employment assistance

This is simple math: Health care equals jobs. And the new health care reform law means even more jobs. In many communities across the United States, the health care industry is the region’s top employer. Indeed, if you put this in a global perspective, the National Health Service in the United Kingdom now employs 1 in every 23 workers in that country, some 1.3 million people. (The NHS is the third largest employer in the world, only ranking behind the Chinese army and India Rail.)

The numbers in Indian Country show that same kind of growth. Look at the figures before President Johnson’s Great Society (and the expansion of federal programs):  The Bureau of Indian Affairs employed 16,035 full time employees in 1969, while the Indian Health Service employed 5,740 people. That trend is now reversed. In 2009 the BIA employed 8,257 full time workers and the IHS had grown to 15,127 employees. These are just the number of federal employees, because tribes or organizations administer roughly half of the Indian health system.

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The demand for health care workers in Indian Country represents a public policy paradox: We need jobs in communities where the official unemployment rate is about 50 percent and yet the Indian Health Service reports shortages of health professionals.

The IHS describes its employment situation this way:

“The physician vacancy rate now stands at approximately 21%, and the average length of service of the approximately 800 federally employed physicians in Indian health is 10 years.

Caught between falling budgets and the rising ranks of the unemployed and underemployed on welfare, the state of California has suspended employment assistance services such as child care subsidy for welfare families, according to The New York Times' Erik Eckholm. 

After vigorously pursuing policies to push more welfare recipients into the workforce, the state is also dropping work requirements and penalties for single parents with a child aged 1 to 2, or those with two children under 6.

By 2011, the state's welfare-to-work program CalWorks will enforce stricter rules for participants to reduce costs.  Until then, the state is slashing those programs because they are ineligible for stimulus act funds. 

The reversal of a decade's worth of welfare policies worries many who supported the cultural change effected by California's carrot-and-stick approach to getting welfare recipients back to work.

Mr. Schwarzenegger did wring savings out of the state’s welfare-to-work program, known as CalWorks, and achieved a future tightening of the rules. But those changes do not start until July 1, 2011. In the interim, to save $375 million a year, the state is trimming the employment assistance programs at the heart of the welfare-to-work approach, especially subsidized child care, and suspending work requirements for a large share of recipients.

Those programs were selected, in large part, because they were not eligible for extra federal money under the stimulus act.

--- Kristen Young