SECTION 13. FEDERAL SOCIAL WELFARE PROGRAMS IN OUTLYING AREAS Table 13-1 shows the outlying areas in which the major Federal social welfare programs are in effect and those areas in which they are not in effect. The word ``yes'' in the column headed ``covered'' under each outlying area designates that Federal law permits the program to operate in that area. The column headed ``special rules'' notes whether the program operates in that area according to the same rules that apply in the States or according to different rules. The notes to the table explain the nature of any special rules. The programs included in the table are: --Aid to families with dependent children (AFDC) --Aid to the aged, blind, or disabled (AABD) --Supplemental security income (SSI) --Food stamps --Medicaid --Medicare --Old-age, survivors, and disability insurance (OASDI) --Unemployment compensation --Earned income tax credit (EITC) --Maternal and child health (MCH) block grant --Title IV-B child welfare services --Title IV-E foster care and adoption assistance --Title XX social services --School lunch and school breakfast --Special supplemental food program for women, infants, and children (WIC) --Summer food service --Child care food In general, extension of these programs to jurisdictions other than States requires that the law authorizing the program specify the area as eligible to participate. Thus, where the table indicates that the area is not covered (``no'' under the column headed ``covered''), the program cannot be implemented without a change in Federal law. In some cases, a program is available to outlying areas by law, but the jurisdiction has not implemented it (these programs are noted by footnotes ``2'', ``3'' or ``14''). In addition, all programs administered by the U.S. Department of Agriculture may be extended to outlying areas at the discretion of the Secretary of Agriculture, even though the area is not specifically mentioned in the authorizing legislation. (These programs are noted by footnote ``7''.) Where such programs have not been implemented, they could be if the Secretary were to authorize operation. TABLE 13-1.--FEDERAL SOCIAL WELFARE PROGRAMS IN THE OUTLYING AREAS ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------- Puerto Rico Virgin Islands Guam Northern Marianas American Samoa Marshall Islands and Micronesia Palau ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- -------------------------------------------- Program Special Covered Special rules Covered Special rules Covered Special rules Covered Special rules Covered Special rules Covered Special rules Covered rules ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------- AFDC........................... Yes............. Yes \1\......... Yes............. Yes \1\......... Yes............. Yes \1\......... Yes \2\......... Yes \2\......... Yes \3\......... Yes \3\......... No.............. ............... No............. ....... AABD........................... Yes............. No.............. Yes............. No.............. Yes............. No.............. No \2\.......... ................ No.............. ................ No.............. ............... No............. ....... SSI............................ No.............. ................ No.............. ................ No.............. ................ Yes............. No.............. No.............. ................ No.............. ............... No............. ....... Food stamps.................... Yes \4\......... Yes \4\......... Yes............. Yes \5\......... Yes............. Yes \5\......... Yes............. Yes \6\......... No \7\.......... ................ No.............. ............... No............. ....... Medicaid....................... Yes............. Yes \8\......... Yes............. Yes \8\......... Yes............. Yes \8\......... Yes............. Yes \8\......... Yes............. Yes \8\......... No.............. ............... No............. ....... Medicare....................... Yes............. Yes \9\......... Yes............. Yes \10\........ Yes............. Yes \10\........ Yes............. Yes \10\........ Yes............. Yes \10\........ No.............. ............... No............. ....... OASDI.......................... Yes............. No.............. Yes............. No.............. Yes............. No.............. Yes............. No \11\......... Yes............. No.............. No.............. ............... No............. ....... Unemployment compensation...... Yes............. No.............. Yes............. No.............. No.............. ................ No.............. ................ No.............. ................ No.............. ............... No............. ....... EITC........................... No \12\......... ................ No \12\......... ................ No \12\......... ................ No \12\......... ................ No \12\......... ................ No \12\......... ............... No \12\........ ....... Maternal/child health.......... Yes............. No.............. Yes............. No.............. Yes............. No.............. Yes............. No.............. Yes............. No.............. Yes............. No............. Yes............ No Child welfare.................. Yes............. Yes \13\........ Yes............. Yes \13\........ Yes............. Yes \13\........ Yes............. Yes \13\........ Yes............. Yes \13\........ No.............. ............... No............. ....... Foster care/adoption........... Yes \14\........ Yes \13\........ Yes \14\........ Yes \13\........ Yes \14\........ Yes \13\........ Yes \14\........ Yes \13\........ Yes \3\......... Yes \3\......... No.............. ............... No............. ....... Social services................ Yes............. Yes \13\........ Yes............. Yes \13\........ Yes............. Yes \13\........ Yes \14\........ Yes \13\........ Yes............. Yes \13\........ No.............. ............... No............. ....... School lunch/breakfast......... Yes \15\........ Yes \17\........ Yes............. Yes \17\........ Yes............. Yes \17\........ Yes............. Yes \17\........ Yes............. Yes \16\........ No.............. ............... Yes............ Yes \18 \ WIC............................ Yes............. No.............. Yes............. No.............. Yes............. No.............. Yes \14\........ No.............. Yes \14\........ No.............. No.............. ............... Yes \14\....... No Summer food service............ Yes............. No.............. Yes............. No.............. Yes \14\........ No.............. Yes \14\........ No.............. Yes \14\........ No.............. No.............. ............... Yes \14\....... Yes Child care food................ Yes............. No.............. Yes............. No.............. Yes............. No.............. Yes \14\........ No.............. Yes \14\........ No.............. No.............. ............... Yes \14\....... Yes ---------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- ---------------------------------------------------------------------------- \1\ The Federal matching rate is 75 percent rather than a rate based on per capita income. However, the Social Security Act sets a dollar maximum on Federal payments for AFDC, emergency assistance, AABD, and foster care and adoption assistance, combined. \2\ The Northern Mariana Islands do not operate an AFDC or an AABD Program. However, section 502 of Public Law 94-241 specifies that all Federal services and financial assistance programs applicable to Guam shall be applicable to the Northern Marianas. Nevertheless, this provision is irrelevant with respect to the AABD Program because the Northern Marianas operate the SSI Program which replaces AABD. \3\ Since October 1, 1988, American Samoa has been eligible to participate, but has not implemented this program. If the program were implemented, the Federal matching rate would be 75 percent. However, the Social Security Act sets a dollar maximum on Federal payments for both AFDC and foster care and adoption assistance, combined. \4\ Puerto Rico receives a block grant of Federal funds with which it operates a cash Nutrition Assistance Program for needy households under rules similar to food stamps. \5\ The regular Food Stamp Program operates in the Virgin Islands and Guam, except that benefit levels differ from those for the 48 contiguous States (recognizing substantially higher food prices), and the degree to which recipients' income is ``disregarded'' for excessively high nonfood living expenses differs from the 48 States (recognizing significant differences in costs of living). Similar adjustments also are made for Alaska and Hawaii. \6\ Under the terms of the 1976 covenant with the Commonwealth and Public Law 96-597, a variant of the regular Food Stamp Program operates in the Northern Marianas. The Commonwealth is eligible for an annual grant of up to $3.7 million for food-stamp-like benefits and administration, but unused amounts may be carried over from year to year. \7\ Section 24 of the Food Stamp Act requires the annual payment of up to $5.3 million to American Samoa to operate a variant of the regular Food Stamp Program. Food stamps were first extended to American Samoa in fiscal year 1994, under the Secretary of Agriculture's discretionary authority to extend the Food Stamp Program (and other Agriculture Department programs) to American Samoa, with any special rules he might specify. \8\ The Federal matching rate is 50 percent rather than a rate based on per capita income; Sec. 1108(c) of the Social Security Act sets a dollar maximum on Federal Medicaid payments to the territories. \9\ Hospital reimbursement rates under the prospective payment system in Puerto Rico are lower than in the States. \10\ Hospital prospective payment system is not applicable. \11\ Currently operating under transitional rules until coverage is complete. \12\ Some U.S. Government employees who are subject to the U.S. income tax while assigned to work in a U.S. territory might be eligible for EITC, but the general population would not be eligible. \13\ Special rules govern how funding allocations are made to these jurisdictions (or would govern if the jurisdiction elected to implement the program), as distinct from the way allocations are made to States. \14\ Jurisdiction is eligible to participate, but has chosen not to implement this program. \15\ Definition of ``school'' includes nonprofit child care centers in Puerto Rico. \16\ American Samoa receives an annual grant to operate its school food service programs. \17\ Different payment rates for meals served apply to Puerto Rico, the Virgin Islands, Guam, and the Northern Marianas. \18\ Palau receives an annual grant to operate its school food service and other child nutrition programs. In fiscal year 1994, it received $1.1 million under this grant. Under the terms of its 1994 Covenant, Palau's annual child nutrition grant is to be phased in over fiscal years 1997-99. Source: Congressional Research Service. Table 13-2 shows the benefit expenditures for the territories for the programs of old-age assistance, aid to the blind, aid to the permanently and totally disabled, aid to families with dependent children (AFDC), supplemental security income (SSI), food stamps, child nutrition, and special supplemental food program for women, infants, and children (WIC) for fiscal years 1970-94. As can be seen in the table, total expenditures for the nutrition programs, including food stamps and programs such as school lunch and school breakfast, overwhelm the amount of money spent on programs such as AFDC. This variation exists because AFDC and other cash assistance programs are capped at significantly lower levels than the nutrition programs. TABLE 13-2.--TOTAL BENEFIT EXPENDITURES BY THE TERRITORIES ON ADULT PROGRAMS, AFDC, SSI, FOOD STAMPS, CHILD NUTRITION, AND WIC, SELECTED YEARS 1970-93 [In thousands of dollars] ---------------------------------------------------------------------------------------------------------------- Fiscal year Territory ----------------------------------------------------------------------------- 1970 1975 1980 1985 1990 1992 1994 ---------------------------------------------------------------------------------------------------------------- Guam: Old-age assistance............ $191 $432 $645 $757 $1,425 $1,455 $2,859 Aid to the blind.............. 5 5 13 7 6 3 3 Aid to permanently and totally disabled..................... 37 113 213 308 323 222 243 Aid to families with dependent children..................... 708 1,728 3,324 2,683 5,047 7,800 12,063 Supplemental security income.. NA NA NA NA NA NA NA Food stamps................... NA 3,540 14,581 18,316 14,522 28,230 21,815 Child nutrition \1\........... \3\ 380 \3\ 1,250 2,670 3,680 3,060 3,166 3,889 WIC \2\....................... NA NA NA 1,270 2,490 3,068 5,126 Puerto Rico: Old-age assistance............ 3,390 4,000 4,309 6,676 6,446 6,317 5,870 Aid to the blind.............. 116 73 58 118 135 128 99 Aid to permanently and totally disabled..................... 2,342 2,738 3,930 9,909 11,399 12,781 11,913 Aid to families with dependent children..................... 25,261 26,434 59,105 62,953 73,162 75,291 73,943 Supplemental security income.. NA NA NA NA NA NA NA Food stamps................... NA 261,006 825,126 789,400 895,474 972,561 1,049,500 Child nutrition \1\........... \3\ 13,34 0 \3\ 44,14 0 84,200 131,350 137,860 149,609 159,700 WIC \2\....................... NA \3\ 2,210 17,140 57,970 87,780 105,903 121,160 Virgin Islands: Old-age assistance............ 163 186 191 224 303 329 306 Aid to the blind.............. 4 5 4 3 13 6 7 Aid to permanently and totally disabled..................... 32 73 152 200 434 431 354 Aid to families with dependent children..................... 633 1,928 1,397 2,795 2,958 3,500 3,458 Supplemental security income.. NA NA NA NA NA NA NA Food stamps................... NA 5,916 18,951 23,061 18,355 18,517 22,547 Child nutrition \1\........... \3\ 380 \3\ 1,960 3,560 5,330 4,250 4,416 5,636 WIC \2\....................... NA \3\ 610 1,120 3,980 4,780 5,223 5,754 Northern Marianas: Supplemental security income.. NA NA 1,379 1,784 1,926 2,045 2,357 Food stamps................... NA NA NA 2,000 1,585 1,858 3,552 Child nutrition \1\........... NA NA 270 2,000 2,540 2,746 2,778 ---------------------------------------------------------------------------------------------------------------- \1\ Child nutrition includes school lunch, school breakfast, child care food, summer service, nutrition education and training, State administrative expenses, and special milk programs. Also includes the value of commodities provided for meal service programs, except where otherwise noted. \2\ WIC amounts reflect the value of monthly food packages and costs for nutrition services and administration. \3\ Cash assistance only. Data not available on commodity donations for these years. NA--Not available. Note.--AFDC = Aid to Families with Dependent Children; SSI = Supplemental Security Income; WIC = Special Supplemental Food Program for Women, Infants, and Children. Source: Congressional Research Service.