Homelessness Data in HHS Mainstream Programs. Summary of Information Collected in 2008 Interviews

02/05/2009

Summary of Information Collected in 2008 Interviews

StateCollection of Homelessness data for program applicants Summary of information collected in interviews conducted February-April 2008
AlabamaAlabama uses a separate TANF and separate Medicaid application. The TANF application does not collect any information related to homelessness or risk factors for homelessness.  The reason is that such information is not needed for eligibility determination for TANF.  Data on homelessness has never been part of the TANF application.  The Medicaid application is usually completed in person at the Medicaid office.  The application does not include any of the homelessness indicators or risk factors.  The main reason for this is that this information is not needed for eligibility determination for Medicaid.  Homelessness information has never been included on the application and there are no plans to add these items in the future.  The state does not wish to ask applicants to provide information that has no bearing on their eligibility for Medicaid.
AlaskaAlaska uses a combined application for the TANF and Medicaid programs. A separate application is used for the SCHIP program.  The combined application does not ask applicants for any of the homelessness indicators or the homelessness risk factors.  However, after the application is completed, eligibility workers conduct an interview with program applicants and they report that homelessness is discussed during this interview.  If an applicant indicates that (s)he is homeless, this information is entered into a comment field in the state Medicaid/TANF database.  This information has not been queried or analyzed and the interview respondents were uncertain about the quality of the information. There are reportedly no plans to add questions to the combined application about homelessness in the future because this information is not needed for eligibility determination.
ArizonaArizona uses a separate Medicaid application and a combined application for the TANF and Medicaid programs.  Both applications ask Do you reside in a shelter? and the question Are you homeless? is being added to the combined application in 2008.  Although the question of shelter residence has been included on the application for many years, no analysis has been conducted on this information.
ArkansasArkansas uses a combined application for the TANF and Medicaid programs. The combined application does not ask applicants for any of the homelessness indicators or the homelessness risk factors.  The application does ask for information about who lives in the household and the relationship of household members to the applicant.  Although homelessness information is not explicitly collected on the application, the interview respondent said that eligibility workers are familiar with the addresses of local shelters and can often tell if applicants are homeless based on interactions during an interview after the application is completed.  Verifying address information is a necessary part of eligibility determination in Arkansas, so informally intake workers determine homelessness but do not enter this information into a database and as a result have not done any analysis of the information.  The reason that homelessness is not explicitly addressed on the application is that the program officials want to keep the application as simple as possible.  Homelessness questions have never been included on the application but the interview respondent said that the application is updated annually and it is possible that such question could be added in the future.
CaliforniaCalifornia uses a combined application for the TANF and Medicaid programs. The combined application asks Are you homeless? and Do you reside in a shelter? of all program applicants.  This information has been collected on the application since the 1980s.  For the TANF program (called CalWorks), applicants and participants who are homeless are eligible for a one-time assistance payment called a Homeless Assistance payment.  Information from the combined application and an interview conducted after the application is completed is used to document homelessness and determine eligibility for the homeless assistance payments.  The state records information on the number of homeless assistance payments made each month and this information is reported in monthly reports aggregated by county and for the state as a whole (available at: what is UUHH? (http://www.dss.cahwnet.gov/research/PG283.htm  accessed on July 31, 2008). The information on homeless assistance payments made is useful for documenting the number of TANF recipients experiencing homelessness at some point but cant be used to analyze trends in homelessness.  Homelessness is documented among TANF applicants and recipients in order to provide the homeless assistance payments to those in need, and also to refer homeless families to additional services since their homelessness can be a barrier to achieving the work requirements of the TANF program.  As part of the services to TANF recipients, case workers attempt to help families identify and remove barriers to employment and self-sufficiency.  There is interest in future analysis of the homelessness data collected from Medicaid and TANF applicants for estimates of the impacts of alleviating homelessness and costs of mainstream services for people who are homeless but this has not been done and the interview respondent said that resource constraints on research limit the type of analysis that can be done.
ColoradoColorado uses a separate Medicaid application and a combined application. The combined application asks Are you homeless?  Do you reside in a shelter? and Do you have a permanent home?  These questions have been asked since at least 1997 and are entered in to a statewide database.  The interview respondent said that some analysis has been done of the homelessness data but no information was available as to the nature of the analysis.  The homelessness items are reportedly collected to help with statewide efforts to enhance access to mainstream programs for people who are homeless.  These items are not asked on the separate Medicaid application because they are not needed for Medicaid eligibility determination.
ConnecticutConnecticut uses a combined application for the TANF and Medicaid programs. The combined application includes the question Are you homeless?  This information has been collected on the application since 1989 and the responses are entered into a state database.  State officials have done some analysis of the information collected as part of a pilot program across the state to examine homelessness.  This information has been used in analysis of impacts of state efforts to alleviate homelessness and to link people discharged from prison to services.  The homelessness information collected from TANF and Medicaid applicants serves as a benchmark against which the impacts of other state efforts can be measured.
DelawareDelaware uses a combined application for the TANF and Medicaid programs. The application can be completed online or on paper copies in a TANF or Medicaid office.  The combined application does not have an explicit question Are you homeless? but for people who complete the application online, a question asking about address type has a drop-down response menu that includes the options of homeless, staying in a shelter, or staying in a domestic violence shelter.  Since these are only available as possible responses to a question about address type on the online version of the application, we have classified this state as one that does not explicitly collect data on homelessness.  However, since the application process does potentially provide on people who indicate homelessness in the interview we collected information about how this information is used whether it could be obtained for analysis.
DCThe District of Columbia uses a combined application for the TANF and Medicaid programs. No information on homelessness indicators or risk factors is collected on the application.  However, homelessness is important for TANF program staff because it can impose a barrier to employment, making it difficult for TANF recipients to satisfy the work requirements associated with TANF receipt.  So for TANF program applicants, housing stability and homelessness is discussed informally during interviews with eligibility workers prior to eligibility determination and again at recertification each year.  The information gathered during this informal process is not entered into a database, so is not readily available for analysis.  The DC official interviewed expects that a question about homelessness will be added to the combined application by the end of 2008.
FloridaFlorida uses a combined application for the TANF and Medicaid programs. Applicants usually fill out the application online without assistance and submit it electronically for consideration.  The combined application asks Do you reside in a shelter? In January 2008, the state compiled information on the status of current Medicaid and TANF beneficiaries and found that 4,370 Medicaid beneficiaries and 321 TANF recipients were reported to be homeless at that time.  The information gathered on the combined application is recorded in a statewide database and can be queried for analysis.  The interview respondent was unsure about exactly how long this question has been included on the application but believes it has been part of the application for at least five years.  The information is collected primarily because the application covers the Supplemental Nutrition Assistance Program (SNAP) and this information is needed to determine eligibility for SNAP.
GeorgiaGeorgia uses a separate Medicaid application in addition to a combined application for the TANF and Medicaid programs. The application is typically filled out and then mailed to the Medicaid or TANF office.  No information on homelessness indicators or risk factors is collected on either application because it is not needed for eligibility determination and the state has made an effort to keep the application as simple and streamlined as possible. Homelessness questions have never been included on the application but could possibly be added in the future, though no definite plans are in place to do so.  If an applicant volunteers that (s)he is homeless, the usual practice would be to enter the TANF or Medicaid office address into the home address field in the database and this could be used as an indicator or homelessness. But this practice is not standardized across the state and may not provide a reliable count of homelessness among program applicants.
HawaiiHawaii uses a separate Medicaid application and a combined application for the TANF and Medicaid programs. Neither application explicitly asks applicants if they are homeless or if they are at risk of homelessness. However, in an interview conducted with TANF applicants after the application is completed, the applicants living arrangement is reviewed and a code for homelessness is entered into the database on the basis of the information collected during the interview.  Approximately 10 years ago, the TANF application did include a question about homelessness but the question was removed in an effort to streamline the application and reduce its length.  The information previously collected was used in federal reporting on the TANF program.  It would be possible to conduct analysis of the living arrangement information collected in the application interview because the information is entered into a state database.  Homelessness information is also collected during annual recertification.  The interview respondent indicated that some analysis of the information gathered during the application interview has been analyzed by researchers at the University of Hawaii to examine the impact of services and to try and strengthen the Housing Choice Voucher program.  Recently, there have been efforts in Hawaii to increase services to homeless individuals and families with three shelters providing additional supportive services and an increase in state funding available for food banks.
IdahoIdaho uses a combined application for the TANF and Medicaid programs. At the time of the interview the state was revising the application and intake process for TANF and Medicaid. Before the changes, the typical approach was for applicants to complete the application in person at the Medicaid or TANF office, usually without assistance.  For TANF applicants, an interview is done after the application is filled out.  The combined application asks one of the homeless risk factors: Are you living with friends or relatives?  This has only been included on the application since 2006, and the item is entered into a statewide database.  Even though applicants are not explicitly asked if they are homeless when applying for benefits, there is a place in the state TANF database to document unusual living situations or lack of address.  It might be possible to run a report from the database to tally the number of applicants who lack an address but this has never been attempted and the age of the system makes the interview respondent unsure about the reliability of the data and the ability to query it to assess this information.
IllinoisIllinois uses a combined application for the TANF and Medicaid programs. The application is typically filled out in person at a TANF or Medicaid office.  Are you homeless? is asked of all applicants.  Interview respondents said that the data from this question is entered into the program intake systems, but is not entered into a statewide database that could be queried or analyzed.  No analysis of the data collected on the combined application has been undertaken.  TANF applicants complete a program assessment with an eligibility worker after the application is completed.  During this assessment, the caseworker discusses homelessness and housing status with the applicant to determine whether the applicant needs additional supportive services beyond what is typically offered to TANF recipients.
IndianaIndiana uses a combined application for the TANF and Medicaid programs. The application is usually filled out and then dropped off at the Medicaid office.  The application does not include questions related to homelessness indicators or risk factors.  But during an interview after the application is filled out, eligibility workers ask applicants if they are homeless and whether they receive housing assistance.  No standard practice is in place to record which applicants indicate homelessness and the responses to these questions are not required to process the application.  These questions have been asked for at least 18 years and there are currently no plans to change the procedures.  The state has never tried to analyze the information gathered in the post-application interviews.  However they use this procedure as a way to support statewide efforts to enhance access to mainstream services for homeless individuals and to identify applicants in need of referrals to specialized services.
IowaIowa uses a separate Medicaid and combined application for TANF and Medicaid programs. The separate Medicaid application is used only when someone is certain that only Medicaid assistance is desired.  Neither application includes any questions on homelessness or risk factors, primarily because this information is not needed for eligibility determination and because of a priority to keep the application simple.  In the past, the combined application included a question about homelessness because homeless individuals and families received expedited processing for SNAP benefits.  In addition, in the past caseworkers would ask applicants for TANF about their living arrangements and monthly rent.  These questions were dropped in 1996 for the SNAP and TANF programs because the State felt they were no longer required after PRWORA (federal regulations meant they were not mandated items to collect).  It is considered unlikely that homelessness questions will be reinstated on the application because state officials want to keep the application as simple as possible and only ask questions absolutely necessary for eligibility determination.  Also, in 2002 Iowas emergency assistance program was eliminated.  This program had been funded with TANF and state resources with the aim of preventing homelessness by providing shelter and rental assistance.
KansasKansas uses a separate Medicaid application and a combined application for the TANF and Medicaid programs. Most applicants complete the application and mail it to a TANF or Medicaid office.  Neither application asks any of the homeless indicators or risk factors, though the application does ask for information on who lives with the applicant.  Information on homelessness is not needed for eligibility determination and that is the main reason that it is not included on the application.  In the past, the combined application asked if applicants were homeless and this was used only for the SNAP Program.  It is possible that homeless questions could be reinstated at some time in the future but there are currently no definite plans to do so.
KentuckyKentucky uses a combined application for the TANF and Medicaid programs. Medicaid only applicants are routed through the application to key items needed only for Medicaid eligibility determination. The application is usually filled out in person at the Medicaid or TANF office where the intake worker enters information into the state database. Both TANF and Medicaid applicants are asked Are you homeless? on the combined application.  SNAP applicants are asked Do you reside in a shelter or a domestic violence shelter?  The data from the homeless question are entered into the state database and has been part of the combined application since 1996.  Information on homelessness is also collected at recertification.  No analysis has been done of this information.  The main reason it is included on the combined application is that a joint database is used for Medicaid, TANF and SNAP and the data are needed for the SNAP.
LouisianaLouisiana uses a separate TANF and separate Medicaid application (no combined application). Applicants for TANF can download a copy of the application from the TANF website and complete it without assistance.  The application is then reviewed by the client and a TANF eligibility worker in the TANF office.  Some applicants choose to complete the application and mail it to the TANF office instead. The TANF application asks Are you homeless? and Do you reside in a shelter?  The responses to these questions are stored in a database but have never been analyzed or queried.  The TANF program respondents were unsure about the reliability of these data.  The Medicaid application does not ask for any information on homelessness or risk factors.  The main reasons are that the state wants to keep the application as simple as possible and that homelessness information is not needed for eligibility determination.  The interview respondent said that the state would not consider adding homelessness questions to the application unless it was required by a Congressional mandate.
MaineMaine uses a combined application for the TANF and Medicaid programs. There are portions of the application that are relevant only to TANF applicants and others relevant only to Medicaid applicants so applicants wishing to apply for only one program are directed to the relevant part of the application.  Maine has moved to a paperless application system so applicants can either call a local office to apply over the phone (with the intake worker filling out the application directly into the database) or go to an office.  The application asks both Medicaid and TANF applicants Are you homeless?  The question is not a required field for the application to be considered but it is entered into the state database and could be queried for analysis.  No analysis has been done of this item to date and the interview respondent was not certain how long the question has been included on the application.  The main reason this question is included on the application is that it is needed to determine eligibility for SNAP.
MarylandMaryland uses a combined application for the TANF and Medicaid programs. Most applicants for assistance fill out the application on-line and then email it through the States Service Access Information Link (SAIL) system.  Maryland residents can apply for SNAP, TANF, Medicaid, Energy Assistance, Child Care Subsidy, and other programs through SAIL.  After submitting an application through SAIL, applicants are contacted by a TANF or Medicaid intake worker and are scheduled for an in-person interview to review and process the application.  The combined application asks Do you not have a place to stay? and one of the response categories allowed for to the question about living arrangement is homeless.  The reason for including this question on the application is to make sure families applying for assistance are referred to appropriate services and receive the help they need.  In addition, because TANF has work requirements associated with receiving assistance, the state wants to be sure to identify potential barriers to employment so that they can help people address them and satisfy the work requirements.  No analysis has been done on the application data regarding homelessness as of the time of the interview.
MassachusettsMassachusetts uses a separate TANF and separate Medicaid application (no combined application). The TANF application is typically completed in person at the TANF office.  The TANF application does not collect any information on homelessness or risk factors.  However, an informal process by which caseworkers confirm the home address given on the application in an interview makes case workers aware in many cases if an applicant is homeless since workers know the addresses of most local shelters.  This is not a formalized convention and the interview respondent did not believe this practice can yield reliable information on the extent of homelessness among TANF applicants.  If a caseworker determines that an applicant is homeless using the informal process, the information is used to provide emergency services and to ensure that the applicant is referred to all available supportive services.  The Medicaid application is typically filled out and then mailed to one of four enrollment centers in the state.  The application asks Are you homeless?  and Do you reside in a shelter?  This information is not entered into a statewide database.  This information, collected since 2005, is part of a statewide effort to coordinate efforts related to homelessness.  A homeless workgroup has been established in Massachusetts comprised of heads of several state agencies.  The group meets quarterly to share information about efforts to serve people who are homeless and to address outreach to homeless individuals and families.  The information was added to the application to help with reporting but thus far no analysis of the information has been undertaken.
MichiganMichigan uses a combined application for the TANF and Medicaid programs. In most cases, people fill out the application and mail it in to a TANF or Medicaid office.  Are you homeless? and Do you reside in a shelter? and Do you reside in a domestic violence shelter?  are asked of all applicants except those applying only for child care assistance.  In addition to asking these questions on the application, some applicants may talk to an eligibility worker about their housing status.  Caseworkers use this information to make referrals to shelters or to suggest support services.  These items have been included on the application for at least ten years, but it is not likely that they could be accessed for analysis.  The application information on homelessness is only entered into the statewide database if the applicant is determined eligible for SNAP.  Those eligible for TANF or Medicaid are referred to services if found to be homeless but the data are not available in the state data systems for these programs.
MinnesotaMinnesota uses a separate Medicaid and combined application for the TANF and Medicaid programs. Both applications ask Are you homeless?  Applicants are also asked whether they expect to have a change in residence or housing situation in the near future.  The main reason this information is collected is to make appropriate referrals for services for applicants who are homeless and to support state efforts to reduce long-term homelessness.  The data are entered into a statewide database but have not been verified or analyzed.
MississippiMississippi uses a separate TANF and separate Medicaid application (no combined application). In most cases, TANF applications are completed in person at the TANF office but some applicants print the application from the program website and mail or bring it to an office.  The TANF application does not include any information on homelessness or homelessness risk factors.  However, during an application interview with TANF program staff, the eligibility worker fills out a housing field in a section of the application called Additional informationthis includes a yes/no field on whether the applicant currently receives housing assistance and an indicator of homelessness.  No analysis of this information has been conducted.  The interview respondent said that the state is attempting to move to a paperless system as much as possible.  They now use a much more streamlined application process than in the past, with the application having been reduced from 23 to 4 pages.  They now use the interactive interview for the application.  The application itself used to include questions on homelessness, but in 2005 a change was made to use the homelessness indicator from the interview with the eligibility worker.  The Medicaid application does not ask questions related to homelessness or risk factors.  In an interview conducted after the applications is completed, intake workers ask applicants to describe their living situation and household members.  This often elicits information on homelessness absent an explicit question on the topic. Homelessness is not included on the application because it is not needed for eligibility determination and the State wants to keep the application as simple as possible.  The application has never included homelessness questions and there are no plans to add homelessness questions to it in the future.
MissouriMissouri uses a separate Medicaid application and combined application for the TANF and Medicaid programs. The combined application covers TANF, Medicaid, SCHIP, and SNAP and is completed on an interactive system called Family Assistance Management information System (FAMIS) in which eligibility specialists enter information to process applications for assistance in real time.  TANF was added to the FAMIS system in 2005 and Medicaid was added in November of 2007.  The State plans to maintain a separate Medicaid-only paper application for applicants seeking only Medicaid assistance.  The combined application completed via FAMIS asks Are you homeless?  Do you reside in a shelter?, and Are you staying in a domestic violence shelter? The separate Medicaid application does not ask any of these questions.  But on the separate Medicaid application, applicants are asked to provide an address, so eligibility specialists reportedly become aware if an applicant resides in a shelter.  On the combined application, the homeless questions are required and are entered into the state database.  No analysis has been done of the responses to these questions.  The reason these homelessness items are included on the combined application is to help enhance access to mainstream services for homeless individuals.
MontanaMontana uses a separate Medicaid application and a combined application for the TANF and Medicaid application. The application is usually filled out by the applicants and then mailed to the TANF or Medicaid office.  Applicants for TANF also must come into the office to complete an interview after filling out the application.  The applications do not include questions about homelessness or risk factors.  However, TANF applicants discuss housing status in the follow up interview.  The reason for not including homelessness questions on the application is that they are not needed to determine eligibility.  The applications have never included homelessness questions and there are no plans to add such questions in the future.
NebraskaNebraska uses a combined application for the TANF and Medicaid programs. The application is typically filled out in person at the TANF or Medicaid office with assistance from an eligibility worker.  The combined application asks Do you reside in a DV shelter? as well as one of the risk factors for homelessness Do you have an eviction notice?  These items have been included on the application for at least 15 years.  The responses are recorded in the statewide database for TANF and Medicaid, but thus far have not been analyzed and no queries have been done to check for data completeness.
NevadaNevada uses a separate Medicaid application and combined application for the TANF and Medicaid programs.  Nearly all (99 percent) applicants reportedly use the combined application. The separate Medicaid application is used mostly if a person is residing in an institution.  Neither application explicitly asks about homelessness or risk factors.  However, for TANF applicants (not Medicaid) a follow up interview is conducted with an eligibility worker after the application is filled out and during this interview the addresses given on the application are confirmed and caseworkers can usually tell if an address given is for a shelter.  This practice has been in place since the 1980s.  If an eligibility worker determines that an applicant is homeless this is entered into the state TANF database.  The main reason this is done is to track shelter costs for SNAP eligibility determination.  No analysis of the data collected has been done.
New HampshireNew Hampshire uses a combined application for the TANF and Medicaid programs. The application is usually filled out in person in the TANF or Medicaid office.  The application includes questions on homelessness indicators:  Are you homeless? and Are you living in a domestic violence shelter?  The main reason these items are collected are to facilitate SNAP eligibility determination, one of the programs covered by the combined application.  In addition, for TANF applicants an interview is also conducted after the application is completed and homelessness is discussed at that time.
New JerseyNew Jersey uses a separate Medicaid and combined application for the TANF and Medicaid programs. Medicaid applicants usually complete the separate Medicaid application unless they know that they want to apply for other benefits as well.  Neither application includes questions on homelessness or risk factors.  The separate Medicaid application is filled out online by the applicant.  For the separate Medicaid application, homelessness data are not included in the application because it is not needed for eligibility determination.  Those completing the combined application must do so in person at a TANF or Medicaid office and also must meet with an eligibility worker after completing the application and housing status is one of the topics addressed in this interview.  On the combined application an explicit question regarding homelessness is considered unnecessary since housing status is discussed during the follow-up interview and homelessness is determined informally during the interview.  However, no analysis of the interview information has been done and there are no standard procedures for recording it.  The applications have never included questions on homelessness and there are no plans to add such questions in the future.
New MexicoNew Mexico uses a separate Medicaid application and a combined application. The separate Medicaid application is used for applicants who are only applying for Medicaid benefits.  The combined application asks Do you have a permanent home? and Do you live with friends or relatives?  These questions have been included on the application since 2002 and responses to them are entered into a state database.  Thus far, no analysis of the data has been completed.  The separate Medicaid application does not include these questions.
New YorkNew York uses a separate Medicaid application and a combined application for the TANF and Medicaid programs. The separate Medicaid application is typically used only in cases when an applicant knows that Medicaid is the only assistance desired.  The separate Medicaid application does not include any of the homeless indicators or risk factors and does not use any sort of informal process to address housing instability or homelessness.  The separate Medicaid application did ask for information on homelessness in the past, but the questions were eliminated because they are not needed for Medicaid eligibility determination and the State wanted to keep the Medicaid application focused on health insurance.  There are no plans to reinstate these questions on the separate Medicaid application.  In contrast, the combined application asks Are you homeless? Do you reside in a shelter? and Do you reside in a domestic violence shelter?  These questions have been included on the application since the early 1980s and are collected because of an interest in the state to learn about the causes of homelessness, identify strategies to prevent homelessness, and how best to serve people who are homeless.  The information is entered into a statewide database and has been analyzed in the past to estimate the number of homeless people applying for benefits and receiving benefits.  For TANF applicants homelessness is also addressed during an interview with intake workers during the application process to make referrals for services.
North CarolinaNorth Carolina uses a separate TANF and separate Medicaid application. Once determined eligible for TANF, applicants for other programs can use a combined application.  The TANF application is usually completed in person at the TANF office.  The same application was being used throughout the state at the time of the interview, but counties have flexibility to modify the application if desired.  The TANF application does not ask about homelessness or risk factors.  But during an interview after the application is filled out, eligibility workers discuss homelessness with applicants.  This informal process does not result in homelessness data being entered into the TANF data system and the interview respondent does not think it would be possible to analyze this information. The main reason for exploring it during the interview is to confirm how/where to send TANF assistance checks to recipients.  The Medicaid application does not include any questions on homelessness or risk factors, but housing status is discussed in a follow-up interview conducted after the application is completed.  The application does not include homelessness questions because they are not needed for eligibility determination and the state would not know what to do with the information if it were collected.  North Carolina is working towards a combined application for Medicaid and TANF, but there are no plans to include questions on homelessness even if a combined application were adopted.
North DakotaNorth Dakota uses a separate Medicaid and combined application for the TANF and Medicaid programs. No homelessness data are collected on either application, primarily because the information is not needed to determine eligibility for benefits.  Also, the state has made an effort to keep the application simple.  There are no plans to modify the applications in the future to add questions about homelessness.  The interview respondent said that state officials would not know how to use information about homelessness even if it were collected.
OhioOhio uses a combined application for the TANF and Medicaid programs. The application asks Are you homeless? for applicants to all programs.  TANF applicants also complete an interview as part of the application process, in which housing situation is discussed.  The homelessness item is a required field on the application and it is entered into the statewide database for TANF and Medicaid.  This item was added to the application in 2000 and is collected to help support the States efforts to enhance access to mainstream programs for people who are homeless.  County workers and homeless advocates are supportive of this data collection practice.
OklahomaOklahoma uses a separate Medicaid and combined application for TANF and Medicaid. The separate Medicaid application is used only when an applicant is applying only for Medicaid assistance.  Those applying for TANF complete a follow up interview after the application is filled out.  The usual process is for the application to be filled out in person at a Medicaid or TANF office.  Neither application includes questions about homelessness or risk factors because these questions are not neededthere is no requirement that the State report on homelessness among program applicants.  About ten years ago, the combined application did include questions on homelessness but they found it was burdensome to collect and as the questions were not essential for determining program eligibility, they were dropped.  At the time of the interview there were no plans to reinstate them.
OregonOregon uses a separate Medicaid and combined application. The combined application was adapted from the SNAP application.  The separate Medicaid application is used when someone knows that Medicaid assistance is the only program they are interested in.  Both are online and can be filled out and taken into an office or mailed in.  The combined application asks Do you have a permanent home? and Do you have an eviction notice?  These items have been included on the application since at least 2004.  The information is entered into a database but has never been analyzed.  At the time the application was initially collected  and reviewed for this study in 2006, the separate Medicaid application asked Are you homeless?  The reason for dropping this question in 2007 was that it had been used to determine premium amounts in the Medicaid program but recent law changes have eliminated premium rules making it unnecessary to know whether Medicaid applicants are homeless.
PennsylvaniaPennsylvania uses a combined application for the TANF and Medicaid programs. The application is usually filled out in person at the TANF or Medicaid office.  After completing the application, caseworkers conduct an interview with program applicants and usually discuss housing status and homelessness at that time.  The application asks Are you interested in housing assistance? and Do you have a permanent home?  These mandatory questions were added to the application in 2004. Interview respondents for this study were unsure how complete the data are and no analysis has been done on these data items.  For TANF applicants, eligibility workers confirm with applicants if they are homeless during the interview.  The reason for doing this is to understand the clients situation fully and to refer clients to needed services.
Rhode IslandRhode Island uses a separate Medicaid application and a combined application. The separate Medicaid application is used when an applicant only seeks Medicaid assistance.  The separate Medicaid application does not include any questions about homelessness or risk factors for homelessness.  The reason is that there is a desire to keep the separate Medicaid application as simple as possible and there are no plans to add homelessness questions to that application in the future.  Applicants who complete the combined application do an interview after the application is completed but this is not required for those only applying for Medicaid.  The combined application asks: Are you homeless?; Do you reside in a shelter?; Do you have a permanent home? and Do you live with relatives? Responses to these questions are not required to process the application but if they are left blank the intake worker will ask about them during the interview.  These homelessness items have been included on the application since 1990.  Information on homelessness is also obtained after eligibility determination for TANF recipients and at recertification for both TANF and Medicaid participants.  No analysis has been conducted of the application data on homelessness.
South CarolinaSouth Carolina uses a separate TANF and separate Medicaid application (no combined application.) For the TANF program, applications are filled out in person at the TANF office and eligibility workers also conduct an interview after the application is filled out.  The application asks Are you homeless?  During the interview, eligibility workers discuss this further with applicants.  The response to the question is entered into the TANF database but no attempts have been made to query this information or to assess the number of homeless applicants in the state.  This process has been in place for at least five years.  The main reason for collecting information on homelessness is to provide information needed for determining SNAP benefits.  The Medicaid application does not include any questions about homelessness or risk factors because they are not needed to determine eligibility.  The application has never included such questions and there are no plans to add such questions to the application in the future.
South DakotaSouth Dakota uses a combined application for the TANF and Medicaid programs. The application is usually completed in person at the Medicaid or TANF office.  The application does not collect any of the homeless indicators or risk factors.  However, for TANF applicants, eligibility workers meet with the applicant to verify the applicants address, monthly rent payments, and inquire about homelessness. These issues are also discussed at annual recertification.  The reason that homelessness information is not explicitly addressed on the application is because of the states desire to keep the application simple and easy to complete.  In the past, the combined application did include homelessness information (asking Are you homeless? and Do you live in a shelter?) but these items were dropped in approximately 2003.  They were removed to simplify the application and because eligibility workers and TANF case managers were finding that if applicants are homeless it is discovered as part of the application process even if not explicitly collected on the application form.
TennesseeTennessee uses a combined application for the TANF and Medicaid programs. The application is completed in person at the TANF or Medicaid offices.  The combined application asks Are you homeless?  This is not a required item for the application to be considered, but the responses are entered into a state database.  This question has been part of the application for 15 years.  Housing status and homelessness may also be discussed with applicants in an interview after the application is completed.  Homelessness also may be addressed at recertification for program participants, but this is an informal process. No analysis has been done thus far of the homelessness question.  The main reason this question is part of the application is to process SNAP eligibility determination.
TexasTexas uses a combined application for the TANF and Medicaid programs. The application is filled out in person at the TANF or Medicaid offices.  The combined application asks Are you homeless? Are you living in a domestic violence shelter? and Do you have a permanent home?  Homeless risk factors are also addressed in the question Do you live with friends or relatives?  These items are not required elements of the application.  However, for the TANF program, the interview respondents report that they have used this information for some descriptive analyses of random samples of TANF applicants for federal reporting purposes.  These questions have been included on the application for at least five years.  Homelessness is also addressed at other times prior to the eligibility determination and again at recertification.  The reason this information is collected on the application is that it helps program staff make appropriate referrals to needed services.  It is also something that local advocates for the homeless encourage the programs to do and the TANF and Medicaid program believes it is the right thing to do.  The interview respondent said that no analysis has been done of these data beyond the TANF reporting and that it would be difficult to provide extracts of this information for analysis.
UtahUtah uses a separate Medicaid and combined application for the TANF and Medicaid programs. Most applications (about 90 percent) are done in person at the TANF or Medicaid office; the other 10 percent are mailed or sent by fax to the office.  The application can be completed on paper or online but the online version is available only in the office.  The application uses an online interface with local public housing agencies to check whether program applicants are receiving housing assistance.  The combined application asks Do you reside in a shelter?  This is a required element on the application but the data are not entered into a state database, making it unlikely that the data could be queried or analyzed.  The interview respondent was unsure about the reliability of this information for analysis.  It is collected primarily to understand applicant circumstances fully.  This question is not included on the separate Medicaid application.
VermontVermont uses a separate Medicaid and combined application for the TANF and Medicaid programs. Applicants usually obtain the application online or from a TANF or Medicaid office, fill it out, and then mail it or drop it off at an office.  Neither application asks for any information on homelessness indicators or risk factors and such items have never been included on the applications.  At the time of the interview, there were also no plans to add homelessness items to the application in the future.  During the application process, an interview with a case manager is conducted and the case manager records information about the applicants sources of support and housing arrangements in what is called a Family Support Matrix.  Case managers typically determine if an applicant is homeless or at risk of homelessness during this process, but this is not recorded in the TANF database.
VirginiaVirginia uses a combined application for the TANF and Medicaid programs. The combined application asks several questions related to homelessness including Do you live in a place not usually used for sleeping?  Do you live in a shelter?  Do you live with friends or family? and Do you live in a welfare hotel? but these questions are not asked of applicants who are seeking only Medicaid assistance because they are not needed to determine eligibility.  However, the questions are asked of SNAP applicants and TANF applicants meet with eligibility workers during the application process and detailed information is collected about homelessness status at that time.  For TANF applicants, this information is entered into the TANF database and is available for analysis, though no analysis has been done..
WashingtonWashington uses a combined application for the TANF and Medicaid programs. The application does not ask for information on homelessness indicators or risk factors.  However, TANF applicants are interviewed by intake workers after completing the application and are asked whether they are homeless.  This information is entered into the TANF database that has been analyzed in the past to prepare reports to the Governor about the number of homeless persons applying for benefits.
West VirginiaWest Virginia uses a separate Medicaid and combined application for TANF and Medicaid. The combined application is used for other applicants for Medicaid and for TANF applicants.  The application process involves an interactive interview with a case manager.  The case manager asks questions and enters responses into the state database.  The combined application asks Are you staying in a domestic violence shelter?  This has been included on the application for at least 10 years and is updated at recertification.  No analysis has been done of this item and the main reason for including it on the application is to facilitate eligibility determination for the Supplemental Nutrition Assistance Program.
WisconsinWisconsin uses a combined application for TANF and Medicaid programs. The application does not ask questions related to homelessness or risk factors.  However, as part of the case management provided to TANF recipients, TANF case workers discuss housing status and homelessness with applicants in an interview after the application is completed and again with recipients of TANF in order to assess barriers to employment and to make referrals to appropriate services that families need.  The state has attempted to eliminate questions from the application that are not directly relevant to determining eligibility. However as part of the application interview for TANF applicants, case managers discuss housing status and there is a code for homelessness or unstable housing that is entered into the state database and could be used to analyze homelessness among TANF applicants and participants.  No analysis has been done thus far and there are currently no plans to change the application process or to add questions about homelessness to the application itself.
WyomingWyoming uses a separate Medicaid and combined application for the TANF and Medicaid programs. The application is usually completed in person at the TANF or Medicaid office and most applicants complete it without assistance from an eligibility worker.  Neither application includes any of the homeless indicators or risk factors, but applicants are asked whether or not they currently pay rent.  The main reason these items are not included on the application is that it is not a mandated federal requirement to collect data on homelessness.  Homelessness indicators or risk factors have never been included on the combined application.  However, the interview respondent said that the question Are you homeless? will likely be added to the combined application sometime in 2008.  Changes being made to the computer system will make it possible to collect this information in a new field.