To date, limited information has been available on the use of title XX funds by the States. Under the Title XX Social Services Block Grant Program, each State must submit a report to the Secretary of Health and Human Services on the intended use of its funds. These pre-expenditure reports are only required to include information about the types of activities to be funded and the characteristics of the individuals to be served.
The Family Support Act of 1988 (Public Law 100-485) strengthened reporting requirements. That legislation required States to submit annual reports containing detailed information on the services actually funded and the individuals served through title XX funds. The Department of Health and Human Services published a final rule on November 15, 1993 implementing the reporting requirements and providing uniform definitions of services. Although all States have now submitted these reports, HHS has not compiled them or released any summary information.
Table 11-3 is a comparison of the primary services offered by the States taken from a Departmental summary of the pre- expenditure reports for fiscal years 1983 through 1994. Based on these reports, at least 35 States use title XX funds for each of the following services: protective services for children; child day care; home-based services; foster care for children; adoption services; prevention/intervention services; adult protective services; and social support services.
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Services 1983 1986 1988 1990 1992 1993 1994
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Adoption....................................................... 36 39 29 35 34 36 38
Case management \2\............................................ ..... ..... 26 26 33 38 34
Counseling..................................................... 30 38 22 21 24 23 30
Day care--adults............................................... 37 31 23 26 28 27 28
Day care--children............................................. 50 52 51 45 47 49 45
Education/training............................................. 28 43 19 17 17 19 19
Emergency \3\.................................................. ..... ..... 15 16 17 21 19
Employment \3\................................................. ..... ..... 21 23 22 23 16
Family planning................................................ 35 30 26 26 26 23 19
Foster care--adults............................................ 25 19 12 10 11 16 14
Foster care--children.......................................... 34 31 29 30 31 37 41
Health-related................................................. 26 36 22 23 30 34 27
Home based \4\................................................. 51 55 45 46 46 45 46
Home delivered/congregate meals................................ 23 28 20 20 22 20 18
Housing improvement............................................ 14 18 10 16 14 14 14
Information and referral....................................... 36 34 23 25 27 26 26
Legal.......................................................... 17 17 17 13 16 19 14
Placement...................................................... 18 20 17 16 17 16 15
Prevention/intervention \5\.................................... 11 35 33 27 31 36 36
Protective--adults............................................. 44 46 34 30 32 36 35
Protective--children........................................... 52 54 38 42 46 50 49
Residential care/treatment..................................... 19 29 21 25 29 27 31
Social support \6\............................................. 2 25 27 45 37 35 37
Special services for children.................................. 19 28 27 19 18 22 15
Special services for the disabled.............................. 36 41 39 34 38 38 34
Special services for juvenile delinquents \2\.................. ..... ..... 16 14 18 17 16
Substance abuse services....................................... 7 13 10 11 15 12 13
Services for unmarried parents................................. 10 10 13 13 14 20 15
Transportation................................................. 25 33 30 25 27 30 27
Other \7\...................................................... 5 36 20 19 19 13 18
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\1\ Includes 50 States, the District of Columbia, and the 5 eligible Insular areas.
\2\ Identified as separate service for the first time in 1987. This is not meant to imply that the service was
first available in 1987.
\3\ Identified as a separate service for the first time in 1988. This is not meant to imply that the service was
first available in 1988.
\4\ Home based services include: homemaker, chore, home health, companionship, and home maintenance.
\5\ Prevention/intervention services include: investigation/assessment, family centered early intervention, home
evaluation and supervision, preventive and restorative.
\6\ Social support services include: socialization, recreation, camping, physical activity, living skills (money
management), day treatment, family development, social adjustment, community living services, family
management, life skills education, personal and financial management.
\7\ Other services include: social services in correctional facilities, services to Hispanics, homeless
services, Indian reservation services, and refugee minority programs.
Source: Fiscal Year Pre-expenditure Reports, U.S. Department of Health and Human Services.
In addition to the pre-expenditure reports, another source of data on title XX is the Voluntary Cooperative Information System (VCIS) of the American Public Welfare Association (1994) funded by the Department of Health and Human Services. VCIS is a national data base comprised of aggregate State program statistics. A total of 33 State or territorial agencies participated in the data gathering activity for fiscal year 1990, which is the most recent conducted by APWA. The annual VCIS report cautions that the data base is incomplete even for these States, since a number of States were able to provide only partial data or their data could not be used due to lack of conformity with the reporting guidelines. Furthermore, the VCIS data base is comprised of both estimated and actual service and expenditure data. Until the reporting system required by the Family Support Act is in place, VCIS provides the only available information that describes the characteristics of recipients and the services and expenditures by States. Moreover, without the application of an appropriate sampling technology, it is not possible to determine the extent to which the data can be generalized to the Nation as a whole.
VCIS data from 31 States show that the Federal title XX social services block grant dollars combined with other Federal dollars (e.g., title IV-B) accounted for 46 percent of total social services expenditures in the 31 States during fiscal year 1990. State dollars accounted for 41 percent of the total. Local dollars and private contributions accounted for the remaining 13 percent.
VCIS data from 28 States for 1990 show that 10 services accounted for almost three-quarters of all services provided under the title XX social services block grant, as measured by recipient counts. These services are: protective services for children (18 percent); information and referral services (12 percent); child day care services (8 percent); homemaker/home management/chore services (7 percent); counseling services (6 percent); preventive services for children and their families (5 percent); family planning services (5 percent); substitute care and placement services for children (5 percent); protective services for adults/elderly (4 percent); and services to status offenders and juvenile delinquents (3 percent).
Data from 23 States show that five services accounted for over two-thirds of the expenditures under the block grant in fiscal year 1990. These services include homemaker/home management/chore services (25 percent); child day care services (16 percent); protective services for children (12 percent); substitute care and placement services for children (12 percent); and services for disabled/handicapped persons (6 percent).