Coordinating and Simplifying Low-Income Assistance Programs

Background

Many older Americans do not participate in the low-income assistance programs for which they are eligible. In 2013 the Census Bureau reported that among older households with incomes below the poverty level, less than one-half (42 percent) received help from Medicaid, food stamps, or public housing.

In addition, a substantial portion of low-income veterans and their family members who qualify for Supplemental Security Income (SSI) benefits are not receiving the needs-based pensions and medical benefits offered by the Department of Veterans Affairs.

Low awareness contributes to low participation in these programs among eligible low-income older adults. Outreach to older Americans is often lacking or is not well coordinated between the government and community-based organizations. Applicants who contact one government agency to apply for a benefit may not be told about other programs for which they might be eligible.

The application process is another barrier to program participation. Applicants may be required to provide the same eligibility information to several programs often in different locations. Forms tend to be long and complicated and lack helpful graphics. Also, forms frequently use colored paper, small type, and a mix of type styles, which make the materials difficult to read. A lack of materials or help in languages other than English is a barrier for people with limited English proficiency. Some older applicants experience discourteous treatment or cultural insensitivity by caseworkers.

Service delivery falls short of meeting the needs of older Americans in need of low-income assistance. Lack of transportation, physical accessibility, and long waiting periods present major challenges. The 1996 welfare reform law repealed several requirements to facilitate program access by older people and people with disabilities. It allowed, but did not require, states to conduct telephone interviews or home visits instead of in-office interviews, take applications over the phone or by mail, and issue food assistance by mail in rural areas.

Coordinating and Simplifying Low-Income Assistance Programs

Improving coordination

In this policy: FederalState

Governments should streamline and coordinate application procedures among different assistance programs, auto-enroll poor and low-income people enrolled in other public benefit programs and inform potential beneficiaries of the range of benefits for which they may be eligible. Eliminating small and arbitrary differences in eligibility criteria, creating a single application form and access point for applicants and training program staff about the availability of other resources should be a high priorities.

Older adult Medicaid beneficiaries not residing in institutional settings should be automatically enrolled in SNAPSupplemental Nutrition Assistance Program (SNAP) SNAP provides a monthly supplement for purchasing nutritious food. If you qualify, you’ll get a debit card to use for groceries. Also commonly called Food Stamps. .

States should integrate government benefit programs through data sharing as states modernize their computer systems. Eligible beneficiaries should be recertified ex parte (automatically) with data from other government benefit programs when feasible to prevent the loss of benefits.

Transforming service delivery

In this policy: FederalLocalState

Federal, state, and local governments should explore new, more consumer-centered systems for providing low-income assistance. The goals are to improve the application and recertification process for individuals and to increase the penetration of these programs into eligible communities.

Improving the application process

In this policy: FederalState

Application forms and program notices should be shortened and simplified to make them less intimidating and easier to understand. Legal concepts, such as the Privacy Act’s requirements or definitions of fraud, should be written in plain language. Materials should be available in large type and in English as well as other languages. All applications should be written so that people with a fourth-grade level of literacy can understand them.

States should:

  • ensure that the agencies responsible for administering low-income assistance programs have complied with federal law by providing applicants who have impairments with reasonable accommodations in the application process and procedures;
  • ensure that employees who process benefit application forms have appropriate training and serve clients with understanding and sensitivity; and
  • provide one-on-one assistance to applicants and establish advocate programs to help low-income people negotiate all phases of the various benefit systems.

States should undertake administrative reforms to improve the application process (such as auto-enrolling poor and low-income people enrolled in other public benefit programs; shortening and simplifying application forms; permitting telephone applications for older adults, people with disabilities, and working families; adopting online applications; and eliminating recertification interviews); and seek federal waivers as needed.

Good models of application formatting and processes should be examined and replicated where applicable.

Outreach

States should make outreach efforts an integral component of these programs and undertake outreach strategies that have proven to be effective in expanding program enrollment.