Securing the Safety Net: Concurrent Participation in Income Eligible Assistance Programs

Introduction: Participation in WIC, Food Stamp (SNAP), Temporary Cash Assistance (TCA) and Medicaid (MAP) programs provides critical nutrition/health benefits to low income families. Concurrent enrollment in these programs provides a powerful safety net; yet, simultaneous participation is reported to be low. Underutilization undermines program objectives, client well being and food security. This paper examines concurrent participation among the most needy WIC clients, at or below 100% of the Federal poverty level (FPL), in SNAP, TCA and MAP. Methods: We examined the Maryland state WIC program infant electronic database (N=34,409) for the 12-month period ending September 2010. Our analysis focused on two-thirds of these infants (N=23,065) who were at/below the 100% FPL. Results: Mothers' mean age was 25.8±6 years; 20.6% White; 52.7% African American, and 23.4% Hispanic. Approximately 10% of infants weighed <2500 grams and 1.5% weighed <1500 grams at birth. Average household income was $10,160; 55.7% were at/below the 50% FPL. Two-thirds (68.4%) participated in MAP, 31% in SNAP and 9% in TCA. Only 8% were enrolled in all three programs whereas 28% were not enrolled in any. There was a statistically significant difference in mean age and household income between multi-program beneficiaries and mothers who solely participated in WIC: 25.6±5 years and $7298±$4496 compared with 27.2±6 years and $12216±$6920, respectively (p<0.001). Discussion: Despite income eligibility, only 8% of WIC families received multi-program benefits. To minimize client burden and program underutilization, a coordinated effort is essential to identify and overcome barriers to concurrent participation among these families.