and in some states, notably California and Wisconsin, from county to county. Some states (or smaller jurisdictions) provide GA benefits merely on the basis of need, but most GA programs are categorical (e.g., Oregon and Washington), restricting eligibility to older people not yet eligible for Social Security or Supplemental Security Income (SSI); to parents waiting for TANF benefits or temporarily suspended from that program; to those with an SSI application pending; or to those who are realistically unemployable by some criteria of age and infirmity but who do not meet the stringent disability criteria of SSI. GA programs also vary in the way that benefits are paid: by cash, by rent and food vouchers, or some combination. Some GA programs are time-limited (in Pennsylvania, e.g.). All GA programs have extremely low benefits, however. In California, the most generous GA allowance is in the City and County of San Francisco, where it is about $330 per monthhis in a city where the monthly fair market rent for a studio apartment now exceeds $800.
Probably because of the over representation of single men among GA beneficiaries, many jurisdictions estimate that the prevalence rate of alcohol and drug problems among GA recipients is several times that of the general population. Historically, GA has been the welfare program most accessible to people with alcohol and drug problems. During the heyday of the post-war skid row (see HOMELESSNESS, ALCOHOL, AND OTHER DRUGS), many large cities used some combination of cash, hotel vouchers, and restaurant chits to keep single addicted men (mainly) roughly housed and fed without giving them much money to handle. This system was largely abandoned as the cost of its administration rose. However, with the elimination of addiction as a qualifying impairment in the SSI program, some cities and counties are considering the revival of such arrangements, perhaps to be administered by community-based nonprofits and combined with mandatory treatment and representative payee provisions. Other may adopt Pennsylvania's approach. There, since 1981, diagnosed abusers of alcohol and/or other drugs may receive GA for 9 continuous months on this basis once in a lifetime so long as they are in treatment.
The thrust of recent federal welfare reform has been to rely on fiscal incentives and penalties to encourage welfare recipients to work and state governments to see that they do. As a corollary, welfare eligibility is once again being used as leverage on the behavior of poor people and drinking and drug use have been salient targets of this efforthose complete effects remain to be seen. Given the resources (no small caveat), many state and local General Assistance programs seem inclined to follow suit.
DANZIGER, S., ET AL. (1999). Barriers to the employment of welfare recipients. Ann Arbor, MI: Poverty Research and Training Center, University of Michigan.
EDIN, K., and LEIN, L. (1997). Making ends meet: How single mothers survive welfare and low-wage work. New York: Russell Sage.
GILLESPIE, E., and SCHELLHAS, B. (Eds.). (1994). Contract with America. New York: New York Times Books.
HIRSCH, A. E. (1999). "Some days are harder than hard": Welfare reform and women with drug convictions in Pennsylvania. Washington, DC: Center for Law and Social Policy.
VARTANIAN, T., ET AL. (1999). Already hit bottom: General Assistance, welfare retrenchment, and single male migration. In S. F. Schram & S. H. Beer (Eds.), Welfare reform: A race to the bottom? (pp. 111-127). Washington, DC: Woodrow Wilson Center Press.