Mail Survey Instrument

MPR Reference No.: 6292-310
Survey Identification Number: |

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OMB Approval Number: xxxx-xxxx
Expiration Date: xx/xx/xxxx

Study of Temporary
Assistance for Needy
Families (TANF)
Diversion Practices
State TANF Director
Questionnaire
January 4, 2007

Introduction
The TANF program is now more than ten years old, and each state continues to explore and
experiment with methods of encouraging work and promoting self-sufficiency. The Administration for
Children and Families (ACF) has initiated the TANF Diversion Practices study to better understand the
strategies states are using to promote employment and self-sufficiency among families applying for cash
assistance and to facilitate information-sharing across states about these practices. As a first step, we are
asking you to complete the short questionnaire about your efforts to engage TANF applicants in work or
work-related activities or to provide financial and other assistance to applicant families to divert them
from the TANF program. We will use the information from this questionnaire to identify and further
explore innovative strategies that may be of interest to other states. After we review your responses, we
will contact you to schedule a follow-up telephone interview to gather additional information. The
follow-up interview will last between 10 and 60 minutes.

Instructions
Always proceed to the next question in the survey unless special instructions tell you to go
elsewhere. Most questions can be answered by simply placing a check mark in the appropriate box. For
a few questions you will be asked to write in a response. Feel free to elaborate on any responses in the
questionnaire margins or to provide additional thoughts about your TANF diversion program at the end of
the questionnaire. Please write “DK” next to the answer category if you do not know an answer.
Please return the completed questionnaire in the enclosed return mail envelope to Mathematica
Policy Research, Inc., P.O. Box 2393, Princeton, NJ 08543-2393, ATTN: Todd Ensor, or fax it to
Mr. Ensor at (609) 799-0005. If you have any questions, please call Todd Ensor at (609) 275-2326.
According to the Paperwork Reduction Act of 1995, no persons are required to respond to a collection of information unless it displays a valid OMB
control number. The valid OMB control number for this information collection is xxxx-xxxx, expiration date xx/xx/xxxx. The time required to complete
this information collection is estimated to average 12 minutes per response, including the time to review instructions, search existing data resources,
gather the data needed, and complete and review the information collected. If you have any comments concerning the accuracy of the time
estimate(s) or suggestions for improving this form, please write to: U.S. Department of Health and Human Services, 200 Independence Avenue, SW,
Washington, DC 20201.

Employment, Self-Sufficiency, and Alternative Income
Support Strategies for TANF Applicants
Please provide the following information for strategies you may have in place, or are planning to put into place, for families
who apply for cash assistance.

B3. Is this program targeted to all eligible TANF
applicants (excluding child-only cases) or a
subset of applicants with certain characteristics?

Section A. Lump Sum Payments To Divert
Applicants From TANF Assistance
A1. Does your state offer or plan to offer lump sum
payments (via cash, vendor payments, or
vouchers) to families applying for cash
assistance with the intent of alleviating the need
for TANF assistance?
1

! Yes, statewide — Go to A2

2

! Yes, at county discretion — Go to B1

0

! No — Go to B1

1

! All eligible applicants

2

! Subset of eligible applicants

B4. Is participation in this program voluntary or
mandatory for the target population?
1

! Voluntary

2

! Mandatory

A2. Please record the month and year of initial or
planned implementation of this program.
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B5. Please record the month and year of initial or
planned implementation of this program.

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Month
Year

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Month
Year

Section B. Pre-TANF Job Search and Assessment
Programs That Provide Short-Term
Financial Assistance
Section C. Work-Related TANF Application
Requirements

B1. Does your state have or plan to implement a
program separate from your TANF cash
assistance program that provides short-term
financial assistance to families who apply for
TANF assistance while they participate in job
search, complete an employability assessment,
or participate in other work-related activities?

C1. In this section we ask about your state’s current
or planned work-related requirements that all or
some TANF applicants complete before they are
approved to receive TANF cash assistance.

1

! Yes, statewide — Go to B2

2

! Yes, at county discretion — Go to C1

Are TANF applicants required to participate
in an orientation program focused on work
requirements or employment-related activities?

0

! No — Go to C1

1

! Yes, statewide — Go to C2

2

! Yes, at county discretion — Go to C4

0

! No — Go to C4

B2. Please record the name of that program.
C2. Is a family’s application for TANF cash
assistance denied if they fail to comply
with the requirement?

Prepared by Mathematica Policy Research, Inc.

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1

! Yes

0

! No

C9. Please record the month and year of initial or
planned implementation of this requirement.

C3. Please record the month and year of initial or
planned implementation of this requirement.
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Month
Year

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Month
Year

C10. Are TANF applicants required to participate in a
job search?

C4. Are TANF applicants required to complete a plan
that outlines what steps they will take to find
employment or move towards self-sufficiency?

1

! Yes, statewide — Go to C11

1

! Yes, statewide — Go to C5

2

! Yes, at county discretion — Go to D1

2

! Yes, at county discretion — Go to C7

0

! No — Go to D1

0

! No — Go to C7
C11. Is a family’s application for TANF cash
assistance denied if they fail to comply
with this requirement?

C5. Is a family’s application for TANF cash
assistance denied if they fail to comply
with the requirement?
1

! Yes

0

! No

1

! Yes

0

! No

C12. Please record the month and year of initial or
planned implementation of this requirement.
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C6. Please record the month and year of initial or
planned implementation of this requirement.
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Month
Year

Section D. Consideration of Alternative Resources
D1. As part of the TANF application process, are
intensive services provided to help applicants
find other means of assistance in lieu of receiving
TANF?

C7. Are TANF applicants required to register for
work?
1

! Yes, statewide — Go to C8

2

! Yes, at county discretion — Go to C10

0

! No — Go to C10

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Month
Year

1

! Yes, statewide — Go to D2

2

! Yes, at county discretion — Go to E1

0

! No — Go to E1

D2. Please record the month and year of initial or
planned implementation of these services.
C8. Is a family’s application for TANF cash
assistance denied if they fail to comply with
the requirement?
1

! Yes

0

! No

Prepared by Mathematica Policy Research, Inc.

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Month
Year

E5.

Section E. Solely State-Funded Cash Assistance
Programs
E1.

Does your state have or plan to implement a
program that is funded solely by state or local
dollars (not TANF or TANF Maintenance of Effort
(MOE) dollars) that provides ongoing financial
assistance to families with children who would
otherwise be eligible for TANF?
1

! Yes, statewide — Go to E2

2

! Yes, at county discretion — Go to F1

0

! No — Go to F1

E6.

Is participation in this program voluntary or
mandatory for the target population?
1

! Voluntary

2

! Mandatory

Please record the month and year of initial or
planned implementation of this program.
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Month
Year

Section F. Final Comments
E2.

Please provide the name of this program.
F1.

Please provide us with materials such as
regulations, reports, or educational material you
have describing these policies or programs. If
they are available on-line, please provide us with
the link and we will download them.

Web Links:

E3.

Is this program available to families who are
applying for TANF assistance?
1

! Yes, statewide — Go to E4

2

! Yes, at county discretion — Go to F1

0

! No — Go to F1
F2.

E4.

To which types of TANF applicants is this
program targeted?

Mark Yes or No for each type
Yes

No

a. Two parent families?.........................

1

!

0

!

b. Families with a household head
attending college?.............................

1

!

0

!

Families experiencing personal or
family challenges? ............................

1

!

0

!

d. Other types of families (Please
describe below) ...................................

1

!

0

!

c.

Prepared by Mathematica Policy Research, Inc.

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We will be following up shortly to discuss your
state’s responses in this questionnaire. In the
meantime, please write in any comments that
might help us prepare for this discussion.

F3.

Please enter the name and telephone number of
the person who completed this questionnaire.

Telephone Number:
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Area Code

F4.

Please enter the name and telephone number of
the person we should contact for the follow-up
telephone interview, if different from the person
who completed this questionnaire.

Telephone Number:
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Area Code

F5.

Thank you for completing this survey. Please
return it in the enclosed return envelope to
Todd Ensor at Mathematica Policy Research, Inc.,
P.O. Box 2393, Princeton, NJ 08543-2393 or fax it
to Mr. Ensor at (609) 799-0005. We will follow up
by phone shortly.

Prepared by Mathematica Policy Research, Inc.

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