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LIHEAP Research Experiences of Selected Federal Social Welfare Programs and State LIHEAP Programs in Targeting Vulnerable Elderly and Young Child Households

Published: December 1, 2008
Audience:
Low Income Home Energy Assistance Program (LIHEAP)
Category:
Publications/Reports, Research, Case Studies

LIHEAP Targeting Performance

This section of the report describes the LIHEAP targeting goals and the performance of the program with respect to those goals.  LIHEAP uses recipiency targeting indexes to measure the extent to which elderly households and young child households receive program benefits.  The performance goals for LIHEAP are to increase the national targeting index for elderly households and to maintain the national targeting index for young child households.  Between FY 2004-2006, targeting indexes have fallen for both groups.  In addition to the targeting initiatives undertaken by the Federal LIHEAP office, additional efforts need to be undertaken by LIHEAP grantees to improve targeting performance under the LIHEAP block grant.

LIHEAP Targeting Goals

Section 2605(b)(5) of the LIHEAP Statute requires States to provide that, “the highest level of assistance will be furnished to those households which have the lowest incomes and the highest energy costs or needs in relation to income… .”  “Highest home energy needs” refers to both high energy burden and the presence of members of vulnerable populations in the household, including young children, individuals with disabilities and frail elderly individuals (LIHEAP Statute, Section 2603(4)).

In response to the Government Performance and Results Act (GPRA) and the Office of Management and Budget’s (OMB) Program Assessment Rating Tool (PART), the LIHEAP program tracks the targeting indexes for households with vulnerable members in accordance with the statutory language and performance goal of providing services to these households at a greater rate than what they represent in the low income household population.

The annual recipiency targeting indexes measure this rate of service by dividing the percent of LIHEAP recipient households that are members of a target group by the percent of all LIHEAP income eligible households that are members of the target group and then multiplying by 100.  For example, if 25 percent of LIHEAP recipient households are elderly and 20 percent of LIHEAP income eligible households are elderly, the recipiency targeting index for elderly households is 125 (100 * (25 / 20)).  

An index above 100 means the LIHEAP program is effectively reaching the target group at a rate higher than its representation in the low income household population.  The long-term goal of the LIHEAP program set for FY 2010 is to increase the annual national recipiency targeting index to 96 for households with an elderly individual and to 122 for households with a young child.  For the purpose of this study, high, moderate, and low recipiency targeting thresholds were established.4  A State has a high elderly recipiency targeting index if the index is greater than or equal to 100, a moderate index if it is greater than or equal 80 but less than 100, and a low index if it is less than 80.  A State is considered to have a high young child recipiency targeting index if the index is greater than or equal to 120, a moderate index if it is greater than or equal 100 but less than 120, and a low index if it is less than 100. 

LIHEAP Targeting Rates and Trends

In FY 2006, the elderly recipiency targeting index at the national level was 74. This means the LIHEAP program underserves these households by providing services at a rate substantially lower than their representation in the low income household population.  This number is also a statistically significant decrease from the previous three years, during which the targeting rate for these households maintained some stability at around 79.  The goal of increasing the targeting index for households with at least one member age 60 or older to 96 by FY 2010 will require substantial and widespread initiatives designed to better inform and enroll these households.

Also in FY 2006, the young child recipiency targeting index at the national level was 115.  This means that the LIHEAP program targets these households by providing services at a rate substantially higher than their representation in the low income household population.  This FY 2006 number is lower than the benchmark young child recipiency targeting index of 122 established in 2003.  As it is unknown why this rate has declined from a high of 122 in FY 2003, there is incentive to investigate potential barriers to enrollment for these households as well as strategies to help reach the goal of 122 by FY 2010.

LIHEAP Targeting Initiatives

Section 2605 (b)(3) of the LIHEAP Statute mandates States, “conduct outreach activities designed to assure that eligible households, especially households with elderly individuals or disabled individuals, or both … are made aware of the assistance available under this title.. .”  According to the 2001 LIHEAP Clearinghouse document, Outreach and Enrollment Strategies for LIHEAP, outreach is defined as, “the various activities LIHEAP providers engage in to promote and increase program awareness with an attendant goal of increased program enrollment. Outreach may also include outreach activities designed to reach and enroll certain populations.” (NCAT, LIHEAP Clearinghouse, 2001).

The LIHEAP Model Plan asks States to report on their outreach activities by declaring whether or not they engage in the following:  providing intake through home visits; placing posters in local social service offices and articles in local newspapers; sending mass mailings to past LIHEAP recipients; and working with other low income programs to encourage referrals and generate access to target groups.  This is a somewhat varied assortment of activities, ranging beyond traditional information distribution.  This indicates that the efforts of the LIHEAP program to increase enrollment of the two target populations can, and should, go beyond the limited mandate of just increasing awareness of those groups.

In 2004, ACF initiated a nationwide LIHEAP outreach campaign focused on the distribution of OCS’ LIHEAP brochure.  ACF furnished brochures to the Administration on Aging so that they could distribute them to their network of service provider. Since this initial campaign, there have been ongoing exploratory efforts in the form of teleconferences with other agencies to learn how to effectively reach vulnerable populations.  In 2007, ACF began an ongoing collaboration with the Head Start Bureau to conduct outreach to Head Start staff at the Federal, State, and Local levels.  There is considerable room for expanding these efforts to understand how complementary programs increase enrollment and how these lessons can be applied to the LIHEAP program. 

LIHEAP Targeting Issues

Sometimes the goal of targeting vulnerable populations can be difficult when a program is faced with multiple competing constraints.  LIHEAP directors may sometimes feel these constraints make outreach a double-edged sword.  If a program engages in too much outreach, it may lead to long lines, people being turned away, smaller benefits or overworked staff.  If a program engages in too little outreach to targeted populations, it risks failing to meet the needs of the most vulnerable households.

Add to this the fact that in 2002, over 70 percent of all income eligible households contained at least one vulnerable member (APPRISE, 2004).  In a situation in which the sizeable majority of people in the general low income population are members of a targeted group, it can be difficult to understand why special efforts are needed to reach such a group —especially if that means potentially excluding nonvulnerable groups from the program.  Upon closer examination, however, certain vulnerable groups, such as elderly households, are in fact being significantly underserved; while other vulnerable groups, such as those with young children, are decreasing in relative participation.  Though the overall percentage of vulnerable households in the income eligible population is high, these groups are not enrolling in the program at levels that meet the LIHEAP performance goals.  As LIHEAP updates its performance goals, it might consider whether it is becoming more difficult to reach these targeting goals because of exogenous changes that are making it more difficult to reach the targeted populations.

LIHEAP program managers from eight States with high, moderate, and low elderly household recipiency targeting indexes were interviewed. LIHEAP program managers from nine States with high, moderate, and low young child household recipiency targeting indexes were interviewed. The interviewed program managers were from Arizona, Delaware, District of Columbia, Georgia, Iowa, Kentucky, Maine, Michigan, Nebraska, New Mexico, New York, Ohio, Rhode Island, South Dakota, Texas, Washington, and Vermont.  The researchers and ACF appreciate the responses and insights furnished by the program managers. The statements, findings, conclusions, and recommendations are solely those of analysts from APPRISE and do not necessarily reflect the views of ACF or of the responding State LIHEAP program managers.

The decline in both the elderly recipiency targeting index and the young child recipiency targeting index was statistically significant at the 95% confidence level.

See Section II.A for a definition of a recipiency targeting rate and for information on how high, moderate, and low targeting rates were assigned.

For both groups, States with targeting indexes at or above 100 are considered to be targeting the population group.  For elderly households, the States with indexes below 100 are further divided into those with indexes above the national average recipiency targeting index and those below the national average.  For young child households, the States with indexes above 100 are further divided into those with indexes above the national average recipiency targeting index and those with indexes below the national average.

Targeting Overview

This section of the report discusses targeting by other Federal social welfare programs.  It identifies how these programs define targeting and why it is important to such social welfare programs.  It examines targeting trends over the last decade.  A 2005 study by the U.S. Government Accountability Office (GAO) is particularly valuable in identifying which Federal means-tested programs consider targeting to be an important policy goal (GAO, 2005).

Targeting Background

Definition and Basic Procedures

For purpose of this study, targeting is defined as the process by which programs, according to their specified goals, attempt to provide access to services for particular population groups.  Examples of the most common target populations include households with children, elderly members, or members with disabilities.  Some programs will also target other groups such as immigrants and “able-bodied adults without dependents.”

The process of targeting involves three basic steps:

Step One:  The first step is to define a targeted group according to the needs of program and estimate that group’s participation patterns.  The participation rate is defined as the number of program enrollees belonging to the targeted group over the number of eligible people belonging to that group.5  Is that group’s participation high or low?  Has it been increasing, decreasing, or remaining stable over the years?  How does this compare with program goals?

ACF uses a LIHEAP targeting index to assess the targeting level for each household group.  The targeting index is the ratio of the percentage of LIHEAP recipients who are members of a target group over the percentage of all income eligible households that are members of the target group. The advantage of using the targeting index is that it tracks both changes in the participation rate of each household group and the share of the eligible population that group represents.  For example, LIHEAP recipient data might show an increase in the percentage of recipients who are households with elderly members, but the percent of eligible households that are elderly also might be increasing.  The targeting index accounts for both factors.

Step Two:  Once the program has an estimate of targeted group participation patterns, the second step is to explore the reasons behind these patterns.  Many programs conduct focus groups with participants and nonparticipants from the targeted population.  These focus groups elicit in-depth information on the barriers households face in obtaining access to the program.  Focus groups also provide the program with strategy suggestions for removing these barriers.  To test the significance of these barriers and strategies, programs will either conduct their own surveys or use readily available national data to develop statistical models. 

Step Three:  The final step is to report the findings of these tests and adjust program procedures as necessary and feasible.

Purpose

There are two main reasons behind tracking program targeting rates.  The first is to improve program access and the second is to improve program integrity.

Program Access
Program access means households are aware of the program, can get information on it and are able, if they wish, to enroll without too much difficulty (Bartlett et al., 2004).  There is an important distinction between this definition of access and the activities currently required by the LIHEAP Statute.  Section 2605(b)(3) of the LIHEAP Statute requires programs to make sure that, “eligible households, especially households with elderly individuals or disabled individuals, or both, and households with high home energy burdens, are made aware of the assistance available under this title.”    Program access moves beyond general awareness such as this, in order to take into account the ease of obtaining accurate information and of applying to the program.

Program Integrity
Improving program integrity is a very different, and sometimes contradictory, reason for tracking participation rates.  Program integrity is generally understood as the proportion of enrolled individuals who are actually eligible for the program.  This has received relatively more attention from Federal agencies in recent years as a result of several widespread monitoring efforts.  The Improper Payments Information Act of 2002 spurred many agencies to allocate resources toward identifying the extent of non-eligible participation.  This Act, in conjunction with OMB guidance, requires agencies to review programs and identify those with significant potential for incorrect payments in order to report those estimated payments to Congress.

These two goals may at times be in conflict.  Efforts to increase program access by casting a wider net may inadvertently decrease program integrity by encouraging the participation of those who are ineligible.  Likewise, efforts to increase program integrity by ratcheting up requirements may in fact shut out those who are actually eligible for participation.  However, there are some strategies proven to address both goals at once.  Streamlining applications, for example, can increase program access by making the application process less daunting and increase program integrity by reducing errors resulting from complex forms.  In any strategy designed to target populations, both access and integrity need sufficient consideration.

Current Targeting Trends and Issues

Trends

There is no consistent type or level of targeting across Federal means-tested programs.  Each program offers different services to low income populations; sometimes they are focused on delivering services to particular segments of the population and sometimes not.  If programs do track the participation of certain groups, they also vary on the extent of analysis and reporting.  Therefore, there is a wide span of program procedures regarding targeting ranging from some that measure, analyze and report on participation rates in detail to those that do not track participation at all.

The following table summarizes the GAO findings (GAO, 2005, p 45).

Table 3-1 - Federal Means-Tested Programs’ Targeting Procedures


Agency

Program

Estimate participation/ coverage rate?

Use as performance measure?

Include in performance report?

U.S. Department of Agriculture (USDA)

Food Stamps

Yes

Yes

Yes

WIC

Yes

No

No

U.S. Department of Health and Human Services/ Administration for Children and Families (ACF)

TANF

Yes

No

No

CCDF

Yes

No

No

Head Start

Yes

No

No

Internal Revenue Service (IRS)

EITC

Yes

No

No

HHS Centers for Medicare and Medicaid Services (CMS)

Medicaid

No

No

No

SCHIP

No

No

No

Social Security Administration (SSA)

SSI

No

No

No

U.S. Department of Education (ED)

Pell Grant

No

No

No

U.S. Department  Housing and Urban Development (HUD)

Public Housing

No

No

No

Housing Voucher

No

No

No

According to the GAO Report (GAO, 2005), USDA included program participating rates for the Food Stamps Program in its program performance report.  In addition, USDA planned to report WIC program participation rates in its upcoming program reports and HHS/ACF reported childcare coverage rates for its CCDF Biennial Report to Congress.  No other programs were found to report on program participation rates or coverage rates.
On the other end of the spectrum, the HHS Centers for Medicare and Medicaid Services (CMS), which administers the Medicaid and State Child Health Insurance Program (SCHIP), did not regularly track participation/coverage rates.  Since the GAO report, however, there have been many efforts to track SCHIP’s performance in light of congressional efforts to limit or eliminate SCHIP funding.  The Social Security Administration (SSA) did not regularly track participation rates for Social Security Insurance (SSI), nor did the Department of Education (ED) for the Pell Grant or Department of Housing and Urban Development (HUD) for the Public Housing or Housing Choice Voucher programs. 
ED and HUD did track alternative performance rates, namely “take-up”--which measures the number of those eligible applicants who received a grant--and “utilization”--which measures the number of recipients who are able to redeem their vouchers. The measure of “take-up” is appropriate for programs where all funding is not expended.  In such programs, policy analysis would look at who is eligible for the program and try to identify barriers to applying for program benefits when there are funds available.  The measure of “utilization” also is somewhat different from targeting.  In the Housing Voucher Program, some households apply for and receive vouchers, but are unable to redeem those vouchers.  For that program, the policy analysis needs to consider barriers to using the vouchers for housing that the household has selected.

Issues

The first issue to address when comparing targeting performance across programs is the difference between entitlement and non-entitlement programs.6  Faced with limited funding, non-entitlement programs necessarily have a lower coverage rate than entitlement programs.  According to the GAO, entitlement programs’ participation rates range from 50 to 70 percent, while non-entitlement programs’ coverage rates range from 10 to 50 percent of the eligible population.  Any performance goals need to consider this disparity.
The second issue affecting the analysis of targeting rates is the fact that for most programs it is quite difficult to accurately measure the eligible population.  This difficulty stems from two problems in the analysis process.  The first problem is the confusion of eligible individuals when they self-report participation in various programs.  SSA argues many survey respondents confuse SSI with Social Security, leading to significant overestimates of program participation. 
The second problem is complex program eligibility requirements that prevent analysts from accurately estimating the numbers of program-eligible households.  For example, CMS notes that eligibility rules for Medicaid and SCHIP vary across States by several criteria, including age, income, assets, and geographic area.  It is therefore difficult and expensive to conduct separate calculations for each State program.  Estimating the population eligible for the Earned Income Tax Credit (EITC) in order to create participation rates is also difficult due to the level of detail needed in the data to estimate the number of qualifying household members.
This relates to another set of problems arising from the limitations of national survey data.  The Current Population Survey Annual Statistical and Economic Supplement (CPS-ASEC) includes some demographic and program participation information, but not necessarily all that is needed to accurately estimate the eligible population.  For instance, the CPS-ASEC does not include some important assets data and leaves out individuals who are institutionalized.  The Census Bureau’s Survey of Income and Program Participation (SIPP) has more detailed information, but is designed as a panel study and is therefore more useful as an indicator of movement through a program rather than of annual participation.7  Some program estimates, such as those for the Pell Grant, must rely on limited data only available outside the confines of these two national surveys.  Research methodology can adjust for these missing data, but methodology differs among evaluating organizations leading to different estimates of program participation.