The Application Process
For TANF, Food Stamps, Medicaid, and SCHIP

Issues For Agencies and Applicants,
Including Immigrants and Limited English Speakers

Submitted to:
U. S. Department of Health and Human Services
Office of the Secretary
Office of the Assistant Secretary for Planning and Evaluation

January 2003

This report is available on the Internet at:
http://aspe.hhs.gov/hsp/app-process03

How to Obtain a Printed Copy

Contents

Executive Summary

Acknowledgements

Chapters

1. Introduction
2. Study Context
   • The Demographic Context:  Immigration and Language Diversity
   • Policy Context:  Welfare Reform and Other Key Developments
3. Applying for Benefits: What Families must do
   • Gaining Access to Program Benefits: Various Initial Points of Entry
   • An Overview of Common Steps in the Application Process
   • Site Specific Application Processes
   • Special Issues for Non-Citizens and Limited English Speakers
4. Application Forms
   • Application Availability
   • Integrated Application Forms
   • Medicaid/SCHIP Program Applications: Streamlined and Simplified
5. Eligibility Determination Policies and Verification Procedures: Special Issues for Immigrants
   • Implementing Non-Citizen Eligibility Rules
   • General Eligibility Documentation and Verification Requirements:  Special Implications for Immigrants
6. The Language Dimension of Applying for Assistance:  Strategies to Meet the Needs of Limited English Speakers
   • Key Language Access Strategies
   • Multiple Language Access Strategies:  Local Level Examples
   • Responding to Increasing Language Diversity
   • Developing Language Services in New Immigrant Destinations

Appendices

1. Study Methodology
2. Language Spoken at Home, Population Ages 5 and Over
3. Study Program Descriptions

List of Exhibits

• 2-1  Total Population, Hispanic, and Asian Shares
• 2-2  Foreign-Born, Non-Citizen, and Recently-Arrived Immigrant Populations
• 2-3  Limited English Proficient (LEP) Adults Ages 18 and Over, by Major Language Group
• 2-4  State-Funded Benefits for Post-Enactment Legal Immigrant Families with Children
• 3-1  Office Structure for Program Application and Eligibility Determination
• 3-2  Access to SCHIP
• 3-3  A Typical TANF/FSP/Medicaid Application Process
• 3-4  Up-Front Eligibility Requirements
• 3-5  Sample TANF and Food Stamp-Only Application Process by Office
• 4-1  Availability of Applications
• 4-2  Key Characteristics of Integrated Applications
• 4-3  Key Characteristics of Medicaid/SCHIP Applications in the Study Sites
• A-1  Change in Benefit Program Participation, 1996 to 1999
• A-2  List of Agencies and Other Organizations Participating in Site Visit Discussions

Acknowledgements

This study could not have been completed without the cooperation and assistance of many individuals. Most importantly, our thanks go to all the state and local program staff, staff from community-based and advocacy organizations, and local discussion group participants who contributed to this study. These individuals were tremendously generous with their time and provided us with a wealth of critical information and insights.

The authors wish to thank many current and former staff at the Urban Institute who played an important role in this project. We especially thank Michael Fix and Wendy Zimmerman for their invaluable work in laying the groundwork for this study and providing constructive suggestions throughout the project. Frank Ullman provided much appreciated assistance with completing the site visits and contributing to the final report. We also thank Ian Hill and Corinna Hawkes for sharing valuable information about SCHIP and Medicaid implementation, based on their own work in this area.

Finally, we are indebted to David Nielsen, our ASPE Project Officer, for his commitment to this project and helpful guidance throughout the study.

This report was prepared by Pamela A. Holcomb, Karen Tumlin, Robin Koralek, Randy Capps, and Anita Zuberi of The Urban Institute for the Office of the Assistant Secretary for Planning and Evaluation (ASPE), U.S. Department of Health and Human Services under contract number HHS-100-99-0003, Task Order No. 14. The views expressed are those of the authors and should not be attributed to the U.S. Department of Health and Human Services or to the Urban Institute, its trustees, or its funders.

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Last updated:  07/17/03