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CWLA Testimony
Comments on the Reauthorization of the Temporary Assistance for
Needy Families Program AuthorityDecember 18, 2001
The
Child Welfare League of America (CWLA), representing 1,160 public
and private nonprofit child-serving agencies, offers the following
recommendations regarding the Temporary Assistance for Needy
Families program (TANF). The well-being of children should be the
primary goal of TANF. Our comments emphasize what we see as the
issues most critical to children, youth, and families.
There
is a long historical link between Title IV-A of the Social Security
Act and the child welfare system. The links that existed under Aid
to Families with Dependent Children (AFDC) continue under TANF,
including funding, the families and children served, and the way the
two programs are administered. A significant percentage of families
in the child welfare system receive cash assistance and services
funded by TANF. TANF funds are also used to provide needed supports
to prevent children from ever coming in contact with the child
welfare system.
The TANF program includes the Emergency
Assistance program, formerly under AFDC. These funds were used to
address family emergencies, including situations that addressed the
welfare of the child. The AFDC and now TANF programs have also been
an important source of support for relatives caring for their kin.
TANF, of course, also touches the lives of many children not in the
child welfare system through the funding of cash assistance, child
care, and other services targeted to children.
The 2002 TANF
reauthorization will offer an opportunity to review the impact and
successes of the TANF program. The reauthorization should focus on
ways to improve the services that best address the continued needs
of vulnerable children and families. TANF must remain a core safety
net program for the more than two and a half million families and
five and a half million children currently receiving TANF
assistance. While the nation strives to make sure that there are
fewer families and children dependent on cash assistance, there will
continue to be many who need our continued support. TANF cannot be
simply labeled as a success or failure-its mission will not end. The
TANF program should be structured in a way to help the most
vulnerable children and families through the most difficult of
times.
Purposes of the ActThe TANF program includes four specific
purposes in its preamble. In many instances the purposes of a law or
act may provide historical context regarding what the Congress and
Administration intended at the time of enactment. Frequently, the
purposes of the Act in a public law may never be referenced again
except in instances of a legal case or historical study. The four
purposes of TANF, however, have taken on a significance not normally
assigned to other laws.
The current TANF purposes are likely
to be changed or expanded in the 2002 reauthorization. CWLA is
concerned that the current purposes reference children only in
purpose one, "provide assistance to needy families so that
children may be cared for in their own homes or in the homes of
their relatives." 1 The
other three purposes reference ending dependence on government
benefits; promoting job preparation, work, and marriage; reducing
out-of-wedlock pregnancies; and encouraging two-parent families. The
current four purposes fail to include any connection between the
program and child well-being. All the goals listed are admirable,
but the promotion of work, marriage, two-parent families and even
current efforts to address poverty reduction should all have as
their ultimate goal the improvement of child well-being. This
ultimate goal must take into account how TANF effects all children
including older children and youth.
CWLA recommends that
child well-being be included in the purpose section of the TANF
block grant. It should be made clear throughout the purpose section
that the well-being of children, including older children and youth,
is a primary focus of the program. The current law should also be
clarified to link each of the current purposes to the improved
well-being of the children in families receiving TANF assistance. In
this way, any programs implemented to address these other goals,
such as the promotion of two-parent families or marriage, will have
as their ultimate goal the improvement of the lives of the children
involved.
Outcome MeasuresCurrent law establishes one outcome measure
for the TANF program. The law requires that specific percentages of
a state's TANF caseload meet federally defined work activities.
These requirements vary by family type (single and two-parent
families) and by time period. States may adjust these rates downward
to the extent that the caseload has decreased since 1996.
A
second "unofficial" outcome has been created-the rate at which a
state has decreased its TANF caseload. While declining caseloads do
effect the required work rates, this figure is not a required
outcome. It has, however, been the focus of political leaders,
policy analysts, and the media. CWLA believes this unofficial
outcome is not a true measure. Recent evidence indicates that some
of the families exiting the TANF caseload may not be accessing the
support services they are still eligible for, and in many instances
are entitled to, such as food stamps, Medicaid, and child care.
Caseload reduction statistics alone do not tell us that families are
doing well.
CWLA recommends that the current outcomes for
TANF be redesigned to provide a more comprehensive measure of how
families and children in these families are fairing as a result of
receiving TANF assistance. The law should be amended to include
child well-being as a more accurate measure.
Many
approaches can be taken to re-design or create outcomes for TANF.
New outcomes can still allow great state flexibility, recognizing
state differences such as budget constraints, economies,
populations, and geographic conditions. The range and number of
factors a state can be measured on, or used to measure itself,
should be expanded. These choices should include strategies that
could address poverty reduction, post-TANF job advancement, wage
progression, and access to needed support services including child
care, food stamps, health care, and most important of all, child
well-being. These outcomes can be flexibly defined by states. We
believe it would be an important advancement if a state, even by its
own design, included outcome measures for the well-being of children
in their TANF plans.
TANF and Child WelfareChild-Only Cases One of the
intersections between the child welfare system and TANF is the
"child-only" caseload. The current regulations under TANF allow for
care of children by a relative other than the child's parent,
frequently referred to as "kinship care." This is an important way
for states to serve children in the most appropriate and beneficial
setting.
Child-only cases under TANF, and under the AFDC
program, have always represented a significant percentage of the
overall cash assistance caseload. In 1999, child-only families
represented 29 percent of the total number of families receiving
TANF. This does not mean, however, that all of these families did
not have a parent in the household or that all these families were
kinship care families. In fact, a majority of the child-only
caseload includes a parent. That parent, or parents, may be
ineligible for TANF because of their legal alien status, disability
status under TANF, or because they receive Supplemental Security
Income. In 1999, of the 29 percent of the caseload that was
considered child-only, 30 percent were children in a family where
the head of the household was related but not the parent. These
child-only kinship families represented approximately nine percent
of the total families on TANF.
CWLA recommends that the
flexibility to serve families through TANF be maintained and not
altered in ways that would restrict states abilities to address the
needs of children eligible for child only grants.
Title IV-E Foster Care and Adoption Assistance The
1996 TANF law repealed the eligibility standards for AFDC. However,
TANF requires states to look back to the AFDC rules that were in
existence on July 16, 1996 to determine Title IV-E Foster Care and
Adoption Assistance eligibility.
CWLA recommends the
eligibility link between Title IV-E foster care and adoption
assistance and AFDC be removed. This change will eliminate a costly
administrative burden and will treat all children with special needs
equitably.
TANF Funding LevelCWLA recommends that the TANF block
grant be funded at a level that will allow states to maintain the
capacity and services states had in 1996. The current level of
funding of $17 billion, including bonuses and the supplemental,
should serve as the base block grant. Funding for the TANF block
grant should be adjusted in each of the next five years by the rate
of inflation and population growth.
We reject proposals
that would reduce TANF funding on the premise that the current TANF
caseload has been reduced since 1996. The caseload is lower in some
instances than it was in 1996, but in many cases the families that
had been receiving TANF are now receiving other supportive services
such as job training, transportation, wage subsidies, and child
care. Families receiving these services are not always counted in
the official caseload figures.
States must have a
continuation of TANF funding to continue expansion of family
supports and to provide continued assistance to some families who
need assistance overcoming more difficult barriers to work such as
mental health, substance abuse, and learning barriers.
CWLA recommends that TANF funds that have been a part of
the TANF block grant as a supplement to states should be maintained
in some form. We recommend such a supplement to the TANF block grant
be carefully targeted to assist states with the highest levels of
poverty.
The supplemental grant that was created in 1996
is an important support for states that qualify. However, some needy
states were left out. For example, the current supplemental TANF
grant fails to assist states such as West Virginia. According to the
2001 Kids Count Data Book, 13 percent of that state's
children are in extreme poverty and another 11 percent are in
working poor families. 2
As Congress debates TANF reauthorization in 2002, it will
take place against the backdrop of a recession. This is the first
time since TANF was created that the economy has experienced a
slowdown. As a result, the TANF contingency fund that was created to
help states in times of recession has not been tested. The
contingency fund was based on the economy of the early 1980s and
1990s. As a result, the two triggers - unemployment and food stamps
- that allow a state to access this fund are set too high. A state
must reach a 6.5 percent unemployment rate to access the contingency
fund. From 1995 through the end of the decade unemployment was at
5.5 percent or lower, with the rate at 4.2 percent by late 1999. For
some states, an unemployment rate of 6.5 percent could require the
unemployment rolls to double from their low point of the last five
years. The food stamp trigger is based on food stamp caseloads of
1994 and 1995. It requires food stamp caseloads to increase by 10
percent to access the contingency fund. The crisis in food stamp
enrollment since 1996 would make this an unobtainable target for
many states in a recession.
CWLA recommends that the TANF
contingency fund be maintained and made more accessible to states.
The current triggers in the law are outdated. The unemployment and
food stamp threshold should be lowered to make them more accessible
to states.
State SpendingUnder the 1996 law, states are required to
spend between 75 to 80 percent of what they had spent under the
previous AFDC program (including child care, JOBS, and Emergency
Assistance). This is referred to as a state's maintenance-of-effort
or MOE.
CWLA recommends that the required MOE spending
level for state TANF spending be maintained at the 75 percent to 80
percent level. The MOE requirement should not be weakened by vastly
expanding what is "countable" toward the state spending requirement.
State TANF spending is a vital part of this program.
States currently contribute approximately $10.5 billion a year.
Reducing that total in some instances would place great pressure on
some state and local policy makers to reduce a state's fiscal
commitment to human service spending. Similarly, greatly expanding
what a state can count toward this spending requirement would allow
some states to count current human service spending, thereby
reducing overall state spending on human services.
Use of TANF FundsUnder current law and regulations there is
a great deal of flexibility in how states may spend federal and
state TANF funds. Federal and state TANF funds can have distinct
spending requirements. This flexibility has allowed states to invest
in important family and child welfare supports.
We are
concerned that this same flexibility could be stretched so far that
some states might supplant current state human service spending by
using their federal or state TANF funds. Both of these TANF funding
streams should be used to supplement or expand human services and
not used to supplant or replace state spending on child welfare
services, as well as other programs like child care. The TANF block
grant is intended to help vulnerable families. If it becomes a
method to substitute one TANF dollar for a current state dollar it
will not reach its goal of helping these families and children.
A U.S. General Accounting Office report 3 found,
"supplanting was a common budget practice among the 10 states in our
study." That same report observed that in spite of this fact,
overall spending in various human services did increase. The GAO
report, however, only studied state practices during prosperous
economic times. The ability to reduce state investments by replacing
state general fund dollars with federal TANF funds or required state
TANF funds could have an overall negative impact on support for
human service funding including child welfare services, especially
in times of economic slowdowns and recessions.
CWLA
supports efforts to prevent supplantation and to maintain state
commitments to use TANF funds to expand services to TANF families
included in the official caseload, in transition from TANF, and for
other vulnerable families.
Child Care FundingChild care should be recognized as an
important service for both children and their families. It is a
critical support for families attempting to leave public assistance,
as well as a fundamental support for working poor and middle income
families. Additionally, child care can be an important part of a
child's development and well-being. The reauthorization of the Child
Care and Development Fund (CCDF) must be enacted with this dual
mission to serve both family and child in mind.
Preserving
the level of federal and state spending on TANF is critical to the
continued expansion of child care. In fiscal year 2000, the amount
of TANF funds transferred into the child care block grant or spent
directly out of federal TANF block grant on child care exceeded the
total of federal child care funds available through the CCDF ($3.9
billion in TANF funds compared to $3.5 billion in available CCDF
funds). Additionally, states have invested TANF MOE funds above the
amount of spending required as part of the CCDF block grant. States
have invested state dollars as matching funds to draw down part of
the federal CCDF dollars. If any of these sources of funding are
reduced, child care programs and services will be reduced and
investments in quality initiatives to improve services will be lost.
CWLA recommends that all TANF funding streams be
maintained as a first step to maintaining the current child care
system.
Funding for the CCDF should be increased.
Current estimates indicate that approximately 12 percent of
potentially eligible children are receiving federally funded child
care services. When the 1996 TANF block grant was created, initial
estimates suggested that the child care funding provided would be so
great that states would not draw all the funding for which they were
eligible.
CWLA recommends that the Child Care and
Development Fund be substantially increased. Federal and state CCDF
funding should be increased gradually each year to ensure that every
child eligible for assistance under the CCDF receive assistance
within five years.
In addition to these two important
funding issues, there are several other steps that should be taken
to improve child care access, quality, stability and the workforce.
Creating a more seamless system of care would enhance child
care systems throughout the country. Because TANF is such a
significant resource for funding child care, this method of using
TANF funds can create some unanticipated difficulties or barriers.
TANF funds spent directly out of the block grant (instead of being
transferred from TANF to CCDF) is considered either TANF
"assistance" or "non-assistance." This classification depends on
whether or not a parent is working. An adult receiving child care
"assistance" is subject to time limits and other TANF requirements
even if they are not receiving TANF cash assistance. Additionally,
direct spending of TANF funds on child care does not subject those
funds to the CCDF quality set-aside (4 percent of CCDF funds must be
spent on quality services) and they are not subject to child care
data collection requirements.
CWLA recommends that the
distinctions between CCDF funded child care and TANF-funded child
care be eliminated. Child care funded through TANF should not be
considered "assistance." TANF funds spent on child care should be
subject to the quality set-aside and the same data collection as
CCDF funds.
Under current CCDF regulations, children in
foster care are not an eligible category for child care services
unless a state specifies in its state CCDF plan that the foster care
system is part of the child protection system. A child in a family
that is receiving, or needs to receive, protective intervention is
eligible for child care subsidies if he/she remains in his/her own
home, even if the parent is not working, in education, or in
training. In these instances, child care serves the child's needs as
much as, or more than, the parent's needs. Likewise, child care
services may also be necessary when a child is placed in foster
care. Under current law and regulation of the CCDF, if Lead Agencies
(Child Care) do not include foster care in their definition of
protective services, they must tie eligibility for CCDF child care
of children in foster care to the status of the foster parent's
work, education or training. This requirement is a barrier to the
care necessary for this population of children.
CWLA
recommends that the current option to cover children in foster care
become a requirement for CCDF services. Foster care is an integral
part of the child protective system. This requirement would not
entitle care, but would make these children an eligible population.
In the past, CWLA has supported legislation that would
increase the payment rates that child care providers receive. This
is an important element of creating a stronger child care workforce.
It is also important to efforts to improve the quality of care. We
reaffirm our support to increase the current reimbursement rates for
child care providers. Most states reimburse below the 75th
percentile-meaning that rates are not sufficient to cover the costs
to provide access for 75 percent of child care providers. While the
market rate survey process and rates based on those surveys is not
the perfect payment system, strong efforts must be made to increase
reimbursements so that staff salaries, training, and the quality of
child care services will improve. An additional strategy for
addressing quality is to improve current training of child care
workers.
CWLA recommends an increase in required
reimbursement rates so they eventually reach 100 percent of the
market.
CWLA recommends that the current federal CCDF
requirements for health and safety be expanded to require minimum
training for child care staff in early childhood development.
Social Services Block GrantThe Social Services Block Grant
(SSBG), Title XX of the Social Security Act, has a long history
dating back to 1956. Much of that history has been linked to federal
welfare programs under Title IV-A. Over the years the role and
significance of SSBG has grown beyond just services to families
receiving federal cash assistance. In 1996, the link between Title
IV-A and SSBG was made in a more ominous way-SSBG was drastically
cut in an effort to create budget savings for the entire "welfare
reform" package. The 15 percent cut to SSBG was not based on a
calculation of need, but rather a political compromise. Since the
1996 welfare act reduced the SSBG authorized funding level from $2.8
billion to $2.3 billion, funding has further eroded. The fiscal year
2001 SSBG funding level is only $1.7 billion, far below what is
needed to provide adequate support to the vulnerable populations
served by SSBG-the elderly, children, and people with
disabilities-and far below the level it would be if it had been
adjusted for inflation.
CWLA strongly recommends that
SSBG funding be restored to its pre-1996 funding level of $2.8
billion.
Another change made to SSBG in 1996 was the
ability of states to transfer 10 percent of their TANF block grant
to SSBG. Some states have used this transfer authority to increase
funding to their child welfare system. Preserving this transfer
should not provide a rational for reducing funding in SSBG with the
hope that states would use the TANF transfer to make up for SSBG
cuts. This was not the purpose of allowing the TANF transfers into
SSBG. The TANF transfer should be carried out for the sole purpose
that was intended in the law, "...only for programs and services
to children or their families whose income is less than 200 percent
of the poverty line." 4
CWLA recommends that the ability of states to transfer
funds between the TANF block grant and SSBG be maintained.
Time Limits and ExemptionsOne of the most dramatic
components of the TANF program is the five-year time limit on use of
federal TANF funds. Since 1996, some of the impact of the time limit
has been modified by flexible regulations. States can use state TANF
funds and extend benefits to families that have exhausted their
benefits. States also have the ability to exempt 20 percent of their
caseload from time limits. The full impact of these provisions can
only be tested over time and through periods of economic recession.
We continue to have great concerns and remain opposed to an
approach that ends assistance regardless of need. The inflexible
time limit does not address economic fluctuations and does not
adequately address the needs of individuals. These time limits are
an ineffective strategy and policy for helping families on public
assistance.
CWLA recommends that TANF time limits be
suspended in a time of recession, depression or economic downturn.
At a minimum, the current time limits should be more flexible by
"stopping the clock" - not counting months in which an adult TANF
recipient is working against their lifetime time limit. Adults
should be allowed to earn back time as a result of work.
The current flat 20 percent exemption means that as TANF
caseloads go down so do the number of families a state can exempt.
In good economic times the families remaining out of work and a part
of the caseload may be the most difficult to move into work. Twenty
percent of a shrinking caseload may not be enough to cover all the
families that should be exempted from the time limits and work
requirements.
CWLA recommends that the current 20 percent
hardship exemption be more flexible to adapt to changing caseloads.
A smaller caseload may actually require a higher level of exemption
because the remaining families may include adults who would be the
most difficult to place in employment.
Teen Pregnancy PreventionBonus to Reward Decreases in
Illegitimacy The 1996 Act created a bonus to reward states
for a "net decrease in out-of-wedlock" births. A few states have
qualified for the bonus while the overall out-of-wedlock birth rate
has increased. State TANF offices are eligible for this incentive
fund based on the reduction of out-of-wedlock birthrates for the
entire population, a population that may have little if any contact
with state TANF offices or the services they provide.
The
findings to the 1996 TANF law include numerous statistics on
out-of-wedlock birth rates and in particular focuses on teenage
births. The findings cite numerous statistics on the negative
consequences of births to teens who are not married. They also link
teen and adolescent births to higher use of cash assistance. It is
clear that a major focus of the findings is a reduction in teen or
adolescent births. This focus is not misplaced. Adolescents who
experience out-of-wedlock births do have a higher incidence of cash
assistance use, school dropout rates, lower job skills, and
additional out-of-wedlock births. There are important programs and
state efforts that address these challenges and in recent years
genuine progress has been made. The current bonus, however, does not
address this population of adolescents.
CWLA recommends
that the TANF bonus, the "bonus to reward decrease in illegitimacy,"
be re-focused to exclusively address the adolescent population.
CWLA also recommends that funds awarded to the top
five states in reducing the out-of-wedlock birth rates for the
adolescent population use those funds not as general TANF dollars,
as they do now, but rather be required to use these funds to
reinvest in teen pregnancy prevention efforts.
Abstinence-Only Education The 1996 Act made
$50 million in federal funds available each year to support
abstinence-only education programs that preclude information about
contraception. In order to be funded, a program cannot undertake an
education program that is inconsistent with the eight-point
definition of abstinence education set forth in the law. All states
except one have utilized these funds. Over the past five years
funding for abstinence-only education has expanded beyond the $50
million per year authorized in the 1996 law. Two other federal
sources, the Adolescent Family Life Act (AFLA) and the Special
Projects of Regional and National
Significance-Community-Based-Abstinence-Education (SPRANS-CBAE)
program, have also made money available.
Unfortunately,
research on federally funded abstinence-only projects will not be
finalized until after reauthorization. However, there is some
available research on sexuality education. A review of evaluations
of abstinence-only education and programs that included information
about contraception by the National Campaign to Prevent Teen
Pregnancy found that "there do not currently exist any
abstinence-only programs with reasonably strong evidence that they
actually delay the initiation of sex or reduce its frequency."
5
The report only included evaluations that met a very high level of
rigor. There is some evidence that particular abstinence strategies
appear to delay the onset of sexual activity. However, this good
news is tempered by negative health consequences for some youth. For
example, a "virginity" pledge - to abstain from sex until marriage -
delays intercourse on average by nearly 18 months. However, when
pledgers did initiate sexual behavior, they were less likely than a
comparison group to use contraceptives, and thereby were at greater
risk for sexually transmitted infections and pregnancy.
It
is important that adolescents be taught that abstinence is the best
way to avoid pregnancy and sexually transmitted infections. However,
this evidence suggests that abstinence-only education does not work
for everyone. Many adolescents will choose to be sexually active,
and it is important to provide them with access to information about
contraception, decision-making skills, and sexual health.
Evaluations of programs that combine abstinence education with
contraceptive information find that they can help delay the onset of
intercourse and increase use of contraception. U.S. Surgeon General
David Satcher adds to this analysis in the report Call to Action
to Promote Sexual Health and Responsible Sexual Behavior.
6
He states that informing adolescents about contraception, "does not
increase adolescent sexual activity, either by hastening the onset
of sexual intercourse, increasing the frequency of sexual
intercourse, or increasing the numbers of sexual partners."
CWLA recommends the continuation of research examining
the positive and negative outcomes of teen pregnancy prevention
initiatives, including abstinence-only education programs. In the
absence of strong evaluations of abstinence-only education programs,
it is important to carefully consider why teen pregnancy has dropped
and the impact of abstinence-only and other sexuality education in
achieving this outcome. There is a need for any evaluation to
examine all strategies addressing the problem of teen pregnancy,
including comprehensive sexuality education, abstinence-only
education, and family planning.
CWLA recommends that
the Congress create a "Teen Pregnancy Prevention Block Grant" to
provide funds to states and local entities for teen pregnancy
prevention initiatives and programs. By combining the various
multi-sources of funding currently available, this block grant would
allow states the necessary flexibility to determine for themselves
which initiatives work best in meeting their state's specific teen
pregnancy prevention needs.
Minor Parent Living
Arrangement The 1996 law prohibits a state from spending TANF
federal funds on assistance to an unmarried minor, custodial parent
unless the teen lives with a parent, legal guardian, or other adult
relative-subject to limited exceptions that reflect that some minor
parents live independently in order to avoid abusive environments.
Federal rules do not require states to report on the number of
minors who are denied TANF assistance because of this provision.
Caseworkers may be unaware that alternate living
arrangements could be made to make the mother and her child eligible
for assistance. As a result, some minor mothers may be "turned away
at the door" if they are not living at home. Additionally, some
minor mothers may not apply for assistance because "word on the
street" about the law is that they must be living "at home." For
some minor mothers this is not possible or safe.
CWLA
recommends that Congress consider adding funds for training and/or
technical assistance to the states in order to ensure that
caseworkers inform minor mothers of their eligibility for TANF
assistance.
CWLA further recommends the establishment
of a federal "transitional eligibility" period to allow minor teen
parents to come into compliance with the rule.
A key
issue for states to consider is who should conduct the assessment of
the minor's living arrangement. It is important to provide a safe,
supportive environment for the minor parent and child(ren) to live
and develop, whether that environment is in the minor's home, the
home of a relative, or an alternate living arrangement such as a
"second chance" home.
CWLA supports funding for "second
chance" homes so that supportive settings can be provided to young
parents in need.
State Plan InformationThe 1996 law allows a great deal of
flexibility. This has resulted in public assistance systems that are
very different from state to state in terms of benefits, programs
and services covered. Much of this information on state TANF
programs is not included in the state TANF plan. HHS publishes some
state data in its annual report to Congress. While this information
can explain some aspects of each state program, it is not complete.
It is also not timely. While the 1998, 1999 and 2000 reports were
released in August of the following year, information from 2001 has
yet to be released. TANF data and information needs to be more
complete and more readily available to state and local policymakers,
associations and families receiving these services.
CWLA
recommends that state TANF plans include greater detail on benefits
and services provided through TANF, as well as information on how
benefit levels, including cash benefits, are calculated by the state
submitting the plan.
ConclusionAs the TANF policy debate advances and specific
reauthorization proposals are considered, the Child Welfare League
of America looks forward to continuing to work with the
Administration, lawmakers, and others to focus the TANF program on
the well-being of children.
References
- Social Security Act [42 U.S.C. 601], Title IV-A, Sec. 401.
- 2001 Kids Count Data Book: State Profiles of Child Well-Being
(2001) Baltimore, MD: Annie E. Casey Foundation.
- Welfare Reform: Challenges in Maintaining a Federal-State
Fiscal Partnership, GAO-01-828 (August 10, 2001) Washington, DC:
United States General Accounting Office.
- Social Security Act [42 U.S.C. 601], Title IV-A, Sec. 404.
- Kirby, D., Emerging Answers: Research Findings on Programs to
Reduce Teen Pregnancy, (2001) Washington, DC: National Campaign to
Prevent Teen Pregnancy.
- The Surgeon General's Call to Action to Promote Sexual Health
and Responsible Sexual Behavior (July 9, 2001) Washington, DC:
Office of the Surgeon General, U.S. Department of Health and Human
Services.
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