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The Southern Regional Initiative to Improve Access to Benefits for Low Income Families With Children

Chapter 2

Information Outreach

Most communication on benefits and services for families has been in the form of bureaucratically worded documents that advise of rights and responsibilities in connection with receipt of benefits. Rarely are there materials that communicate information on available benefits in an easy to understand, “user friendly” manner.

Public policy makers often assume that the passage of laws and/or the appropriation of funding will result in benefits reaching the citizens who are eligible to receive them. With programs for low income families, however, insufficient attention and resources have been devoted to the development of effective communication strategies to inform them about available benefits. Thus, many families are not aware of government benefits that can help provide health coverage for their children, assist them in paying for child care, and allow them to keep more of what they earn.

Initial Development of Information Outreach Brochures

In a study conducted by the Southern Institute in cooperation with the North Carolina Department of Human Resources and the Tennessee Department of Human Services, serious misconceptions about the availability of benefits were identified.1 The findings showed that families on welfare and families receiving Transitional Medicaid, as well as community organizations who work to help them, lacked information or were misinformed about the availability of health coverage and other benefits.

As part of the study, personal interviews were conducted with randomly chosen recipients of Aid to Families With Dependent Children (AFDC) and Transitional Medicaid benefits. During the interviews, specific questions were asked in order to determine the degree to which recipients understood how benefits changed when they left welfare for work. The questions related to AFDC (the cash assistance welfare program), Medicaid, food stamps, child care and housing.

Table 2 shows the findings from the recipient interviews. The program least understood was Medicaid, with 76% incorrect responses. Forty-seven percent (47%) of the responses related to child care assistance were incorrect. Responses indicated that many believed that families had to be on welfare to receive any assistance with health coverage and child care.

TABLE 2
PERCENTAGE OF RECIPIENTS PROVIDING INCORRECT RESPONSES TO THE IMPACT OF EARNINGS ON BENEFITS
Benefit Percentage Providing Incorrect Responses
AFDC 24%
Food Stamps 6%
Medicaid 76%
Child Care 47%
Housing 24%
Source: Southern Institute on Children and Families, 1994. Data collected from recipient interviews in Charlotte, North Carolina and Nashville, Tennessee.

The Southern Institute published its report in March 1994 and recommended that state social services officials in the southern states develop “user friendly” materials to effectively communicate the benefits available through various programs. With support from the North Carolina Department of Human Resources, 18 focus groups were held in six counties to assist in the development and testing of information outreach brochures that communicated the availability of Medicaid benefits for children, the Earned Income Tax Credit (EITC), child care and food stamps. Subsequent to the NORTH CAROLINA information outreach project, nine additional focus groups were held in three counties in GEORGIA with support provided by the Georgia Division of Family and Children Services.

In each state, focus groups were held in urban and rural counties with the following groups: 1) AFDC and Transitional Medicaid recipients (chosen randomly); 2) community organizations; and 3) employers. In North Carolina, 144 persons participated in the focus groups. In Georgia, 89 persons participated.

In both states, pretest and post test questions were administered to measure the knowledge of focus group participants regarding general Medicaid eligibility rules for children, Transitional Medicaid, the Earned Income Tax Credit and child care. The pretest results in both states clearly demonstrated the need for aggressive information outreach. The GEORGIA pretest results are summarized below.

Recipients

Community Organizations and Providers

Employers

For illustration purposes, the first page of the three GEORGIA outreach brochures are displayed on page 12 and each brochure is included in its entirety in Appendix C.

After reading through the outreach brochure, focus group participants were given a post test to measure gains in knowledge. No discussion was held prior to the post test. Results showed that the communication effectiveness of the outreach brochures was statistically significant in both states. Table 3, Table 4 and Table 5 display the GEORGIA post test results by target group.

TABLE 3
RECIPIENTS
PERCENTAGE OF CORRECT ANSWERS
ON THE PRETEST and POST TEST, BY PROGRAM
Program Pretest Post Test
Earned Income Tax Credit 41% 86%
Medicaid 38% 81%
Child Care 76% 93%
Source: Southern Institute on Children and Families, 1996. Data collected for the Georgia Information Outreach to Reduce Welfare Dependency Project.

TABLE 4
COMMUNITY ORGANIZATIONS
PERCENTAGE OF CORRECT ANSWERS
ON THE PRETEST and POST TEST, BY PROGRAM
Program Pretest Post Test
Earned Income Tax Credit 71% 96%
Medicaid 61% 98%
Child Care 81% 100%
Source: Southern Institute on Children and Families, 1996. Data collected for the Georgia Information Outreach to Reduce Welfare Dependency Project.

TABLE 5
EMPLOYERS
PERCENTAGE OF CORRECT ANSWERS
ON THE PRETEST and POST TEST, BY PROGRAM
Program Pretest Post Test
Earned Income Tax Credit 38% 100%
Medicaid 61% 96%
Child Care 50% 100%
Source: Southern Institute on Children and Families, 1996. Data collected for the Georgia Information Outreach to Reduce Welfare Dependency Project.

Replication of the Information Outreach Brochures in the Southern States

Following the development of the outreach brochures in Georgia and North Carolina, two states (FLORIDA and TENNESSEE) asked the Southern Institute to adapt the information outreach brochures for use by their states. Thus, when this project began, 13 states and the District of Columbia were not using the outreach brochures. On site visits to the remaining 13 southern states and the District of Columbia during this project, presentations on the information outreach brochures were made to those attending the state meetings.

States were informed that through this project the Southern Institute could provide technical assistance to adapt the information outreach brochures for use by their states. Printing and distribution costs would be the responsibility of each state.

The information outreach brochures were enthusiastically received by persons attending the site visit meetings. All states and the District of Columbia have indicated that they will take advantage of the opportunity to produce the brochures for use in their outreach efforts. At present, 10 southern states have completed production and are using the brochures statewide. Table 6 provides the status of replication of the information outreach brochures across the southern region.

TABLE 6
STATUS OF INFORMATION OUTREACH BROCHURES
JANUARY 1998
State In Use In Draft Stage Planning
To Use
Alabama     X
Arkansas     X
Delaware X    
District of Columbia   X  
Florida X    
Georgia X    
Kentucky X    
Louisiana     X
Maryland X    
Mississippi X    
Missouri   X  
North Carolina X    
Oklahoma   X  
South Carolina X    
Tennessee X    
Texas     X
Virginia X    
West Virginia     X
Note: Most states produced all three outreach brochures for use statewide. South Carolina and Tennessee did not produce the “Facts for Employers” brochure.
Source: Southern Institute on Children and Families, 1998.

Use of the information outreach brochures provides strong evidence that states in the South intend to be proactive in getting messages to low income families about the availability of health coverage and other benefits. While the outreach brochures are especially helpful to families leaving welfare for work, states indicate that the brochures will also be used in their efforts to reach out to families who have no connection with welfare and in their job development efforts with employers.

Information Outreach Videos

Six information outreach videos were developed through this project. The videos are designed to be used in conjunction with the information outreach brochures.

Each state that uses the information outreach brochures has been provided the following videos and has been advised that they can make additional videos or they can order them from the Southern Institute at cost:

Two focus groups were held in South Carolina to test the video, Have You Heard About Benefits for Working Families??? Focus group participants were parents of children who were income eligible for Medicaid, but not enrolled in Medicaid. Results indicated that the messages in the video effectively communicated that health coverage and other benefits are available to low income families and these benefits are available to working two parent families in addition to single parents. For many participants, these points were new information.

Participants suggested many possible viewing sites for the video. “Doctor’s office” was the most frequent response. Other suggestions included hospitals or emergency room waiting areas, government offices such as social services agencies and health departments, libraries, schools, PTA meetings, women’s shelters, churches, post offices, work break rooms and low income housing areas.

The video was positively associated with a feeling of encouragement. Many participants said they themselves could benefit from the new information and/or that they had friends who could benefit from the information.

____________________

1 Sarah C. Shuptrine, Vicki C. Grant and Genny G. McKenzie, A Study of the Relationship of Health Coverage to Welfare Dependency (Columbia, SC: Southern Institute on Children and Families, March 1994).