In a Coma? Don’t Forget to Keep Exercising Your Personal Responsibility.

From Columbus, Ohio, comes the story of a woman whose welfare and food stamp benefits were terminated because she failed to attend a job training program she was required to enroll in. The reason she missed the training was that she was in the hospital, in an induced coma, fighting for her life.

If you are thinking this must all have just been a big mistake, keep reading.

The woman, Kimberly Thompson, once had a warehouse job packing boxes that enabled her to support herself and her and her 15-year old daughter. But in May, 2013, she needed to have a hysterectomy. After the operation, she was unable to return to her physically demanding job right away. She applied for and began receiving cash assistance, Medicaid and food stamps, and she enrolled in a job training program to meet the work requirement that was a condition for receiving cash assistance. But shortly afterward, an infection she had contracted following her surgery worsened dramatically, and her doctors placed her in a coma in order to save her life.

When she awakened from the coma, she discovered that her cash assistance and food stamps had been terminated. She called the welfare agency to find out why and learned that the reason was that she had missed her training class. The agency gave her two days to prove that she had a good reason not attending. Weak, unable to move (seven of her toes had been amputated) and only slowly regaining her cognitive capacities, she was unable to do so before the agency ended her benefits.

In agency-speak, Thompson had violated the Self Sufficiency Contract that she had signed. That contract, which set out a timetable for her to attain “self-sufficiency and personal responsibility,” said that she would face sanctions if she did not comply in full with her work assignments. And when she missed her training class, the agency ended her cash assistance immediately. Ohio law allowed her to appeal the agency’s sanction, and at that appeal she was able to convince the agency that being in a coma was a satisfactory reason for missing class. Eventually her benefits were restored, but by that time — unable to work and without any other income — she became homeless.

If you are thinking that the welfare agency in Ohio, whose policy is to terminate benefits first and entertain pleas from desperate people later, is made up of particularly mean-spirited people, keep reading.

Under federal law, states are required to show that at least half of their recipients of cash assistance are employed or engaged in job training. Any state that falls short faces the loss of federal funding.

The obvious way for a state to meet this requirement is to ensure that cash assistance recipients get jobs or job training. But that’s not the easiest way. The easiest way is simply to eliminate people from the welfare rolls altogether — decreasing the denominator of a fraction can yield the same result as increasing the numerator. The cash assistance caseload in Ohio has fallen by more than 30 percent since 2011, a result in part of its policy of terminating benefits first and entertaining pleas from desperate people later. And Ohio is only one of many states using strict work requirements to reduce caseloads.


Could something similar happen in Massachusetts? It may have already started. The cash assistance caseload here has fallen by 19 percent since 2011, not too far behind Ohio’s 30 percent reduction. State welfare agencies do not keep track of how families fare after they stop receiving cash assistance, so we have no assurances that these families are living in stable situations. Inquiring minds would be interested to know whether this caseload decline (numbering 10,000 families), is contributing to the dramatic rise in family homelessness in Massachusetts over the same time.

And our welfare agency is getting more authority to terminate cash assistance benefits. In the past, families that include a disabled family member have generally not been subject to a work requirement. A new law, which was enacted by the Legislature this summer and which has not yet been implemented, allows the agency to adopt a stricter standard of disability, which would have the effect of making more families subject to a work requirement. In passing this law, the Legislature acknowledged the extra difficulties disabled parents would have in meeting a work requirement, so it also provided funds for services to help families receiving cash assistance make their transitions to work. But when the state encountered a budget shortfall recently, funding for these services was cut by more than 90 percent.

Our incoming Governor, therefore, will have a lot of choices to make — between reducing caseloads and reducing poverty.

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