Welfare parents risk cuts Preschool checkups must be proved, or payment is less

December 18, 1992|By Laura Lippman | Laura Lippman,Staff Writer

Thousands of welfare clients, their checks already reduced by the state's budget crisis, could lose more money next month if they can't prove that their preschool children received annual medical checkups.

The final phase of Maryland's welfare reform goes into effect Jan. 1, as the state joins a growing nationwide movement to make clients more responsible.

Under Maryland's reform plan, responsibility is defined by two specific actions -- getting checkups for preschoolers and ensuring that older children attend school at least 80 percent of the time. State officials maintain that the program is not intended to punish, just to encourage clients to send their children to school and make sure they are healthy.

But the disincentives -- losses of $25 per child per monthly check -- outstrip the possible rewards, $20 annually for each checkup. There is no cash incentive for attending school.

On Wednesday, the state began mailing warnings to those who have not met the requirements. The state's approximately 80,000 welfare households already have received several reminders over the past eight months, by mail and in person. Yet, almost 10 percent have not complied with the reform plan, according to the Department of Human Resources.

Kathy Cook, director of Human Resources' office of police development and administration, said she had expected more people to respond.

"We've been working with them since April," Ms. Cook said. "We sent mailings. And every client had at least one conversation with a social worker."

Officials said the paperwork created by the new requirements is simple. Forms were mailed to the clients for their physicians to fill out as proof of checkups. A second set of the forms is being sent out this week.

But Baltimore welfare advocate Annie Chambers said her office, Operation Life, has received a steady stream of complaints from disgruntled or confused clients.

"They want medical records for the mother. They want medical records for the children," she said. "Women are coming in every day. We get calls every day."

The changes also affect all welfare families in public housing. These households, about 16,000 statewide, will lose $45 a month in benefits, although part of that loss will be offset by an increase in food stamps.

This cut is an attempt to remedy the disparity that exists between families in subsidized housing, who pay an average of $154.61 in rent, and those in private-sector housing, where rents often exceed the average welfare benefit of $359.

While Maryland is the first state to tie preventive health care to welfare benefits, the attendance aspect of its program is not new. Wisconsin tried a similar tack, dubbed "Learnfare," and ran into unexpected problems. Some women were penalized unfairly because school systems issued flawed attendance reports. In other cases, older children traded their attendance for material goods or greater freedom.

Maryland plans to use an automated master file to double-check attendance. A mother will be asked to provide documentation only if her social worker receives a report that a child has been truant.

Other states' reform plans include changes such as allowing women to marry while on welfare, or giving clients a chance to work without losing all benefits. Carolyn W. Colvin, secretary of the Department of Human Resources, said in an interview last month that she would like to try these reforms in Maryland.

But the department cannot offer more incentives, she said, because the reform plan is not expected to cut costs.

"The problem is money," she said. "What we're doing was not designed as a cost-containment action, so it doesn't really produce any savings that can be used for those rewards."

Maryland was the second state, after Wisconsin, to receive a federal waiver to experiment with Aid to Families with Dependent Children, a New Deal-era entitlement program now synonymous with "welfare."

Ms. Colvin and Gov. William Donald Schaefer announced the changes in November 1991, when the number of individuals on AFDC topped 220,000, up from 180,000 just two years earlier. The rolls have stayed at that level during the past year.

It was originally expected that welfare clients would be receiving significantly more money when the reforms went into effect. For example, a family of three was to have received $401 a month as of Jan. 1, up from $377.

On Sept. 30, in response to the state's budget deficit, the governor and the Board of Public Works rolled back checks to the 1988 levels, the largest cut they could make under federal regulations. A family of three now receives $359 a month, and there are no immediate plans to reinstate the cut.

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