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By Athena Mandros

The growing payer, health plan, and care coordinator interest in incorporating social factors into reimbursement models and social services into service systems, is being driven by the move to measure and pay for that elusive concept – “value.” Like many elements in the U.S. health care system, access to social services varies widely by state. In my previous article, Where Does Your State Rank In Consumer Cash Assistance?, the differences in TANF cash benefits were striking. While the measures of consumer access to cash benefits are many, just a couple examples illustrate the issue. The states with the highest and lowest per capita spending on cash assistance were the District of Columbia ($91.44), New York ($88.49), Indiana ($3.55), and Texas ($2.39). The states with the highest and lowest monthly cash assistance benefits were Alaska ($602), New York ($573), Arkansas ($154), and Mississippi ($140).

But cash benefit statistics just paint part of the picture of TANF assistance. There are a wide range of non-cash benefits, which can include:

Work-related activities – Individuals receiving TANF cash benefits are required to participate in programs that either help them procure a job or ready them for the job market. This can include job searching, job-related skills, and education activities.

Transportation – TANF funding can be used for vouchers or reimbursement for public transportation. Some states may also reimburse for private transportation.

Child care – States can use TANF funding for subsidized child care provided to individuals participating in work-related activities or to low-income individuals with jobs. Most often, the consumer chooses a child care facility and the TANF program reimburses the program directly. Depending on the consumer’s income, they may be required to pay “co-payments.”

Prevention of out-of-wedlock pregnancy – States may use TANF dollars to provide services and activities related to pregnancy prevention among single, low-income women. This can include transferring funds to the department of public health to run sex education programs in schools, evidence-based programs to reduce teenage pregnancy, and pre-pregnancy family-planning services.

Two-parent family formation and maintenance – Funds can also be used for services, activities, and programs intended to promote two-parent families, such as: promoting responsible fatherhood, homemaker/caretaker services, and family life and parenting education. For a profile of how one state is using TANF funds for two-parent family formation and maintenance, check out Why do welfare funds go to marriage counseling?

States may also spend TANF dollars on other activities, including administration and systems, and individuals development accounts.

When spending on TANF non-cash benefits is ranked per capita, the District Of Columbia ranks the highest at $162.42 per person, followed by Hawaii, Rhode Island, Michigan, and Connecticut. The state that spends the least on per capita non-cash benefits is Idaho at $9.64. Other states with lowest per capita spending on non-cash benefits include Illinois, South Dakota, Missouri, and Virginia.

States Spending Of TANF Funding On Non-Cash Benefits: The States With Highest & Lowest Per Capita Spending

State

Per Capita Spending

Dollars Spent On Non-Cash Benefits

Percent of Spending On Non-Cash Benefits

District Of Columbia

$162.42

$107,170,913

62%

Hawaii

$120.74

$171,486,615

75%

Rhode Island

$103.77

$109,470,635

79%

Michigan

$93.29

$925,077,227

78%

Connecticut

$91.66

$329,497,653

82%

Virginia

$15.13

$125,966,797

60%

Missouri

$14.39

$87,236,385

65%

South Dakota

$13.91

$11,868,460

43%

Illinois

$10.16

$130,921,900

89%

Idaho

$9.64

$15,759,469

77%

What non-cash benefits do states with the highest per capita spending utilize? All states, as required by federal regulations, use their TANF funds for work-related activities. Most also use their funds for transportation, two-parent family formation, and the prevention of out-of-wedlock pregnancy.

Selected Spending On Non-Cash Benefit Types By States With The Highest Per Capita Spending
Prevention Of Out-Of-Wedlock Pregnancy Two-Parent Family Formation Child Care Transportation Work-Related Activities
District Of Columbia $1,434,018 $0 $0 $1,006,596 $34,642,863
Hawaii $16,832,637 $2,422,172 $0 $1,305,985 $96,970,976
Rhode Island $0 $0 $2,647,066 $208,771 $10,261,560
Michigan $466,491,070 $33,658,697 $0 $0 $62,872,734
Connecticut $56,853,330 $20,980,667 $3,059,105 $0 $17,691,042

In the states with the lowest per capita spending on non-cash benefits, the make-up of spending is quite different than states that spend the most. Fewer states use their TANF funds for the prevention of out-of-wedlock pregnancy, two-parent family formation, and transportation. However, the states with the lowest spending for capita are more likely to use funds for child care or assistance under programs that preceded TANF.

Selected Spending On Non-Cash Benefit Types By States With The Lowest Per Capita Spending
Prevention Of Out-Of-Wedlock Pregnancy Two-Parent Family Formation Child Care Transportation Work-Related Activities
Virginia $0 $52,057,951 $0 $0 $52,057,951
Missouri $0 $0 $0 $0 $23,599,561
South Dakota $0 $0 $802,914 $0 $4,107,946
Illinois $0 $0 $0 $4,041,828 $21,986,125
Idaho $93,596 $5,749,982 $57,851 $93,596 $5,749,982

Understanding what non-cash, TANF benefits are available in the state you’re operating in, is important. For provider organizations serving consumers with complex conditions, it’s essential to understand the full scope of social supports that are available – cash assistance is one direct benefit for consumers living in poverty; but even in those states that spend very little on cash assistance, there are other programs that can be beneficial. Generally these benefits have more liberal requirements than cash benefits, and some, such as transportation and child care, may be useful to consumers in need of services and supports in the community.

Comparing spending on TANF and non-cash TANF benefits in your state can help you to determine the resources that are most likely to be available and whether or not they will be helpful to your consumers. For more on the TANF program and its role in helping consumers, be sure to check out: What Income Assistance Is Available To Consumers Through TANF & How Does It Vary By State?: An OPEN MINDS Market Intelligence Report.


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