2009 cat testing kitfinal

8/8/2019 2009 Cat Testing KitFINAL

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Contents

Overview

IntroductionWhy Do a Testing Project in Your State?

Getting the FactsLearn How Your State Determines Who is Eligible for the BenefitLearn What the Barriers Might Be in Your State

Mounting Your Testing ProgramRecruit TestersPrepare Your Testers and VolunteersInterview Testers, Document their Experiences and their Stories

Charting Your ResultsCharting Your ResultsWriting Your ReportMoving into Action/MediaSummary

Appendices

ICAN Flyers

Hunger Pains: Oregon Food Stamp Program Fails to Deliver


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NWFCO and its affiliates have used testing projects to expose barriers to access to public programs like the Food Stamps Program and the State Children's Health InsuranceProgram (SCHIP). By documenting these barriers, we have been able to give grassrootsgroups a tool they can use to organize and open the programs to many more people.

Testing projects can be used to document barriers to any public benefit program. Someexamples of possible programs you could investigate with a testing project include: Food Stamps Public health coverage programs, including Medicaid, SCHIP, or state health

coverage programs Charity care policies at public or non-profit hospitals Interpretation and translation services at hospitals Low-Income Home Energy Assistance Program (LIHEAP)

This kit explains, step-by-step, how to test your states application process for a public benefit program and how to use what you learn from your test. The project includes

seven steps, each outlined in this kit:

1. Learn about the eligibility requirements in your state and about the barriers that prevent eligible people from receiving the benefit in your state

2. Recruit testers and volunteers3. Train your team4. Perform the test5. Analyze the results6. Write your report7. Present your results to the media

This kit includes stories and model materials from two successful testing campaigns. Onewas a testing project that NWFCO performed with the Idaho Community Action Network (ICAN) of the State Children's Health Insurance Program (SCHIP) in Idaho in 1999. Thesecond was a testing project that NWFCO performed with Oregon Action of the FoodStamps program in Oregon in 2000. Both testing projects resulted in campaigns that won

big changes to the programs that were tested.


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Why Do a Testing Project in Your State?

Community organizations can expose barriers to access to public benefits programs for people in each state and open the program to many more people. People who are eligiblefor programs like Food Stamps and SCHIP, low-income families and particularlyimmigrant families, can be easily intimidated by state caseworkers and prevented fromsucceeding in their applications. Community organizations can help these people to beheard.

This project can be a victory for the families you work with, providing access tocritical benefits.

Organizations benefit by building membership and constituencies on these issues.

This should always be a winning campaign. Programs like Food Stamps and SCHIP

have funding already and support from state legislatures. Many of the barriers to coverage are illegal practices, so efforts to eliminate these

barriers are supported by the Federal government and its agencies.

Public exposure of these problems has proven to get fast action by state agencies.

Testing projects can be used to win changes in the practices at particular local officesthat are not following State or Federal rules, and they can also be leveraged to winstate-wide changes in program policies and rules that impact all offices in the state.


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Learn How Your State Determines Who Is Eligible forthe Benefit

Eligibility for public benefits is based on income measured as a percentage of the FederalPoverty Level (FPL). Each program covers individuals or families up to a certain FPL.Youll need to find out that income requirement. A chart that shows income at various

percentages of FPL looks like this:

2009 Federal Poverty Guidelines

Number of family

members 100% FPL 185% FPL 200% FPL 250% FPL1 $10,830 $20,036 $21,660 $27,075

2 $14,570 $26,955 $29,140 $36,425

3 $18,310 $33,874 $36,620 $45,775

4 $22,050 $40,793 $44,100 $55,125

5 $25,790 $47,712 $51,580 $64,475

6 $29,530 $54,631 $59,060 $73,825

7 $33,270 $61,550 $66,540 $83,175

8 $37,010 $68,469 $74,020 $92,525For eachadditionalperson add $3,740 $6,919 $7,480 $9,350

*1/23/09 guidelines. Guidelines are revised annually; you should check to be sure thatthese numbers are still accurate. Guidelines for Alaska and Hawaii are slightly different.

Some states allow applicants to deduct some expenses, like day care for children or dependent adults, from their income before considering income eligibility.

Some states count the value of a familys assets, like a car or bank account, in the incomeeligibility test.


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Immigrant Eligibility for Public Benefits

Public benefits programs have different rules about how citizenship status impactseligibility. It is important to research how citizenship status impacts eligibility for the

program you are testing in your state before you begin recruiting testers.

Undocumented ImmigrantsUndocumented immigrants do not qualify for most federally funded programs. 1 Some

programs, like the Low-Income Home Energy Assistance Program, may be available tohouseholds that include undocumented immigrants if one person in the household is acitizen or legal resident, but penalize those households in the way they calculatehousehold income.

Non-citizen Immigrants with Legal StatusEligibility for immigrants with legal status who are not yet citizens changes with each

program and each state. One issue for legal permanent residents is the five-year bar.Lawful permanent residents and some other categories of immigrants with legalimmigration status who have arrived in the U.S. after August 22, 1996 are not allowed toreceive some federally-funded benefits for five years after they secure their immigrationstatus.

Naturalized Citizens and Children of ImmigrantsAll citizens who meet the income eligibility requirements qualify for public benefits,including immigrants who have become citizens through the naturalization process andU.S.-born children of immigrants. A child born in the United States is always a citizen. If a child is a citizen, it does not matter whether other members of the childs family arecitizens when applying for a benefit that covers the child, like SCHIP. Only the child hasto show proof o f citizenship, if asked. Only the child applying can be required to providea social security number. The federal government has forbidden states to ask for thatinformation about family members, even parents. Programs that Cover ImmigrantsSome states have created programs that are paid for with state funds to cover immigrantswho do not qualify for federally-funded programs because of their status. Congress alsochanged the rules for the SCHIP program in 2009 to allow states to choose to cover children who would otherwise be excluded by the five-year bar. You will need to check your state's rules as well as the federal rules to figure out eligibility.

This information is provided in much more detail at the following website:

www.nilc.org

1 There are a few exceptions. For example, undocumented immigrants are eligible for emergency Medicaid if they qualify under the income and other eligibility rules for their state Medicaid program.
http://www.nilc.org/http://www.nilc.org/


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This website has an article explaining the issue, Overview of Immigrant Eligibility for Federal Programs , by Tanya Broder and Jonathan Blazer, May 2009, as well as a chartthat explains which programs immigrants with each category of status are eligible for.


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Learn What the Barriers Might Be in Your State

Interview low-income advocates, caseworkers, and people who have applied for the benefit in your state to learn what barriers exist in your state that prevent eligible

people from getting the benefit. These are the things youll want to test for.

Some questions you might ask are: Do caseworkers offer information about the program voluntarily when people ask

for help for their families? Are applicants discriminated against based on race or because they are

immigrants? Are immigrant testers required to submit extra documents? Arethey threatened or intimidated about their immigration status?

Are language services really provided to limited English proficiency applicants?Federal law requires that states communicate with applicants for federally-funded

programs, orally and in writing, in a language understood by the applicant.

Are there procedural barriers that prevent people from completing the application process? Do caseworkers set interview appointments for times when working people cant go to meetings? Are they unwilling or unable to do interviews over the phone or in places closer to the applicants home than the state office?

Do caseworkers understand and follow the Federal or State rules for eligibility?Do caseworkers demand social security numbers for household members anddocumentation about household members who will not be receiving the benefit?

Do caseworkers in different offices follow the same rules and treat applicantsalike?

When an application is rejected, what criteria are used? Are there criteria thatallow caseworkers to use their own discretion?

Are caseworkers respectful or intimidating to applicants? How many meetings with a caseworker does an applicant have to attend before adecision is made?


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Recruit Testers

We suggest that you pick a minimum of 3 places in the state to include in your testing project. Include at least one rural office and one urban office. Choosing offices indifferent areas of the state allows you to show that the problems you encounter are part of a statewide pattern, not just a localized problem. Comparing the experiences of your testers in several offices also allows you to point out situations in which local offices are

being arbitrary in their policies and decisions.

We also suggest that you recruit testers from a variety of backgrounds and races to testfor discrimination.

Its important to recruit enough families to be able to show that their treatment is asignificant pattern of treatment by the state offices. Some families might not qualify,especially if your state has very complicated requirements, and others might drop out for other reasons.

Ways to recruit testers:

Sit in the waiting rooms of free health clinics and Indian Health Centers and talk to people

Spread the word through the network of families and friends of your organizationslow-income members

Check food bank lines, ask at local churches that provide services to low-income

people, and inform legal aid offices that youre looking for volunteers Distribute flyers in low-income neighborhoods

If your organization does door-to-door recruitment, ask people to participate as youcanvass in low-income neighborhoods

Ask farmworker unions and migrant councils to help recruit among their membership

Its a good idea to make up a worksheet for your recruiters to use to help them figure outif a person will be eligible for the program, and to gather basic information for your

project about the child and family. Here are is an example of a recruiting survey that wasused in the SCHIP testing project in Idaho. You can adapt it using eligibility criteria for the program you will be testing.


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Sample Recruiting Form

Name of person helping you fill out this form: ______________Phone: ___________

Are you in: (Please circle) city 1 city 2 city 3

Your Name: _________________________________

Phone: ______________________________

Address: _________________________________________________________

Do you Need Translator? Yes _____ No _____

Language: Spanish___________

Vietnamese________ Cambodian_________ (Add the most common languages in your area)Other______________

Are you?

Male _____ Female _____

White_____ Hispanic/Latino____ Black _____ Native Am. ____ Other_____

Single ______ Married ______ Divorced ______ Other_____

What grade level did you finish in school?

Did not graduate from high school____________ Graduated from high school_________________ Attended college__________________________ Graduated from college____________________ Other__________________________________

Name of child Age NowInsured?

Insured SixMonths Ago?

Citizen or qualified alien(A qualified alien is a legal

permanent resident who arrived inthe US before August 22, 1996.)

Not a citizen orqualified alien


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What is your Gross Monthly Income Level? What is your income source?(These are the relevant income levels for the Idaho SCHIP program in 1999. Replace them with the income levels for your state's program today.)

______ Under $1,000 _____ Employment ______ $1,001 - $1,450 _____ TANF or welfare ______ $1,451 - $1,850 _____ Soc. Security ______ $1,851 - $2,200 _____ Disability ______ $2,201 - $2,570 _____ Other ______ Over $2,570

Additional comments:


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Prepare Your Testers and Volunteers

Have an eligible family run through the application process in each of the locations thatyou plan to test before you set up your testing plan. In the Idaho SCHIP testing project,the original plan was to have all of the testers in one location go in to the office andapply, one after the other, and then be immediately interviewed about the experience byvolunteers. Unfortunately, the application process at the Idaho Department of Health andWelfare was not as simple as they expected. Each of the testers was handed anapplication and given an appointment to return later and apply. The organizers then hadto arrange to interview each of the applicants after their appointments, which were spreadout over several weeks.

Its important to be flexible and able to adapt to whatever system you find. If you send inan advance tester, to see generally how the process works, youll be able to plan and havea better idea of what resources youll need to complete the test.

Find out if:

the office will take applicants off the street and allow them to apply on the spot;

the office will set appointments for interviews when people walk in;

the office will set appointments over the phone;

applicants are required to go to the office to apply or can order an application andsend it back without going to an office;

applicants have to make multiple visits to the office to complete the application;

the office schedules many appointments for each day.

Some states will provide applications to people who call for them and allow applicants tosend in completed applications. Some dont require any interview, either face-to-face or over the phone. That makes applying much easier for applicants, but you will want totest how the office staffs treat applicants, so ask your testers to go in to an office to pick up an application.


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Training

Before the test begins you could have a training session for both the testing families andthe volunteers who will be interviewing them to collect the results of the test. Thefollowing training plan is based on the training ICAN did for its testers in the SCHIPtesting project, based on the questions they planned to ask.

Sample CHIP Research Training for TestersBased on training given in Idaho February, l999

Approximate time: 1.5 hours(Have enough copies of the recruitment forms and the getting the application role-play

for everyone. Have two copies of the appointment role-play for you and organizer only)

Ask people to fill out recruitment form while they are waiting to begin and be sure tocollect them.

Welcome

Define CHIP (10 minutes)Discuss what participants know about the CHIP program.

Prepare a poster with the key facts about CHIP and your states program and hang it soeveryone can follow along with your explanation and refer to it during the program.Prepare a handout with the same information to give to the testers after the training.

Explain benefits, eligibility requirements, and purpose of the CHIP program.

Explain application process for your state.

Explain purpose of testing projects, examples of past testing (10 minutes)

The following is a sample explanation, prepared for the Idaho testing project.

We want to help you get CHIP benefits, so we want to help you through the process,AND we want to make it easier for others too, so we're asking your help in documentingwhat your experience is when applying. We've tried to get as many people as possible tohelp with this from 3 different parts of the state: Lewiston, Nampa/Caldwell, and Burley.We want to document if people are having difficulties accessing CHIP, and if certaingroups of people have more difficulty than other groups; that is, if they are beingdiscriminated against.

I believe everyone here is eligible for CHIP and during the next week you'll beapplying for benefits. In order to document what is preventing people from getting CHIP


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benefits, we're going to ask you to answer a few short questions immediately after you pick up the application form for CHIP and after your appointment with the caseworker.We want you to specifically describe whether the caseworker talked with you aboutCHIP, and whether his or her comments or actions were positive, or negative.

Has anyone had any experience with a public institution (like DH&W - not in

applying for CHIP necessarily) that was positive? Can you say what made it so? Negative? Can you describe what made it so?We want to do the same thing here, remember what was positive and negative, and weare depending on you to remember details and to tell us afterward. We don't want you totake notes or tape record, or change anything about the way you would act if you werenot in this role of observing. Think for a minute what you might do that would changethe possibility of getting benefits (example: lie, not show up for the appointment, tell thecaseworker we're watching him or her). We don't want you to change your behavior inanyway - just be yourself. We simply want you to observe what happens as you get anapplication and during your appointment. We don't believe that this should not in anyway affect whether or not you get benefits.

This kind of observation has been done by other groups, like this one, to makesure that government programs and laws preventing discrimination are working for people. In l989 there was a big study in Chicago to see if black people werediscriminated against in applying for public housing. A group like Idaho CommunityAction Network got complaints that people were being denied housing, and they thoughtit was due to their race. So the organization sent people to look at apartments who weresimilar in income and education and gender but were different races. They sent a black

person to apply first, then a white person, and they interviewed each afterwards and theyfound that blacks were being discriminated against and because of this 'research',

practices in renting apartments changed. This technique of finding people who aresimilar in all areas except race been used also to see if there is discrimination in lending

practices of banks. It hasn't been used much in welfare and other benefits. So you're partof a new and important study here in Idaho. We're asking you to tell us about yourselvesin a lot of detail so that we can find out if people who have a lot of similarities are beingtreated differently if their only difference is race. We don't need for the two to go to thesame office or at the same time because, unlike an apartment that might be rented, CHIP

benefits should be accessible for all and there is no time constraint. So, we're going to belooking at these issues of possible discrimination over the next week.

Any questions so far?

Research Steps (5 minutes: Write steps up on chalkboard if possible)

Explain each step of the project, including directions about when and where testersshould be, and how long each step should take.

Does anyone have any questions?

Review questions (5 minutes)


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Ask testers to summarize for you what youve discussed so far.

Prepare a poster that spells out the key points you want to emphasize, especiallythat they should not ask for CHIP by name when they ask for assistance .

Review the questions youll be asking the testers when they report on each stageof the test. For example:

We are going to now go over the main questions we are going to ask you after you have picked up your application. By knowing them in advance, you might be able to payattention to the situation.

1. Did the caseworker tell you how to apply for CHIP specifically? We want tosee if they offer to tell you about CHIP when you pick up the application - we don't wantyou to have to ask for CHIP.

2. Did the caseworker act in a positive way or make positive comments to you?3. Did the caseworker act in a negative way or make negative comments to you?

Does that seem doable? Any questions?

Role Play (30 minutes total (20 to model and analyze, 10 to practice 1:1))

Model Good Secretary and Bad Secretary and Bad Caseworker examples and facilitate post role-play discussion after each.

Discussion format for good secretary: ask people to identify positive actions/commentslike offering a translator, offering information about how long the process will take, andusing the term CHIP.

Discussion format for bad secretary: Ask people to identify negative actions/ commentslike: didnt offer any extra/helpful information, told person when to come for anappointment without asking if that would work, didn't say the word "CHIP"

Discussion format for bad caseworker: Ask people to identify negative actions/comments like: got up and walked away to talk with colleague, discounted entireapplication, didn't set another appointment.

Then break people into pairs telling them to practice just good and bad secretary and feelfree to adapt their characters - but be realistic, then talk about it with one another. Each

person should practice asking for the application in this exact way. We don't want peopleever to ask for CHIP when they go in for an application.

Ask one pair to perform their role-play before the group, and ask them and the group tocomment on what went well, etc, in their play.


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Summarize, writing points on chalkboard. Repeat the main questions youll be asking inthe interview, and remind testers that they do not need to act at all, but just be themselves.

Closing Q&A (10 minutes)Any questions? Are you ready?

Go over logistics.

End (10 minutes)Take more time to complete recruitment forms and then collect formsHand out copies of your What is CHIP? summary.

Sample Getting the Application Role-PlaysDeveloped for CHIP Research TrainingIdaho February, l999

Good secretary

Client: Hi, can you help me? Nobody in my family has health insurance.

Good secretary: Yes, first you need to fill out an application for Medicaid its good for theChildren's Health Insurance Plan also, then you need to have an appointment with a caseworker. Do you need help filling out this form? We have translators.

Client: No thanks, but can I take it home with me?

Good secretary: Yes and let's set an appointment, can you come in next Friday?

Client: No, I can't, I work then, but I could come in Tuesday or Wednesday?

Good secretary: OK, how about Tuesday at 10 am? The appointment will take about anhour.Be sure to bring all the documents listed here, including your children's birth certificatestoo.

Bad secretary

Client: Hi, can you help me? Nobody in my family has health insurance.

Bad secretary: Yes, first you need to fill out this application.

Client: Do I need to fill it out now?

Bad secretary: No.


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Client: What happens once I fill it out?

Bad secretary: Then you meet with a caseworker.

Client: Can I make an appointment?

Bad secretary: Yes, you need an appointment, next Friday 10 a.m.

Client: Sorry, but I can't come in that day because I work then, but I could come inTuesday or Wednesday?

Bad secretary: OK, Tuesday at 10 am. Be sure to bring all the documents listed here,including your birth certificate and your children's birth certificates too.

Bad Caseworker

Bad Caseworker: OK, what are you here for?

Client: Nobody in my family has health insurance and I'd like help.

Bad Caseworker: Let me see your application. (looks at it quickly, gets up walks awaytalks to another imaginary caseworker about their lunch date, comes back). You've filledthis out all wrong (tears the application in half and throws it away). You need to start allover again. Here's another form.

Client: Can you tell me what was wrong?

Bad Caseworker: You didn't have the right documents. Your children's birth certificatesshowed different dates. You'll have to go to the hospital and get it corrected.

Client: But what about the application? What was wrong with it? Can I get insurancefor my kids?

Bad Caseworker: Come back when your documents are corrected. Next Person?


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Training Volunteers

Training for volunteers who interview testers and complete questionnaires can be similar to tester training in many ways. You could begin with the informational sessions that

begin the tester training sample above:WelcomeDefine CHIP (10 minutes)Explain purpose of testing projects, examples of past testing (10 minutes)Research Steps (5 minutes: Write steps up on chalkboard if possible)Review Questionnaires (10 min)

Review the questions on the questionnaire and discuss the importance of the informationthey ask for. Explain how the demographic information can be used to showdiscrimination against particular groups. Review the barriers you expect to encounter and explain how the questions on the questionnaire willshow those barriers in practice.

Discuss Confidentiality Issues (10 min)

Some of the questions on the questionnaires will make testers uncomfortable, like thequestions about immigration status. Ask volunteers which questions they think mightcause testers to be uncomfortable or lose trust in your organization. Discuss those issuesand how to approach them without making testers uncomfortable.

Remind volunteers that all information collected in the test must be kept confidential.Your group will want to identify families that are comfortable taking public roles in thecampaign; discuss how volunteers can explain those roles without frightening publicity-

shy testers.

Teach Listening Skills (10 min)

Filling in the spaces on the questionnaire is important, but gathering stories is equallyimportant. Review listening skills and remind volunteers that they need to record asmuch of the testers experiences as they can.

Role Play (30 minutes total (20 to model and analyze, 10 to practice 1:1))

Model good interview skills and have the group discuss the role play. Have the group

break into pairs and practice. Ask one or two pairs to perform their role play for thegroup and discuss.

Closing Q&A (5 minutes)Any questions? Are you ready?Go over logistics.


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Interview Testers, Document their Experiences andtheir Stories

As each family finishes each step of the application process, have volunteers interviewthem and record their experiences. The questionnaires volunteers used in the OregonFood Stamp project follow this section. Try to include questions that discuss all of theissues you wanted to test with your project. As you interview families you might learnabout issues you hadnt known existed.

Collect horror stories of particularly bad treatment and try to document them. Youllwant to include them in your final report and your press information.

Some of the questions on the following questionnaires are very specific. Remind your volunteers that other information, especially stories, is very important. Youll want to

have peoples stories in their own words for your report. Ask volunteers to write downstories as people tell them, as much as they can, and to explain answers like other.


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Oregon ActionFood Stamp Testing Project

Response Sheet Number 1: First Visit to Food Stamps office

Instructions: Complete this response sheet after your firstvisit to the food stamp office. Please fill out the formcompletely and do not leave any answers blank. If you needhelp, please ask.

Name: ____________________________ Ethnicity:

______________ Phone: ______________

Number of adults in household: ________ Number of children

in household: _______________If anyone if your household works for wages, answer the

following questions:

First job: Hourly wage: __________ Hours per week:

_________ Hours per month: _____

Second job: Hourly wage: _________ Hours per week:


Third job: Hourly wage: __________ Hours per week:


Do the adults in your household have health insurance?

Yes No

Do the children in your household have health insurance?

Yes No

Date you applied for food stamps: __________________________Today's date: ____________

Location you applied for food stamps:

______________________________________________

What language do you prefer to speak:

______________________________________________


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Oregon Action staff person name:

__________________________________________________

1) Did the person helping you encourage you tocomplete and return the first page of theapplication immediately?

Yes

No

2) Was it explained to you that you needed toreturn for an interview with a completedapplication and supporting documents at a latertime?

Yes

No

3) Were you told to return during a mass intaketime (i.e. between 7:00 a.m. or 9:00 a.m.) or aspecific appointment time?

Intake

Appointment

4) Was the interview time offered convenient foryour schedule?

Yes

No

5) [Skip if answer to #4 is Yes.] Why was the timeinconvenient for you?

Work SchoolOther

6) [Skip if answer to #4 is Yes.] Were youprovided with an alternative time that wasconvenient for your schedule?

Yes

No

7) [Skip if answer to #4 is Yes.] Did the personhelping you offer to send a food stamps workerto your home to interview you or hold theinterview over the phone?

Yes

No

8) Were you told that you needed to fill out theentire application and bring the requireddocuments before returning to the office foryour interview?

Yes

No

9) Were you told that if you were unable to locatethe required documents that you could insteadprovide the name of someone, like a landlord or

Yes

No


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an employer, who could confirm your statements?

10) Did the person helping you ask if you had anyquestions?

Yes

No

11) Were you provided with a phone number oranother way to contact a food stamps worker ifyou needed help while filing out theapplication?

Yes

No

12) Were you asked if you needed help buying foodimmediately or if you were in a crisissituation?

Yes

No

13) Did the food stamps worker read all sectionsof the application you turned in while you werewaiting?

Yes

No

14) Were the directional signs in the office clearand did you understand where to apply for foodstamps at the office?

Yes

No

15) Did you tell the person helping you that youwere applying only for Food Stamps and not anyother programs?

Yes

No

16) Non-English Speakers Only: Were you directedto a food stamp worker who spoke your preferredlanguage during your visit?

Yes

No

17) Non-English Speakers Only: [Skip if answer to#13 was No.] How long did you wait for someoneto help you in your preferred language?

< 15 min.15 3030 - 1

hr.

> 1 hr.another

day

18) Non-English Speakers Only: [Skip if answer to#13 was No.] Were you provided with anapplication in your preferred language?

Yes

No


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19) How long did you wait before you received anapplication?

< 15 min.15 - 30> 30 min.

20) Please rate the helpfulness of the person whogave you an application. A rating of 1 is thebest rating and means the person was veryhelpful. A rating of 4 is the worst rating andmeans the person was not helpful.

1

234

21) What was the name of the person who helpedyou? _________________

22) Did you know that you could have received anapplication by mail?

Yes

No

Other questions:

23) How did you know which food stamps office to go to?

24) Did anything particularly negative or positive happenduring your visit that you would like to comment on?


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Oregon ActionFood Stamp Testing Project

Response Sheet Number 2: After the food stamp interview

Instructions: Complete this response sheet after yourinterview at the food stamp office. Please fill out theform completely and do not leave any answers blank. If youneed help, please ask.

Name: _______________________________________________

Phone: ______________

Date of your food stamps interview:________________________ Today's date: _________

Oregon Action staff person name:

__________________________________________________

Questions about the food stamp application:

Did you fill out the entireapplication form?

Yes

No

[Skip if answer to #1 is Yes.] Whydidn't you fill out the entireform?

Directions unclear

Lacked requiredinformation

Did not have time

Other____________________

Did you understand that there wereparts of the form that you did notneed to complete in order to applyfor food stamps?

Yes

No

Please rate the clarity orunderstandability of the

1 = completelyunderstandable


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application. A rating of 1 = thebest. A rating of 4 = worst.

2 = basicallyunderstandable

3 = difficult tounderstand

4 = very difficult tounderstand

Please estimate how long it tookyou to fill out the application:

less than 1 hour

between 1 and 2 hours

between 2 and 3 hours

more than 3 hours

Questions about the food stamp interview:

25) What time did you arrive at theFood Stamps office?

26) What time did your interviewbegin?

27) What time did your interviewend?

28) Were you interviewed on the dayyou were told to return?

Yes

No

29) Non-English speakers only: Wereyou interviewed by someone who

spoke your language or were youprovided with a translator?

Yes

No

30) Non-English speakers only: Howlong did you wait for someone tohelp you in your preferredlanguage?

< 15 min. 15 3030 - 1 hr.> 1 hr.


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had to return on adifferent day

31) Were you required to sign theself-sufficiency plan?

Yes

No

32) Were you required to sign theJobs and Jobs Plus Rights andResponsibilities document?

Yes

No

33) Were you required to sign the"Cooperating with Child SupportEnforcement..." document?

Yes

No

34) Were you required to provideproof of citizenship?

Yes

No

35) Was the grievance procedureexplained to you?

Yes

No

36) Were you told that you or yourfamily might be eligible for otherprograms, like health care or cashassistance?

Yes

No

37) If there were errors on yourapplication, did the food stampworker help you correct them?

Yes

No

38) If you were unable to provide arequired document were youinformed that you could providethe name of someone, like anemployer or a landlord, who couldconfirm you statement?

Yes

No

39) Were you asked if you had anyquestions?

Yes

No

40) Did you tell the person helping Yes


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you that you were only applyingfor food stamps?

No

41) Were you told when you wouldlearn if you were eligible forfood stamps?

Yes

No

42) Outside of the food stampsoffice, have you ever seen aposter or heard a radio or TV addescribing the food stamp program?

Yes

No

43) How would you rate the treatmentyou received during your

interview? A rating of 1 =excellent. A rating of 4 = verypoor.

1 = excellent

2 = adequate

3 = poor

4 = very poor

44) How would you rate the patienceof the person interviewing you? Arating of 1 = extremely patient.A rating of 4 = not patient atall.

1 = extremely patient

2 = somewhat patient

3 = not very patient

4 = impatient

45) What was the name of yourinterviewer?

Other questions:

Do you feel you were treated with respect at the food

stamp office?

Did the person helping you make any particularly positive

or negative comments during your interview?


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Did anything particularly negative or positive happen

during your visit that you would like to comment on?


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Charting Your Results

As you interview families, it can be helpful to enter the information you collect into achart.

Important information to include in your charts:

Each step of the application process

Each familys experience with each issue you have decided to focus on in your study

Notes about horror stories

A good chart will show you at a glance which steps still have to be completed in the

applications. That can save organizing time and youll be able to tell how much of your project is complete and how much time you still need to devote to it. Collecting resultsfor all families about one issue in one spot will make it easier to generalize aboutexperiences as you plan what to focus on in your report.

Two sample charts follow; you can adapt them to suit your project. Some testers willhave experiences you didnt expect. Leave space in your chart to add those experiences.


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Sample Charts to Organize Questionnaire Information

# of

kids

Monthly

Income

Race Town Offered

CHIP?

Which

documentswere youasked toshow?

Does the

staff treat peoplefairly?

Comments Next

Step

How long did

you wait?How long didtheappointmenttake?

6 $1,451-1,850

Black Nampa No SS# for Kidsat appt.

Cant sayyet

Wasnt toldto bring in all

paperwork

10 minute waitfor appt., 50-min appt.

Name Did you go to1st

Appointment?

Whatwas thenextstep?

Did thenext stephappen?Comments

Whichdocumentswere youasked toshow?

Were birthcertificatesrequested for

people other than the kidsand for whom?

Have youreceived CHIP/Medicaid for your kids?

If you weredisqualified,what areyour nextsteps to getcovered?

Comments/Stories

Anna Yes Interview.

Yes MarriageLicenseandPaternityform.

Yes, theywanted birthcertificates for everyone thatwas in thehousehold

Yes She had tosend awayto Mexicoto getmarriagelicense.


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Writing Your Report

Prepare a report that describes the experience of your testers when they applied. One way to

organize your information is to choose several common barriers testers faced in the application process. For example, in evaluating the ICAN testing project, organizers chose six issues: lack of access to translation services, the failure to publicize CHIP availability, lack of privacy for applicants, the length and complication of the application form, discrimination, and thedifficulties to working parents of scheduling mandatory interviews during the workday. In theOregon food stamps project, organizers chose seven issues: an inflexible and inconsistentinterview process; inadequate access to language services for non-English speakers; a long andconfusing application; inadequate and discourteous service; food stamps offices that weredifficult to contact; a failure to provide families in crisis with immediate service; and a failure of offices to follow up with families, forcing them to repeatedly contact the offices to obtain foodstamps.

In your report, explain how you conducted the test, and who your testers were. Then focus oneach of these barriers, explain how the barrier affects applicant families in general, and provideexamples of individuals experiences confronting the barrier.

Suggest how each of the barriers could be eliminated. These suggestions are very important. Besure to make them a part of all of the information you distribute.

Prepare one-page fact sheets about each of your issues, explaining the problem and proposingyour solutions. Try to make these summaries simple and eye-catching.

The report that NWFCO and Oregon Action prepared after the food stamp testing project, andthe one-page summaries that NWFCO and ICAN prepared after the SCHIP project are attachedas examples.

Moving into Action/Media

Ask some of your testers and their families to speak about their experiences at your pressconference. Before the conference, help them to prepare short statements about their experiences. Listen as they practice their statements and role-play a press conference, askingquestions reporters are likely to ask them. Invite organizations you work with to join you in your actions and statements to the media.


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Summary

What you will have accomplished when you complete this project:

1. Built a membership base of members who have worked on the issue, recruited members towork as testers, trained them to perform the test, and prepared them to act asspokespersons to the press about the issue.

2. Documented problems in your state that prevent people from receiving benefits.

3. Produced written material about your project and access to the benefit program, includingfact sheets and a report.

4. Publicized your actions through the media and removed the barriers for people in your state.


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Many of our members are eligible for CHIP. We asked them towrite down their experiences with the Department of Healthand Welfare when they tried to apply for the program.

We found that many people were treated differently. Most peo-ple did not have positive experiences with the Departmentsworkers. Our Latino members experienced the most difficulttime getting Medicaid/CHIP.

One person had their application torn up by a Departmentof Health and Welfare worker.

Another was pressured to withdraw her application by acaseworker.

Another was given an appointment when she was unable tocome in because of work. When she complained, the case-worker stated that she had to take what she could get. Noother alternative was offered.

Still others have been turned down or discouraged from ap-plying, although their children were eligible for Medicaid/CHIP.

Unfortunately, we keep collecting these horror stories. In orderto address this problem, the Department must develop a clearprocedure for taking Medicaid/ CHIP applications. There mustbe a complaint system for investigating peoples complaintsabout how they are treated by the Department of Health andWelfare. There must be careful training of Department work-ers, to ensure that they are up-to-date about the current Medi-caid/CHIP rules and treat all people with dignity and respect.

I DAHO C OMMUNITY A CTION N E T WORK

Childrens HealthInsurance Program

All Applicants

Should beTreated theSame Way

1311 West JeffersonBoise, ID 83702

Phone: 208-385-9146

I DAHO C OMMUNI TY A CTION N E TWORK


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Only children who are applying for CHIP should be asked for

their citizenship status and social security numbers. Parentsmay not want to disclose this information or may not have their

social security number available. Asking for this information

from parents is not required and a childs Medicaid eligibility

may not be based upon whether a parent provides it.

Some states have included statements on the applicationforms that protect privacy:

Citizenship information for those age 19 and over is op-

tional. Connecticut

Parents applying for KidCare only for their children do not

need to provide proof of legal immigration status for them-

selves. Illinois

If you are applying for Medicaid for a child, you are not re-

quired to provide your own social security number (SSN) inorder for the child to receive Medicaid, but we must have

the childs SSN in order for the child to receive Medicaid.

Model HCFA application.



Privacy


Phone: 208-385-9146



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Many working families whose children are eligible for Medi-

caid/ CHIP dont know about the program or believe that they

are not eligible. We need a strong publicity campaign to get

the word out, similar to the Department of Health and Wel-

fares highly successful Baby Your Baby Campaign in 1991-

92.

The Baby Your Baby Campaign got the word out using many di f-

ferent media: It used television and public service announce-

ments in English and Spanish, brochures explaining health pro-

grams. A series of information sheets on a variety of health

topics, billboards, posters and tables at community events that

publicized the program. Many people learned about needed

health programs through the publicity campaign which played

a key role in dramatically lowing Idahos infant mortality rate.

Publicity can have the same effect in lowering the uninsurance

rate among Idahos children. We want a new Baby Your baby

Campaign for CHIP!!



Publicity:

A NewBaby Your Baby

Campaign


Phone: 208-385-9146



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Idahos Medicaid/CHIP application form is seventeen pages

long and very difficult for some parents to complete. Idaho

can rewrite its Medicaid application to be much shorter. The

Health Care Financing Administration (HCFA) the federal

agency that oversees Medicaid, has designed a two pagemodel application form. Over forty states have shortened their

applications to four pages or less. Many are just two pages

and easy to complete.

Idaho also needs to develop an easy application process.

Many people report having to visit the Department of Healthand Welfare offices two, three, even four times to be able to

submit a complete application and find out if they can enroll

their children on CHIP/ Medicaid.

People should be able to find out whether they are eligible for

services quickly. Right now, people have to wait for two tothree weeks to find out whether their children are enrolled on

CHIP. Children shouldnt have to wait to get this coverage. The

Department should process these applications immediately so

children can get health coverage right away.



SimpleApplication

Form and Process


Phone: 208-385-9146



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Idahos Department of Health and Welfare is required by law to

communicate with Medicaid/CHIP applicants in a language un-

derstood by the applicant, including English and Spanish.

The Department should ensure that:

All CHIP materials, applications, flyers, brochures and other

documents should be available in Spanish.

Its toll-free number has Spanish speaking workers availableat all times to respond to the questions by Spanish speak-

ing families.

It has hired bi-lingual outreach workers to work in Hispanic

communities in Idaho to enroll Medicaid/ CHIP eligible chil-

dren.

Trained translators are available at all offices during work-

ing hours to ensure that families applying for services fully

understand the process and that their concerns are heard.



Access toTranslation

Services


Phone: 208-385-9146



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Working families have a difficult time applying for CHIP. The

Departments offices are not open after working hours, and it

wont take applications by telephone or mail. This restrictions

prevent many parents from signing their children up for CHIP.

Idaho should allow Medicaid/ CHIP applications to be proc-

essed at more sites outside of Department of Health and Wel-

fare (out-stationing). Idaho is required to allow pregnant

women and children to apply for Medicaid/CHIP at locationsother than the Medicaid office. These places include commu-

nity health centers, migrant health centers, health care pro-

grams for homeless people and health clinics operated by In-

dian tribes. Additional out-stationing can take place in other

settings, including schools, early childhood programs, WIC clin-

ics, family resource centers, one-stop career centers andchurches.

The Department can also allow working parents to submit their

applications by mail or by telephone. Thirty-four states allow

mail-in applications and six of these will interview families over

the telephone.



Making it Easier to

Apply for Medicaid/

CHIP


Phone: 208-385-9146



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Hunger Pains:Oregon Food Stamp Program Fails to Deliver

National Breaking Barriers Series: No. 2

By Carson Strege-Flora

Oregon ActionNorthwest Federation of Community OrganizationsMay 2000


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Table of Contents

Executive Summary ... ..pa

Introduction . .

Key Findings . p

Barriers to Enrollment ...p

1. Applicants in crisis are not provided with requiredexpedited servicepage

2. AFS interview process is inflexible andinconsistent...page

3. AFS provides inadequate services for limited Englishspeakers..page

4. Applicants must repeatedly contact AFS to obtain foodstamps..page

5. AFS uses a long and confusing application.page

6. AFS provides inadequate and discourteous service toapplicants.page

7. AFS offices are difficult to contact...page

V. Conclusion...page

Endnotes..page

Appendix 1: Letter from USDA to Oregon AFS Division

Appendix 2: Idahos simplified application


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Executive Summary

Tim Riddle works part-time but doesnt earn enough to live on.Tim and his six-year-old son, Chris, live at a homeless shelterin Medford, Oregon. As money grew short in late January, Timrealized he would not be able to provide enough food for his sonand went to the welfare office to apply for food stamps.Despite federal requirements to do so, Tim was not screened foremergency food stamps and was told he needed to wait a month forhelp.

Theres nothing scarier for a father than not knowing where hischilds next meal is coming from. Tim Riddle.

Unfortunately, stories like Tim Riddles are all too common in

Oregon. According to the United States Department ofAgriculture (USDA), Oregon tops the list of states with thehighest percentage of people experiencing hunger. i The USDAestimates that more than one-eighth of Oregon households arefood insecure, meaning that these households do not alwayshave assured access to enough food to fully meet their basicneeds. About half of these households experience painfulfeelings of hunger. ii

The food stamp program is Oregons largest and most importantprogram in the fight against hunger, particularly for children.

About 40 percent of food stamp recipients in Oregon arechildren. iii Benefits are modest, but food stamps can mean thedifference between hunger and a healthy diet for families. In anaverage month, about 100,000 households receive food stamps inOregon. iv

Despite the benefits food stamps offer families, participationin Oregons food stamp program is declining. Since 1996,participation has plummeted by 20 percent. v Yet, Oregons foodbank network reported a 16 percent increase in demand foremergency food boxes between 1998 and 1999. vi Additionally, datafrom the USDA indicate that the number of hungry people inOregon may be at a three-year-high. vii USDA data find that thenumber of food insecure households in Oregon has increased from146,591 in 1996 to 194,594 in 1998, an increase of eight percentin just three years. viii

The purpose of this study is to identify policies and practices thatdelay or impede applicants from obtaining food stamps. Oregon Actionidentified 25 low-income Oregon residents in the winter of 2000 whowanted to apply for food stamps and who agreed to participate in twointerviews. Participants were interviewed in accordance with aprotocol developed for this study after they had obtained an

application at an Oregon public assistance office and after they hadcompleted the required food stamp interview. This study trackedapplicants through the enrollment process but, due to time constraints


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Division, which administers the food stamp program, has the power toeliminate all the barriers identified in this report.

Barriers to accessing food stamps in Oregon

AFS does not provide families in crisis with immediate serviceas required by law.

AFS interview process is inflexible and inconsistent.

AFS provides inadequate services for Non-English speakers.

Applicants must doggedly pursue and repeatedly contact AFS toobtain food stamps.

AFS uses a long and confusing application.

AFS provides inadequate and discourteous service.

AFS offices are difficult to contact, particularly hinderingworking applicants from applying.

Some key findings of the report

Only 46 percent of applicants were instructed to complete theemergency services screening tool used by AFS. If AFS doesnot use its emergency services screening tool, applicants incrisis situations are left with no ability to purchase food.

At some offices, applicants must arrive between 7:00 a.m. and9:00 a.m. to sign-up for interviews. If interview slots aretaken, applicants must return the next day; requests forappointments are generally denied. Applicants with morning obligations are shutout of the process.

Applicants waited an average of 6.5 days for their AFSinterview. Applicants request food stamps because they need food. Making them wait a week to have their required interview unnecessarily elongates the time they must wait for food.

Non-English speakers waited four times longer than Englishspeakers to receive applications in their languages.Applicants should not receive substandard service simply because they do not speak English.

Forty-four percent of applicants rated the understandabilityof the AFS application as difficult to understand or verydifficult to understand A confusing application can


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Simplify and accelerate the application process

Encourage applicants to file application forms on the same day ofinitial contact.

Inform applicants about their right to file an incompleteapplication to begin the process. Streamline the interview process so that clients wait no more than 2

days for an interview. Simplify the 16-page application by using the Idaho application as a

model (see appendix). Provide applicants with a clear list of documentation required. Provide all clients with the option of a specific interview time. Inform eligible applicants of their right to a home or phone

interview. Provide translators in a timely manner to all applicants who speak

limited English. Do not use translators who are not fully fluent in both English andanother language.

Train front desk staff to fully explain the food stamp process andengage with clients.

Provide more out-stationed AFS workers to enroll applicants in theirneighborhoods.

Provide evening office hours for working clients. Improve phone system so clients can access the information they

need. Provide clients with sufficient information so that they do not have

to repeatedly contact the office. Allow applicants to apply at the AFS office closest to their home or

work.

Provide expedited services for applicants in crisis

Inform clients about how the expedited food service process works. Train staff on how to identify clients needing expedited service. Develop and use a satisfactory screening tool to identify people in

need of emergency assistance.

Treat applicants with dignity and respect

Train all workers in basic customer service skills. Hire an independent research group to survey clients about the

treatment they receive. Provide clients with the required information about the grievance

and appeal procedures. Use directional signs in the office. Inform applicants about other programs available to them.

Develop an effective outreach program to educate potential applicants

Maintain a statewide toll-free food stamp hotline for applicants. Develop outreach campaigns that include neighborhood-basededucational activities.


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Over the past year, members of Oregon Action have described alarmingproblems when applying for food stamps. Many applicants experiencedlong delays at the Adult and Family Services (AFS) Division officeswhere food stamps are processed. Others reported that they feltdiscouraged and mistreated by AFS workers. Some detailed incidents atAFS offices that appeared to be in violation of food stamp law. ManyOregon Action members felt that AFS offices were more focused oncreating barriers to the food stamp program than helping them enroll.

The food stamp program is Oregons largest and most importantprogram in the fight against hunger, particularly for children.About 40 percent of food stamp recipients in Oregon arechildren. ix Benefits are modest. In Oregon, the average perperson benefit is $70 per month, but food stamps can mean thedifference between hunger and a healthy diet for families. x Inan average month, about 100,000 households receive food stamps

in Oregon. xi

Despite the benefits food stamps offer families, participationin Oregons food stamp program is declining. Since 1996,participation has plummeted by 20 percent. xii Yet, Oregons foodbank network reported a 16 percent increase in demand foremergency food boxes between 1998 and 1999. xiii Additionally,data from the USDA indicates that the number of hungry people inOregon may be at a three-year-high. xiv USDA data find that thenumber of food insecure households in Oregon has increased from146,591 in 1996 to 194,594 in 1998, an increase of eight percent

in just three years.xv

Because the decline in food stamp participation is occurring atthe same time that Oregons hunger rates are increasing, it isvery unlikely that people are leaving food stamps because theyare enjoying the benefits of the expanding economy and findinghigh wage employment. The explanation that food stampparticipation is declining because Oregonians no longer needfood stamps is inadequate.

To understand why the food stamp program is under-utilized,

Oregon Action and the Northwest Federation of CommunityOrganizations interviewed 25 food stamps applicants about theirexperiences when applying for food stamps. We examined theenrollment policies and practices at seven AFS local branchoffices in Portland and Medford, Oregon in order to identifypolicies and practices that hinder applicants from applying forfood stamps.


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Key Findings

This report found the following barriers at Adult and FamilyServices offices in Medford and Portland. These barriers

unnecessarily delay and impede applicants during the food stampapplication process.

Barrier 1 AFS does not provide families in crisis with immediateservice as required by law.

Fifty-six percent of applicants were not instructed to complete theemergency screening tool used by AFS. Some homeless applicants werenot provided expedited services. Other applicants determined eligiblefor expedited service waited two or more weeks to get food stamps.

Barrier 2 AFS interview process is inflexible and inconsistent.

AFS provided only a quarter ofapplicants with specificinterview times; others attendedduring first come, first serveinterview sessions. Interviewtimes during first come, firstserve sessions fill early andapplicants must return each dayto take another number.

Barrier 3 AFS provides inadequate services for limited Englishspeakers.

Limited English speaking applicants waited four times longer thanEnglish speakers to obtain applications in their language. AFS doesnot always provide adequate translator service.

Barrier 4 Applicants must doggedly pursue and repeatedly contactAFS to obtain food stamps.

To get help, applicants repeatedly contacted AFS offices, oftenwithout success. AFS phone systems are deficient and applicants weregenerally unable to contact workers. Many applicants reported thatwhen they did leave messages, workers did not return their calls.

Barrier 5 AFS uses a long and confusing application.

AFS requires applicants to complete a 16-page, cumbersomegeneral public assistance application form. The applicationdoes not specify which documents are required for food stamps.Applicants often have to make several trips to the office toprovide the necessary documentation.

Barrier 6 AFS provides inadequate and discourteous service.

AFS does not provide applicants with basic required information about


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applicant to apply. At some offices, applicants must arrivebetween 7:00 a.m. and 9:00 a.m. to sign-up for an interview. xviii

There is no enrollment hotline phone number.


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Barrier 1: AFS does not provide families incrisis with immediate service as required bylaw.

Findings: Only 46 percent of applicants were instructed tocomplete the expedited service-screening tool used by AFS. xix

Only 12 percent of applicants were asked about theircurrent situation or need for emergency assistance by frontdesk workers. Of the three homeless applicants, only one wasdetermined eligible for expedited service. The other twohomeless families waited three to four weeks for their foodstamp benefits. Only one applicant was told that she could provideincome verification in ways other than a written document.

The general lack of urgency and sluggishness evident in AFSbranch offices particularly harms those with emergency foodneeds. Expedited processing means local offices must providefood stamps to qualified individuals within seven days ratherthan the standard 30 days and is a critical component of thefood stamp program. Expedited service reduces the timeapplicants in crisis must wait for their food stamps. Eligibleapplicants have almost no income or assets and are at seriousrisk of not being able to access food. When AFS does not screenfamilies for expedited service, eligible families mustunnecessarily endure additional days without food.

AFS inadequate expedited food stamp process may violate federallaw.

Under federal law, every applicant must be screened forexpedited service. The USDA requires all states to designapplication procedures that identify households eligible forexpedited food stamp processing at the time assistance is

requested.xx

None of the offices in Medford or Oregonconsistently screened applicants for expedited serviceeligibility. Three homeless families that should have beenimmediately identified as potentially eligible for expeditedservice were required to go through the standard process,including providing all required verification. Federal lawrequires that families eligible for expedited service need onlyinitially provide proof of identity and residency. Income andother verification can occur later. xxi In a separate study, theUSDA identified serious problems with AFS expedited food stampprocess and required AFS to take corrective action but

applicants continue to experience problems.xxii

Pull quotes for sidebar:


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I told them I needed emergency assistance. The front deskperson told me to come back almost three weeks later for anappointment. Name withheld, West Main AFS office in Medford.

Barrier 2: AFS interview process isinflexible and inconsistent.

Findings: Seventy-five percent of the employed applicants whorequested alternative interview times because of jobconflicts were denied an alternative interview time. All of the unemployed applicants who requestedalternative interview times because of educational,training or job search conflicts, childcare problems, ortransportation problems were denied an alternative

interview time. Only one applicant was provided with the option of ahome or telephone interview. Applicants waited an average of 6.5 days before theywere interviewed by AFS. Twenty percent of applicants waited ten days or morefor their required interview. Eight percent of applicants were provided with anapplication but not told that they needed to return for aninterview.

Applicants who were told to return for an interviewduring a general intake time waited an average of 70minutes before their interview began. One applicant waitedtwo hours and twenty minutes. On average, interviews lasted 40 minutes, but somewere as short as 15 minutes and others took over 90 minutes.

The AFS prolonged interview process ignores the serious needs offood stamp applicants by making them wait for unnecessarily longperiods of time. Some AFS offices make clients return onlyduring a specified two-hour period for their interviews. If the

interview slots fill up for that day, applicants are sent homeand required to return another day. For applicants who areworking, time spent at the welfare office means missing pay andendangering the financial stability of their families. Forapplicants who are in training or who are searching for work,long waits at AFS offices interferes with their ability tobecome self-sufficient.

AFS interview process may violate state law and federaldirectives.

In its December 1998 review of three Portland area AFS offices,the USDA found that the first come, first system could hinderapplicants and suggested several corrective actions. It does


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I had to take time off work for my 2:00 p.m. appointment butwasnt seen until 2:40. I missed more work. For people on foodstamps, every hour of work counts. Sarah Anderson, SE PowellAFS Office in Portland.

My kids missed breakfast and the first two hours of schoolbecause the only time they gave me for an interview was in theearly morning, Dannette Gill, Albina AFS office in Portland.

Barrier 3: AFS provides inadequate service forlimited English speakers

Findings: Limited English speakers waited four times longer than English

speakers to receive applications. An AFS worker with limited Spanish interviewed a speaker of

Spanish. The worker was not able to understand that theapplicant was in a crisis situation.

A speaker of an African dialect had to locate and bring hisown translator to the AFS office to obtain services.

Applicants who do not speak English deserve the same level ofservice as applicants who speak English. Limited Englishspeakers who applied for food stamps at AFS offices had to waitsignificantly longer for help simply because they spoke another

language. Limited English applicants were generally morefearful about applying for food stamps than English speakers.The additional barriers they faced at every level of the foodstamp application process discouraged them further.

AFS deficient services for limited English speakers may violatefederal law.

The Civil Rights Act of 1964 protects limited English speakersrights to access public assistance services and requires officesto meet the needs of limited English speakers in a timely

manner. Local offices must provide a translator who isproficient in English and the applicants language to aid alimited English speaker. xxv The St. Johns AFS office in Portlandwas unable to provide a Spanish translator, the West Main AFSoffice in Medford provided an inadequate Spanish translator, andthe Albina AFS office in Portland required an Oromo speaker tolocate his own translator. Federal law also requires states tohave application forms and client notices available in languagesthat people speak in the community. xxvi Client notices andapplications in other languages were not available at alloffices, nor were there signs about how to obtain non-Englishmaterials.



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Its frustrating that it takes so long and that you have to sitthere and wait while you are hungry. Name withheld, Oromospeaker, Albina AFS Office in Portland.

Barrier 4: Applicants must doggedly pursue andrepeatedly contact AFS to obtain food stamps.

Findings: Fifty-six percent of applicants were not encouraged to file

their application on the same day they contacted the office.

Applicants contacted the office an average of three timesduring the application period. Several applicants contacted the office more than six times

during the application period.

It is critical that food stamp applicants file their applicationas soon as they receive it. Thirty days after an application isfiled, food stamp offices must deliver food stamps to eligiblehouseholds. For families in a crisis situation, food stampoffices must deliver food stamps to eligible families in sevendays. In addition, food stamp benefits are pro-rated from the

date of application. If applicants are not told to file theirapplications immediately, applicants food stamps are delayedand the amount of benefits received is smaller.

AFS offices require that applicants visit the office at leasttwice, unnecessarily extending the food stamp enrollmentprocess. In Oregon, applicants must first obtain a food stampapplication and then return at a later date to the AFS officefor the required interview. However, many applicants had torepeatedly contact the office for information or clarificationabout their situation. Often, applicants had to make additionalcontacts with the office because they did not understand whichdocuments to provide. More often, applicants contacted theoffice because they had received no response from the AFSoffice. These repeated contacts, especially when an in-personcontact was made, significantly extended the food stampenrollment process.

AFS practices may violate federal law.

The USDA requires states to encourage applicants to file anapplication form on the same day the household first contacts theoffice seeking assistance. xxvii The USDA notes that it is important that

applicants be informed that they do not need to complete the entireapplication in order to file it on the same day of initial contact. xxviii

In addition, USDA officials have noted that procedures requiring food


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kept telling them I was in an emergency situation. I was downthere every other day for three weeks and I called every day. I left messages, but no one ever returned my calls. They justkept putting me off. I kept telling them my kids were hungry,

but they did nothing. After we got our food stamps, they told me my they accidentally mailed my file to Roseburg. [Roseburg is four hours south of Portland.] I was afraid they were going to cut me off completely because I was going to miss anappointment in Roseburg. After more calls, they finally mailed my file back to the Portland office. Audrey Spivey, Metro AFS office in Portland.

Barrier 5: AFS uses an unnecessarily long andconfusing application.

Findings: Forty-four percent of applicants rated theunderstandability of the 16-page AFS application asdifficult to understand or very difficult tounderstand. AFS uses a combined application to gather eligibilityinformation for all assistance programs. However, 87percent of applicants were not told about other programsavailable to them. Only 30 percent of households with uninsured children

were told about the Childrens Health Insurance Programor Medicaid. Ninety-two percent of applicants were not offered anyassistance in obtaining necessary verification. Sixty-eight percent of applicants did not understandthat parts of the application were not applicable to foodstamps.

If applicants are intimidated by the length of the applicationform, they may not apply for the food stamps that they need.Households applying for food stamps often get their first sense

of the program when they see the application form. A long andcomplicated application form that uses confusing language andrequires applicants to produce a long list of documents maydiscourage prospective applicants. Using a short applicationthat provides a brief list of the required verificationdocuments would reduce the amount time applicants spend on theapplication and sends a positive message about the availabilityof food stamps.

AFS application may violate state and federal law.

The USDA has urged all states to simplify their applicationforms because it believes a simpler application will eliminatemany of the barriers keeping families from food stamps. xxx


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the application also indicates that the application does notmeet Oregon state law requiring applications to be in plainlanguage. xxxii


I had to ride my bike back and forth from my home and to theoffice three times to get them all the documents they wanted. I lost a days pay because I missed a full day at work. Namewithheld, West Main AFS office in Medford.

I told them I had no money and couldnt pay my rent or my Oregon Health Plan bills. They told me that this was where youcome for food stamps, not for other stuff and that I should borrow money from a friend. Michael Kelly, Albina AFS office

in Portland.

Barrier 6: AFS provides inadequate anddiscourteous service to applicants.

Findings: Forty-four percent of participants felt they were nottreated respectfully. Only 20 percent of the applicants were told or sawinformation about the grievance procedure.

5. About a third of applicants reported that they did notunderstand where to apply for food stamps because thedirectional signs were unclear.

Applicants rated the helpfulness of the front deskstaff on a scale of one to four, with one being the bestrating. Applicants gave the front desk staff an averagerating of three or not very helpful. Eighty-eight percent of applicants were not asked ifthey had questions about the process.

6. Eighty percent of applicants were not given atelephone number or another way to obtain help.

7. Most AFS offices did not post USDA-requiredinformation about the food stamp process.

Applicants who dont understand the food stamp enrollmentprocess and are not provided with a way to access help are morelikely to be discouraged and miss out on vital food stampbenefits. Applicants who are not told about their right to filetheir application on the same day an application is obtainedunnecessarily elongates the time applicants must wait for foodstamp benefits to begin. xxxiii Unfairly denied applicants maynever get the food stamps they deserve if they do not understand

how to appeal a decision. Applicants who are treated rudely aremuch more likely to give up before they finish the applicationprocess.


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lack of good directional signs cannot be a barrier toenrollment, but this problem has yet to be fully corrected. xxxvi


I told my caseworker that I couldnt get a job right nowbecause of my injury. She told me that she was hurting all thetime too but managed. Dannette Gill, Albina AFS office inPortland.

During my interview, my worker was very distracted and keptgossiping with another worker about the people on welfare. Thenthey both looked at me for a minute but my worker said, Dontworry, she doesnt know who we are talking about. Then shetold me that I stunk of cigarettes. Bobbie (last namewithheld), Albina AFS office in Portland.

The front desk people waited an hour before they startedcalling numbers. They were talking on the phone with friends.I know everything they did the night before. Name withheld,Albina AFS office in Portland.

Barrier 7: AFS offices are difficult to contact,particularly hindering working applicants fromapplying.

Findings: At some offices, applicants are told they can only submit

applications and sign-up for interviews during 7:00 a.m. and9:00 a.m.

No offices are open during evening hours for day-shiftworkers.

No statewide, toll-free informational number is maintained. Applicants who used the voice mail system reported difficulty

and frustration. None of the applicants who went to the wrong office were

provided with the phone numbers, and in some cases addresses,of the correct office.

No AFS workers offered to forward applicants completedapplications when they were submitted to the wrong office.

Day-shift workers lose pay when applying for food stamps,causing more financial instability for their families. None ofthe eight offices reviewed in this report offered evening hoursfor working clients to apply for food stamps. Some offices arealso closed for lunch, making it impossible for applicantsworking the day-shift to apply without missing work.Applicants who cant get help become frustrated and may give up

before completing the food stamp application process.Applicants who arrive at the wrong office and are not assistedare unnecessarily required to spend more time in the application


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is submitted. xxxvii AFS policy manual requires branch officeworkers to assist applicants who come to the wrong branch. xxxviii

This did not occur when applicants went to the wrong officeswith completed applications. Additionally, after its review in

December 1998, the USDA instructed Portland branches to remainopen in the evenings at least one evening per month, whenpossible. xxxix

Short story for sidebar:I went to the St. Johns AFS office on February 11 to request afood stamp application. When I got there, they just handed methe application and didnt tell me anything. I took it back toSt. Johns a few days later. The caseworker at St. Johns told me that I needed to go to the SDS office because thats where I get my disability benefits. When I got to the SDS office they

told me they couldnt use the application I filled out for St.Johns. They gave me another 16 page application to complete. Keith Jackson, SDS office in Portland.


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Conclusion

This report demonstrates that serious barriers in Oregons food stampprogram impede applicants from accessing food stamps. These barriers

include an unnecessarily lengthy application process, inadequatecustomer service for clients, and an inconsistent expedited serviceprocess. Adult and Families Services appears to treat clientsrequests for food stamps as inconsequential and without urgency.These barriers are particularly disturbing in a state with a growingpercentage of hungry people and a declining percentage of people usingfood stamps.

Some of the barriers identified in this report appear to violate stateand federal law. Others are simply bad policies. AFS shouldimmediately develop an action plan that includes participation fromcommunity groups. The action plan should include, at a minimum, thefollowing:

Simplify and accelerate the application process

Encourage applicants to file application forms on the same day ofinitial contact.

Inform applicants about their right to file an incompleteapplication to begin the process.

Streamline the interview process so that clients wait no more than 2days for an interview.

Simplify the 16-page application by using the Idaho application as amodel (see appendix).

Provide applicants with a clear list of documentation required. Provide all clients with the option of a specific interview time. Inform eligible applicants of their right to a home or phone

interview. Provide translators in a timely manner to all applicants who speak

limited English. Do not use translators who are not fully fluent in both English and

another language. Train front desk staff to fully explain the food stamp process and

engage with clients. Provide more out-stationed AFS workers to enroll applicants in their

neighborhoods. Provide evening office hours for working clients. Improve phone system so clients can access the information they

need. Provide clients with sufficient information so that they do not have

to repeatedly contact the office. Allow applicants to apply at the AFS office closest to their home or

work.

Provide expedited services for applicants in crisis

Inform clients about how the expedited food service process works. Train staff on how to identify clients needing expedited service. Develop and use a satisfactory screening tool to identify people in


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Use directional signs in the office. Inform applicants about other programs available to them.

Develop an effective outreach program to educate potential applicants

Maintain a statewide toll-free food stamp hotline for applicants. Develop outreach campaigns that include neighborhood-based

educational activities.


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Research Methods

Hunger Pains: Oregon food stamp program fails to deliver is based on

data collected during February and March of 2000 by Oregon Action andthe Northwest Federation of Community Organizations. The objective ofthis study is to identify policies and practices that delay or impedeapplicants from obtaining food stamps in Oregon.

Data were gathered from 25 food stamp applicants identified by OregonAction. Ten of the study participants were white, ten were black, andfive were Hispanic. Five participants spoke limited or no English.Forty percent of the study participants were working and 70 percent ofthe applicants had children. Applicants applied at three offices inMedford and four offices in Portland. Researcher intervention in theapplication process was limited to providing rides to AFS offices. In

one case, a bilingual researcher intervened to help a Spanish-speakingapplicant when no Spanish-speaking AFS workers were available to help.

Applicants were interviewed twice in accordance with the protocoldeveloped for this project. The first interview occurred after theapplicant obtained an application. The second interview occurredafter the required interview at AFS. Applicants also shared theexperiences in narrative form during their interviews withresearchers. Some applicants requested that their names be withheldfrom the report. In addition, researchers looked for posted andwritten information at each AFS office visited by an applicant.


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Endnotes


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i Mark Nord, Kyle Jemison, Gary Bickel, Prevalence of Food Insecurity and Hunger, by State, 1996-1998 , Food and Rural Economics Division, Economic Research Service, U.S. Department of Agriculture, 1999, p. 3.ii Ibid. The USDA classifies a household as hungry if the food intake for the adults in the householdhas been reduced to an extent that it implies that adults have repeatedly experienced the physicalsensation of hunger. Household Food Security in the United State in 1995: Summary Report of theFood Security Measurement Project, USDA, September 1997, p. v.iii Michael Leachman, Oregon Center for Public Policy, telephone conversation, April 3, 2000.iv Food Research and Action Council, Oregon Food Profile 1999. www.frac.org.v United State General Accounting Office, Food Stamp Program: Various Factors Have Led toDecline in Participation , July 1999, p. 33. Because of eligibility restrictions created by welfarereform in 1996, the number of able-bodied adults with no children has declined by 46 percent.Leachman, April 3, 2000.vi Michael Leachman, HowMany Hungry Oregonians? Measuring Food Insecurity and Hunger,Oregon Center for Public Policy, November, 1999, p. 1.vii Nord, Prevalence of Food Insecurity , p. 17.

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