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1 Welfare Reform: Implications for TANF Recipients with Disabilities Webcast on Welfare and Disability January 21, 2004 Eileen P. Sweeney Center on Budget.

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Presentation on theme: "1 Welfare Reform: Implications for TANF Recipients with Disabilities Webcast on Welfare and Disability January 21, 2004 Eileen P. Sweeney Center on Budget."— Presentation transcript:

1 1 Welfare Reform: Implications for TANF Recipients with Disabilities Webcast on Welfare and Disability January 21, 2004 Eileen P. Sweeney Center on Budget and Policy Priorities 820 First St, NE, Suite 510 Washington, DC fax

2 2 I.What we know about people with disabilities and TANF II.The ADA and Section 504 apply III.What’s happening in Washington? IV.Talking about TANF and disability

3 3 I. What we know about people with disabilities and TANF The Urban Institute’s national survey of current welfare recipients found: 48 percent had either poor general or mental health, with 25% reporting poor general health and 35% reporting poor mental health. Overall, for 32 percent either their health limited their work or they were in very poor mental health, with 18% reporting that their health limits work and 22% reporting very poor mental health.

4 4 There is a high incidence of people with mental impairments among parents on and off of TANF National information from the Urban Institute over one-third of current recipients scored low on a standard mental health scale while close to one-fourth scored in very poor mental health approximately one-fifth of former recipients who were not working scored very poor on the mental health scale, placing them in the bottom 10 percent nationwide

5 5 The General Accounting Office has confirmed that high numbers of parents on TANF have disabilities 44 percent of TANF recipients reported having physical or mental impairments, a proportion almost three times as high as among adults in the non-TANF population 38 percent of TANF recipients in 1999 reported an impairment severe enough that the individual was unable or needed help to perform one or more activities, such as walking up a flight of stairs or keeping track of money and bills.

6 6 GAO confirmed high numbers of parents with mental impairments on TANF “Considering both severe and nonsevere impairments, 29 percent of TANF adults reported a mental impairment, such as frequent depression or anxiety or trouble concentrating.” GAO notes that self-reporting probably results in underestimates of mental impairments and “hidden” impairments such as learning disabilities.

7 7 GAO report: Welfare Reform: More Coordinated Federal Effort Could Help States and Localities Move TANF Recipients with Impairments Toward Employment, GAO-02-37, October 2001, available at under November 1, 2001

8 8 In a second report, GAO provided some additional information: Recipients with impairments are half as likely to exit TANF as recipients without impairments. People with impairments are less likely than people without impairments to be employed after leaving TANF. Some receive SSI, while others do not.

9 9 Overall, 44 percent of TANF recipients had impairments or were caring for a child with impairments, compared with 15 percent of the non-TANF population. Fifteen percent of TANF families with an adult recipient had a child with a disability, compared to three percent of the non-TANF population. Eight percent of TANF families had both an adult and a child with disabilities. (Among non-TANF families, this figure is one percent.)

10 10 In their first month after leaving TANF, 36 percent of leavers with impairments reported having no personal or household earnings, or SSI, compared with 23 percent of leavers without impairments.

11 11 GAO report: Welfare Reform: Outcomes for TANF Recipients with Impairments GAO , July 2002, available at

12 12 MDRC findings Based upon research in four large urban counties: Cuyahoga County, OH; Los Angeles, CA; Miami-Dade, FL; and Philadelphia, PA

13 13 MDRC: Compared with national samples, women in the survey sample had substantially higher rates of personal health and mental health problems and children’s health problems.

14 14 On a scale indicating the number of potential health barriers to employment (out of eight specific health problems), three out of four women in the survey sample had at least one such barrier, and 40 percent had two or more health problems.

15 15 MDRC also found that the data “do not fully capture the severity of the health- related hardships the families face.” In addition, about 20 percent of current welfare recipients in the survey sample indicated that they had one or more children with a health problem.

16 16 MDRC report: Denise F. Polit, Andrew S. London, John M. Martinez, The Health of Poor Urban Women: Findings from the Project on Devolution and Urban Change, May Changepage.htm Changepage.htm

17 17 The Urban Institute has found that “[p]erhaps the strongest predictor of not participating in work activity is the presence of multiple obstacles.” Loprest and Zedlewski, Current and Former Welfare Recipients: How Do They Differ? Urban Institute, Discussion Paper 99-17, November 1999

18 18 Some parents with disabilities have been sanctioned off of TANF As many as one-fourth to one-half of parents who are no longer receiving TANF due to a sanction for failure to comply with the state’s welfare rules indicate that they were unable to comply with the rules because of their disability, health condition, or illness. The studies suggest that others who face learning disabilities or who have a low IQ find it difficult to understand and comply with the program’s rules.

19 19 More from MDRC: “Negative experiences with the welfare agency were more prevalent among women with health problems.” “Welfare recipients with multiple health problems and with certain health problems (notably, physical abuse, risk of depression, having a chronically ill or disabled child) were more likely than other recipients to have been sanctioned in the prior year.”

20 20 “Welfare leavers with multiple health problems were more likely than other women who had left welfare to say that they had been terminated by the welfare agency rather than that they left of their own accord.”

21 21 Studies in Utah and Delaware suggest that parents who face learning disabilities or who have low intelligence find it difficult to understand and comply with the program’s rules. One-third of the families who were sanctioned in Utah, thereby losing their family’s entire cash benefit, cited an individual health condition as the reason for their failure to participate; one-fifth cited mental problems.

22 22 In Iowa, one-fifth of parents who were placed in the state’s limited benefit plan a second time – the plan in which families that have not complied with program rules receive a reduced benefit (akin to a sanction) – said that their disability/health contributed to their being returned to the sanction status, while almost three out of ten cited their lack of understanding of program rules. Chronic health conditions identified as contributing to being placed in the program included drug addiction, manic depression, and chronic asthma.

23 23 A study conducted by the Minnesota Department of Human Services found that sanctioned families were four times as likely as the caseload as a whole to have a substance abuse problem, three times as likely to have a family health problem, twice as likely to have a mental health problem, and twice as likely to have been a recent victim of domestic violence.

24 24 Children in sanctioned families A study in three cities – Boston, Chicago, and San Antonio – found that children in sanctioned families are more likely to have behavior problems and emotional problems than children in other families on welfare or who never received welfare.

25 25 The researchers concluded: “We need to attend much more carefully to the plight of families experiencing welfare sanctions. Sanctioned families have a number of characteristics that serve as markers of concern for the healthy development of children and youth. As such, state and federal governments should explore options for identifying and reaching out to the most disadvantaged and high-risk families involved in the welfare system.”

26 26 “Possible policy options include assistance to bring families into compliance with rules before they are sanctioned, closer monitoring of sanctioned families, and the provision of additional supports, such as mental health services, academic enrichment, after-school programs, and other family support services.”

27 27 Source: Chase-Lansdale, Coley, Lohman, et al., Welfare Reform: What About the Children? Welfare, Children and Families: A Three-City Study, Policy Brief 02-1, Johns Hopkins University, pdf

28 28 A medical study issued in 2002 additional information about young children in sanctioned families. Study looked at the impact of sanctions on the health of infants and toddlers. Study was done in six US cities from 8/98 through 12/00: Baltimore, Boston, Little Rock, Los Angeles, Minneapolis, and Washington, DC.

29 29 Households with children aged 36 months or younger whose welfare benefits had been terminated or reduced by sanctions had odds of being food insecure 1.5 times as great as comparable households whose benefits were not decreased. Young children in families whose welfare benefits had been terminated or reduced by sanctions had 1.3 times the odds of having been hospitalized since birth.

30 30 Conclusion: “Terminating or reducing benefits by sanctions, or decreasing benefits because of changes in income or expenses, is associated with greater odds that young children will experience food insecurity and hospitalizations.” Source: Children’s Sentinel Nutrition Assessment Program, The Impact of Welfare Sanctions on the Health of Infants and Toddlers, July 2002, Arch Pediatr Adolesc Med, Vol 156, , available at:

31 31 TANF programs serve many families with severe disabilities — policies need to be responsive to this important fact At the beginning of welfare reform, “work first” approach People labeled as “hard to serve” — welfare offices had simply exempted people in the past and then often ignored them. Same folks that others — particularly organizations that have been working with people with disabilities — knew how to help to gain greater independence.

32 32 Over time, state TANF programs have tended to modify their “work first” approaches Recognize that there are many people with barriers, including disabilities, on TANF See people cycling back onto the rolls Know that many who leave TANF are not working and do not receive SSI Realize that many who are being sanctioned do not understand how to comply, the consequences of failing to comply, or have the ability to comply

33 33 In addition to pre-sanction review mechanisms, some states have been improving screening and assessment earlier in the process Those that have done this — like Iowa — have found that fewer people are out of compliance and fewer people are being sanctioned.

34 34 II. States and counties are legally obligated to comply with the federal civil rights laws Section 504 and the Americans with Disabilities Act (ADA) apply Lest there be any question, the 1996 TANF law specifically incorporates the key federal civil rights laws.

35 35 Common goals of TANF and ADA/§504 dovetail Success in complying with the ADA and Section 504 can create exactly the types of results Congress hoped for in TANF

36 36 HHS OCR Guidance on TANF and the ADA/ §504 ·Available at: ·Worth reading, re-reading, and sharing – provides helpful context for thinking about people with disabilities in TANF; also helpful information about best practices

37 37 Two key principles: Individualized treatment Effective and meaningful opportunity

38 38 Individualized treatment Requires that individuals with disabilities be treated on a case-by-case basis consistent with facts and objective evidence Individuals with disabilities may not be treated on the basis of generalizations and stereotypes.

39 39 Effective and meaningful opportunity Individual with disabilities must be afforded the opportunity to benefit from TANF programs that is as effective as the opportunity the TANF agency affords to individuals who do not have disabilities, and must also be afforded “meaningful access” to TANF programs.

40 40 To implement these two principles, there are 3 key legal requirements: Ensure equal access through the provision of appropriate services Modify policies, practices and procedures to provide such access Adopt non-discriminatory methods of administration

41 41 When thinking about the rules, it is important to remember that they apply not only to a person with disabilities who is the caretaker relative, but also to family members with a disability.

42 42 These rules should be infused into everything the TANF agency, its agents, and contractors do.

43 43 These rules apply no matter what position the person holds: Policy maker/policy implementer Office manager/supervisor Case worker Receptionist Security officer

44 44 The person who designs the state’s or county’s notices and signage Vocational specialist Trainer/trainee Contract procurement specialist

45 45 And, also more globally in how the office functions: In the contents of notices In the signage about rights In the terms included in contracts with private providers or other public agencies to provide services In how the agency thinks about each and every policy it has that affects the people the agency serves and their families.

46 46 The important role of reasonable accommodations Must happen at different levels — built into policies Staff must have the ability to design accommodations on a case-by-case basis, taking into account the individual’s disability.

47 47 Contractors must know that they can make the changes needed to serve the person with a disability — and that the state or county will pay them. Important to consult with the person to see what he or she thinks will work — what he or she needs to succeed.

48 48 What kinds of steps are reasonable accommodations? Allowing an individual to do work activities part- time, or during flexible hours. Providing support services such as equipment, a job coach, or tutor. Placing a person in “inactive status” if necessary to allow the individual to participate in health, mental health, or substance abuse treatment or rehabilitation services, if the individual chooses to do so.

49 49 Providing the individual with work activities in a specific work environment (including indoor work, work in a quiet area) that enables the individual to participate in work activities Providing the individual with particular types of jobs or work activities that are consistent with the individual’s limitations, such as work that requires limited standing or lifting, or that involves limited contact with the public.

50 50 Clients must be allowed to do things at different times/places or for a different amount of time when needed because of a disability. Some examples: –If the person has a disability and can’t come to the agency for the application interview, a home visit must be provided. –Allowing a client to reschedule a fair hearing when there is good cause (including a disability-related reason)

51 51 –If a person needs longer to complete an education program due to his/her disability, extend the time to allow the person to enter into and/or complete the program. –A person can ask for an application on someone else’s behalf (i.e., someone who can’t come to the office for a disability-related reason) and the agency must give it to the person asking for it or mail it to the person who wants to apply.

52 52 –If a client has a disability and can do some work, assigning the person to a particular work environment (i.e., indoors) is an accommodation to which a client may be entitled. –Assessment interview must be scheduled at a time that doesn’t conflict with medical/mental health treatment.

53 53 Clients must be allowed to do less of something, or to do something for fewer hours, or to not do it at all, when needed because of a disability. Examples: If a client has a disability or is a caretaker for a household member with a disability but is able to do some work, part-time work is an accommodation to which a client may be entitled. Number of job contacts during a job search must be determined on an individual basis — disability, the disability of a household member, and LEP must be taken into account when determining the number.

54 54 Reduced number of job contacts is a reasonable modification. Waiver of job search in addition to part time employment is a reasonable accommodation. Waiver of job search or job club if it would be futile for a person with a disability. Working less than 30 hours if needed for a disability-related reason.

55 55 Caring for a family member with a disability can affect work An individual who is needed on a substantially continuous basis to care for a child or other member of the household with a disability is not going to be able to work outside the home. If the care needed is part-time, then the person may be able to do part-time work activities, however, it will be important to ensure that the hours involved are compatible with the need to care for the family member with a disability.

56 56 Agency staff must think about whether a disability is involved at all times, but especially whenever: There is an issue of intent. There is an issue of non-compliance or lack of cooperation. There is a question about failure to appear for an appointment. Whether the person has “good cause” for acting or failing to act.

57 57 The worker has any suspicion that a person may have a health condition or be caring for a person with a health condition. A person can not read or write. Evidence the worker has requested has not been provided. A person cannot complete a task in the fixed period generally required.

58 58 When assessing whether a family knew or should have known (and when they knew or should have known) that receipt of funds or a change in circumstances would affect their eligibility for or the amount of their benefits, staff must assess whether the person has a disability that makes it likely that the person did not understand the consequences of receipt of the payment or of failure to report the payment or change in circumstances.

59 59 It is important that the worker continue contact with the client once s/he has been assigned to a work activity to make sure it is appropriate. Statements from the client that a particular placement is difficult because of a health condition should immediately raise questions.

60 60 If it is not appropriate, the worker should rectify the problem — possible actions include: — reassigning the client to another work activity — revising the hours, days, or times of day of the work activity — revising the conditions under which the activity is performed — determining that participation is not currently feasible — stepping back and determining that another assessment or a more in-depth assessment may be needed in order to determine what accommodations are needed

61 61 Much needs to be done to bring state TANF programs into compliance with Section 504 and the ADA. It’s only in the past few years that some states have started to look more seriously at the supports and services that parents with barriers, including disabilities, need. Remember to refer back to the HHS/OCR Guidance (see slide 36)

62 62 III. What’s happening in Washington? What is most surprising is that the Administration and many in Congress still don’t think of TANF as serving people with disabilities. As a result, they have not designed their proposals to address the needs of parents and children with disabilities in TANF.

63 63 It is important to share information with Congress about the connection between TANF and disability. Help them to ensure that their policy choices this year help rather than harm people with disabilities and their families.

64 64 How would provisions in the President’s welfare proposal affect people with disabilities? Because the President’s proposals do not increase funding and significantly restrict states’ flexibility in how they design their TANF programs, people with disabilities in TANF are very likely to face even bigger obstacles to getting help in TANF than they do now.

65 65 Where things stand in Congress right now The 1996 law had been set to expire at the end of Fiscal Year 2002 (September 30, 2002). However, it has received short extensions since then while awaiting a complete reauthorization. The current extension continues the program through March Before then, Congress will either pass a TANF reauthorization law, another short extension, or something in-between.

66 66 House of Representatives The House of Representatives passed its bill, HR 4, on February 13, Vote was

67 67 Senate Finance Committee The Finance Committee marked up its bill, also known as HR 4, in September Bill awaits consideration by the full Senate, likely to be early in 2004.

68 68 There are some indications that the full Senate may consider its welfare bill in the next few weeks. But, this could change.

69 69 Universal engagement Current law: States must ensure that adults are “engaged in work” as determined by the state within 24 months. State option to develop Individual Responsibility Plans for recipients

70 70 House bill: States must develop self-sufficiency plans for all parents and caretakers receiving assistance within 60 days of TANF enrollment. Plan must detain work activities.

71 71 Senate Finance bill States must develop self-sufficiency plans for all parents and caretakers receiving assistance within 60 days of TANF enrollment. States must outline in TANF plan how they intend to require parents and caregivers to engage in work or other sufficiency activities. Each plan must contain activities designed to assist the family achieve their maximum degree of self-sufficiency, supportive services that the state intends to provide, steps to promote child well-being, and information on work support assistance for which the family may be eligible.

72 72 Assessments Current law: State must conduct an initial assessment of skills, prior work experience and employability within 30 days of a recipients enrollment in TANF.

73 73 House: Similar to current law. Senate Finance Committee: Similar but also requires screening and assessing for work barriers, work supports, other assistance and family support services, well-being of children.

74 74 Work participation rates Current: 50% FY 2003 and later (important role of caseload reduction credit) House bill: 55% FY 2005, 60% FY 2006, 65% FY 2007, 70% FY 2008 Senate Finance: same as House

75 75 Participation rate credits Current: caseload reduction credit (CRC) House: retains CRC, but bases it only on recent declines in caseload

76 76 Senate Finance: Replaces with an employment credit: — # of families employed after leaving cash assistance — larger credit, families w/higher earnings — state can include families who received short- term benefits and earned at least $1,000 in quarter after receiving the benefit, or TANF- funded child care, or transportation subsidies

77 77 — credits are capped and can not reduce a state’s work rate by more than specified amounts: (40% in FY2004, declining to 20% in FY 2008)

78 78 Hours of participation Current: 30 hours/week ○ if child under age 6: 20 hours/week ○ no partial credit for families engaged in work activity, but for fewer hours House bill: 160 hours/month, regardless of child’s age

79 79 Senate Finance bill: 34 hours/week ○if child is under age 6: 24 hours ○ partial credit for single parents who participate for 20+ hours

80 80 Important to families with disabilities: 1.What does “universal engagement” mean? 2.Hours: # of hours required credit for partial work? what counts as work activity?

81 81 What counts as work? Current: Primary work activity: first 20 hours: ○ paid or unpaid work, including OJT, work experience, and community service ○ vocational educational training (12 months) ○ job search (6 weeks) ○ providing child care for other participants

82 82 Secondary — hours over 20, can be: ○ any of the above ○ job skills training ○ education related to employment ○ satisfactory secondary school attendance or participation in GED classes

83 83 House bill: 24 hours and limits countable activities to: ○ paid or unpaid work including OJT, supervised work experience, supervised community service ○ may count other “qualified activities” (state decides) for only 3 months in any 24 month period

84 84 Senate Finance: primary: 24 hours ○ primary activities under current law ○ certain “barrier removal” activities and education activities, up to 6 months in a 24 month period ○ in months 4-6, barrier removal activities must be combined with some work or work readiness activities

85 85 After first 24 hours of work activity, can count: ○ current law plus substance abuse counseling or treatment ○ programs designed to remove barriers ○ post-secondary education ○ adult literacy programs or activities ○ programs covered under a waiver approved for any state after 8/22/96

86 86 And, under Senate Finance bill, a state may deem a single parent caring for a child with a disability or adult relative with a disability to meet all or part of the work requirement.

87 87 S. 1523: The Pathways to Independence Act of 2003 Very important development last July Bipartisan: Senators Smith (R-OR), Jeffords (I-VT), and Conrad (D-ND)

88 88 S provides: States can count as work activity caring for a child with a disability or an adult relative with a disability.

89 89 Rehab services count as work activity according to the following rules: ○ First 3 months: all ○ Second 3 months: must do “some” work activity too

90 90 After six months: ○ Builds on partial work credits in Senate Finance bill ○ If a person is determined to need rehab services beyond six months, up to ½ of required hours can be in rehab services so long as at least ½ of required hours are in work activities.

91 91 Important role of the CCD TANF Task Force of the Consortium for Citizens with Disabilities CCD website:

92 92 Improvements included in the Senate Finance bill that are important to people with disabilities Allows states to count as work the time that a caretaker relative spends caring for a child with disabilities or an adult relative with disabilities (amendment by Senator Conrad)

93 93 Rehab services can count as work for 6 months, not three (amendments by Senators Hatch and Jeffords) There also is modest language saying that a state has to review the person’s individual responsibility plan prior to imposing a sanction and make a good faith effort to meet with the person (amendments by Senators Hatch and Kerry)

94 94 So, two parts of S are included in the Senate Finance bill: caring for a child or adult relative with a disability and allowing rehab services to count for up to 6 months. Advocates for people with disabilities are working to get the last piece of S — give states flexibility to go beyond six months on rehab services, where needed

95 95 IV. When talking about TANF and people with disabilities, there are a few things to be aware of: #1: Despite all of your work to the contrary, there is an assumption that if you are a person with a disability or represent people with disabilities, you just want exemptions from the TANF work requirements.

96 96 It is important to be clear (even if it isn’t raised by the person you are speaking with) that that is not what you are about – that you want people with disabilities to have equal and meaningful access to the state’s/county’s services and supports and you want to make sure that people with disabilities get the chance to move to work whenever that is appropriate.

97 97 #2. Twisted logic: “If you really care about helping people with disabilities to move to work, you would support increasing the hours to 40 hours per week and the work participation rate to 70 percent. That’s the only way that states are going to be forced to address the needs of people with disabilities and help them to go to work.”

98 98 What’s wrong with this? A. Right now, it’s the flexibility that states have in TANF that allows them to think creatively about how to design programs to meet the needs of people with disabilities. Increasing work requirements for families and states will reduce state flexibility and result in more people with disabilities and other barriers being pushed out the door into work settings, no matter how inappropriate that may be.

99 99 B. Those tighter rules will increase the number of people with disabilities who are unable to comply with the rules and end up sanctioned and off of the program. Reducing caseloads by moving low-income people with disabilities off TANF without jobs is not success for the state nor for the family. Including mandatory full-family sanctions – as the House has done – will make the situation worse. Studies already show that parents with disabilities are being improperly sanctioned off of TANF.

100 100 #3. “You really shouldn’t be worried about states not having flexibility – our bill will give them lots of flexibility through the superwaiver provision.” That’s not the flexibility that people with disabilities need their state to have. They need states to be able to be flexible in designing the programs or steps, on an individual level, that will help the person or family move to greater independence. Depending on how it is written, the “superwaiver” proposals could let states wipe out federal laws in programs that are important to low-income families — including TANF, Food Stamps, Title XX block grant, and housing — that could result in families no longer being eligible for benefits they now receive. That’s not the kind of flexibility needed.

101 101 Useful resources from CBPP about TANF reauthorization and/or people with disabilities and TANF People with disabilities and TANF Eileen Sweeney, Recent Studies Indicate that Many Parents Who are Current or Former Welfare Recipients Have Disabilities or Other Medical Conditions, Center on Budget and Policy Priorities, February 2000, Eileen Sweeney, HHS Guidance Explains How Federal Laws Barring Discrimination Against People with Disabilities Apply in State and County TANF Programs, Center on Budget and Policy Priorities, February 2001,

102 102 TANF Reauthorization Sharon Parrott, Heidi Goldberg, Shawn Fremstad, Recycling An Unwise Proposal: State Concerns and New State Fiscal Realities Ignored in House Republican Welfare Bill, Center on Budget and Policy Priorities, February 2003, Sharon Parrott, Jennifer Mezey, Bush Administration Projects That The Number of Children Receiving Child Care Subsidies Will Fall by 200,000 During the Next Five Years, Center on Budget and Policy Priorities and Center for Law and Social Policy, February 2003,

103 103 Martha Coven, An Introduction to TANF, Center on Budget and Policy Priorities, January 2003, 02tanf2.htm Zoe Neuberger, Sharon Parrott and Wendell Primus, Funding Issues in TANF Reauthorization, Center on Budget and Policy Priorities, February 2002, Heidi Goldberg, Improving TANF Program Outcomes for Families with Barriers to Employment, Center on Budget and Policy Priorities, January 2002,

104 104 Sharon Parrott, Shawn Fremstad, The Senate Finance Committee’s TANF Reauthorization Bill, Center on Budget and Policy Priorities, September 2003, Key Provisions in TANF Reauthorization Bills Passed by the Senate Finance Committee and the House, Center on Budget and Policy Priorities and Center for Law and Social Policy, September 2003, tanf.pdfhttp://www.cbpp.org/ tanf.pdf

105 105 Shawn Fremstad, Immigrants and Welfare Reauthorization, Center on Budget and Policy Priorities, January 2002, Robert Greenstein, Shawn Fremstad, Sharon Parrott, “Superwaiver” Would Grant Executive Branch and Governors Sweeping Authority to Override Federal Laws, Center on Budget and Policy Priorities, May 2002,


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