TANF/FSP/Medicaid. The application process in Arlington is somewhat more complicated than Seattle in that it includes two additional steps — a screening and an orientation. Both steps occur prior to the eligibility interview and are intended to facilitate the application process. Applicant screenings are typically conducted the same day that the applicant initially comes to the welfare office and makes contact with an intake/reception worker (see box, “Pre-Eligibility Determination Screening in Arlington”). After the screening, applicants receive an appointment for an orientation and eligibility interview that they attend on the same day. The appointment letter states when and where the orientation session and interview will be held and what documents to bring for verification. During the orientation, case aides help applicants review, complete, and sign the application and other necessary forms. This group orientation includes a review of TANF eligibility rules and expectations.
Pre-Eligibility Determination Screening in Arlington
In Arlington, screenings are conducted for TANF/FSP/Medicaid (as well as food stamp-only or Medicaid-only) after the applicant makes initial contact with the reception/intake clerk — usually on the same day. The county welfare agency implemented screenings to increase the speed and efficiency of the eligibility determination process by ensuring that clients understand what they may apply for, how they should complete the application, and which documents are needed for the eligibility interview. Although these screenings constitute an additional step in the application process, they appear to help offset some of the difficulty applicants would normally encounter with the state’s relatively long and complicated integrated application (available only in English). In order to help applicants determine exactly which parts of the application they need to complete, screeners go through the form, highlighting the parts that the applicant needs to fill out and crossing out the parts they do not need to complete. Tenured eligibility workers with strong knowledge of eligibility rules and documentation requirements fill the screener positions.
Food Stamps and Medicaid/SCHIP. Individuals applying only for food stamps (or food stamps and Medicaid) follow a process that is similar to the integrated application process. One key difference is that the “group” orientation is more individualized than the TANF orientation. Although applicants are instructed to show up at the same time and sit together in one room, case aides see them on an individual basis and go over their application and paperwork to make sure it is in order. Following the orientation, applicants meet individually with an eligibility worker for their eligibility determination interview.
The application process for individuals applying only for Medicaid or SCHIP is greatly simplified. These individuals may mail in their application to the welfare office. Medicaid applicants do not need to go through the screening or orientation processes, but they still must come to the welfare office for a face-to-face eligibility interview. SCHIP applicants are also encouraged to come to the welfare office for assistance with the application and verification process. Recent changes in Virginia’s SCHIP program transferred responsibility for processing SCHIP applications from local welfare offices to a centralized private enrollment broker.17 The enrollment broker (BENOVA) determines eligibility via phone and mail for SCHIP applications across the state.
Applicants are screened over the phone, first for Medicaid and then for SCHIP. If eligible for Medicaid-only, the enrollment broker is supposed to send the application to the welfare office where it is treated like other Medicaid-only applications. If eligible for SCHIP, the application is completed over the phone and mailed to the applicant for signature. The Arlington welfare office will accept SCHIP applications (with income documentation) and send it on behalf of applicants to the enrollment broker’s central processing unit. The same process is used if families applying for Medicaid at the welfare office are determined ineligible because they are over income. The Medicaid-only application process can also be completed at a local public hospital, which houses an out-stationed Medicaid eligibility worker.