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Contents

Overview
Introduction
Why Do a Testing Project in Your State?

Getting the Facts


Learn How Your State Determines Who is Eligible for the Benefit
Learn What the Barriers Might Be in Your State

Mounting Your Testing Program


Recruit Testers
Prepare Your Testers and Volunteers
Interview Testers, Document their Experiences and their Stories

Charting Your Results


Charting Your Results
Writing Your Report
Moving into Action/Media
Summary

Appendices

ICAN Flyers

Hunger Pains: Oregon Food Stamp Program Fails to Deliver


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 Insurance
Program (SCHIP). By documenting these barriers, we have been able to give grassroots
groups 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. Some
examples 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 state’s 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 volunteers
3. Train your team
4. Perform the test
5. Analyze the results
6. Write your report
7. Present your results to the media

This kit includes stories and model materials from two successful testing campaigns. One
was 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. The
second was a testing project that NWFCO performed with Oregon Action of the Food
Stamps program in Oregon in 2000. Both testing projects resulted in campaigns that won
big changes to the programs that were tested.
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 eligible
for programs like Food Stamps and SCHIP, low-income families and particularly
immigrant families, can be easily intimidated by state caseworkers and prevented from
succeeding in their applications. Community organizations can help these people to be
heard.

♦ This project can be a victory for the families you work with, providing access to
critical 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 offices
that are not following State or Federal rules, and they can also be leveraged to win
state-wide changes in program policies and rules that impact all offices in the state.
Learn How Your State Determines Who Is Eligible for
the Benefit
Eligibility for public benefits is based on income measured as a percentage of the Federal
Poverty Level (FPL). Each program covers individuals or families up to a certain FPL.
You’ll 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% FPL
1 $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 $92,525
For each
additional
person add $3,740 $6,919 $7,480 $9,350

*1/23/09 guidelines. Guidelines are revised annually; you should check to be sure that
these 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 family’s assets, like a car or bank account, in the income
eligibility test.
Immigrant Eligibility for Public Benefits

Public benefits programs have different rules about how citizenship status impacts
eligibility. 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 Immigrants
Undocumented immigrants do not qualify for most federally funded programs.1 Some
programs, like the Low-Income Home Energy Assistance Program, may be available to
households that include undocumented immigrants if one person in the household is a
citizen or “legal resident,” but penalize those households in the way they calculate
household income.

Non-citizen Immigrants with Legal Status


Eligibility 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 legal
immigration status who have arrived in the U.S. after August 22, 1996 are not allowed to
receive some federally-funded benefits for five years after they secure their immigration
status.

Naturalized Citizens and Children of Immigrants


All citizens who meet the income eligibility requirements qualify for public benefits,
including immigrants who have become citizens through the naturalization process and
U.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 child’s family are
citizens when applying for a benefit that covers the child, like SCHIP. Only the child has
to show proof of citizenship, if asked. Only the child applying can be required to provide
a social security number. The federal government has forbidden states to ask for that
information about family members, even parents.

Programs that Cover Immigrants


Some states have created programs that are paid for with state funds to cover immigrants
who do not qualify for federally-funded programs because of their status. Congress also
changed 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.
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 chart
that explains which programs immigrants with each category of status are eligible for.
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 you’ll 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? Are
they 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 can’t go to meetings? Are they unwilling or unable to do interviews over
the phone or in places closer to the applicant’s 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 and
documentation about household members who will not be receiving the benefit?
● Do caseworkers in different offices follow the same rules and treat applicants
alike?
● When an application is rejected, what criteria are used? Are there criteria that
allow 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 a
decision is made?
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 in
different 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 test
for discrimination.

It’s important to recruit enough families to be able to show that their treatment is a
significant 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 organization’s
low-income members

♦ Check food bank lines, ask at local churches that provide services to low-income
people, and inform legal aid offices that you’re looking for volunteers

♦ Distribute flyers in low-income neighborhoods

♦ If your organization does door-to-door recruitment, ask people to participate as you


canvass in low-income neighborhoods

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

It’s a good idea to make up a worksheet for your recruiters to use to help them figure out
if 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 was
used in the SCHIP testing project in Idaho. You can adapt it using eligibility criteria for
the program you will be testing.
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 Now Insured Six Citizen or “qualified alien” Not a citizen or
Insured? Months Ago? (A qualified alien is a legal “qualified alien”
permanent resident who arrived in
the US before August 22, 1996.)
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:
Prepare Your Testers and Volunteers
Have an eligible family run through the application process in each of the locations that
you 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 and
apply, one after the other, and then be immediately interviewed about the experience by
volunteers. Unfortunately, the application process at the Idaho Department of Health and
Welfare was not as simple as they expected. Each of the testers was handed an
application and given an appointment to return later and apply. The organizers then had
to arrange to interview each of the applicants after their appointments, which were spread
out over several weeks.

It’s important to be flexible and able to adapt to whatever system you find. If you send in
an advance tester, to see generally how the process works, you’ll be able to plan and have
a better idea of what resources you’ll 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 and
send 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 to
send in completed applications. Some don’t require any interview, either face-to-face or
over the phone. That makes applying much easier for applicants, but you will want to
test how the office staffs treat applicants, so ask your testers to go in to an office to pick
up an application.
Training
Before the test begins you could have a training session for both the testing families and
the volunteers who will be interviewing them to collect the results of the test. The
following training plan is based on the training ICAN did for its testers in the SCHIP
testing project, based on the questions they planned to ask.

Sample CHIP Research Training for Testers


Based 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 to
collect 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 state’s program and hang it so
everyone 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 documenting
what your experience is when applying. We've tried to get as many people as possible to
help 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 certain
groups of people have more difficulty than other groups; that is, if they are being
discriminated against.
I believe everyone here is eligible for CHIP and during the next week you'll be
applying for benefits. In order to document what is preventing people from getting CHIP
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 about
CHIP, 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 we
are depending on you to remember details and to tell us afterward. We don't want you to
take notes or tape record, or change anything about the way you would act if you were
not in this role of observing. Think for a minute what you might do that would change
the possibility of getting benefits (example: lie, not show up for the appointment, tell the
caseworker we're watching him or her). We don't want you to change your behavior in
anyway - just be yourself. We simply want you to observe what happens as you get an
application and during your appointment. We don't believe that this should not in any
way affect whether or not you get benefits.
This kind of observation has been done by other groups, like this one, to make
sure 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 were
discriminated against in applying for public housing. A group like Idaho Community
Action Network got complaints that people were being denied housing, and they thought
it was due to their race. So the organization sent people to look at apartments who were
similar 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 they
found that blacks were being discriminated against and because of this 'research',
practices in renting apartments changed. This technique of finding people who are
similar 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 part
of a new and important study here in Idaho. We're asking you to tell us about yourselves
in a lot of detail so that we can find out if people who have a lot of similarities are being
treated differently if their only difference is race. We don't need for the two to go to the
same 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 be
looking 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 testers
should be, and how long each step should take.

Does anyone have any questions?

Review questions (5 minutes)


Ask testers to summarize for you what you’ve discussed so far.

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

Review the questions you’ll be asking the testers when they report on each stage
of 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 pay
attention to the situation.
1. Did the caseworker tell you how to apply for CHIP specifically? We want to
see if they offer to tell you about CHIP when you pick up the application - we don't want
you 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/comments
like offering a translator, offering information about how long the process will take, and
using the term CHIP.

Discussion format for bad secretary: Ask people to identify negative actions/ comments
like: didn’t offer any extra/helpful information, told person when to come for an
appointment 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 entire
application, didn't set another appointment.

Then break people into pairs telling them to practice just good and bad secretary and feel
free 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 people
ever 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 to
comment on what went well, etc, in their play.
Summarize, writing points on chalkboard. Repeat the main questions you’ll be asking in
the 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 forms
Hand out copies of your “What is CHIP?” summary.

Sample Getting the Application Role-Plays


Developed for CHIP Research Training
Idaho 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 the
Children's Health Insurance Plan also, then you need to have an appointment with a case
worker. 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 an
hour.
Be sure to bring all the documents listed here, including your children's birth certificates
too.

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.


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 in
Tuesday 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 away
talks to another imaginary caseworker about their lunch date, comes back). You've filled
this out all wrong (tears the application in half and throws it away). You need to start all
over 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 certificates
showed 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 insurance
for my kids?

Bad Caseworker: Come back when your documents are corrected. Next Person?
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:
Welcome
Define 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 information
they ask for. Explain how the demographic information can be used to show
discrimination 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 the
questions about immigration status. Ask volunteers which questions they think might
cause testers to be uncomfortable or lose trust in your organization. Discuss those issues
and 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 the
campaign; 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 equally
important. Review listening skills and remind volunteers that they need to record as
much 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 the
group and discuss.

Closing Q&A (5 minutes)


Any questions? Are you ready?
Go over logistics.
Interview Testers, Document their Experiences and
their Stories

As each family finishes each step of the application process, have volunteers interview
them and record their experiences. The questionnaires volunteers used in the Oregon
Food Stamp project follow this section. Try to include questions that discuss all of the
issues you wanted to test with your project. As you interview families you might learn
about issues you hadn’t known existed.

Collect “horror stories” of particularly bad treatment and try to document them. You’ll
want 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. You’ll want to
have people’s stories in their own words for your report. Ask volunteers to write down
stories as people tell them, as much as they can, and to explain answers like “other.”
Oregon Action
Food Stamp Testing Project
Response Sheet Number 1: First Visit to Food Stamps office

Instructions: Complete this response sheet after your first


visit to the food stamp office. Please fill out the form
completely and do not leave any answers blank. If you need
help, 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:
_________ Hours per month: _____
Third job: Hourly wage: __________ Hours per week:
_________ Hours per month: _____

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:
______________________________________________
Oregon Action staff person name:
__________________________________________________

1) Did the person helping you encourage you to Yes


complete and return the first page of the No
application immediately?

2) Was it explained to you that you needed to Yes


return for an interview with a completed No
application and supporting documents at a later
time?

3) Were you told to return during a mass intake Intake


time (i.e. between 7:00 a.m. or 9:00 a.m.) or a 
specific appointment time? Appointment

4) Was the interview time offered convenient for Yes


your schedule? No
Work
5) [Skip if answer to #4 is Yes.] Why was the time
inconvenient for you? School
Other

6) [Skip if answer to #4 is Yes.] Were you Yes


provided with an alternative time that was No
convenient for your schedule?

7) [Skip if answer to #4 is Yes.] Did the person Yes


helping you offer to send a food stamps worker No
to your home to interview you or hold the
interview over the phone?

8) Were you told that you needed to fill out the Yes
entire application and bring the required No
documents before returning to the office for
your interview?

9) Were you told that if you were unable to locate Yes


the required documents that you could instead No
provide the name of someone, like a landlord or
an employer, who could confirm your statements?

10) Did the person helping you ask if you had any Yes
questions? No

11) Were you provided with a phone number or Yes


another way to contact a food stamps worker if No
you needed help while filing out the
application?

12) Were you asked if you needed help buying food Yes
immediately or if you were in a crisis No
situation?

13) Did the food stamps worker read all sections Yes
of the application you turned in while you were No
waiting?

14) Were the directional signs in the office clear Yes


and did you understand where to apply for food No
stamps at the office?

15) Did you tell the person helping you that you Yes
were applying only for Food Stamps and not any No
other programs?

16) Non-English Speakers Only: Were you directed Yes


to a food stamp worker who spoke your preferred No
language during your visit?

< 15 min.
17) Non-English Speakers Only: [Skip if answer to
#13 was No.] How long did you wait for someone 15 – 30
to help you in your preferred language? 30 - 1
hr.
> 1 hr.
another
day

18) Non-English Speakers Only: [Skip if answer to Yes


#13 was No.] Were you provided with an No
application in your preferred language?
< 15 min.
19) How long did you wait before you received an
application? 15 - 30
> 30 min.
1
20) Please rate the helpfulness of the person who
gave you an application. A rating of 1 is the 2
best rating and means the person was very 3
helpful. A rating of 4 is the worst rating and 4
means the person was not helpful.

21) What was the name of the person who helped


you? _________________

22) Did you know that you could have received an Yes
application by mail? No

Other questions:

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

24) Did anything particularly negative or positive happen


during your visit that you would like to comment on?
Oregon Action
Food Stamp Testing Project
Response Sheet Number 2: After the food stamp interview

Instructions: Complete this response sheet after your


interview at the food stamp office. Please fill out the
form completely and do not leave any answers blank. If you
need 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 entire Yes


application form? No

♦ [Skip if answer to #1 is Yes.] Why Directions unclear


didn't you fill out the entire Lacked required
form? information
Did not have time
Other
____________________

♦ Did you understand that there were Yes


parts of the form that you did not No
need to complete in order to apply
for food stamps?

♦ Please rate the clarity or 1 = completely


understandability of the understandable
application. A rating of 1 = the 2 = basically
best. A rating of 4 = worst. understandable
3 = difficult to
understand
4 = very difficult to
understand

♦ Please estimate how long it took less than 1 hour


you to fill out the application: 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 the


Food Stamps office?

26) What time did your interview


begin?

27) What time did your interview


end?

28) Were you interviewed on the day Yes


you were told to return? No

29) Non-English speakers only: Were Yes


you interviewed by someone who No
spoke your language or were you
provided with a translator?

< 15 min.
30) Non-English speakers only: How
long did you wait for someone to 15 – 30
help you in your preferred 30 - 1 hr.
language? > 1 hr.
had to return on a
different day

31) Were you required to sign the Yes


self-sufficiency plan? No

32) Were you required to sign the Yes


Jobs and Jobs Plus Rights and No
Responsibilities document?

33) Were you required to sign the Yes


"Cooperating with Child Support No
Enforcement..." document?

34) Were you required to provide Yes


proof of citizenship? No

35) Was the grievance procedure Yes


explained to you? No

36) Were you told that you or your Yes


family might be eligible for other No
programs, like health care or cash
assistance?

37) If there were errors on your Yes


application, did the food stamp No
worker help you correct them?

38) If you were unable to provide a Yes


required document were you No
informed that you could provide
the name of someone, like an
employer or a landlord, who could
confirm you statement?

39) Were you asked if you had any Yes


questions? No

40) Did you tell the person helping Yes


you that you were only applying No
for food stamps?

41) Were you told when you would Yes


learn if you were eligible for No
food stamps?

42) Outside of the food stamps Yes


office, have you ever seen a No
poster or heard a radio or TV ad
describing the food stamp program?

43) How would you rate the treatment 1 = excellent


you received during your 2 = adequate
interview? A rating of 1 =
excellent. A rating of 4 = very 3 = poor
poor.
4 = very poor

44) How would you rate the patience 1 = extremely patient
of the person interviewing you? A 2 = somewhat patient
rating of 1 = extremely patient.
A rating of 4 = not patient at 3 = not very patient
all.
4 = impatient

45) What was the name of your


interviewer?

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?
♦ Did anything particularly negative or positive happen
during your visit that you would like to comment on?
Charting Your Results
As you interview families, it can be helpful to enter the information you collect into a
chart.

Important information to include in your charts:

♦ Each step of the application process

♦ Each family’s 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 you’ll be able to tell how much of your
project is complete and how much time you still need to devote to it. Collecting results
for all families about one issue in one spot will make it easier to generalize about
experiences as you plan what to focus on in your report.

Two sample charts follow; you can adapt them to suit your project. Some testers will
have experiences you didn’t expect. Leave space in your chart to add those experiences.
Sample Charts to Organize Questionnaire Information

Name # of Monthly Race Town Offered Which Does the Comments Next How long did
of kids Income CHIP? documents staff treat Step you wait?
adult were you people How long did
tester asked to fairly? the
show? appointment
take?
Jane 6 $1,451- Black Nampa No SS# for Kids Can’t say Wasn’t told 10 minute wait
1,850 at appt. yet to bring in all for appt., 50-
paperwork min appt.

Name Did you go to What Did the Which Were birth Have you If you were Comments/
1st was the next step documents certificates received CHIP/ disqualified, Stories
Appointment next happen? were you requested for Medicaid for what are
? step? Comment asked to people other your kids? your next
s show? than the kids steps to get
and for whom? covered?
Anna Yes Intervi Yes Marriage Yes, they Yes She had to
ew. License wanted birth send away
and certificates for to Mexico
Paternity everyone that to get
form. was in the marriage
household license.
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 the
difficulties to working parents of scheduling mandatory interviews during the workday. In the
Oregon food stamps project, organizers chose seven issues: an inflexible and inconsistent
interview process; inadequate access to language services for non-English speakers; a long and
confusing application; inadequate and discourteous service; food stamps offices that were
difficult 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 food
stamps.

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

Suggest how each of the barriers could be eliminated. These suggestions are very important. Be
sure 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 proposing
your solutions. Try to make these summaries simple and eye-catching.

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

Moving into Action/Media


Ask some of your testers and their families to speak about their experiences at your press
conference. Before the conference, help them to prepare short statements about their
experiences. Listen as they practice their statements and role-play a press conference, asking
questions reporters are likely to ask them. Invite organizations you work with to join you in your
actions and statements to the media.
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 to
work as testers, trained them to perform the test, and prepared them to act as
spokespersons 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, including
fact sheets and a report.

4. Publicized your actions through the media and “removed the barriers” for people in your
state.
I DAH O COMMUN I T Y ACT I ON N E T WORK

Children’s Health
Insurance Program
Many of our members are eligible for CHIP. We asked them to
write down their experiences with the Department of Health
All and Welfare when they tried to applyfor the program.
We found that many people were treated differently. Most peo-
Applicants ple did not have positive experiences with the Department‘s
Should be workers. Our Latino members experienced the most difficult
time getting Medicaid/CHIP.
Treated the • One person had their application torn up bya Department
Same Way of Health and Welfare worker.
• Another was pressured to withdraw her application by a
caseworker.
• Another was given an appointment when she was unable to
come in because of work. When she complained, the case-
worker stated that she had to take what she could get. No
other 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 order
to address this problem, the Department must develop a clear
I DAH O C OMMUN I TY procedure for taking Medicaid/ CHIP applications. There must
AC T ION N E TWORK be a complaint system for investigating people’s complaints
about how they are treated bythe Department of Health and
1311West Jefferson
Welfare. There must be careful training of Department work-
Boise, ID 83702
ers, to ensure that theyare up-to-date about the current Medi-
Phone: 208-385-9146
caid/ CHIP rules and treat all people with dignity and respect.
I DAH O COMMUN I T Y ACT I ON N E T WORK

Children’s Health
Insurance Program
Onlychildren who are applying for CHIP should be asked for
their citizenship status and social security numbers. Parents

Privacy may not want to disclose this information or may not have their
social security number available. Asking for this information
fromparents is not required and a child’s Medicaid eligibility
maynot be based upon whether a parent provides it.

Some states have included statements on the application


forms 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-
I DAH O C OMMUN I TY quired to provide your own social security number (SSN) in
AC T ION N E TWORK
order for the child to receive Medicaid, but we must have
1311West Jefferson the child’s SSN in order for the child to receive Medicaid.”
Boise, ID 83702
Model HCFA application.
Phone: 208-385-9146
I DAH O COMMUN I T Y ACT I ON N E T WORK

Children’s Health
Insurance Program
Many working families whose children are eligible for Medi-

Publicity: caid/ CHIP don’t know about the programor believe that they
are not eligible. We need a strong publicitycampaign to get
A New the word out, similar to the Department of Health and Wel-
Baby Your fare’s highly successful “Baby Your Baby” Campaign in 1991-
Baby 92.

Campaign The BabyYour Baby Campaign got the word out using many dif-
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 Idaho’s infant mortality rate.

I DAH O C OMMUN I TY
AC T ION N E TWORK
Publicity can have the same effect in lowering the uninsurance
1311West Jefferson
Boise, ID 83702 rate among Idaho’s children. We want a new Baby Your baby
Phone: 208-385-9146
Campaign for CHIP!!
I DAH O COMMUN I T Y ACT I ON N E T WORK

Children’s Health
Insurance Program
Idaho’s Medicaid/CHIP application form is seventeen pages
Simple long and very difficult for some parents to complete. Idaho

Application can rewrite its Medicaid application to be much shorter. The


Health Care Financing Administration (HCFA) the federal
Form and agency that oversees Medicaid, has designed a two page
Process model 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 Health
and 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
I DAH O C OMMUN I TY services quickly. Right now, people have to wait for two to
AC T ION N E TWORK
three weeks to find out whether their children are enrolled on
1311West Jefferson CHIP. Children shouldn’t have to wait to get this coverage. The
Boise, ID 83702
Department should process these applications immediately so
Phone: 208-385-9146
children can get health coverage right away.
I DAH O COMMUN I T Y ACT I ON N E T WORK

Children’s Health
Insurance Program
Idaho’s Department of Health and Welfare is required by law to
Access to communicate with Medicaid/CHIP applicants in a language un-
Translation derstood bythe applicant, including English and Spanish.
Services
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 available


at all times to respond to the questions bySpanish speak-
ing families.

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


communities in Idaho to enroll Medicaid/ CHIP eligible chil-
dren.
I DAH O C OMMUN I TY
AC T ION N E TWORK ♦ Trained translators are available at all offices during work-

1311West Jefferson ing hours to ensure that families applying for services fully
Boise, ID 83702 understand the process and that their concerns are heard.
Phone: 208-385-9146
I DAH O COMMUN I T Y ACT I ON N E T WORK

Children’s Health
Insurance Program
Working families have a difficult time applying for CHIP. The
Department’s offices are not open after working hours, and it

Making it won’t take applications by telephone or mail. This restrictions


prevent manyparents from signing their children up for CHIP.
Easier to
Apply for Idaho should allow Medicaid/ CHIP applications to be proc-
Medicaid/ essed at more sites outside of Department of Health and Wel-
CHIP fare (out-stationing). Idaho is required to allow pregnant
women and children to apply for Medicaid/ CHIP at locations
other 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, familyresource centers, one-stop career centers and
churches.

I DAH O C OMMUN I TY The Department can also allow working parents to submit their
AC T ION N E TWORK applications by mail or bytelephone. Thirty-four states allow
1311West Jefferson mail-in applications and six of these will interview families over
Boise, ID 83702 the telephone.
Phone: 208-385-9146
Hunger Pains:
Oregon Food Stamp Program Fails to Deliver
National Breaking Barriers Series: No. 2

By Carson Strege-Flora

Oregon Action
Northwest Federation of Community Organizations
May 2000
Table of Contents
● Executive Summary ...
……………………………………………………..page

● Introduction ……….
……………………………………………………….page

● Key Findings ……….


………………………………………………………page

● Barriers to Enrollment
……….…………………………………………..…page

1. Applicants in crisis are not provided with required


expedited service…page

2. AFS interview process is inflexible and


inconsistent…..……………….page

3. AFS provides inadequate services for limited English


speakers..………page

4. Applicants must repeatedly contact AFS to obtain food


stamps………..page

5. AFS uses a long and confusing application


…………………………….page

6. AFS provides inadequate and discourteous service to


applicants.………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: Idaho’s simplified application


Executive Summary
Tim Riddle works part-time but doesn’t earn enough to live on.
Tim and his six-year-old son, Chris, live at a homeless shelter
in Medford, Oregon. As money grew short in late January, Tim
realized he would not be able to provide enough food for his son
and went to the welfare office to apply for food stamps.
Despite federal requirements to do so, Tim was not screened for
emergency food stamps and was told he needed to wait a month for
help.

“There’s nothing scarier for a father than not knowing where his
child’s next meal is coming from.” – Tim Riddle.

Unfortunately, stories like Tim Riddle’s are all too common in


Oregon. According to the United States Department of
Agriculture (USDA), Oregon tops the list of states with the
highest percentage of people experiencing hunger.i The USDA
estimates that more than one-eighth of Oregon households are
“food insecure,” meaning that these households do not always
have assured access to enough food to fully meet their basic
needs. About half of these households experience painful
feelings of hunger.ii

The food stamp program is Oregon’s largest and most important


program in the fight against hunger, particularly for children.
About 40 percent of food stamp recipients in Oregon are
children.iii Benefits are modest, but food stamps can mean the
difference between hunger and a healthy diet for families. In an
average month, about 100,000 households receive food stamps in
Oregon.iv

Despite the benefits food stamps offer families, participation


in Oregon’s food stamp program is declining. Since 1996,
participation has plummeted by 20 percent.v Yet, Oregon’s food
bank network reported a 16 percent increase in demand for
emergency food boxes between 1998 and 1999.vi Additionally, data
from the USDA indicate that the number of hungry people in
Oregon may be at a three-year-high.vii USDA data find that the
number of food insecure households in Oregon has increased from
146,591 in 1996 to 194,594 in 1998, an increase of eight percent
in just three years.viii

The purpose of this study is to identify policies and practices that


delay or impede applicants from obtaining food stamps. Oregon Action
identified 25 low-income Oregon residents in the winter of 2000 who
wanted to apply for food stamps and who agreed to participate in two
interviews. Participants were interviewed in accordance with a
protocol developed for this study after they had obtained an
application at an Oregon public assistance office and after they had
completed the required food stamp interview. This study tracked
applicants through the enrollment process but, due to time constraints
and the lengthy enrollment process, it does not track which applicants
were ultimately enrolled in the food stamps program and instead
focuses on the barriers that prevent applicants from applying for food
stamps. A future report will examine if applicants are being wrongly
denied for food stamps.

This report outlines seven barriers that obstruct applicants during


the application process, including some that appear to be in violation
of federal and state law. Oregon’s Adult and Family Services (AFS)
Division, which administers the food stamp program, has the power to
eliminate all the barriers identified in this report.

Barriers to accessing food stamps in Oregon

• AFS does not provide families in crisis with immediate service


as 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 to


obtain food stamps.

• AFS uses a long and confusing application.

• AFS provides inadequate and discourteous service.

• AFS offices are difficult to contact, particularly hindering


working applicants from applying.

Some key findings of the report

• Only 46 percent of applicants were instructed to complete the


emergency services screening tool used by AFS. If AFS does
not use its emergency services screening tool, applicants in
crisis situations are left with no ability to purchase food.

• At some offices, applicants must arrive between 7:00 a.m. and


9:00 a.m. to sign-up for interviews. If interview slots are
taken, applicants must return the next day; requests for
appointments are generally denied. Applicants with morning
obligations are shutout of the process.

• Applicants waited an average of 6.5 days for their AFS


interview. 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 English


speakers 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 understandability


of the AFS application as “difficult to understand” or “very
difficult to understand.” A confusing application can
discourage applicants from applying for the program.

• Several applicants contacted the office more than six times


during the application period. Making applicants repeatedly
contact the office is an inefficient way to provide services.

Solutions
Simplify and accelerate the application process

• Encourage applicants to file application forms on the same day of


initial contact.
• Inform applicants about their right to file an incomplete
application 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 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
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-based
educational activities.

Introduction
Over the past year, members of Oregon Action have described alarming
problems when applying for food stamps. Many applicants experienced
long delays at the Adult and Family Services (AFS) Division offices
where food stamps are processed. Others reported that they felt
discouraged and mistreated by AFS workers. Some detailed incidents at
AFS offices that appeared to be in violation of food stamp law. Many
Oregon Action members felt that AFS offices were more focused on
creating barriers to the food stamp program than helping them enroll.

The food stamp program is Oregon’s largest and most important


program in the fight against hunger, particularly for children.
About 40 percent of food stamp recipients in Oregon are
children.ix Benefits are modest. In Oregon, the average per
person benefit is $70 per month, but food stamps can mean the
difference between hunger and a healthy diet for families.x In
an average month, about 100,000 households receive food stamps
in Oregon.xi

Despite the benefits food stamps offer families, participation


in Oregon’s food stamp program is declining. Since 1996,
participation has plummeted by 20 percent.xii Yet, Oregon’s food
bank network reported a 16 percent increase in demand for
emergency food boxes between 1998 and 1999.xiii Additionally,
data from the USDA indicates that the number of hungry people in
Oregon may be at a three-year-high.xiv USDA data find that the
number of food insecure households in Oregon has increased from
146,591 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 at


the same time that Oregon’s hunger rates are increasing, it is
very unlikely that people are leaving food stamps because they
are enjoying the benefits of the expanding economy and finding
high wage employment. The explanation that food stamp
participation is declining because Oregonians no longer need
food stamps is inadequate.

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


Oregon Action and the Northwest Federation of Community
Organizations interviewed 25 food stamps applicants about their
experiences when applying for food stamps. We examined the
enrollment policies and practices at seven AFS local branch
offices in Portland and Medford, Oregon in order to identify
policies and practices that hinder applicants from applying for
food stamps.
Figure 1: Oregon food stamp participation compared to hungry
households.xvi

500,000

400,000
Oregon households

300,000

200,000

100,000

0
Hungry households Food stamp participants

Figure 2: Food stamp participation compared to food insecure


households.xvii

250000
Oregon Households

200000
Food
150000 Insecure
100000 Food Stamp
Participation
50000

0
1996 1997 1998 1999
Key Findings

This report found the following barriers at Adult and Family


Services offices in Medford and Portland. These barriers
unnecessarily delay and impede applicants during the food stamp
application process.

Barrier 1 AFS does not provide families in crisis with immediate


service as required by law.

Fifty-six percent of applicants were not instructed to complete the


emergency screening tool used by AFS. Some homeless applicants were
not provided expedited services. Other applicants determined eligible
for 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 of


applicants with specific
interview times; others attended
during first come, first serve
interview sessions. Interview
times during first come, first
serve sessions fill early and
applicants must return each day
to take another number.

Barrier 3 AFS provides inadequate services for limited English


speakers.

Limited English speaking applicants waited four times longer than


English speakers to obtain applications in their language. AFS does
not always provide adequate translator service.

Barrier 4 Applicants must doggedly pursue and repeatedly contact


AFS to obtain food stamps.

To get help, applicants repeatedly contacted AFS offices, often


without success. AFS phone systems are deficient and applicants were
generally unable to contact workers. Many applicants reported that
when 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, cumbersome


general public assistance application form. The application
does not specify which documents are required for food stamps.
Applicants often have to make several trips to the office to
provide the necessary documentation.

Barrier 6 AFS provides inadequate and discourteous service.

AFS does not provide applicants with basic, required information about
the enrollment process, including appeal and grievance procedures.
Applicants reported that caseworkers made inappropriate comments about
their looks, lifestyle, and life choices.

Barrier 7 AFS offices are difficult to contact, hindering


working applicants from applying.

Most AFS offices offer client services only between 8:00 a.m.
and 5:00 p.m., making it difficult for a day shift working
applicant to apply. At some offices, applicants must arrive
between 7:00 a.m. and 9:00 a.m. to sign-up for an interview.xviii
There is no enrollment hotline phone number.
Barrier 1: AFS does not provide families in
crisis with immediate service as required by
law.
Findings:
• Only 46 percent of applicants were instructed to
complete the expedited service-screening tool used by AFS.xix
• Only 12 percent of applicants were asked about their
current situation or need for emergency assistance by front
desk workers.
• Of the three homeless applicants, only one was
determined eligible for expedited service. The other two
homeless families waited three to four weeks for their food
stamp benefits.
• Only one applicant was told that she could provide
income verification in ways other than a written document.

The general lack of urgency and sluggishness evident in AFS


branch offices particularly harms those with emergency food
needs. Expedited processing means local offices must provide
food stamps to qualified individuals within seven days rather
than the standard 30 days and is a critical component of the
food stamp program. Expedited service reduces the time
applicants in crisis must wait for their food stamps. Eligible
applicants have almost no income or assets and are at serious
risk of not being able to access food. When AFS does not screen
families for expedited service, eligible families must
unnecessarily endure additional days without food.

AFS’ inadequate expedited food stamp process may violate federal


law.

Under federal law, every applicant must be screened for


expedited service. The USDA requires all states to design
application procedures that identify households eligible for
expedited food stamp processing at the time assistance is
requested.xx None of the offices in Medford or Oregon
consistently screened applicants for expedited service
eligibility. Three homeless families that should have been
immediately identified as potentially eligible for expedited
service were required to go through the standard process,
including providing all required verification. Federal law
requires that families eligible for expedited service need only
initially provide proof of identity and residency. Income and
other verification can occur later.xxi In a separate study, the
USDA identified serious problems with AFS’ expedited food stamp
process and required AFS to take corrective action but
applicants continue to experience problems.xxii

Pull quotes for sidebar:

“I made it clear that I was in an emergency situation but


nothing was done.” – Name withheld, Broadway AFS office in
Portland.

“They told me I had to wait seven days before I could turn in


my application and have my interview. I’m a diabetic and need
food now.” – Barby Campbell, West Main AFS office in Medford
“I told them I needed emergency assistance. The front desk
person told me to come back almost three weeks later for an
appointment.” – Name withheld, West Main AFS office in Medford.
Barrier 2: AFS interview process is
inflexible and inconsistent.
Findings:
• Seventy-five percent of the employed applicants who
requested alternative interview times because of job
conflicts were denied an alternative interview time.
• All of the unemployed applicants who requested
alternative interview times because of educational,
training or job search conflicts, childcare problems, or
transportation problems were denied an alternative
interview time.
• Only one applicant was provided with the option of a
home or telephone interview.
• Applicants waited an average of 6.5 days before they
were interviewed by AFS.
• Twenty percent of applicants waited ten days or more
for their required interview.
• Eight percent of applicants were provided with an
application but not told that they needed to return for an
interview.
• Applicants who were told to return for an interview
during a general intake time waited an average of 70
minutes before their interview began. One applicant waited
two hours and twenty minutes.
• On average, interviews lasted 40 minutes, but some
were as short as 15 minutes and others took over 90 minutes.

The AFS prolonged interview process ignores the serious needs of


food stamp applicants by making them wait for unnecessarily long
periods of time. Some AFS offices make clients return only
during a specified two-hour period for their interviews. If the
interview slots fill up for that day, applicants are sent home
and required to return another day. For applicants who are
working, time spent at the welfare office means missing pay and
endangering the financial stability of their families. For
applicants who are in training or who are searching for work,
long waits at AFS offices interferes with their ability to
become self-sufficient.

AFS’ interview process may violate state law and federal


directives.

In its December 1998 review of three Portland area AFS offices,


the USDA found that the first come, first system could hinder
applicants and suggested several corrective actions. It does
not appear that any of these corrective actions had been taken
by February 2000.xxiii The AFS practice of denying applicants’
requests for alternative interview times and not offering
applicants off-site or telephone interview options contradicts
the AFS goal of helping people obtain and maintain employment.
Not providing clients with the option of non-office interviews
also violates AFS policy.xxiv

Pull quotes for sidebar:


“I had to take time off work for my 2:00 p.m. appointment but
wasn’t seen until 2:40. I missed more work. For people on food
stamps, every hour of work counts.” – Sarah Anderson, SE Powell
AFS Office in Portland.

“My kids missed breakfast and the first two hours of school
because the only time they gave me for an interview was in the
early morning,” – Dannette Gill, Albina AFS office in Portland.

Barrier 3: AFS provides inadequate service for


limited 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 the
applicant was in a crisis situation.
♦ A speaker of an African dialect had to locate and bring his
own translator to the AFS office to obtain services.

Applicants who do not speak English deserve the same level of


service as applicants who speak English. Limited English
speakers who applied for food stamps at AFS offices had to wait
significantly longer for help simply because they spoke another
language. Limited English applicants were generally more
fearful about applying for food stamps than English speakers.
The additional barriers they faced at every level of the food
stamp application process discouraged them further.

AFS’ deficient services for limited English speakers may violate


federal law.

The Civil Rights Act of 1964 protects limited English speakers


rights to access public assistance services and requires offices
to meet the needs of limited English speakers in a timely
manner. Local offices must provide a translator who is
proficient in English and the applicant’s language to aid a
limited English speaker.xxv The St. John’s AFS office in Portland
was unable to provide a Spanish translator, the West Main AFS
office in Medford provided an inadequate Spanish translator, and
the Albina AFS office in Portland required an Oromo speaker to
locate his own translator. Federal law also requires states to
have application forms and client notices available in languages
that people speak in the community.xxvi Client notices and
applications in other languages were not available at all
offices, nor were there signs about how to obtain non-English
materials.

Pull quotes for sidebar:

“I talked with their Spanish speaking worker when I got my


application. I tried to explain that I needed food stamps right away,
but she was not a native Spanish speaker and seemed to not understand
me.” – Gloria Cruz Rodas, West Main AFS office in Medford. [Gloria
went to the office on 2/8/2000. She was given an interview for
2/23/00 where it was determined she needed expedited service. She
should have received her food stamps by 2/15.]
“It’s frustrating that it takes so long and that you have to sit
there and wait while you are hungry.” – Name withheld, Oromo
speaker, Albina AFS Office in Portland.

Barrier 4: Applicants must doggedly pursue and


repeatedly 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 times
during 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 application


as soon as they receive it. Thirty days after an application is
filed, food stamp offices must deliver food stamps to eligible
households. For families in a crisis situation, food stamp
offices must deliver food stamps to eligible families in seven
days. In addition, food stamp benefits are pro-rated from the
date of application. If applicants are not told to file their
applications immediately, applicants’ food stamps are delayed
and the amount of benefits received is smaller.

AFS offices require that applicants visit the office at least


twice, unnecessarily extending the food stamp enrollment
process. In Oregon, applicants must first obtain a food stamp
application and then return at a later date to the AFS office
for the required interview. However, many applicants had to
repeatedly contact the office for information or clarification
about their situation. Often, applicants had to make additional
contacts with the office because they did not understand which
documents to provide. More often, applicants contacted the
office because they had received no response from the AFS
office. These repeated contacts, especially when an in-person
contact was made, significantly extended the food stamp
enrollment process.

AFS practices may violate federal law.

The USDA requires states to encourage applicants to file an


application form on the same day the household first contacts the
office seeking assistance.xxvii The USDA notes that it is important that
applicants be informed that they do not need to complete the entire
application in order to file it on the same day of initial contact.xxviii
In addition, USDA officials have noted that procedures requiring food
stamp applicants to return a second day creates barriers to
participation.xxix

Pull quotes for side bar:


“It took me five calls to figure out which office I needed to go
to.” – Michael Kelly, Albina AFS office in Portland.

“My husband and four children are homeless and have no money.
AFS made us wait so long to get food stamps. It was horrible. I
kept telling them I was in an emergency situation. I was down
there every other day for three weeks and I called every day. I
left messages, but no one ever returned my calls. They just
kept 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 an
appointment 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 and


confusing application.
Findings:
♦ Forty-four percent of applicants rated the
understandability of the 16-page AFS application as
“difficult to understand” or “very difficult to
understand.”
♦ AFS uses a combined application to gather eligibility
information for all assistance programs. However, 87
percent of applicants were not told about other programs
available to them.
♦ Only 30 percent of households with uninsured children
were told about the Children’s Health Insurance Program
or Medicaid.
♦ Ninety-two percent of applicants were not offered any
assistance in obtaining necessary verification.
♦ Sixty-eight percent of applicants did not understand
that parts of the application were not applicable to food
stamps.

If applicants are intimidated by the length of the application


form, 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 and
complicated application form that uses confusing language and
requires applicants to produce a long list of documents may
discourage prospective applicants. Using a short application
that provides a brief list of the required verification
documents would reduce the amount time applicants spend on the
application and sends a positive message about the availability
of food stamps.

AFS’ application may violate state and federal law.

The USDA has urged all states to simplify their application


forms because it believes a simpler application will eliminate
many of the barriers keeping families from food stamps.xxx
Certainly if AFS is not going to use the information collected
by the combined application to inform applicants of other
programs, the long application serves only to lengthen the food
stamp process. In addition, the application does not appear to
meet USDA requirements in a number of ways, including providing
appropriate lists and descriptions of documents required. The
application also does not list required information about the
agency’s obligation to help applicants locate documents.xxxi The
large number of applicants who reported difficulty understanding
the application also indicates that the application does not
meet Oregon state law requiring applications to be in plain
language.xxxii

Pull quotes for sidebar:

“I had to ride my bike back and forth from my home and to the
office three times to get them all the documents they wanted. I
lost a day’s pay because I missed a full day at work. ” – Name
withheld, West Main AFS office in Medford.

“I told them I had no money and couldn’t pay my rent or my


Oregon Health Plan bills. They told me that this was where you
come 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 and


discourteous service to applicants.
Findings:
• Forty-four percent of participants felt they were not
treated respectfully.
• Only 20 percent of the applicants were told or saw
information about the grievance procedure.
5. About a third of applicants reported that they did not
understand where to apply for food stamps because the
directional signs were unclear.
• Applicants rated the helpfulness of the front desk
staff on a scale of one to four, with one being the best
rating. Applicants gave the front desk staff an average
rating of three or “not very helpful.”
• Eighty-eight percent of applicants were not asked if
they had questions about the process.
6. Eighty percent of applicants were not given a
telephone number or another way to obtain help.
7. Most AFS offices did not post USDA-required
information about the food stamp process.

Applicants who don’t understand the food stamp enrollment


process and are not provided with a way to access help are more
likely to be discouraged and miss out on vital food stamp
benefits. Applicants who are not told about their right to file
their application on the same day an application is obtained
unnecessarily elongates the time applicants must wait for food
stamp benefits to begin. xxxiii Unfairly denied applicants may
never get the food stamps they deserve if they do not understand
how to appeal a decision. Applicants who are treated rudely are
much more likely to give up before they finish the application
process.

AFS’ inadequate service may violate federal and state law.

Oregon state law requires AFS to provide information about the


grievance procedure to applicants.xxxiv In addition, federal law
requires states to post signs explaining the application process
and the right to file an application on the day of initial
contact.xxxv A 1999 AFS study of Portland offices found that the
lack of good directional signs cannot be a barrier to
enrollment, but this problem has yet to be fully corrected.xxxvi

Pull quotes for sidebar:


“I told my caseworker that I couldn’t get a job right now
because of my injury. She told me that she was “hurting all the
time too” but managed.” – Dannette Gill, Albina AFS office in
Portland.

“During my interview, my worker was very distracted and kept


gossiping with another worker about the people on welfare. Then
they both looked at me for a minute but my worker said, ‘Don’t
worry, she doesn’t know who we are talking about.’ Then she
told me that I stunk of cigarettes.” – Bobbie (last name
withheld), Albina AFS office in Portland.

“The front desk people waited an hour before they started


calling 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 from
applying.
Findings:
• At some offices, applicants are told they can only submit
applications and sign-up for interviews during 7:00 a.m. and
9:00 a.m.
• No offices are open during evening hours for day-shift
workers.
• 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’ completed
applications 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 of
the eight offices reviewed in this report offered evening hours
for working clients to apply for food stamps. Some offices are
also closed for lunch, making it impossible for applicants
working the day-shift to apply without missing work.
Applicants who can’t 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 assisted
are unnecessarily required to spend more time in the application
process.

AFS’ failure to adopt user-friendly practices may violate state


and federal law.

The USDA requires AFS offices that receive application forms


from outside of their service area to mail the application form
to the correct office on the same day that the application form
is submitted.xxxvii AFS’ policy manual requires branch office
workers to assist applicants who come to the wrong branch.xxxviii
This did not occur when applicants went to the wrong offices
with completed applications. Additionally, after its review in
December 1998, the USDA instructed Portland branches to remain
open in the evenings at least one evening per month, when
possible.xxxix

Short story for sidebar:


“I went to the St. John’s AFS office on February 11 to request a
food stamp application. When I got there, they just handed me
the application and didn’t tell me anything. I took it back to
St. John’s a few days later. The caseworker at St. Johns told
me that I needed to go to the SDS office because that’s where I
get my disability benefits. When I got to the SDS office they
told me they couldn’t use the application I filled out for St.
John’s. They gave me another 16 page application to complete.”
– Keith Jackson, SDS office in Portland.
Conclusion

This report demonstrates that serious barriers in Oregon’s food stamp


program impede applicants from accessing food stamps. These barriers
include an unnecessarily lengthy application process, inadequate
customer service for clients, and an inconsistent expedited service
process. Adult and Families Services appears to treat clients’
requests for food stamps as inconsequential and without urgency.
These barriers are particularly disturbing in a state with a growing
percentage of hungry people and a declining percentage of people using
food stamps.

Some of the barriers identified in this report appear to violate state


and federal law. Others are simply bad policies. AFS should
immediately develop an action plan that includes participation from
community groups. The action plan should include, at a minimum, the
following:

Simplify and accelerate the application process

• Encourage applicants to file application forms on the same day of


initial contact.
• Inform applicants about their right to file an incomplete
application 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 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
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-based
educational activities.
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 and
the Northwest Federation of Community Organizations. The objective of
this study is to identify policies and practices that delay or impede
applicants from obtaining food stamps in Oregon.

Data were gathered from 25 food stamp applicants identified by Oregon


Action. Ten of the study participants were white, ten were black, and
five were Hispanic. Five participants spoke limited or no English.
Forty percent of the study participants were working and 70 percent of
the applicants had children. Applicants applied at three offices in
Medford and four offices in Portland. Researcher intervention in the
application process was limited to providing rides to AFS offices. In
one case, a bilingual researcher intervened to help a Spanish-speaking
applicant when no Spanish-speaking AFS workers were available to help.

Applicants were interviewed twice in accordance with the protocol


developed for this project. The first interview occurred after the
applicant obtained an application. The second interview occurred
after the required interview at AFS. Applicants also shared the
experiences in narrative form during their interviews with
researchers. Some applicants requested that their names be withheld
from the report. In addition, researchers looked for posted and
written information at each AFS office visited by an applicant.
Endnotes
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 household
has been reduced to an extent that it implies that adults have repeatedly experienced the physical
sensation of hunger. Household Food Security in the United State in 1995: Summary Report of the
Food 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 to
Decline in Participation, July 1999, p. 33. Because of eligibility restrictions created by welfare
reform 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. These data were calculated using Oregon Current
Population Survey Food Security Supplements of September 1996, April 1997, and August 1998.
Annual prevalence of estimates of food insecurity and hunger for states have significant margins
of error because of the limited number of households surveyed in each state.
viii
Ibid.
ix
Leachman, telephone conversation, April 3, 2000.
x
Ibid.
xi
Food Research and Action Council, Oregon Food Profile 1999. www.frac.org.
xii
United States General Accounting Office, Food Stamp Program: Various Factors Have Led to
Decline in Participation, July 1999, p. 33. Because of eligibility restrictions created by welfare
reform in 1996, the number of able-bodied adults with no children has declined by 46 percent.
Leachman, April 3, 2000.
xiii
Michael Leachman, HowMany Hungry Oregonians? Measuring Food Insecurity and Hunger,
Oregon Center for Public Policy, November, 1999, p. 1.
xiv
Nord, Prevalence of Food Insecurity, p. 17. These data were calculated using Oregon Current
Population Survey Food Security Supplements of September 1996, April 1997, and August 1998.
Annual prevalence of estimates of food insecurity and hunger for states have significant margins
of error because of the limited number of households surveyed in each state.
xv
Ibid.
xvi
400,000 hungry household estimate for 1998 from Leachman, How Many Hungry Oregonians, p.
10. Food stamp participation data for July 1998 from Oregon public assistance data charts,
www.afs.hr.state.or.us/papage.html, p. 36.
xvii
Food insecure data from Nord, Prevalence of Food Insecurity, p. 17. These data were calculated
by the USDA using Oregon Current Population Survey Food Security Supplements of September
1996, April 1997, and August 1998. Annual prevalence of estimates of food insecurity and hunger
for states have significant margins of error because of the limited number of households surveyed
in each state. Food stamp participation data for July 1996-1999 from Oregon public assistance
data charts, www.afs.hr.state.or.us/papage.html, p. 36.
xviii
Many offices tell applicants to arrive an hour before AFS offices open for client services because
interviews are scheduled on a first come, first serve basis.
xix
The first two pages of the application is the tool AFS uses to screen people for expedited
service.
xx
7 CFR 273.2
xxi
Ibid.
xxii
. Letter from Dennis Stewart, Western Regional Director, Food Stamp Program, to Jim Neely,
Deputy Administrator, Adult and Family Services Division, received January 14, 1999 re: Portland
area AFS branch office review.
xxiii
Stewart, letter received by AFS January 14, 1999.
xxiv
The AFS Family Services Manual directs local offices to provide applicants with the option of
home or telephone interviews if the adult family member is elderly, disabled, faces transportation
problems, or other hardships exist. These hardships can include illness, bad weather, conflicting
work hours, or other reasons.
xxv
7 CFR 272.4(b)(3).
xxvi
7 CFR 272.4(b)(2),(3).
xxvii
7 CFR 273(c)(2)(i).
xxviii
65 Federal Register 10864.
xxix
United State General Accounting Office, Food Stamp Program: Various Factors Have Led to
Decline in Participation, July 1999, p. 14.
xxx
Letter from Dan Glickman, U.S. Department of Agriculture, to all state Governors, dated July 12,
1999, re: the Clinton Food Stamp Initiative.
xxxi
For requirements see 7 CFR 273.2.
xxxii
ORS 411.967 requires all written material published by AFS for potential or current public
assistance clients to be written in plain, understandable language and gives specific instructions
about how AFS must comply with these standards
xxxiii
7 CFR 273.2.
xxxiv
ORS 411.977.
xxxv
7 CFR 273.2.
xxxvi
Adult and Family Services District 2, “Shopper Study”, 1999.
xxxvii
7 CFR 273.2(c).
xxxviii
AFS Family Services Manual, Food Stamp Program, Section B, p. 9.
xxxix
Stewart, letter received by AFS January 14, 1999.