Another possible performance measure related to child and family well-being is a broad measure that examines the percentage of needy children that receives TANF and/or other types of assistance, including Medicaid/SCHIP, Food Stamps, and child care.
Measurement issues. In calculating this measure, care would have to be taken to ensure that individuals receiving benefits from more than one program are not double counted in the numerator of the rate. Otherwise, the extent to which states are serving eligible needy families would be overstated. This measure could be calculated based either on children or family units.
Data issues. This measure is relatively complex to calculate and would require a combination of both administrative and survey data. Similar to the Food Stamp and Medicaid/SCHIP measures, the denominator of the rate could be calculated relatively easily using the American Community Survey. However, because it requires knowledge of the receipt of a number of different programs, determining the numerator of the rate is more difficult. The ACS cannot be used to determine the numerator of the rate because it does not capture whether individuals use certain public assistance programs - particularly child care subsidies and Medicaid/SCHIP. While administrative data from each of these programs could be used to calculate the numerator, this is more complicated than other similar measures discussed in this paper because a number of administrative data sources would have to be used and linked together (TANF, Food Stamps, Medicaid/SCHIP, and child care). Thus, while it is not impossible to calculate this measure, it is more burdensome for states than some of the other related measures.
Fairness issues. States with more generous benefit programs for TANF, child care, and Medicaid/SCHIP will perform better on this measure - at least initially - than states with less generous programs. While the goal of this measure may be to encourage states to expand these programs, states that have already done so will start out with an advantage on the performance measure when capturing absolute performance. States that have more restrictive coverage could potentially perform better on a measure based on improvement. In addition, as discussed above, state administrators may not have control over the size of the needy population in their state. States with a greater population below the federal poverty line may have more difficulty succeeding on this type of measure compared to states with fewer poor people.