Doctors Join Welfare Debate; 'Finding Common Ground' Research Looks at Reform Policies' Impacts on Health of Poor Women, Children

6/7/2002

From: Chrissy Baldino, 202-833-6023 or 703-966-8309 (cell) for Finding Common Ground; chrissy.baldino@bh.ddb.com

WASHINGTON, June 7 -- Researchers from two leading medical institutions have joined forces to bring doctors' voices into the welfare reform debate for the first time.

This initiative, Doctors Speak Out About Welfare Reform has been built around the five-year research project of Finding Common Ground, a collaborative project between Columbia University's Mailman School of Public Health and Boston Medical Center. Doctors Speak Out spotlights Finding Common Ground's findings about the struggle of families with chronically ill children under the stringent requirements of the 1996 Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) and makes recommendations covering welfare reform policies to relieve these burdens.

Over a dozen medical organizations, including the American Academy of Pediatrics, the American College of Obstetrics and Gynecology, and the National Medical Association have endorsed Doctors Speak Out as a means of drawing attention to the health needs of poor families. Together these organizations are creating a dialogue that adds a new angle to the welfare debate.

"The families of chronically ill children have unique challenges that are exacerbated by current policies," says Wendy Chavkin, MD, MPH, interim chair of the Heilbrunn Department of Population and Family Health at the Mailman School of Public Health at Columbia University. "If you're a single mother with a child who requires repeat hospitalization, you're penalized for making the health of your child your first priority. It's next to impossible for you to hold onto a self-sustaining job. Welfare policy should make allowances for these families."

Finding Common Ground has based its Doctors Speak Out recommendations on national data generated by other organizations and their own primary data collection efforts in several U.S. cities. The findings reveal that the well-being of chronically ill children and their families is compromised by current welfare reform policies emphasizing work.

According to co-Principal Investigator Paul Wise, MD, MPH, director of social and health policy at Boston Medical Center, "The health community has been a missing voice in the welfare reform debate until now. `Doctors Speak Out' adds the critical child health perspective to the discussion."

KEY FINDINGS

Doctors Speak Out highlights several notable findings:

-- Families with chronically ill children face serious barriers to self-sufficiency, including difficulties sustaining employment, problems obtaining health insurance and increased prevalence of maternal health problems

-- Current TANF policies impose strict work requirements that conflict with recipients' ability to care for chronically ill children; state diversion practices also deter many families with chronically ill children from applying for much needed benefits

-- The plight of families with chronically ill children is exacerbated by the overall decline in Medicaid and Food Stamps to eligible families in need

-- Adequate data to monitor families with chronically ill children, including both appropriate health indicators and relevant outcomes, are not currently mandated by the PRWORA

POLICY RECOMMENDATIONS

"Doctors Speak Out" calls for several federal-level solutions to address the challenges of families with chronically ill children. Among these policy recommendations are expanded exemptions from work requirements and medical leave, extensions of benefits for families with chronically ill children, and federally subsidized child care for children with special needs, addressing medical care requirements. In addition, the project recommends including information about the health of welfare recipients and leavers in federal reporting requirements.

Finding Common Ground and the "Doctors Speak Out About Welfare Reform" initiative is a collaborative effort between researchers at Columbia University's Mailman School of Public Health and Boston Medical Center. The project is dedicated to developing a public health agenda that integrates the healthcare needs and rights of women and children, and to reframing public discourse so that advocacy for one is seen to benefit both.