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Appendix A: Study Methodology

The information included in this report is drawn primarily from site visits to six different localities across the nation (Arlington, VA; Dallas, TX; New York, NY; Raleigh, NC; Sedalia, MO; and Seattle, WA). Although they are representative of neither the nation as a whole nor the states in which they are located, the sites nonetheless offer rich and varied examples of the application process and practices used by public agencies and faced by immigrant and LEP persons when the y apply for the following four federal benefit programs: Temporary Assistance for Needy Families (TANF), the Food Stamp Program (FSP), Medicaid, and the State Children’s Health Insurance Program (SCHIP).

Site Selection Criteria

The process used to select sites was designed to yield a sample that is diverse in terms of the policy environment as well as the immigrant population’s total size, language diversity, and mix of citizenship and immigration status. More specifically, the criteria considered when selecting the six sites included: (1) demographics of the immigrant population; (2) trends in public benefit caseloads; and (3) availability of safety net assistance for legal immigrants.

Immigrant-Related Demographic Data. Data on metropolitan area characteristics from the U.S. Current Population Survey (CPS)1 were used to rank sites according to the following demographic factors: total population; foreign-born share of the total population; share of the foreign-born population entering within last ten years; and share of the foreign-born population from the top three countries of birth (as a measure of immigrant diversity). Sites were selected with the intent of achieving a mixture of sites with large and diverse immigrant populations, as well sites that are new settlement areas (i.e., those with small but rapidly growing immigrant populations).

The final six sites chosen for the study vary considerably along these selection criteria. For example, the sites range in total population size from New York, the largest city in the country, to Sedalia (MO), a small Midwestern town in a county of about 39,000 people. The foreign-born share of the population is also highest in New York (33 percent in the metropolitan area) and lowest in Raleigh (5 percent) and Sedalia (estimated at 5 percent by respondents). The foreign-born populations of Raleigh and Sedalia grew very rapidly during the 1990s, making these two localities new immigrant settlement areas.

Public Benefit Caseload Trends. TANF, FSP and Medicaid caseload participation between 1996 and 1999 were examined to identify general caseload trends in the four focal programs. As shown in Exhibit A-1, AFDC/TANF declines were greatest in Texas, followed by North Carolina and Missouri. FSP declines were also greatest in Texas, followed by Washington and Virginia. Although Medicaid coverage dropped nationally and in some of the states included in our study between 1996 and 1997, by 1999 coverage had increased in all six states: by single digit percentages in New York, North Carolina and Texas, and by double-digit shares in Missouri and Virginia. In all five states except Texas, the growth in the new SCHIP program brought increases in public health insurance coverage into the double digits, but by 2000 Texas’s SCHIP program had also enrolled very large numbers of children.

Exhibit A-1:
Change in Benefit Program Participation, 1996 to 1999
(Study Sites)

State	AFDC/TANF (% Change)	FSP (% Change)	Medicaid (% Change)	Medicaid+SCHIP (% Change)
Missouri	-42.5%	-26.3%	37.9%	45.7%
New York	-31.5	-26.6	1.4	17.3
North Carolina	-48.4	-19.9	4.6	17.3
Texas	-54.4	-41.0	4.1	6.0
Virginia	-44.9	-32.7	10.9	13.6
Washington*	-35.7	-35.9	127.4	127.4
U.S. Total	-42.1	-28.8	13.1	18.6

* Washington State Medicaid figures are for Fiscal Year 1998, because figures for 1999 are incomplete on agency websites. Source: Program trend data were obtained from the following agency websites: TANF—U.S. Department of Health and Human Services, Agency for Children and Families (http://www.hhs.gov./new/stats/newstat2.html) Food Stamp Program—U.S. Department of Agriculture, Food and Nutrition Services, (http://www.fns.usda. gov/pd/fspmain.htm); Medicaid: U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, (http://www.hcfa.gov/medicaid/msis/mstats.htm); SCHIP—U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, http://www.hcfa.gov/init/children.htm

Availability of Safety Net Assistance for Legal Immigrants. In order to capture differences in state choices about providing benefits to non-citizens, the availability of state substitute programs for legal immigrants losing eligibility for TANF, food stamps and/or Medicaid under PRWORA was examined in combination with state rankings previously developed by the Urban Institute based on the availability of several different benefit programs, using data from 1998 (Zimmermann and Tumlin 1999). Of the final sites selected, the states of Washington and Missouri were ranked “most available” (i.e., state substitute benefit programs for legal immigrants are most available in these states). New York was ranked “somewhat available,” North Carolina and Virginia “less available,” and Texas “least available.” It should be noted that “less available” and “least available” were the most common rankings when all 50 states are considered, with a total of 21 states ranked “less available,” and another 12 states ranked “least available.”

Site Visit Data Collection

Urban Institute researchers visited all of the six sites between June 2001 and January 2002. The primary source of information was in-person, semi-structured discussions with welfare agency staff knowledgeable about and/or directly involved in some aspect of the application process. Using semi-structured guides, team members conducted in-person discussions with bilingual and monolingual English-speaking staff in the following positions:

• Front-desk intake/receptionists workers,

• Pre-screeners,

• Eligibility workers,

• Eligibility supervisors,

• Program administrators and managers,

• Outreach workers,

• Workers who conduct TANF or other program orientations,

• Workers who conduct pre-eligibility home visits or other types of verification,

• Staff responsible for non-citizen eligibility, language access, and community outreach, and

• Interpreters under agency contract.

In addition to agency staff, we held discussions with staff at community-based organizations (CBOs) and other community groups familiar with immigrant and limited English proficient applicants' experiences with public benefit applications. The CBOs and other community groups involved in the study are engaged in program outreach, the provision of interpreter services, or assistance for immigrants and limited English speakers to navigate the benefit application process. Follow-up telephone discussions with key respondents were conducted as well as additional phone discussions with new respondents as needed. (See Exhibit A-2 for a summary list of agencies/offices participating in site visit discussions for this study.)

To supplement in-person discussions, we conducted a limited number of observations of reception area, front-desk, application screening, and interview procedures at the welfare offices and other application sites. The purpose of these observations was to enrich our understanding of the application process as gleaned from discussions with agency staff. Observations were only conducted after voluntary agreement was obtained from both agency staff and applicants. In addition, a total of seven group discussions were held with non-citizens and other limited English speakers who had applied for one or more of the study’s focal programs within the past year.

Of the six sites chosen, the three smallest sites—Raleigh, Arlington, and Sedalia—each have one central welfare agency (some with satellite offices or out-stationed staff), and the site visits covered most, if not all, major application locations. In the larger sites—New York, Dallas, and Seattle—there are multiple welfare offices providing application and eligibility determination services for TANF, food stamps, Medicaid and SCHIP to individuals residing in those jurisdictions. In these larger sites, we visited at least two public benefit office locations that were identified as either making special efforts to accommodate immigrant applicants; serving multiple language groups (including less common language groups), or serving primarily one non-English language group (usually Spanish). In all sites, discussions were also held with a small sample of staff responsible for conducting application assistance and/or eligibility determination interviews in locations other than public welfare offices (e.g., hospitals, health providers, non-profit social service agencies, and, in New York City, Facilitated Enrollers.) The final selection of offices and other application locations visited was made in consultation with program administrators and knowledgeable CBO staff.

Exhibit A-2:
List of Agencies and Other Organizations
Participating in Site Visit Discussions

 

Arlington (VA):

Arlington County Department of Human Services

Arlington Free Clinic
Arlington Pediatric Center
Northern Virginia Area Health Education Center
Arlington Diocese Office of Resettlement
Northern Virginia Regional Planning Commission
Children’s Health Care Connection
Hispanic Committee of Northern Virginia

Dallas (TX):

State-Level

Texas Department of Human Services

Office of Immigration and Refugee Affairs,
Government Relations
Civil Rights Department
Office of the General Counsel
Texas Works Program Administration

Center for Public Policy Priorities
Texas Immigrant and Refugee Coalition
Texas Association of Community Action Agencies

Local-Level

Texas Department of Human Services

Ross Avenue Office, Dallas
New York Avenue Office, Arlington

Parkland Health and Hospital System, Eligibility and Patient Registration
Children’s Medical Center, SCHIP Outreach
Work Advantage, Fort Worth

Community Council of Greater Dallas
Catholic Charities of Dallas, Inc.
The Hmong American Planning and Development Center, Inc.
East Dallas Counseling Center, Inc.
The Dallas Concilio

New York City (NY):

New York City Human Resources Administration

Office of Refugee and Immigrant Affairs
Eligibility Verification and Review Office
Refugee and Immigrant Job Center
Bay Ridge Job Center
New Utrecht Food Stamp Office
Medical Assistance Programs
Paperless Office System

New York Immigration Coalition
Make the Road by Walking, Inc.
Health Plus
Children’s Aid Society

Raleigh (NC):

Wake County Department of Human Services

Family and Children’s Medicaid/Food Assistance/Work First
North Carolina Employment Services Commission

Poverty Law Litigation Project
Hispanic Family Center
Lutheran Family Services

Seattle (WA):

Washington Department of Social and Health Services

Kent Community Services Organization
Rainier Community Services Organization

Seattle Office of Economic Development, Seattle Jobs Initiative
Hopelink
Community Health Access Program
Community Health Center of King County
Public Health Department of Seattle & King County, Access and Outreach
Eastgate Public Health
TRAC Associates Agency
Northwest Justice Project
Refugee Women’s Alliance
The Children’s Alliance
Consejo
World Relief
Center for Multicultural Health
Highline School District, Medicaid Outreach
Kids Health 2001, Cross Cultural Health Care Program
YWCA of Seattle
Asian Counseling and Reference Service

Sedalia (MO):

Missouri Department of Social Services, Division of Family Services, Pettis County
Bothwell Regional Health Center

Pettis County Community Partnership

1 At the time that the sites were selected in 2001, data from Census 2000 and the Census 2000 Supplementary Survey (C2SS) which provides LEP population characteristics were unavailable.(back)

 

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