Abstract
This article comments on changes made by health-related organizations and in community health during the first years of New Jersey's welfare reform policy implementation in Camden, Essex, and Hudson counties (1992-1998). Throughout these years, county welfare agencies made organizational changes that shifted their focus from supporting family well-being to encouraging work. Health care provider organizations now are beginning to make organizational changes in response to the ripple effects of welfare reform policy. Specific actions to initiate and influence healthy welfare policy reformulation are presented.
ON AUGUST 22, 1996, President Clinton signed into law the Personal Responsibility and Work Reconciliation Act of 1996 (P.L. 104-193). This federal law replaced the open-ended entitlement program, Aid to Families with Dependent Children (AFDC), with a block grant for states to provide time-limited cash assistance for needy families, the Temporary Assistance to Needy Families (TANF) block grant. The effects of this federal welfare reform law on health-related organizations and communities only now are beginning to be known.
The New Jersey Family Development Program, enacted in 1992 and redesigned in 1997 as Work First New Jersey, is very similar to the new federal law. A review of changes made by health-related organizations and community health during the first 2 years of New Jersey's welfare reform policy implementation in Camden, Essex, and Hudson counties is presented below. Analysis of these changes provides insight into the possible health consequences of the Personal Responsibility and Work Reconciliation Act. The findings have implications for the health of people in disadvantaged communities and for the organizations that serve them.