Challenges and solutions to public assistance system alignment: How trauma-informed programming unveiled barriers to aligning TANF and Medicaid

Cross-sector collaboration and systems alignment can address social determinants of health, improve family well-being, and create a more equitable society. In attempts to align Temporary Assistance for Needy Families (TANF) and Medicaid to promote health through its trauma-informed program, The Building Wealth and Health Network (The Network) encountered three major challenges to meeting those goals including TANF’s culture of compliance, societal and systems-level forces of racism and discrimination, and misaligned partnerships. Utilizing intentional efforts to address these challenges, such as incentives for innovation and partnerships and the promotion of racial equity initiatives, can address these challenges and improve the effectiveness of these programs while promoting health equity. (author introduction)