Some have recently suggested that providing access to non-cash programs through separate offices may help de-stigmatize these programs and distinguish them from traditional “welfare”, thereby improving the capacity of Medicaid, SCHIP, and food stamps to be effective supports for working families (Dion and Pavetti 2000). Among our six sites, only New York City has such specialized offices. Some offices only accept Medicaid/SCHIP applications, and other offices only process applications for food stamps. Applicants who come to these offices and appear to need additional forms of assistance or services, notably TANF cash assistance, are supposed to be referred to one of the TANF welfare offices (which also provide Medicaid and food stamp eligibility determination services for TANF cases).4 Efforts have also been made in New York to provide access to Medicaid for families that applied for TANF but either were not qualified or withdrew their applications by co-locating a Medicaid worker within each TANF office. These workers review applications that have been rejected or withdrawn from TANF for Medicaid eligibility and then transfer the cases to the appropriate specialized office.
While there are not separate specialized Medicaid or food stamp offices in Raleigh and Arlington, these sites have adopted the same approach as New York, albeit on a smaller scale. TANF and non-TANF units are physically separated and have different reception and waiting areas for applicants. In order to streamline casework, workers in the TANF unit also handle food stamps and Medicaid for TANF families.