Wednesday, December 19, 2012

Low-Income People Want Access to Medicaid

How do low-income people feel about not having health insurance? It is “scary,” and people feel “vulnerable” and “worried” according to a new report titled “Faces of the Medicaid Expansion: Experiences of Uninsured Adults who Could Gain Coverage.” These words will ring true for practitioners who work with low-income noncustodial parents, especially in Black and Latino communities where people are much more likely to not have access to affordable health insurance and healthcare.

The Kaiser Commission on Medicaid and the Uninsured recently conducted focus groups in four cities to learn what low-income uninsured people think about the possibility of becoming newly eligible for Medicaid in 2014 as a result of the Affordable Care Act (ACA), also known as Obamacare. The focus groups were held in: Cincinnati, Ohio; Houston, Texas; Las Vegas, Nevada; and Tampa, Florida. These four states “currently have very limited Medicaid eligibility” for adults with dependent children, and do not offer Medicaid to non-disabled adults without dependent children — so-called “childless adults” which include the majority of typical noncustodial parents.

As a result of the US Supreme Court’s decision regarding the constitutionality of the ACA, each state’s policymakers have the option to expand Medicaid to all low-income adults or not. Many states’ governors have indicated they will expand Medicaid eligibility. However, several states’ policymakers have expressed significant opposition, particularly where black people are more likely to gain new access to health insurance, according to CFFPP’s analysis in our August 2012 Policy Briefing. Of the four states in the Kaiser focus groups, Nevada has indicated it will expand Medicaid to all low-income adults, but the governors of the more-populous states of Florida and Ohio remain undecided, and the governor of Texas has said he will not expand Medicaid. Black and Latino people in Florida and Texas are especially likely to not have health insurance.

Practitioners who work with low-income noncustodial parents can play a particularly important role by helping to educate parents about upcoming changes to Medicaid eligibility and dispelling misconceptions about the program that parents may have. According to the Kaiser report, most focus group participants were “unaware that the law will provide new health coverage options” and some “were skeptical that they could ever qualify for Medicaid since they have never been eligible in their adult lives.”

If people had access to health insurance through an expansion of the Medicaid program, “nearly all” of Kaiser’s focus-group participants said they would enroll in Medicaid. Additionally, low-income people in the focus groups said they “would seek preventive care … get a check-up and establish a relationship with a primary doctor” as well as seek care for ongoing and/or chronic physical and mental health issues.

CFFPP welcomes comments and questions regarding this post, either below, on CFFPP's Facebook page, or by email to Nino Rodriguez, program and policy specialist, at nrodriguez@cffpp.org.

Thursday, November 15, 2012

Healthy Masculinity Action Project Offers Trainings for Town Halls

The Healthy Masculinity Action Project (HMAP) is a two-year effort “designed to raise the visibility of healthy masculinity and build a new generation of male leaders across the country who model non-violent, emotionally healthy masculinity, serving as positive change-makers in society.” Organizations, practitioners, and community members can become involved by forming action teams and organizing local town halls. HMAP offers training and resources to help make locally-organized events happen. A first step is to review the Healthy Masculinity Action Guide, and then contact info@healthymasculinity.org for technical assistance.
The HMAP initiative is a national partnership of six organizations, led by Men Can Stop Rape, and including the National Resource Center on Domestic Violence, Men Stopping Violence, Coach for America, the Women of Color Network, and A CALL TO MEN. The town hall meetings will happen in the spring of 2013, followed by a listening tour and the production of a documentary film about the project.
CFFPP welcomes comments and questions regarding this post, either below, on CFFPP's Facebook page, or by email to Nino Rodriguez, program and policy specialist, at nrodriguez@cffpp.org.

Thursday, October 18, 2012

Supportive Questions Can Identify and Mobilize Parents’ Strengths and Resources

Low-income noncustodial parents may struggle to pay child support, while also trying to support themselves and others who may depend on them, such as other children, partners, family, and/or dependent adults. Such parents, in turn, may also receive support—financial, in-kind, or emotional—from people in their family, circle of friends, and/or community. For social service providers working with low-income parents to achieve their goals, identifying and mobilizing parents’ and families’ networks of support can be vital so that parents are able, in turn, to support other people that depend on them, especially their children.

Two supportive inquiry techniques can be helpful for practitioners working with noncustodial parents: relational questions, and solution-focused questions. Relational questions build on motivational interviewing techniques that many social workers and case managers already use. Solution-focused questions are based on techniques from solution-focused brief therapy and counseling. A useful summary of these inquiry techniques, with references for further reading, has been developed for community supervision professionals: “Implementing the Family Support Approach for Community Supervision” by Tracy G. Mullins and Christine Toner, published in 2008 by Family Justice (now a program at the Vera Institute of Justice), and the American Probation and Parole Association (APPA). Given that many low-income noncustodial parents who owe child support potentially face sanctions similar to people under community supervision—including the threat of incarceration—this publication may be useful to social service providers working with low-income parents. See particularly Sections III and IV, pages 14 to 46.

The following are examples of the kind of relational and solution-focused questions that can be used to highlight and activate resources in a parent’s network of support:
  • Relational Questions:
    • “Whom do you help?”
    • “Who asks you for help?
    • “If things change in your life, who will be the first to notice?”
  • Solution-Focused Questions:
    • “Were there times recently when this problem did not occur?”
    • “On a scale of 1 to 10, how are things right now? What would have to happen for you to move up just one step?”
    • “I know things are tough now, but I am really interested in just how you have survived. How have you kept going in the face of these problems?”
    • “What will be different in your life, 12 months from now, that will tell you the problem is solved?”
CFFPP welcomes comments and questions regarding this post, either below, on CFFPP's Facebook page, or by email to Nino Rodriguez, program and policy specialist, at nrodriguez@cffpp.org.

Friday, October 5, 2012

Racial Stereotypes Can Affect Case Management Decisions

Social service providers, including those working with low-income noncustodial parents, should be attentive to how case management decisions impacting their clients can be affected by bias due to racial stereotypes. A body of research from the last 20 years has shown that people of color are more negatively affected than white people in a variety of contexts—as job seekers, medical patients, and retail customers—when a person has a “marker” or cue that is consistent with a negative racial stereotype, for example if an African American man has a criminal record. This type of negative bias has been confirmed in welfare-to-work programs as well, based on research that interviewed case managers and reviewed administrative data.

Joe Soss, Richard Fording, and Sanford Schram published a book, “Disciplining the Poor,” in 2011, that gathers findings from many of their studies on social services for low-income people. The results of their research on how racial bias affects sanction decisions in case management are summarized in a freely-available presentation: “Sanctions and Welfare Reform: The Florida Project.” Although their focus was on welfare-to-work programs, their findings likely apply to other social service settings where clients can be penalized for not following program rules. This may especially be true in programs serving noncustodial parents that track attendance, job-search activities, work hours, and child support paid. Noncustodial parents of color in such programs, particularly African Americans, may be harshly affected if racial stereotypes influence case managers’ decisions. Sanctions in programs serving low-income noncustodial parents can in turn often lead to a punitive response from the child support enforcement system and/or the probation, parole, and criminal justice system.

The following are findings from the work of Soss, et al, that case managers working with noncustodial parents should be aware of:
  • “Minority clients, by contrast [to white clients], are vulnerable to the attachment of discrediting, stereotype-consistent markers, such as having multiple children and having received a prior sanction.” In other words, a black client who has a trait that confirms a negative stereotype, such as a criminal record or having children with multiple partners, is more likely to be treated more harshly than a white client with a similar trait.
  • Case managers of all races and ethnicities were just as likely to exhibit bias against minority clients.
  • “More experienced case managers…are significantly less likely to impose sanctions” on any clients, whether white or minority.
CFFPP welcomes comments and questions regarding this post, either below, on CFFPP's Facebook page, or by email to Nino Rodriguez, program and policy specialist, at nrodriguez@cffpp.org.

Thursday, September 20, 2012

Voting Resources for People With Criminal Records

“Can I vote if I have a criminal record?"

This is a question that some low-income noncustodial parents are likely to ask social service providers as the national elections approach. The laws that determine whether a person with a criminal conviction can vote vary greatly from state to state. Two states—Maine and Vermont—have no crime-related voting restrictions, allowing people to vote while incarcerated in state prison. All other states do impose voting restrictions, some of them very severe, and at least 12 states ban people for life from voting in certain circumstances. While state laws typically prohibit people with felony convictions from voting, some states also prohibit people who have been incarcerated for certain serious misdemeanors.

Although poll taxes were outlawed as unconstitutional in 1966, at least eight states require people who have been convicted of a felony to pay any fines, fees or restitution before their voting rights can be restored. These states include: Alabama, Arizona, Connecticut, Florida, Iowa, South Carolina, Virginia, and Washington. This is an additional financial burden for low-income noncustodial parents who are also struggling to support their children and families.

Two online resources can help noncustodial parents who have a criminal record determine their eligibility to vote. Both provide nationwide information about relevant state laws and regulations. The Institute for People With Criminal Records’ Felons Voting webpage includes summaries of each state’s laws and has links to state voter registration agencies. ProCon.org’s State Felon Voting Laws webpage includes information about both felony and misdemeanor restrictions as well as links to state statutes and voting restoration applications. 

CFFPP welcomes comments and questions regarding this post, either below, on CFFPP's Facebook page, or by email to Nino Rodriguez, program and policy specialist, at nrodriguez@cffpp.org.

Friday, September 7, 2012

Fathers Advisory Council Contributes to Program Development

By Jayde Bennett, Research Intern

A recent article highlights the importance of noncustodial fathers contributing their perspectives to the design of programs that will serve other fathers like themselves. “Fatherhood Intervention Development in Collaboration With African American Non-Resident Fathers,” by Wrenetha Julion, et al., was published in the online version of Research in Nursing & Health. The article states that “because interventions developed in partnership with African American fathers not residing with their children are virtually nonexistent, existing interventions fail to address the multiple factors that constrain these fathers’ positive involvement with their children.” Moreover, “existing programs do not address the unique needs of African American fathers who are unmarried, no longer romantically involved with their children’s mothers, and non-resident.”
 
Lack of proximity to their children, societal and contextual barriers, lack of personal and interpersonal resources, and negative societal portrayals of “deadbeat dads” are a few of the many factors that impede African American fathers’ involvement with their children. In an effort to highlight the importance of African American noncustodial fathers’ input in the development of fatherhood intervention programs, Wrenetha A. Julion, Susan M. Breitenstein, and Donald Waddell sought to “engage community members in a Fathers’ Advisory Council to develop an intervention to help fathers surmount constraints to involvement with their children.” The Fathers Advisory Council participated in a series of 13 focus groups in which they “reviewed, gave meaning to, refined, and extended the findings from previous meetings in order to facilitate the design of a linguistically, culturally, and contextually appropriate fatherhood intervention.”

The program developed, Building Bridges to Fatherhood, “aimed at increasing fathers’ involvement with their preschool aged children (2-5 years), improving mother father relationships, and improving both father and child outcomes.” The program was divided into three core units, as agreed upon by the Fathers Advisory Council: “(a) Fatherhood, aimed at bolstering fathers’ knowledge and confidence; (b) Communication, aimed at helping fathers effectively interact with their children’s co-parent; and (c) Parenting, focused on nurturing and guiding young.”

Fathers Advisory Council members also had the opportunity to share their own struggles and challenges as noncustodial African American fathers. Some individuals described not wanting to be seen as a “good-time daddy”—which they defined as the type of father that only engages in “‘fun activities’ with his children and ‘seldom provides discipline and guidance’”—while others “expressed disdain with the concept of ‘time-outs,’” as they considered this discipline style to be “based upon White middle class parenting practices” and thus irrelevant to African American fathers.

The Council members agreed that take-home handouts would be a helpful resource for fathers involved in the program to share with other people who also care for their children, such as mothers and family relatives. Council members said that weekly practice assignments would be helpful in encouraging individuals to share their experiences and what they learned from their time with their children. The Council members were also “particularly proud of a handout that was developed to portray ‘keeping your cool,’” which meant that “despite being angry and frustrated with their children’s mothers, fathers needed to be able to remain calm so that they did not jeopardize their opportunities to spend time with their children.”

In addition, Fathers Advisory Council members agreed that the intervention program should “address the challenges of reestablishing relationships with children after release from correctional settings.”

When asked to reflect on their participation in the development of a program for African American fathers, Council members touched upon three major themes: (1) Personal benefit;  (2) a sense of altruism they felt in helping others like themselves; and (3) valuing group meetings as a “viable means of giving and receiving support” from others with similar concerns.

The lessons learned through these focus groups provide valuable insights into the view of noncustodial African American fathers that extend “beyond stereotypical depictions of uninvolved, uninterested, financially negligent, and selfish men.” The men involved in the Fathers Advisory Council were dedicated to helping others like themselves. The input and involvement of Council members illustrate the importance of collaboration with members of the intended audience, as their contributions proved invaluable to the research and overall program development. The Building Bridges to Fatherhood program has been used in a small pilot study for testing for future acceptance and feasibility. Once the efficacy and sustainability of the program is established, the Building Bridges to Fatherhood intervention program will be able to address the needs of African American noncustodial fathers in a more expansive manner.

CFFPP welcomes comments and questions regarding this post, either below, on CFFPP's Facebook page, or by email to Nino Rodriguez, program and policy specialist, at nrodriguez@cffpp.org.

Thursday, August 16, 2012

Federal Child Support Performance Incentives Can Inform Advocacy for Noncustodial Parents

If you are a practitioner who works with low-income noncustodial parents, an understanding of how your local state’s child support enforcement agency receives federal funding may help you advocate for parents in certain circumstances.

State child support enforcement agencies receive a significant portion of their funding from performance-based incentives that measure various aspects of each state’s child support program. For example: the ratio of current child support collected to the amount owed; and the percentage of paternities established for children with child support cases born to unmarried parents. The federal “Child Support Enforcement FY 2010 Preliminary Report” has a summary of the formulas used to determine these incentive payments to states.

The federal incentive payments that states receive account for anywhere from 7% to 54% of each state’s child support enforcement agency budget, according to a 2007 report from the Congressional Research Service. The national average is 25%. In fiscal year 2010, the combined federal incentive payments to the states amounted to $504 million.

Because of how these federal incentive payments are calculated, it may be possible to favorably advocate for noncustodial parents in the following circumstances:
  • Downward modification of a current support order to a more appropriate amount. The federal formulas provide an incentive to state enforcement agencies to decrease the amount of current child support that a parent owes, especially when this is likely to increase the amount that the parent actually pays. A training document for child support workers in Pennsylvania called “Federal Incentives – Myths & Facts” makes this point clearly: “One large non-paying order can have a tremendous impact.” In other words, smaller orders help local child support agency’s bottom line, whether that support is paid or not, by improving the ratio of child support owed to child support paid. This circumstance is especially common among low-income noncustodial parents.
  • Closing paternity and order-establishment cases quickly if the custodial parent cannot be located, or if the child has reached the age of emancipation. These circumstances will be less common, but practitioners should be aware that child support enforcement has an incentive to close these cases because it will improve performance for federal funding. The Pennsylvania training cited above notes that “many states have experienced substantial success… through case clean-up and case closure.”
CFFPP welcomes comments and questions regarding this post, either below, on CFFPP's Facebook page, or by email to Nino Rodriguez, program and policy specialist, at nrodriguez@cffpp.org.