January 1999
DHHS, Administration for Children and Families (ACF)
Interest in job retention and advancement among welfare recipients was heightened among government officials, social service providers, academics, and the general public when Congress enacted Public Law 104-193 on August 22, 1996. The Personal Responsibility and Work Opportunity Reconciliation Act changed the focus of the welfare system from income support to work. There has been considerable research to date on a number of welfare-related issues including the duration of welfare spells, characteristics that are associated with long spells, and the impacts of demonstration programs that attempt to help women avoid dependency. But despite numerous evaluations, there is limited information available on the effectiveness of programs and services designed to help welfare recipients retain and advance in jobs. To help build knowledge about how best to help welfare recipients sustain employment and advance in the labor market, the Administration for Children and Families (ACF) issued planning grants to 13 states. The Employment Retention and Advancement Project is designed to help states implement and refine their employment, retention, and advancement strategies. At the request of ACF, The Lewin Group compiled a summary of the research on the employment patterns of welfare recipients and services that have attempted to help recipients remain in jobs and advance in the labor market.
Client Area: Federal Government
Expertise Area: Employment, Training, and Workforce Development
January 1999
DHHS, Administration for Children and Families
This report contains the proceedings of a meeting held November 12-13, 1998 on the Administration for Children and Families' (ACF) Employment Retention and Advancement grant program. Attending the meeting were representatives of the ACF, the 13 states that received grants for the Employment Retention and Advancement project, and The Lewin Group, along with other staff from the Department of Health and Human Services, researchers, and members of the welfare community. The purpose of the meeting was to share information on each state's demonstration plans and the latest research regarding retention and advancement.
Client Area: Federal Government
Expertise Area: Employment, Training, and Workforce Development
July 1998
DHHS, Office of the Assistant Secretaryfor Planning and Evaluation (ASPE)
This report examines the relationships among health insurance, employment, and program participation of people with disabilities. An empirical analysis is conducted of the expansions in the income threshold for the Supplemental Security Income (SSI) work incentive program established by Section 1619 of the Social Security Act. This act allows many working SSI recipients to maintain Medicaid eligibility even after their incomes rise above the level that makes them ineligible for SSI payments. The empirical results indicate that some SSI recipients who work don't earn as much as they could in order to limit their Social Security earnings and stay below the 1619(b) threshold. The numbers and types of disabled people who adjust their earnings vary depending on their age, sex, medical condition, and the income threshold of each state. A separate analysis is also performed using data from the Survey of Income and Program Participation and National Health Interview Survey to generate estimates of the relationships between employment, health insurance, and program participation for a broader population of persons with disabilities. The findings show a large difference in the program participation and employment patterns of persons with less severe disabilities compared to those with severe disabilities.
Client Area: Federal Government
Expertise Area: Health Reform
May 1998
DHHS, Office of the Assistant Secretaryfor Planning and Evaluation (ASPE)
Lewin contact: Lisa Alecxih
This report assesses the statistical issues involved in the production of state-level estimates related to health and welfare issues from three national surveys: the Current Population Survey (CPS), the Survey of Income and Program Participation (SIPP), and the National Health Interview Survey (NHIS). With the devolution of many welfare programs from the Federal Government to the states, there is a strong interest in being able to track the health and welfare of the population in each state. This would allow for examination of the effect of various state welfare initiatives.
Client Area: Federal Government
Expertise Area: Income Security
May 1998
National Insitute on Drug Abuse, National Institute on Alcohol Abuse and Alcoholism
The Lewin Group developed estimates of the costs of drug and alcohol abuse in 1992 for The National Institute on Drug Abuse (NIDA) and the National Institute on Alcohol Abuse and Alcoholism (NIAAA). The study estimated the economic cost to society from alcohol and drug abuse at $246 billion in 1992. Alcohol abuse and alcoholism cost an estimated $148 billion, while drug abuse and dependence cost an estimated $98 billion.
Client Area: Federal Government
Expertise Area: Chronic Disease / Cost of Illness, Mental Health and Substance Abuse
March 1998
DHHS, Health Resources and Services Administration
The organ donor community has been active in its attempts to increase organ donation but needs to establish a methodology to evaluate the success of its activities. The study cites three essential elements of a successful evaluation: rigorous evaluation methodology, tested performance indicators, and an evaluation activity that relates to the ultimate goal of the program. The report provides an overview of evaluation methods, a discussion of performance indicators, and examples of evaluation elements for selected types of organ donation activities.
Client Area: Federal Government
December 1997
DHHS, Office of the Assistant Secretary for Planning and Evaluation (ASPE)
The U.S. Department of Health and Human Services commissioned The Lewin Group to develop a comprehensive data strategy to support its goal of obtaining better public health infrastructure data at Federal, state, and local levels. This report summarizes the proposed strategy for collecting infrastructure-related data. For the purposes of this study, the public health infrastructure is defined as the systems, competencies, relationships, and resources that enable performance of the essential services of public health for every community. The work consisted of three major activities: an assessment of information needs about the public health infrastructure;the identification and evaluation of existing data sources; and the development of alternative strategies for responding to identified "gaps" in available infrastructure-related data.
Client Area: Federal Government
November 1997
Presidential Advisory Commission on Consumer Protection and Quality in the Health Care Industry
The study estimates the benefits to consumers and administrative costs to government and providers under Consumer Bill of Rights. Consumer empowerment, the ability to tailor plan choice to personal need, and quality improvement were found to be major benefits. Costs of information disclosure were estimated to be between $0.59 and $2.17 per insured person per month. Costs of external appeals were estimated at $.003 to $.07 per person per month.
Client Area: Federal Government
October 1997
DHHS, Office of the Assistant Secretaryfor Planning and Evaluation (ASPE)
Summary: Health insurance access is an important factor in decisions to work or participate in public programs for single mothers, older workers and the elderly. Many DI and SSI beneficiaries say they are deterred from working for fear of losing their benefits. Recent legislative proposals are designed to address these issues through expanded eligibility for government provided health insurance programs.
Client Area: Federal Government
Expertise Area: Health Reform, Income Security
October 1997
DHHS, Office of the Assistant Secretary for Planning and Evaluation (ASPE)
The study describes the unique role of public health laboratories (PHLs) in a changing market. The report, written for PHL directors and state and federal policy makers, concludes that PHLs must be flexible as they work to retain a key role in the traditional public health mission-providing safety net services and promoting the national health. The report says also that significant federal leadership is required to promote an effective role for PHLs in a fluid and changing environment.
Client Area: Federal Government
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