Center for Public Policy Prioritieswww.cppp.org Making the Case for an Adequately Funded Eligibility System Funding State Services Conference Center on Budget and Policy Priorities Making the Case for an Adequately Funded Eligibility System November 14, 2006 Celia Hagert, Senior Policy Analyst

Center for Public Policy Prioritieswww.cppp.org The Big Picture

Center for Public Policy Prioritieswww.cppp.org Looking Back a Decade

Center for Public Policy Prioritieswww.cppp.org State, Federal Welfare Reform Instigate Staffing Reductions TANF/Food Stamp caseloads decline following state and federal welfare reforms in Legislature begins reducing staff –96-99: 12% cut –96-01: 18% cut

Center for Public Policy Prioritieswww.cppp.org Number of families seeking services did not drop Applications for benefits increased due to Medicaid growth Food Stamp applications dropped 12%, TANF 37% Medicaid applications increased 18% Food Stamp and Medicaid caseloads much larger than TANF

Center for Public Policy Prioritieswww.cppp.org Fewer clients, but heavier workload: Individual workload grew due to welfare reform policies, substantial increase in frequency of Food Stamp renewals Average time for eligibility interview increased from 50 to 90 minutes. Passage of CHIP in 1999 required more work

Center for Public Policy Prioritieswww.cppp.org Workload increases, staffing cuts continue: 99-01

Center for Public Policy Prioritieswww.cppp.org Services to clients suffer Only one-third of eligible households get Food Stamps Only 1 in 4 children referred to Medicaid from CHIP successfully enrolled Procedural denials surge in kids’ Medicaid (>65% denial rate in transfer of kids from CHIP to Medicaid)

Center for Public Policy Prioritieswww.cppp.org Customer Service Shortcomings Turnover rates ranged from 32 to 38% in metro areas, Training, customer service suffer as understaffed offices with inexperienced workers try to keep up Many positions remained unfilled due to difficulty recruiting and retaining workers in competitive job market. Vicious cycle: heavy workload high turnover heavier workload difficulty recruiting/training staff, etc. Several lawsuits related to customer service shortcomings

Center for Public Policy Prioritieswww.cppp.org Advocates propose eligibility policy reform, simplification in 2001 Eliminate face-to-face initial interview requirement*/assets test and allow 12 months of continuous eligibility for children’s Medicaid* Eliminate vehicle asset test for Food Stamps and TANF* Allow “hardship” clients to have phone interviews for Food Stamps* Use policy simplification as opportunity to reduce staff workload *6-month renewal, $15K vehicle exemption, FS phone interview all passed

Center for Public Policy Prioritieswww.cppp.org Advocates propose eligibility policy reform, simplification in 2001 Eliminate face-to-face initial interview requirement*/assets test and allow 12 months of continuous eligibility for children’s Medicaid* Eliminate vehicle asset test for Food Stamps and TANF* Allow “hardship” clients to have phone interviews for Food Stamps* Use policy simplification as opportunity to reduce staff workload; argument rejected, cuts continue *6-month renewal, $15K vehicle exemption, FS phone interview all passed

Center for Public Policy Prioritieswww.cppp.org State Proposes Modernization, Outsourcing in % reduction in staff Close one-half of local offices Set up call centers, online application Replace higher-paid, policy- knowledgeable staff with lower-paid, les skilled contract workers Better use of technology –centralized computer system –paperless system

Center for Public Policy Prioritieswww.cppp.org Advocates Voice Concerns, Urge Caution Too few staff = poor customer service, delays in benefits, and improper denials No staffing analysis, state ignored staffing shortages Not enough attention to special populations Too little testing, too aggressive timeline No proposals to simplify policy

Center for Public Policy Prioritieswww.cppp.org Advocacy Challenges How to counter the “bread is too fresh” response to criticism Just protecting state employees, big government? Lack of involvement from other advocates/nonprofits –Busy protecting vital services –Fed up with current system –Fear of retribution, strain on relationship with state administrators Huge budget shortfall in 2003: Cuts in infrastructure preferable to cuts in services

Center for Public Policy Prioritieswww.cppp.org Advocacy Challenges Legislature/Congress more pro-privatization, anti-government: Many lawmakers interested in shrinking sate services, gov’t’s role in providing them Lack of understanding of eligibility determination system: –Complicated rules, many can’t be changed just because perceived as “bureaucratic” –Hard-to-serve clients –Lack of funding for staff, technology biggest problem

Center for Public Policy Prioritieswww.cppp.org Advocacy Strategies Involve feds, urge scrutiny/monitoring of new system Engage media Engage members of Congress Build support among fellow nonprofits, advocacy groups (particular for vulnerable populations) State legislation to require pilot, testing

Center for Public Policy Prioritieswww.cppp.org What Happened? Technical problems, lack of testing complicate roll-out Aggressive timeline, unrealistic expectations lead to premature loses of state staff Poor training of contract workers Children lose health insurance (-100K from Dec 05-Apr 06) Backlog, delays in application processing: timeliness drops below federal standards Frustration among clients and staff

Center for Public Policy Prioritieswww.cppp.org Workload Soars

Center for Public Policy Prioritieswww.cppp.org Heavy Use of Temporary Staff Number of temporary staff increased from less than 2% in 2004 to 30% in Sep 2006

Center for Public Policy Prioritieswww.cppp.org Timeliness

Center for Public Policy Prioritieswww.cppp.org Caseload Declines

Center for Public Policy Prioritieswww.cppp.org Caseload Declines

Center for Public Policy Prioritieswww.cppp.org Error Rates Increase

Center for Public Policy Prioritieswww.cppp.org Outlook is Grim FY 2007 figure includes both state and contract staff

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