Research CalFresh participation rate

[lippytak]

'Participation rate' is the % of eligible individuals who are enrolled in a program at a point in time. The CalFresh participation rate in California is pretty low, suggesting there is a big opportunity (data from 2010): (source)

We need to do a lit review to better understand:

• What is the current CalFresh participation rate in CA? In SF? Across counties?
• What demographic groups have the lowest participation rate? Employed or not employed? Age groups? Racial/language groups?
• What are the data sources and basic methods for these estimates?

Some initial resources are in the wiki: https://github.com/codeforamerica/health/wiki/Research:-Who-is-Eligible,-Interested,-and-Not-Enrolled-in-CalFresh%3F

[lippytak]

If there’s time @daguar will take a first pass this sprint.

[daguar]

:thumbsup:

[lippytak]

Technically this is content. And this is a need. Maybe it's a content need? cc @lynnfine @dschrimmer

[daguar]

(updated tag to @dschrimmer )

[alanjosephwilliams]

@lippytak did you file this with the content team? It might be helpful to bring it into their primary queue.

[daguar]

"Program perception can also significantly impact CalFresh participation, especially among seniors and working families."

Source: http://cfpa.net/CalFresh/CFPAPublications/LDEP-FullReport-2013.pdf

^ Interesting thing — unclear what this is based on, but interesting nonetheless for honing in on (seniors) and (working families) as groups affected hugely by (brand perception/framing).

[daguar]

From a recent lit summary ( http://web.stanford.edu/group/scspi/_doc/c-well/CWell_Rsearch_Update_1.pdf ):

"Can the stigma associated with using the Food Stamp Program be reduced by the simple device of renaming it?

In an experiment by Diane Whitmore Schanzenbach, the Food Stamp Program was relabeled as the “Golden State Alliance” in outreach materials. The intervention was then tested by assessing whether take-up increased relative to that secured under the conventional outreach materials currently distributed by the United States Department of Agriculture (USDA).

The relabelling did indeed appear to modestly reduce stigma. More non-enrolled eligibles expressed interest in applying for Food Stamps in the no-stigma condition (25.8%) than in the control condition (20.9%). In addition, Whitmore found that, when eligible recipients received application assistance and had their application filed directly by H&R Block staff, they were nearly 18% more likely to apply for benefits."

[daguar]

"Why do low-income women not use food stamps? Findings from the California Women’s Health Survey" Lucia Kaisera, Public Health Nutrition http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=2639268&fileId=S1368980008002528

Key excerpts:

• "Over 42 % of potentially eligible non-participants cited ‘don’t need them’ as the reason for not applying for FSP"
  • "Potentially eligible non-participants who cite ‘don’t need them’ as a reason for not applying are less likely to be food insecure, to have inadequate income and to use alternative emergency aid, compared to women citing all other reasons."
• "...but 34·9 % either do not think they are eligible or do not know how to apply."
  • "The highest level of need is among those who cite worry about citizenship or stigma as reasons for not applying."

[daguar]

The USDA gave out a shitton of grants targeted at increasing participation from 2003-2008: http://www.fns.usda.gov/snap/food-stamp-program-participation-grants

Looking at the evaluation reports for these grants might be fruitful.

[daguar]

"FOOD WITHIN REACH: STRATEGIES FOR INCREASING PARTICIPATION IN THE FOOD STAMP PROGRAM IN CALIFORNIA" (2009, California Budget Project, Scott Graves and Jennifer Tucker) http://www.cbp.org/pdfs/2009/091221_Food_Stamps.pdf

This is apparently a pretty important report — it was the one that made many of the recommendations since-adopted in CalFresh, specifically:

• Elimination of the asset test
• Elimination of the fingerprinting requirements
• Elimination of in-person interview requirement (rec for counties)

[daguar]

Also from the CBP report's suggestions:

"Implement convenient ways to apply for food stamp benefits and evaluate the effectiveness of those strategies.

Individuals incur costs, such as lost wages due to missing work, when they must visit a county social service office to apply for food stamp benefits. Those costs can be avoided or minimized if counties implement or increase the use of more convenient ways to apply for benefits, including by putting applications online and placing county eligibility workers in convenient locations (“out-stationing”). To the extent that counties provide alternative ways to apply for food stamp benefits, they should evaluate the effectiveness of those strategies, including by tracking how many FSP applicants use each one, assessing which strategies boost participation, and reporting the results. Systematic evaluation would allow program administrators to assess how well underserved populations are being reached and help guide counties toward the most successful and cost-effective strategies."

THIS IS US, PEOPLE.

[daguar]

One more interesting rec (in terms of mapping an intervention to specific target groups) from the CBP report:

"Promote the opt-out alternative. As noted above, legal immigrants may not be aware that they can apply for food stamp benefits for eligible members of their household, including their children, while not applying for themselves. Counties can increase awareness of the opt-out alternative by actively promoting it. For example, at least three counties have designed supplemental materials that explain the opt-out process and allow adults to exclude themselves from the FSP eligibility review while applying for benefits on behalf of other members of their household. Similar county efforts to incorporate greater transparency and flexibility into the FSP application process could increase enrollment of other eligible Californians as well, including foster children and residents of domestic violence shelters, homeless shelters, and residential drug and alcohol programs."

[RebeccaCoelius]

Valuable fact sheet that puts SNAP enrollment in context of poverty, food insecurity, and other food programs in the United States. There are other useful links on the page too. http://www.feedingamerica.org/hunger-in-america/impact-of-hunger/hunger-and-poverty/hunger-and-poverty-fact-sheet.html

highlights: In 2013, 45.3 million people (14.5 percent) were in poverty. In 2013, 14.7 million (19.9 percent) children under the age of 18 were in poverty.

In 2013, 49.1 million Americans lived in food insecure households (14% of all households), including 33.3 million adults and 15.8 million children.

Eight states exhibited statistically significantly higher household food insecurity rates than the U.S. national average 2011-2013:[vii] <- note lack of CA despite low rates of CalFresh enrollment! United States 14.6% Arkansas 21.2% Mississippi 21.1% Texas 18.0% Tennessee 17.4% North Carolina 17.3% Missouri 16.9% Georgia 16.6% Ohio 16.0%

In 2013, 62 percent of food-insecure households participated in at least one of the three major federal food assistance programs –Supplemental Nutrition Assistance Program (SNAP-formerly Food Stamp Program), The National School Lunch Program (NSLP), and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC). [viii]

[RebeccaCoelius]

Related national map of food insecurity: http://www.feedingamerica.org/z-testing/nigel-testing/map-the-meal-gap.html

[RebeccaCoelius]

This describes statewide efforts to improve CalFresh participation rate- related to the recc doc @daguar posted 3 days ago. http://www.cdsscounties.ca.gov/foodstamps/res/pdf/StateEffortsToIncreaseParticipation.pdf

Target subgroups: -those enrolled in MediCal

• Spanish and other non English speaking
• seniors
• homeless
• working students

Policy: Implementation of Assembly Bill 6 (AB 6-Fuentes) -Semi-Annual Reporting (SAR) is mandated to be implemented no later than October 1, 2013. California is the last state in the country to convert to SAR and this transition is expected to increase participation, reduce administrative burden and churning of cases, and improve program access while maintaining program integrity. CDSS requested waivers to align SAR with CalWORKs which, unfortunately, were for the most part, denied. We are working on defining the implementation of SAR in light of the denials. -AB 6 also required CDSS to design, implement, and maintain a “Heat and Eat” utility assistance initiative that would grant CalFresh households a nominal (approximately 10 cents) Low Income Home Energy Assistance Program (LIHEAP) benefit. LIHEAP became effective January 1, 2013. The LIHEAP benefit allows applicants to use a standard utility deduction which will increase benefits for many households.

• Elimination of the Statewide Fingerprinting Imaging System (SFIS) requirement as a condition of CalFresh eligibility began on January 1, 2012. A gradual increase in CalFresh participation is anticipated due to the absence of this requirement.
• Application Workgroup - CDSS is leading a workgroup whose task is to simplify the existing CalFresh (DFA 285) application.

CalFresh Refresh (that is the name..) <--- unclear how many of these are widely happening -Eliminating the Requirement for a Face-to-Face Interview at Application and Recertification -Average Monthly Student Income CDSS was approved for a waiver of current policy which required a student of higher education work a minimum of 20 hours per week in order to be eligible for CalFresh benefits. Now it can be averaged over a month.

• Eliminating the required interview for Elderly/Disabled Recipients
• Automation Changes Bucket: Case Management, E-Notices, Application Assistance Portals, Provide electronic verification of client income and assets, Allow use of telephonic signatures on applications, Implementing Regional or Consortia-based Call Centers

[daguar]

SF Food Security Task Force: Assessment of Food Security in SF (2013) https://www.sfdph.org/dph/files/mtgsGrps/FoodSecTaskFrc/docs/FSTF-AssessmentOfFoodSecurityInSF-2013.pdf

Not much of new value here, but SF-specific context.

[alanjosephwilliams]

@daguar is this an evergreen issue? If not, we should take the time to pull out the salient data into the wiki and close it down.