Improving child support enforcement for children receiving SSI

Less than half of all children who receive Supplemental Security Income (SSI) benefits and live in a single-parent home receive child support services. Although filing for child support is a condition of eligibility for income assistance programs such as Temporary Assistance for Needy Families (TANF), it is not a condition of eligibility for SSI benefits. Requiring single custodial parents applying for SSI on behalf of their children to pursue child support payments might result in more children on SSI receiving child support, and since the Social Security Administration (SSA) excludes one-third of child support when determining benefit amounts, increased receipt of child support would enhance the financial well-being of SSI children. Improving access to data on child support would enhance the integrity of the SSI program by reducing overpayments to children receiving child support. This article looks at the child support provisions in SSI and other means-tested programs and discusses policy options for improving receipt of child support and access to related data. Requiring cooperation with child support enforcement agencies would be consistent with the philosophy that the SSI program should serve as a program of last resort. Whenever possible, both parents should take primary responsibility for their children. While such a requirement has the potential to improve the financial status of children receiving SSI, factors such as their low-income status and their involvement with the TANF program raise questions about how much those children will actually benefit from such a requirement. Even if many additional children do not receive child support, the requirement demonstrates SSA's dedication to the stewardship of the SSI program. However, if custodial parents fail to comply with the requirement, children may be worse off as a result of the requirement. SSA should carefully pursue a requirement to induce cooperation while protecting children to the greatest extent possible. Improving access to child support data would enhance the integrity of the SSI program by reducing overpayments to children receiving child support. Given the reality of limited administrative resources as well as the apparent difficulties of gaining access to the needed child support data, SSA must decide which data matches to pursue and which requirements enhance the program enough to justify the additional resources. Although the options discussed in this article may be chosen independently, there are important interactions to consider. For example, although a requirement to pursue support might result in more children receiving child support, SSA would still rely on parents to report that income unless it was able to gain better access to child support data. Implementing the option to require cooperation with child support enforcement (CSE) agencies could improve verification of income from child support if field offices developed better communication with local CSE offices. However, by itself, it would not have as great an effect on overpayments as would having direct access to child support data. In a 1999 report, the General Accounting Office acknowledged that the potential benefit reductions would be offset by the cost for SSA to administer a child support cooperation requirement and by the costs to the CSE programs to provide services. The report suggested that the goals of promoting parental responsibility and increasing the income of children receiving SSI should be pursued despite the costs. Requiring cooperation may increase administrative costs by $6 million over 5 years and may result in program savings. Gaining access to data may be more expensive and may not prevent overpayments to the same extent as other data-matching workloads on which SSA has placed a priority. SSA should continue to work with federal child support enforcement and with individual states to develop a cost-effective way to identify child support income.     

Caring, Controlling, Contracting and Counting: Governments and Non-profits in Community Services

Performance measurement and contracting out are central elements of new public management systems. At first sight these elements seem necessarily connected for reasons of accountability. However, for some kinds of services, implementation of conventional performance measurement systems may exacerbate tensions in contracting out. Using a case study of child and family welfare services in NSW, this paper shows that differences in the missions and operating modes of public and non-government community service providers are thrown into sharp relief by performance measurement, when observed from the perspective of practitioners in service-providing agencies. Practitioners perceive that their priorities in service provision differ sharply from those of the department funding their activities — and seeking to measure their performance. These findings pose challenges for the 'partnership' model now prevalent in community services provision.     

Reducing child support debt and its consequences: Can forgiveness benefit all?

As child support debt owed nationally persists at enormous levels, both noncustodial parents and the custodial families who are not receiving support suffer significant hardships, and states are forced to expend greater resources on collection and enforcement efforts. This paper presents findings from an evaluation of a demonstration program developed to help noncustodial parents with large child support debts reduce their debt while simultaneously increasing child support paid to families, through gradual forgiveness of arrears conditional on payment of current child support obligations. The evaluation employs a randomized experimental design, nonexperimental analyses using propensity score matching and multilevel modeling techniques, and focus groups and follow‐up interviews. Results show a pattern of effects that suggests individuals responded to the program as intended. State‐ and family‐owed child support debt balances decreased for program participants, and participants paid more toward their child support obligations and arrears and made more frequent child support payments. The study findings suggest promise for the effectiveness of this program model in reducing child support debt burdens and in increasing families' receipt of child support, and they also point to ways in which the implementation of the program might be improved. © 2011 by the Association for Public Policy Analysis and Management.     

Short Term Placements: An Exercise in Organisational Culture Exchange

This article explores the process of setting up some short (one week) and longer (six month) exchanges between two government departments on the Central Coast of NSW, with the express purpose of assisting organisational change through this form of professional development. The article outlines the program's objectives and achievements, as well as the evaluation results and benefits to the two departments taking part. The exchanges all occurred within a context of services for children and families, but the concept of the exchanges and their educational and organisational benefit have much broader application to any instance where a number of government departments are being asked to collaborate or work more closely on issues. On the Central Coast of New South Wales, the Area Health Service and the Department of Community Services have undertaken an organisational cultural exchange experiment through short placements between various sections of the two government departments and also some longer term secondments. The purpose was to increase the understanding and skills of professionals within the two agencies to understand each other's roles better, and to also achieve better client outcomes for the often shared client group of the two departments. The exchanges have all taken place in services that work with children and families and were organised with a child protection focus in mind, although the program is transferable to other contexts.     

Improving large-scale implementations by applying research and data analysis: A case study on First 5 LA's implementation of PCIT in Los Angeles County

This paper presents the case of First 5 LA's 5-year countywide implementation of the Parent–Child Interaction Therapy (PCIT) program. Enthusiasts of PCIT point to it as a high-quality parenting program with the potential to positively influence child behavior, reduce recidivism into the child welfare system, and increase caregiver's confidence and self-esteem. In September 2012, First 5 LA, an independent County agency in Los Angeles that advocates on behalf of parents with young children, began a $20 million countywide implementation of PCIT. The collaborative effort between First 5 LA, the Los Angeles County Department of Mental Health, the Los Angeles County Department of Children and Family Services, and the University of California, Davis demonstrates the role that research and data analysis can play in improving large-scale implementations. The authors of this paper were contracted to conduct an evaluation of the implementation of the countywide PCIT program, and preliminary outcomes were analyzed after the first round of data collection in early 2015. This paper will discuss this case and provide examples of how research and data analysis were used effectively to make key improvements to the design and implementation of the program. The paper will then discuss bureaucratic challenges and constraints with the collaborative use of research and data. The paper will conclude with some recommendations on how research and data can effectively be used to influence policy implementation in large-scale implementations involving collaboration among multiple organizations.     

Medicaid matters: children's health and Medicaid eligibility expansions.

In the late 1980s, a series of federal laws were enacted which expanded Medicaid eligibility to more of the nation's children. States had a great amount of discretion in how fast and how far these expansions were implemented. As a result, there was great variation among the states in defining who was eligible for the program. This variation provides a rare opportunity to disentangle the effect of Medicaid from a child's socioeconomic status. Using data from the National Health Interview Survey, we address whether the Medicaid expansions improved the health and functional status of children. Econometric models were developed using fixed-effects regressions, and were estimated separately for white, black, and Hispanic children. White children experienced statistically significant reductions in acute health conditions and functional limitations. Black and Hispanic children showed some evidence of improved health conditions and functional status, but this evidence is inconclusive in the study sample. This may be due to differences in their access to appropriate health services or to the smaller sample size of minorities in each geographic area. The findings are also relevant to the implementation of the Children' Health Insurance Program (CHIP), the latest federal effort to expand access to health care to poor and near poor children. In many states, CHIP is being implemented in whole or in part through further Medicaid expansions.     

Rediscovering Implementation: Public Sector Contracting and Human Services

There is vast literature on how to implement public policies, with endless case studies emphasising a few key lessons. The drive to contracting in the public sector raises familiar threats to coherent program implementation, and adds those of control and incentives. Contracting fragments program responsibility among multiple contractors, and separates policy agencies from service delivery contractors. It raises questions about political control and accountability, and the prospect of gaps between intention and outcome. This paper 'rediscovers implementation' by reviewing the practical difficulties of constructing public-private relationships which can deliver quality human services. After considering broad arguments about the efficacy of contracting, the paper turns to the provision of human services by examining the contracting out of welfare services and the Job Network. Our argument is modest: that public sector contracting fails if the challenges of implementation are not addressed explicitly, since service delivery through the private sector can falter for exactly the same reasons as traditional public bureaucracies.     

Administrative Easing: Rule Reduction and Medicaid Enrollment

Administrative burden is widely recognized as a barrier to program enrollment, denying legal entitlements to many potentially eligible individuals. Building on recent research in behavioral public administration, this article examines the effect of voluntary state reductions in administrative burden (administrative easing) on Medicaid enrollment rates using differential implementation of the Affordable Care Act. Using a novel data set that includes state-level data on simplified enrollment and renewal procedures for Medicaid from 2008 to 2017, the authors examine how change in Medicaid enrollment is conditioned by the adoption of rule-reduction procedures. Findings show that reductions in the administrative burden required to sign up for Medicaid were associated with increased enrollments. Real-time eligibility and reductions in enrollment burden were particularly impactful at increasing enrollment for both children and adults separate from increases in Medicaid income eligibility thresholds. The results suggest that efforts to ease the cognitive burden of enrolling in entitlement programs can improve take-up.     

JOBS Implementation in 1991: The Progress of Ten States

The Job Opportunities and Basic Skills Training Program (JOBS),enacted by the Family Support Act of 1988, provides an arrayof services intended to increase the earning capacity and labor-forceparticipation of welfare recipients. Because the law gives statesdiscretion in creating JOBS programs, a ten-state, three-yearstudy of JOBS implementation is under way. During federal fiscalyear 1991, the first year in which all states must operate JOBS,most of the ten states made incremental changes to the programsthey had in place before JOBS. They designed their programsto be flexible enough to cope with uncertainty about the typesand availability of service components. As a group, they spentenough to draw down 43 percent of their federal JOBS funds.To obtain education, training, and employment services, statewelfare agencies are contracting with many organizations. Moststate welfare agencies are also obtaining resourcesfrom otheragencies without payment. Although states generally implementedJOBS with little fanfare, they all planned to meet the federalmandates for program participation and targeting of expendituresin 1991.     

SOCIAL PROGRAM INNOVATION AND DISSEMINATION: A STUDY OF ORGANIZATIONAL CHANGE PROCESSES

The dissemination of social program innovations that have been demonstrated to be effective through rigorous evaluation is an important issue. The classical dissemination framework emphasizes the position that programs implemented with fidelity to the original model are most likely to produce the positive outcomes demonstrated in the model's evaluation phase. However, critics suggest that local programs that are extensively modified are more likely to meet local goals and, therefore, are more likely to be sustained within the organization. The present research examined the implementation, effectiveness, and routinization of seven innovations replicated in a nationwide sample of organizations. The innovations were diverse in both content and implementing context and were located in a variety of sites, including schools, courts, prisons, police departments, and social service agencies. The results suggest that the innovations were replicated with acceptable levels of fidelity to the disseminated program models, and that higher-fidelity implementations tended to be more effective than those implemented with lower fidelity. The implications of the findings for social program dissemination policy are discussed and the authors propose an expansion of Berman's contingency model of innovation dissemination.     

Coordination in Youth Affairs: The Politics of Non-Decision-Making

One of the components associated with the widely heralded shift to 'new managerialism' in the public sector has been an increased emphasis on coordination between government departments as a means to enhance effective service provision. This article examines the capacity for coordination to fulfil this objective. Drawing upon a case study of coordination in youth affairs in Western Australia, the article examines the process by which the coordination mechanisms become enveloped in the 'politics of non-decision-making'. By this is meant that a set of power relationships create tensions at a number of levels — between commonwealth and state government agencies; between state government agencies and within individual agencies — which act to prevent effective decisions from being taken. The implications of this case study for the capacity of 'new managerialism' to produce effective policy outcomes in complex social policy areas is highlighted. Evidence from this study suggests that, in an era of restricted resources and heightened competition within the public sector, agencies are pushed to more clearly define their boundaries.     

Federal labor protetons and the privatization of public transit

Federal transportation officials assert that labor protections in the Urban Mass Transportation Act inhibit the propensity of local transit agencies to contract with private firms for services. The authors present results from a survey of a large sample of transit managers and econometric analysis to support their conclusion that labor protections do not appear to reduce the incidence of contracting. The labor protections, however, may be costly to transit management in other ways. The authors recommend actions, aside from repeal of labor protections, to increase contracting by local transit agencies.     

The Medicaid Mandates of the 1980s: An Intergovernmental Perspective

Medicaid, the health care program for the poor, has undergone significant changes in the last fifteen years. Many of those changes relate to the intergovernmental nature of the program. Medicaid is jointly operated, with the federal and state governments sharing program costs. Despite a set of program guidelines dictated by the federal government, states have traditionally had substantial latitude in Medicaid decisions. However, a series of developments in the 1980s led to increasing constraints on state Medicaid discretion, including federal mandates to expand Medicaid coverage. This article examines the inception and effectiveness of the Medicaid mandates from the perspective of interstate equity of health care services for poor families.     

The Evaluation of Performance in the Mexican Federal Government: A Study of the Monitoring Agencies' Modernization Process

An initial assessment of the Mexican government’s implementation of the Model for the Performance Evaluation of Internal Control Organizations (MIDO) can reveal its actual influence on the organizational culture of those agencies. MIDO began in 2003 as an instrument to transform all federal monitoring agencies into effective, performance‐driven organizations. It seeks to modify the behavior of internal control organizations in order to shift their rigid focus on control to a more flexible perspective. The idea is to allow them to take co‐responsibility for the performance of the agencies they supervise. The author exposes a contradictory and paradoxical result of the program’s implementation: the “net organizational effect” is different from MIDO’s stated objective. The internal control organizations are not only adopting the discourse of performance, but also they are adapting it to fit their own purposes while keeping their traditional function of supervision intact. They have not internalized the co‐responsibility culture, as MIDO proposes, despite accepting the discourse of performance evaluation.     

State Agencies’ Use of Administrative Data for Improved Practice: Needs,Challenges, and Opportunities

Growing interest in the use of administrative data to answer questions around program implementation and effectiveness has led to greater discussion of how government agencies can develop the necessary internal data infrastructure, analytic capacity, and office culture. However, there is a need for more systematic research into how states find different pathways and strategies to build administrative data capacity. Drawing on interviews with almost 100 human service agency staff and their data partners, the authors examine the realities of administrative data use. They summarize the experiences of data users in order to address two main challenges: limited analytic capacity and challenges to linking or sharing data resources. The article concludes by examining a range of approaches that government agencies take to improve data quality and capacity to analyze that data.     

Income, assets, and health insurance: economic resources for meeting acute health care needs of the aged.

In this article, the authors use data from the Survey of Income and Program Participation (SIPP) to examine the relationship between economic resources and acute health care needs among the aged. The circumstances of individuals who rely on Medicare as their only form of health insurance are considered in detail because they are potentially more vulnerable when faced with health care expenses. Particular attention is given to the amount of family income and personal contingency assets held by this group and the level of out-of-pocket liability for acute care they might have been expected to face in 1984. The authors point out that their research findings would be strengthened by linkage of a more current SIPP data set to Medicare program records and the development of Medicaid eligibility simulation capability in the SIPP context.     

The three faces of evaluation

Program evaluation can be used for three purposes: to learn about a program's operations and effects, to control the behavior of those responsible for program implementation, and to influence the responses of outsiders in the program's political environment. Most agencies fail to take full advantage of all three faces of evaluation. They begin their evaluation programs too late; they assign evaluation responsibilities to staffs which lack the requisite skills; or they yield to temptations to distort or suppress evaluation findings. The case of the evaluation of civil service reform demonstrates how these multiple purposes can be pursued together with constructive results. It also suggests several lessons of more general relevance.     

Toward a physician payment policy: Evidence from the Economic Stabilization Program

Concern over the rising cost of medical care has focused policy attention on methods of paying physicians. Unfortunately, limits placed on fees paid by public medical care financing programs, Medicare and Medicaid, adversely affect those programs' primary objective: making office-based physicians' services available to the poor and the elderly at affordable prices. This suggests that a second policy instrument, controls on physicians' private charges, may be needed. The Economic Stabilization Program (ESP) provides the only recent U.S. experience with a system which constrained both physicians' private charges and public payments. Using Medicare and Medicaid claims data for a large sample of California physicians, we simulate what physicians' private charges and supplies of services to Medicare assignment and Medicaid patients would have been in the absence of ESP. The simulations suggest that without ESP, private charges would have been higher and the quantities of services provided to poor and elderly patients lower than were actually observed. We believe, therefore, that the ESP experience supports the argument that controls over both public and private fees are needed in order to simultaneously contain costs of and maintain access to physicians' services by Medicare and Medicaid beneficiaries.The research for this paper was supported by Contract No. 600-76-0054 from the Social Security Administration, USDHEW. We wish to thank our colleagues Judith Feder, John Holahan, William Scanlon, and Judith Wagner for their helpful comments. James Bluck provided excellent research assistance. The findings and opinions expressed in this paper are solely those of the authors, and do not necessarily reflect the positions of either The Urban Institute or The Department of Health, Education, and Welfare.     

Rational fantasies

This is a case study of how (and why) the National Institute of Education used program evaluation and systematic planning, both orchestrated by guidelines and rules, for managing the implementation of one broad-aim educational innovation. The story has two main themes. The minor theme concerns uncertainty—about the goals of the innovation, how to develop them, and, indeed, NIE's survival. The major theme concerns NIE's attempt to use rational management strategies—evaluation and long-range planning—to reduce the uncertainties. It was hoped that guidelines would shape the developers' evaluation and planning efforts to produce information which would satisfy a variety of audiences—NIE top managers, Congress, oversight bureaus, the academic community. The case study will show that this use of rationality and control to direct the innovation's implementation produced a number of problems. These included invalid information, unsurfaced conflict, information which the development agencies could not share with NIE, and an unrealistic notion at NIE about what was happening in the field. Rather than producing more accurate information for managerial decision-making, then, the guidelines produced information that was far from the truth. This in turn made the development and implementation of the innovation more confused, and rather than reducing uncertainty, increased it all around.     

Ministerial Leadership and Endorsement of Bureaucrats: Experimental Evidence from Presidential Governments

Scholars have debated what constitutes effective ministerial leadership with respect to administrative competence versus political influence. The authors contribute experimental evidence to this debate through a unique survey design of endorsement experiments. Using original data from 949 national civil servants in South Korea, this article examines civil servants’ assessments of ministerial leadership in three central dimensions of public management: internal management, interbranch coordination, and policy formulation/implementation. Further, existing variation in the characteristics of agencies is used to test whether such variation induces systematic differences in civil servants’ responses. Findings show that that civil servants’ attitudes toward ministerial leadership are asymmetric in nature. Ministers with civil service backgrounds are endorsed in all three dimensions, whereas ministers with legislative backgrounds receive increased support only for interbranch coordination skills. The levels of support for ministers with different backgrounds also vary across agency types. This analysis has implications for public management practice and agency control in presidential governments.