Tornado-scale winds tore through the Upper Midwest the weekend of June 5, devastating whole communities without warning, obliterating the town of Spencer, South Dakota. In its aftermath businesses and governors immediately requested millions of dollars in federal disaster assistance. That terrifying storm was similar to another sobering event on June 1, held right on our campus, offering abundant warning - University of Wisconsin-Milwaukee's first conference on welfare reform: What Have We Learned so Far? Wisconsin has received inordinately positive national and international publicity for its putatively phenomenal achievements in reducing its welfare rolls, the costs of which never came close to those of that tornado. This issue of Health & Social Work marks two years since the groundbreaking Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (P.L. 104193) was signed by President Clinton, implementing Temporary Assistance to Needy Families (TANF) block grants. This column presents a preliminary assessment of Wisconsin's, and particularly Milwaukee's, experiences with this 1990s version of new federalism. Reforms, just like tornadoes, hit localities and real people: landlords, grocery stores, frontline social workers, administrators, local officials, neighbors, schools, businesses, and citizens in general. As in every community affected by recent welfare changes, social workers in Wisconsin, and especially Milwaukee, have found themselves coping with unprecedented complexities and frustrations. Having to adjust our mindsets to revere employment as the panacea it is touted to be, many of us struggle, knowing too well the problems with local implementation and therefore the hollowness of its moral messages about work. The changes in welfare provisions for any local community must be seen in context. Wisconsin has a population of about 5 million people, of whom fewer than 7 percent are people of color and not quite 2.5 percent are foreign born. Milwaukee is the largest county in Wisconsin with 959,275 residents; and the city of Milwaukee has a population of 628,088, of whom 36.6 percent are people of color, as are 58.7 percent of the children. Nationally, 20 percent of children are living in poverty, twice the rate of adults. Milwaukee ranks 43rd among the United State's 50 largest cities in child poverty at 38 percent (Annie E. Casey Foundation, 1997). A 1995 labor market study found unemployment in central city Milwaukee at 21.5 percent (University of Wisconsin-Milwaukee, Employment & Training Institute, 1995), whereas unemployment for the city as a whole was 4.8 percent and only 3 percent for the Milwaukee metropolitan area. Statewide unemployment this year reached a 30-year low. Such disparities set the context in which human services are delivered. The mid-to-late 1990s have seen a number of significant changes in Milwaukee County's human services infrastructure. At the end of 1995, the state eliminated general assistance, leaving 5,500 adults in Milwaukee County with no visible means of support. In 1996, after operating it for three-quarters of a century, Milwaukee closed its only public hospital, transferring care and an annual county subsidy of about $60 million in 1996 and 1997 to the adjacent private Froederdt Hospital. In late 1997 the county devised a plan to disperse about $30 million worth of care through the General Assistance Medical Program (GAMP) throughout the county. GAMP-eligible consumers, who must be sick and have incomes of less than $800 per month, must now register with one of 12 community-based clinics, five of which are sites for the homeless, each supported by a different hospital. In addition, in 1995 the county closed its major inpatient mental health complex, contracting out the bulk of care to several outstationed Community Support Teams. And in 1996, in response to a lawsuit by the American Civil Liberties Union, the state passed legislation to turn over operation of the Milwaukee County child welfare system to the state Department of Health and Family Services in January 1998. …
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