 Good afternoon, and thank you all for coming. And I appreciate that the circumstances this week have been a little more challenging than usual. So I appreciate everyone who came out today. I'm Elizabeth Lauer-Bash with the Center for Law and Social Policy, our class. And I'd like to welcome you here today on behalf of the organization sponsoring this. First, the New America Foundation, where we're located today, and thank you for having us. And Alina Sprague from New America will be speaking later. This event is also co-sponsored by the Coalition for Access and Opportunity, which is a coalition of groups that have come together to share and publicize best practices, identify federal opportunities, and promote policy reforms to strengthen the safety net by removing barriers to participation. Our members are very diverse, that include practitioners, researchers, advocates, working together to improve access to and better coordinate the range of federal income and work supports. The coalition is co-convened by CLASP, by First Focus, and by Singlestop USA. And our friends from Singlestop are based in New York City and regret that they're unable to come down today as they had planned. So thank them as well. The goals of the coalition are to improve individual and family financial support to advance health and well-being, protect against material hardship, and promote opportunity and pathways to the middle class through the range of safety net programs that people are eligible for. And we know that these programs have made a huge difference in the recession as well as in better times. But particularly in recent years, people would have been in much worse situation if these programs had not been in place. No one wants to be on these programs. We all recognize that a job that is secure, that pays good wages, is the long-term solution to poverty. But when those are not available, or for people who have barriers that prevent them from working, we're very grateful that these programs are out there and available to give people the healthcare, the food, and the income that they need to support themselves and their families. But we also know that our safety net programs couldn't work better than they do. Many people either don't get any benefits even though they're eligible, or get some, but not all of the programs that they could get. Others do get them, but only after spending an enormous amount of time and effort figuring out what they're eligible for and going to different offices to apply. So one of the goals here is to think about the ways in which states are moving to make this an easier process in ways that it could be even better in the future. We are at a very critical time for benefit access at the moment. There is still a great deal of high need due to the recession. And we've made some real improvements in the system over the past decade. Snap or food stamps, which we're gonna hear more about soon, has really become much more accessible over the past decade due to a combination of federal and state reforms. Under CHIP, the Children's Health Insurance Program, Express Lane Eligibility has really put aside a lot of the rent, tape, and rules that have made it hard for people to access public benefits in the past. And that's one of the reasons that we see children's rates of uninsurance declining, even as we know that fewer people have access to employer-provided insurance. Programs like School Lunch have direct certification that's been assigned the paperwork. This has been a combination of policy choices, again at the state, federal, and local levels, but also information technology improvements that have made things possible that weren't available in the past. But a lot of these programs are under pressure now. Some of it is some explicit political attacks aimed at outreach programs and aimed at the policies that have made it easier for people to get on programs. We also know that state agencies are stretched very thin. There's a lot of demands on them. Their funding has been cut. In some states, we're hearing stories, particularly on of unemployment, insurance of people calling and calling to apply for their benefits and just getting the busy signal over and over again. So it's a real opportunity to think about how can we build on the progress that we've made so far? How can we prevent it from wearing away? And what improvements can we make in the future? And in particular, the Affordable Care Act, or healthcare reform, presents an opportunity to make some improvements as we move forward. I'm gonna weigh in two reports that are also available outside that the coalition has put out. One is specifically about how human service programs and their clients can benefit from healthcare reform and from the funding opportunities that are available under it, and the opportunities that states have to really rebuild their eligibility infrastructure. And the other one is more of a forward-looking vision of what a 21st century public benefit system would look like. With that introduction, I'm gonna turn to our panelists and I'm not gonna read their full bios which are available as handouts, but I'll turn first to Alina Sprague from the New America Foundation to talk about asset limits and their new work. Thank you. I'd first just like to reiterate what Elizabeth said and thank you all for coming despite the weather earlier this week. It's great to see so many people in the room and to know so many more watching online. And I think that's really a testament to how important this issue is at this particular moment. So what I'm going to be talking about, as Elizabeth mentioned, is a very specific aspect of this larger red tape issue that we've identified, which is asset limits in public assistance programs. This is probably not new information to a lot of people in the room, but just for the sake of context. Asset limits are a cap on the amount of savings and resources that an applicant or participant in a particular public benefits program can maintain and remain eligible for benefits. Asset tests vary widely across states and programs, both as far as the actual dollar value of the total asset holdings and as far as the specific resources that count towards that limit. For example, in TANF, which is temporary assistance for needy families, basically cash welfare, six states have now eliminated their asset tests entirely while others range from a low of $1,000 to a high of $15,000. By contrast with SNAP, formerly known as food stamps, most states now do not have an asset test for the vast majority of applicants, though 10 states have maintained the federal limits of $2,000 per household. To prove resources and pass the asset test essentially, applicants often must bring a burdensome amount of paperwork and information to their eligibility interviews, ranging from bank statements to car titles to even funeral agreements, which must in turn be reviewed and potentially verified by eligibility workers. This is a really time-consuming process and the sheer paperwork requirements themselves have been found to deter some people from accessing the benefits that they both need and qualify for. So one of the most obvious negative effects of asset limits is that they prevent the accumulation of sufficient assets to whether an emergency, like damage from hurricanes, for example. The asset poverty line is the level of savings that a family would need to survive at the poverty level for three months in the absence of income. That's currently $4,632 for a family of three. This is actually higher than the asset tests for SNAP and 10 states and TANF in 41 states. So these policies quite literally compel families to remain in asset poverty to receive any assistance. For this research, we chose to focus in particular on how asset tests affect the administration of the programs. This is a question that has important implications both for our participants and for state and local agencies, particularly in light of recent state budget cuts and reduced staff. Furthermore, just in the past two years, two states that had previously eliminated their SNAP asset tests, Pennsylvania and Michigan, have chosen to bring them back. Additionally, there have been proposals in the recent Farm Bill debate to eliminate broad-based categorical eligibility, which is the mechanism by which states have been able to increase or eliminate their SNAP asset tests. So to gather this information about the effects on the administration of the programs, we sent a survey to state administrators from a wide array of states who've made different policy choices with respect to their asset tests in TANF and SNAP, and then conducted follow-up interviews with these administrators, as well as with advocacy organizations, particularly in these states where these organizations played an instrumental role in bringing about policy change. So with that introduction, I'm just going to go through some of our key findings and some lessons that we learned from administrators that could be helpful to states that may be considering similar policy changes in the future. First, for every state that we spoke to that collected this data, we heard that very few applicants to either SNAP or TANF really had any assets to speak of, their asset levels very rarely approached what the asset limit was or used to be. Just for example, in Alabama, the year before it eliminated its TANF asset test, only 15 out of over 21,000 denials and also 15 out of over 20,000 closures were due to excess assets. This is maybe one of the more extreme examples that we heard, but we heard similar figures and anecdotal data from almost all the states that we spoke with. I think what we can glean from this information is that evaluating assets is just not the most efficient way for eligibility workers to be spending their time since very few applicants would be disqualified based on these assessments. So another thing that we heard that sort of plays off of this first finding is that eliminating asset tests broadly reduced or increased administrative simplicity and streamlined eligibility determinations. The process of verifying assets is full of rules and exemptions, and it's generally a very complex evaluation that requires significant documentation. Again, most of the reports that we heard about increased simplicity were more on the anecdotal side than based in solid data figures, and that's partly because many states eliminated asset tests in tandem with other simplifications, such as simplified reporting, and thus it was difficult for them to isolate the effects of limiting the asset test. Still, and I will touch again on this momentarily, some states were able to offer cost estimates of eliminating the asset test prior to implementing the change. For example, in Virginia, prior to eliminating its TANF asset test, the state estimator would spend an additional $127,000 on benefits for 40 additional families, but this would be offset by about $323,000 in savings and administrative costs. Another issue that we looked at was the overlap in caseloads among programs with different asset tests in place. Nationally, around 8% of SNAP households also received TANF, and about 81% of TANF households also received SNAP. Among the surveyed states, there was significant variance in these figures. In California, for example, a full 20% of the SNAP households also received TANF, and practically speaking, that means that even though the SNAP asset test has been eliminated in California, 20% of SNAP recipients will still be subject to the $2,000 TANF asset test. Overall, this speaks to the problem of how inconsistent rules in programs targeting families with similar needs can both perpetuate confusion about eligibility and limit the ability of a reform that occurs in one program in isolation to reduce red tape and burden some paperwork requirements. I think this also says that there needs to be a recognition that a single family may qualify for and be subject to different rules in, for example, TANF, SNAP, and Medicaid, unless even a well-intentioned rule that simplifies eligibility in one program will have diminished practical effects if similar requirements remain in others. On a related note, some states described issues with implementation of asset test reforms that mitigated their effectiveness. For example, in Louisiana, we heard about case workers still asking applicants about assets even if they shouldn't be subject to an asset test, in part just because there was inadequate training of some of these workers following the policy change. Similarly, many states reported that their applications had not been updated to reflect changes to their policy. At least 22 states with combined applications still ask applicants for asset information even if they are only applying for SNAP and they've gotten rid of the SNAP asset test. I should note that in general, combined applications which typically allow applicants to apply for SNAP, TANF, and Medicaid all at once have facilitated more efficient access to benefits for families that are most in need in that sense of help cut down on the red tape that we're talking about. But the fact is that this underlying lack of coordination among the programs included on the applications can perpetuate misconceptions about eligibility and compel applicants to provide burdensome and unnecessary information. Finally, I just wanna touch on the actual impetus for eliminating the asset test in a few of the states that we spoke to. States reported a variety of different motivations for implementing this policy change. First among them, again, was administrative simplicity. As I mentioned before, the calculation of cost savings was something that some states did before implementing their policy change. It's a way to sort of explain its economic basis. Others also found that they would, well, they forecasted that they would have shorter application processing times. For example, in Colorado, which is the most recent state to eliminate its TANF asset test, the Department of Human Services found that eliminating the TANF asset test would probably cut back on about 15 minutes per case interaction and therefore up to 20 minutes during the first 45 days of a new case when they anticipated that there'd be five to six case interactions with that new client. Other states eliminated their asset test to improve their payment accuracy. Ohio in particular eliminated its SNAP asset test when it was facing $3 million in sanctions from the USDA Food and Nutrition Service because of its high error rate in SNAP. The state hired an outside consultant to kind of think of some ways that it could lower its error rate and one of the ideas it came up with was implementing broad-based categorical eligibility and eliminating the asset test. Like I mentioned before, determining asset eligibility and making these evaluations is really complex because the rules and exceptions are often unpredictable and seemingly arbitrary in a lot of cases, so it's an error-prone assessment. And since Ohio did eliminate its SNAP asset test, it's found its error rate has declined significantly. Lastly, several states noted that their motivation for eliminating an asset test was because they recognized the tension between having these asset limits in place and the missions of the programs that they were administering. Specifically in Louisiana, the state chose to eliminate its TANF asset test in part because they recognized it conflicted with initiatives it had in place to promote savings for college and retirement for TANF recipients. In Colorado, administrators also noted that having their TANF asset test kept families in a state of financial vulnerability and therefore created barriers to long-term self-sufficiency which could actually increase the time spent on benefits. So now that was a lot of information, condensinage for a period of time. There's much more where that came from in the paper that we are just releasing today and you can find some copies on the table outside. And we're also going to be producing a data site to put some of this information into a more visually accessible form over the next few weeks. But just to include, I'd say that an overarching lesson of this research was that eliminating asset tests not only cuts red tape for applicants, but also eases the burden and potentially the costs of administering these programs. Thank you. Thank you so much. Our next speaker is Donnie Rosenbaum of the Center on Budget and Policy Priorities and she's an expert on the SNAP program or food stamps and has also been working on a project funded by the foreign foundation to help states think about cross-program issues and using administration. Thank you. So yes, I was asked to talk about SNAP access and I'm going to talk about that some and then I'm also going to talk about the cross-program issues, particularly in light of healthcare reform. So thank you very much for inviting me to be here. I'm very happy to be here. So the lead here is that SNAP access is actually very good. I think that we've seen in the last few years during the recession that the structure of the SNAP program, I mean when I think about access, I guess I should start by saying I think about both eligibility who's eligible for the program and does it serve the people who it's intended to reach and then how hard is it for people to access the benefits? What is the red tape that's involved and so forth? So I think on both fronts actually, the program is very strong. The structure of the program allows for when more people need help, they can participate if they choose to apply. Currently there's about 46 and a half million people who which as we've heard from a lot of different sources lately is a big increase during the recession and this means that both in terms of program rules and in terms of administrative access, the program is able to expand to meet the need and then will contract when the need declines. The growth that we've seen in SNAP has been in every state, some states more than others, but every state has grown and over the last couple of years as the economy has started to rebound a little bit very slowly and especially with long-term unemployment remaining very high, we've also seen the growth in SNAP begin to level off. So and then again this week of course I think it's important to think about the ability of the program to respond not just to economic conditions but also to disasters. There's a feature of the program that enables SNAP to be one of the first programs that's on the ground offering help to people when grocery stores start to reopen and very temporary help usually of only a month or two so that's really important. Participation rates among those who are eligible are very high. The most recent estimates are for 2009 but we have no reason to think they've come down since then and in 2009 the Department of Agriculture found that 72% of all individuals who are eligible participated in SNAP. Almost 90% of the benefits for which people qualified were actually paid to these eligible people or provided to eligible people on their EBT cards. Meaning that the people who are most likely to participate among those who are eligible are the people who qualify for the highest benefits and that some of the gaps in the participation rate are among people who qualify for lower benefits. Notably senior citizens have lower than average participation rates. Working families historically have as have eligible citizens that live in households with ineligible non-citizens. And actually for working households we're seeing some improvement in recent years. The 2009 participation rate for working families stood at 60% which is an all-time high nationally. And of course like everything else in SNAP the participation rates vary by state. We have some states where the participation rate is close to 100% and others where it's barely above 50%. That's the minority, the ones in the 50% obviously but there are some where there are struggles. So that's the overall picture. I'm gonna talk briefly about access to SNAP in particular and then I'm gonna switch and talk to what I think is the most important SNAP access issue currently which is about thinking about the package of benefits that people qualify for. So within SNAP access is certainly changing. In part because of the greater use of technology as was mentioned, as Elizabeth mentioned in response to higher case loads sort of out of necessity and also because of the direction that the health community has been moving in for a number of years in terms of mostly with children's coverage up until now but now under healthcare reform is envisioned sort of for all of health coverage which is a simpler, more streamlined, more automated system under the Affordable Care Act. So the old vision for access to SNAP was that you went into the local human services office and you sat down with a case worker and you had a 45 minute or hour long interview and then you were told whether you were eligible or not. This expectation that people will make frequent trips to the human services office in order to apply for SNAP and then over time to keep SNAP is changing across the country. There's now 37 states that have online applications and about half of the states also offer other online services. There's much, much greater use of the telephone for both interviews and for inquiries. Many states have set up call centers like what you experience when you try to talk to your health insurance or your anything these days, car rental, whatever. A growing number of states are looking at same day service in SNAP where states aim to have only one sort of point of contact with an applicant or with a family and cover all that's necessary to issue benefits either that day or within 24 hours and then also have less paperwork over time for people to retain benefits. And this is done by greater use of automated data sources, collateral contacts and reduced verification requirements wherever possible while at the same time maintaining very, very high program integrity. The SNAP error rate which is one of the most rigorous of all public benefit programs is also at historic lows right now. Meaning that we know because of the way that the program goes in and looks at and samples cases that almost everybody, 98% of people who receive SNAP benefits are eligible. So the cost of participating have been reduced for many. The people of access to these kinds of technologies and the abilities to use them or the ability to get help using them. Others may face new barriers. I was recently at a local office in a southern state where I was sitting in on an interview and seeing their fancy new automated system. And I sat in on an interview with a woman who was a part-time hairdresser, self-employed, who had come in with her blank recertification form and the worker sat and helped her fill it out. And she said, you know, I always do this. I always come in because I'm afraid I'm gonna make a mistake. And I know if I sit here and she walks through it with me that we'll get it right together. So that kind of individualized attention may be harder to get now in the environment that states are moving to. States really vary in the degree to which the shift to automated methods is being pushed versus just being offered as an additional opportunity for accessing the program. And so I think it's important to remember that not all low-income populations have access to the technology, to the internet or the same ability to be able to use it. We hear about prepaid telephone plans being a problem for people when they have to wait on hold for a long time or participate in an interview over the telephone. Many, many states are closing local offices, which would mean that people who live in remote areas have to drive farther if they do want to be able to see somebody and talk through things with them. And there are increased or still high reports of untimely benefits, lost paperwork, long wait times in person and on the telephone, and auto closure, which is sort of a fancy way of saying that the state had materials from people but didn't have the time to act on it. And so the computer automatically will close cases. And that can lead to what is called churning sometimes where we're seeing certainly increased attention to this phenomenon where people who are eligible have their cases closed for whatever reason and then usually an administrative barrier of some kind and then turn around and reapply understandably because they still qualify for benefits. In some places, 50 to 75% of new applications are coming from people who recently were on the program but who sort of fell through the cracks because the system may be difficult to navigate. So these types of access problems obviously may disproportionately affect some of the neediest families. And when I think about that 90% participation rate, I think about the fact that the programs, in terms of benefits getting out the door, that currently the program is really successful in being able to serve the neediest families. And so when we move towards these, when states and local communities move towards these new types of approaches, they hold a lot of promises for many people and we need to think about the risks that they may pose to other people. And then lastly under current law before I turn to the parts about healthcare reform, I just would be remiss if I didn't point out in terms of access that there are some eligibility gaps in SNAP still, notably for some legal immigrants and unemployed childless adults who face a three month time limit. The three month time limit has been suspended in most parts of the country during the recession. But basically if you don't have children and you're between 18 and 49, you can only get food stamps SNAP for three months over a three year period if you're not working. And so that time limit will be coming back in the coming years and is really a serious weakness in the program. And we can talk if people want to about what some of the other changes that are legislatively under consideration in coming in Congress right now if folks wanna go there. But I'm gonna skip that because I'm running out of time. Mostly what I wanna talk about looking forward to the next few years, what is the big future of SNAP access? And we really think it's as I said about packaging SNAP with other public benefit programs and safety net programs for low income populations. We at the center on budget tend to start with SNAP and Medicaid because those are the two programs that have the broadest reach. And because of the opportunities that are coming under healthcare reform for as was mentioned for very, very big improvements to eligibility systems and other changes. But other benefits also are important such as childcare, education and employment services, cash assistance, energy assistance and others housing and others can also WIC school meals can also be included in that package. The technology that's available, the cloud, the enterprise and architecture, the rules engines, I'm learning all these terms, it makes it possible. It really expands the degree to which information can be shared and things can be streamlined. But the policies and procedures and how human beings interact with those systems behind the scenes and in front of the scenes is also very important. And I don't think there is a one size fits all kind of approach. The states along with the local communities and the federal government with input from others need to figure out how a coherent vision can be made to package all these benefits together. Right now in most states, people who apply through the human services door are able to access health benefits, especially the lowest income families. But there's a risk I think under healthcare reform as states may split sort of the health piece off as they aim to integrate the health programs across the different health coverage options. And so there is this risk that the lowest income people will face new barriers in accessing a package of benefits. So there are ways to set things up so that human services programs get to take advantage of all the positive changes that are being made in the health area. And I should say these positive changes are independent of whether states choose to take the expansion of Medicaid. All of these changes are going to be happening even in states in terms of being able to line up with the federal exchange and being able to use new technologies are gonna be happening even if states don't take advantage of the Medicaid expansion. And the administration as was also mentioned has made important resources available for states to be able to include human services programs in the new vision. Some states are taking the lead on thinking this through. For example, as Elizabeth mentioned, we're working on a project known as the Work Support Strategies Grant founded by the Ford Foundation and with the Urban Institute as the lead where six states are really undergoing major revisions and redesigns to their work support systems, primarily SNAP, Medicaid and childcare with an eye towards integrated approaches. I don't have time to go through all of the, well, let me just say, I don't have time to go through all of the things. I wanna point out two papers that are on our website. One is called Improving the Delivery of Key Work Support Programs. I didn't bring copies because these are both really long. But this one is more, lays out the vision and goes through some of the innovative policies and practices that are underway. And this one is a toolkit called Coordinating Human Services Programs with Healthcare Reform Implementation. It's intended for state agencies. It goes through a lot of sort of questions that states may wanna ask about how they're setting things up and what the different opportunities are and provides tools and so forth for thinking through how they might wanna answer some of those questions. But in the short term, I think it's really important for, there are major opportunities for states to be able to use SNAP information to automatically enroll people in Medicaid come a year from now when states are looking at rolling out healthcare reform as of January 1st, 2014, they're gonna be starting to have their systems up and running in October. Virtually all SNAP recipients in the state that takes the expansion will be eligible for healthcare through Medicaid. And so taking advantage of the recent information that's available without having to make people apply through a new system will both make that transition seamless for the recipients and also, you know, lop off a whole bunch of people for whom states are not gonna have to do separate new eligibility determinations. So I wanna close by saying, I think it's important to think through the spectrum of different customers that are served in the various programs that people talk about when they talk about the safety net or the work support system and think about how we can have a system in place that meets the needs of the full spectrum of people who interact with that system. Some people will just need work support benefits. And so giving them the speediest, lowest touch, most accurate access to benefits is very important. Others have a more complicated range of issues and challenges for the adults and the children in those families to be able to succeed. And so it's important to think through how does that richer set of benefits become available to them also in the least burdensome way possible. Thank you so much, Donnie. So as we've heard, all of these policies are implemented through the states and by the states and there's a great deal of variation across the states. So we didn't think it was really important to have the state perspective on this panel. Our final speaker is Vince Kildoff, who's the Deputy Executive Director for the Family Investment Agency from Administration, sorry, for the state of Maryland. And thank you very much for joining us. Thank you, Elizabeth. Maryland is among the states that embrace many of the current strategies for increasing participation in its safety net programs and cutting red tape. We adopted online applications. We're conducting some data matching, simplifying eligibility rules. We've also expanded our outreach campaign in recent years and looking ahead, but not too far ahead. We're designing our state's health insurance exchange to accommodate, to serve as a portal for other assistance programs. In terms of making those kinds of things happen, I consider our agency to be fortunate to have both the governors and the legislature's support for expanding program access and reducing barriers to eligibility. What it leaves us the flexibility to apply a broad strategy to expand program access without the worry of political considerations, sometimes holding us back. So one could almost say, though, the support is so good it's almost as if it's mandated. For instance, Governor O'Malley supports the president's goal of ending childhood hunger by 2015. And as a result of the governor's partnership to end childhood hunger, Maryland's Food Supplement Program, which is our name for SNAP, added 61% more households with minor children to the program between December 2008 and September 2012. The partnership includes state agencies that operate other safety net programs as well as community-based organizations. So that's a great partnership there. And the governor staff holds hunger stat meetings to review the agency's performances towards our goals and hold us accountable. The Maryland General Assembly also has been active and it authorized the no wrong-door work group in 2010. The group was co-chaired by the state's SNAP director and by an executive from one of the local CBOs. The primary goal was reducing barriers to access at every point in the service delivery system. The final report came out in 2011 and listed a number of short-term and long-term goals. This is a very influential group. I'll be touching on many of their goals because a lot of them were implemented. The lesson from that experience, in my opinion, is that legislative bodies can be effective at bringing agencies and community groups to the table. Earlier, I mentioned the service delivery system and one of the element is online applications. And Dottie told us that it's the extent to which those are used. So it's not as if they're a new strategy for strengthening the safety net and reducing barriers to participation. And as Dottie noted, many state and local governments are in the early stages of adjusting to the effects of that model on their local offices. That key difference being both case managers and the applicants don't have that face-to-face contact. It's the online application and the phone interview model. It also changes other communications. We had, for instance, the video clips running in waiting rooms is just not reaching as large an audience as it did in the past. But there are some strategies state and local governments can employ when adjusting to these new models. One, a real, very straightforward, is the messages we used to have in our, we still have in our local offices, those need to be out on the web in a format that can be accessible, either mobile or by a desktop. And I think the online application questions need to be reviewed carefully. And it's, you know, both on the customer-facing side and as they come back to the, say, the case manager or the agency side on the back end. I think there's a risk of not capturing all the customer's needs. You know, if the application forms, so to speak, don't have enough blanks, I guess, to fill in. My concern is we may lose some of that communication process in our efforts to make these online applications clear and simple and short. That's, you know, there's a risk there. And second is to make sure that those, you know, when we capture those, when we do it right and capture all those, that they're communicated to the staff at the back end. I don't want to get too far in the weeds, but many states use legacy mainframe eligibility systems, some of them from the 1980s. And it's important that those interfaces from the more flexible new ends of the system make it back to the sort of the green screen parts of it. So the case managers have had information to work with. Training, again, to reiterate that, I'm conducting those interviews effectively without the face-to-face contact in order to pick up on some of the unmet needs. Maryland is in the process of changing its new worker training model to a scenario-based sort of more general customer-focused model. Formally, we used a module-based one where you did a week of systems training, where it was a module for systems training, a module for SNAP policy, another one for Medicaid policy. And very excited about the change that we're putting forward. And we've been using online refresher training for veteran staff for more than a year now, using information from our evaluation data to inform us, okay, what kind of questions, what kind of policies need some clarifications, or what areas, it really allows us to tailor that training. It also, we're not pulling people off the line for long periods of time. It's essentially an online, we don't like to use the word, but it's a quiz. And it has some tips and some questions, and so there's, it's a great feedback loop as well. You can see, make sure the folks get it. States using call centers should also receive the staff managing this call center should also get some interview training on that because these aren't long contacts, but it's a contact and we should take advantage of it. Last point, the lack of the physical point of entry is not a bad thing. In Maryland we have, I think we're up to about 75 registered partners to file applications online through our sale portal. And it's, I think the number's large because that online option lowers the cost of providing assistance to the public. They can reach far more people than if they, sort of the old model where you had to do home visits or actually drive people to offices. So that's definitely a plus. Now I'm gonna transition from meeting the unmet needs of customers who found us to the agencies finding people who may have unmet needs and aren't yet with us. Data matching is an effective strategy we've adopted for that purpose. Two ways to do this, GIS mapping, low income populations or other demographic data versus your active caseloads. You can also match databases of your active caseloads for various programs against each other. Find those who are participating in some but not the others. An outreach partner in Maryland's been mining the LIHEAP or the Federal Heating Assistance recipient list to find households that receive energy assistance but aren't participating at SNAP. That makes a lot of sense because the income guidelines in our state are very similar. The partner first used this in a project to target elderly households. Now they're starting a new project to reach families with minor children. Another way to reduce red tape, pretty obviously, is to simplify the eligibility rules that created in the first place. In my opinion, this is one of the best outreach strategies available. Both parties in the transaction benefit. There's the lower verification and other burdens on the customer side. We've heard the other presenters talk about this, the cost savings on the agency side, that the reduction in workload, the federal rule changes. It's gonna repeat that in the past 10 years, it's made this easier. The expanded categorical eligibility that was mentioned earlier, Maryland's adopted that. And we've dropped the asset limit for our TANF program as well. And it was, again, the data showed that it was this tiny sliver of clients that had assets that either led to enough to close their cases or have them denied. And it just wasn't cost effective. We've adopted, in another program, a six-question check at the midpoint for a SNAP certification to reduce the burden again on both sides of the transaction. Formal outreach is another area where we've been active in strengthening the safety net. Our partnerships with community-based organizations for SNAP outreach has grown in each of the past three years in Maryland. I believe we have 14 agreements in place this year. And SNAP outreach is also a great way for local CBOs to leverage their resources. This program essentially doubles their money. We've also found an unintended benefit back to some of the themes we've been hitting today. These partners are working very closely with customers and very deeply in the application process. And they're serving as eyes and ears in our local offices and especially for large states of really far-flung operations. They may be picking up on some sort of red tape issues or other things that say the state's management evaluations may not pick up. In our state, when we get that kind of feedback during our meetings, we're able to go out there and address it right away. I've been involved in the development of Maryland's health insurance exchange. I'm pleased that the plan is to operate that system as a portal for other assistance programs in Maryland. And it's gonna replace our agency's online application in 2014. And as far as I can recall, the push to coordinate those safety net programs with the healthcare reform was back at that no wrong door work group. More specifically on how we coordinate these programs, it's in the process, there'll be points where the applicant can opt in to other assistance programs. There's an opportunity fairly early in the medical assistance application process where they can choose some of those other programs. And then there's also one at the end. It's sort of like we're asking, are you sure you don't need this kind of help? And I think that's a great feature. So in closing, those are some of the ways that some of the things we've been doing and some of the ways other government agencies can expand access to the programs and strengthen the safety net. Thank you. Well, thank you very much and to all of our panelists. I'm gonna kick off with some questions. Take the moderator's privilege, but there will also be an opportunity to get questions from the audience. So you'll be thinking about what you'd like to ask. A lot of these improvements have been, as you said, sort of behind the scenes, I think, without a lot of legislative attention, although some states positive, but I think now perhaps they're getting a little more attention and it not always in positive ways. I guess I was wondering if all of you can talk maybe to some of the pressures that are happening now to either bring asset limits a lot down or not criticizing outreach spending and how you would respond to them. Sure, I can get started on that. Well, I will say that one thing that I heard from, one example that came up from almost every state administrator who I spoke to about the issue of reducing or eliminating asset tests and some of the political pressures that came up was the lottery winner issue, which I imagine a lot of people in this room have also heard about. There were two lottery winners in Michigan because there was no asset test in their state for SNAP continuing to receive SNAP benefits. And this issue got a lot of public attention was widely covered in the media and consequently, there was a significant additional pressure on SNAP administrators to maintain program integrity and avoid having a situation like that occur in their own states. So I definitely heard from ministers that that was something that they were very conscientious of and really feeling as they move forward with potential policy reforms. That being said, as far as the actual process of implementing reforms to asset tests, we heard from different states that there were sort of two ways of going about it, depending on the state either going through the legislature, which is often a more sort of public process that got more attention or sort of doing this quieter way by amending the administrative code. And I think one of the issues that comes up there is if we're talking about eliminating red tape and actually reaching more people who may be eligible, letting them know that there will be less of a burden when they come into apply for benefits, it's kind of a trade-off when you're saying, well, we're gonna keep this change quiet. So on the one hand, you may keep it quiet and then there's less of a public outcry when people find out that you can qualify for benefits while still having money in your bank account. But at the same time, the newly eligible people that you may want to reach are the people who have previously been deterred from applying for benefits because they know they have to apply, they have to supply all these documents that they may not have readily accessible. That could be what you're sacrificing. So I think there are a lot of considerations there about what your ultimate goals are for implementing a policy change like that. I think we've identified that it tends to benefit both the agency and the participants, but sort of weighing who you're targeting with the policy changes is going to affect that assessment. Some of the legislation we'll see every year, affecting access, you see lawful presence bills which adds, again, burden on both sides. Most of these are gonna add burdens on both sides of the equation. You see lawful presence, you see drug testing, reinstituting assets. In a lot of cases, the physical note will sink the bill, especially these times of tight-state budgets. On one hand, there's pressure coming, but on the other end, the budget situation is actually pushing back. Just to make sure everyone, when he says the physical note, that means that when the legislative analysis office comes back, they say it would cost more money to implement this policy than it would save. Correct, yes. Thanks. Well, SNAP is a little bit caught in the crosshairs right now. There is a farm bill that's been being worked on for about a year. It has a lot of really good oversight provisions in it. It also has some pretty deep cuts that would eliminate eligibility for about two to three million SNAP recipients by eliminating this option that's been, primarily by eliminating this option that's been mentioned called expanded categorical eligibility. I think that there's some misunderstanding about what that option is. Some have portrayed it as an automatic eligibility sort of thing, that it's a major expansion that has contributed a lot to caseload growth. When in fact, many people have said, including the Congressional Budget Office and others, that the major reason for program growth is the recession and increased hardship and that that is expected to turn around by the end of, but within the budget period that's under consideration, the program will be back to where it was prior to the recession as the share of GDP, which is sort of the measure for whether program spending is contributing to long-term budget pressures. But nonetheless, this two million person, two to three million person cut would affect predominantly working families, families with children, senior citizens would roll back the asset test, which of course hurts people who are recently unemployed and people who are trying to sort of put their lives back together and save for their futures and also would roll back benefits to people who are just barely above the program's gross income limit, but have expenses that make them be able to qualify for a benefit because they have high shelter expenses or childcare expenses. It's not the case that people are standing out on street corners handing out EBT cards to everybody. In fact, everybody who qualifies under expanded categorical eligibility goes through the same application process. They have to provide all the same verification documents, have an interview to document their circumstances and so forth. It's just that at the end of that process, if the answer would otherwise be no, you're not eligible because your assets are modestly over the limit or your gross income is modestly over the limit but you can qualify for a benefit under the formula, the eligibility worker is able to give those benefits. So, and then in terms of access, I guess what I would say is a lot of the access kinds of issues that we've been talking about have not been a big part of the debate in Washington. I think partly because of the budgetary pressures, as was mentioned, and because healthcare reform is a bit controversial and so people don't necessarily aren't right now talking about that, but one may expect that in coming months there will be more attention paid to that. But most of the things I was talking about are things that, almost all of the things I was talking about are things that don't require any kind of changes in federal law, that there is already a great deal of flexibility for states to be able to package benefits, reduce access barriers and that the hard work is to happen at the state level, at the county level and in coordination and collaboration among federal agencies and state agencies across the different program areas in figuring out the path that works for being able to package these benefits. Do we have audience questions? I think we have a microphone, so. Hello, I have a question for Mr. Kilduff. You had mentioned that one of the benefits of the online applications is that you can use the data from, for example, the SNAP beneficiaries with the LIHEAP ones and compare across this, make sure that people who are eligible for both were getting those benefits. I think that's what you had said. So once you'd identified who those people were, how would you then perform the outreach to those individuals and would you do it on like an individual basis or in kind of a more broad sense? Thanks, that's a good question. The partner we have through the SNAP outreach program, they do it on an individual basis. They have a memory and of understanding with us and they've set up sort of a mailing center in our state and they actually will contact them, let them know there's a good chance. I'm trying to remember the details, whether there's some phone follow-up as well. It's a model that they've used very successfully in Pennsylvania and in the Philadelphia in particular. So that's one way of doing it through that very specific matching and the mailing and realize there's cost involved there. But over time you figure the amount of a SNAP benefit per month coming into a state, the math makes sense. Hi, I'm Mark Groenberger. There's one thing I want to ask Ms. Rosenbaum briefly. Did you, and then a general question for all of you, did you say that 60% of SNAP recipients are working families? One of you three said that? Well, did I say that? You said participation among working families. Participation among eligible, I can answer that question too. The one that you did ask. What I said was, yes, the participation rate among eligible working families is 60% in 2009. In fact, the reason I sort of was like, did I say that? Is that when we look at the most recent data on the share of families with children where there is somebody who is not disabled and not elderly in the home, 60% of them are working families, have earnings in the home. So that is actually at the time while they're getting SNAP. Okay, of course, you would expect that a major reason that people get SNAP is that they lost their jobs or they had some other event, family disillusion or whatever that made them eligible. But so if you were to look forward and back and see how much work is there around us, it would be even higher. But at a point in time when they're receiving SNAP, it's 60%. Okay, and here's the question for the panel in general. We've talked a little bit about the future, but let's really talk about the future, which is what happens when the budget cuts sequester, whatever you want to call it, the cliff kicks in in practical terms to TAMF and to SNAP, how much gets cut, how many people get thrown off the rolls, et cetera, et cetera, et cetera. Well, in the immediate sequester issue, the legislation that created in exempted low income programs largely, so SNAP and TANF are not sequesterable, Medicaid, there's only a tiny portion of it that is subject to it. So in the very short term, if sequester happens, there is not an immediate impact on this. Obviously, if the president said that sequester is not gonna happen, we'll see how the lame duck plays out. Many of the proposals that are out there to replace sequester would have big impacts on these programs, but I certainly don't have a crystal ball as to how it's gonna play out. I don't know if anyone. I know with the Lahi program is part of discretion subject to the sequester and in Maryland, we're bracing for potential, it's about a $5 million cut, and so you have to build that sort of pad into your budget to make sure that you can weather that without too much disruption, but it will affect, there's two ways it can affect. It'll either mean lower benefits or depending on how the state does it, it'll be a lower benefits or they'll have to cut the program off earlier if they don't have enough to meet the need of the resident population. You're doing that analysis now or has Maryland made a decision on how to approach it? We made a decision and we went ahead and put $5 million in reserve, just in case. And as somebody who works for an organization that has budget in its title, I will say that we think that getting the fiscal house in order is very important and that there are way, I mean in past budget deficit, big budget deals, there have been efforts made, successful efforts to either expand or protect low income programs, so it is possible to do without putting at risk the most vulnerable. The major deficit reduction packages of 1990, 1993 and 1997 all protected programs for low income Americans as did the Boll Simpson proposal that was under consideration last summer that pushed out the, that created the sequester, the resolution of which created the sequester and the current cliff that we're looking at. So I guess I would say that I don't disagree that these programs are very much at risk in the coming debates, but that it's important to also know that lots of people are working to protect them and that it is certainly, these are not programs that are contributing to the long term fiscal problems in the country and so there's no reason why they can't be protected as part of the resolution. Just to clarify my, while the big programs like SNAP are not subject to sequester, as you know, LIHEAP, WIC, which is the special nutrition program for women, infants and children, Head Star, there are a number of important programs that are subject to sequester and I will take, again, moderate and privileged to just jump in, but if you wanted to talk a little about sort of how you think about perhaps some of these capped programs, such as childcare, subsidies in the context of trying to get people eligible for the package, where, you know, since, you know, if someone's eligible for SNAP and they apply, they'll get it. If someone's eligible for childcare, subsidies and they apply, they may not be able to get it depending on, you know, the state policy and waiting lists. So if you have thoughts on some. I mean, I think that is a big question and problem. I think that the issue that we consider, for example, as part of this project I talked about is the question of continuity of care and whether the kinds of things, for example, in childcare, when you have churning, when you have people leaving assistance, not because they're really ineligible, but because they failed to be able to navigate the system and provide the required documents or they, you know, their case got closed for an administrative reason like that. You're putting the, you know, the child's well-being at risk when you remove them from care and you have lack of continuity of care. So it is clearly a challenge when there's a CAPT program, when there are waiting lists, but to have somebody drop off and have to go to the end of the waiting list as a result of administrative, you know, procedures that aren't friendly to continuity of care. So that's how we're thinking about it. And some of the states that are in the project are states that do provide childcare to everybody who qualifies. So they're able to, they're worrying about how it will expand their costs, but they're able to consider it. Hi, I'm Meredith Dotson with Results. I was thinking about some of the danger, what I consider dangerous proposals out there, and I'm glad, Dotty, you talked about the categorical eligibility proposals in the Farm Bill as it relates to SNAP, but also just the broader proposals around block granting and the idea that how important it is that these programs can respond to disasters and certainly we're thinking a lot about natural disasters right now in this country. So I'm wondering if by any chance we have any, if you've seen even just in the last few days in Maryland between the pretty dramatic snowfall in the western part of the state and flooding and that sort of thing, if you have any kind of anecdotal evidence about how you've been able to, any uptick in applications or just kind of how you see the importance of being able to respond and the kind of flexibility that perhaps block granting would really restrict? It, I think it's, for us, it's too early to tie it to that, the most recent event, but what we saw during the recession would have been very difficult for programs to grow to meet the need if there was sort of block granting across the board for these sorts of things. TANF, even with TANF, we did see pressure there in a lot of states, saw pressure there. The block grant, you know, there was sort of a combination of maybe carryover from some of the good years before the recession to help meet that need, but it wasn't enough. You know, that's the theory behind the block grants that are all even out. And we certainly took full advantage of the contingency funding available. We were able to let the case load grow to where, you know, to where it needed to go and now it's coming back down. And so it could behave. So TANF could behave as a counter cyclical program. And that's, to me, that's the danger when you block grant. Good morning. This, my name is John Cargans. I was with Talk Radio News Service. Ms. Sprague, you mentioned earlier, Ohio had high incidence of some errors and that the USDA stepped in and essentially fixed the situation with regards to people's cases and whatnot. I'm wondering, is there any kind of political will or any kind of plan for some kind of appeal for cases on a federal level? I know that for families and individuals who are of low income, if they basically, you know, aren't able to get what they need, that the appeal usually happens just down the hallway or the cubicle next to them. So there really isn't much that they can do if they're not able to, you know, if someone, if another pair of eyes can't see this case from a perspective where policies are conflicting and they're just simply following the letter of the law, is there any kind of, and just a quick comment to what you mentioned earlier about people in Michigan. I think sometimes the media focuses on the extraordinary, it's probably more typical that families who are eligible don't get what they're supposed to get and that's obviously a bigger story to other people, so thank you. Thank you. I might yield this question to someone else who can better answer the question about the appeals process. To my knowledge, there's no federal remedy, all the appeals for denials of public benefits would occur at the state level, is that accurate? The appeals are at the state level. There are federal efforts to monitor states in terms of timeliness. They check to, they do have, they look at errors in the SNAP program but also at what the rate of getting benefits to people on time is, and in the error rate system there are overpayments and underpayments, so on an aggregate level, and there's also looking at denials and terminations. So at the aggregate level they are looking to see how states are performing and make sure there's not major problems but on an individual case by case basis, all of those appeals happen at the state level. I want to note just that it is really useful also for SNAP that the federal government does in fact measure participation rates and how many of the eligible are receiving benefits and for example under TANF, there is not such a measure and it might be helpful to have something like that in other programs. My name's Alice Day, I'm a concerned citizen, trying to keep an eye on what's out there. In thinking about some of the changes you were talking about to the way the system is managed in general terms, making it more automated using more technology, is there a problem with literacy in this? Do you think that more people will fall through the cracks because of having to maneuver those different systems or isn't that an issue at all? Do you see that the population in general is in need of these programs is able to handle those things and work for themselves with them as well as under the old system? Well Vince may have actual hands-on experience with what the answer to that is for online services. I mean this is part of why I made the point that some states vary a lot in how much they're pushing people to those kinds of methods of access versus offering it as an alternative to going in person. I do think that there's issues with literacy, with disabilities. They may not all of the screens be accessible to people who have certain disabilities, limited English proficiency. There's a whole host of reasons why people may not be able to navigate the new technologies. On the other hand as I said there are people who can and so to me it's making sure that you can reach the full spectrum of people who are needing help. And this is part of why I think it's important that people have an opportunity to be able to talk to somebody in person or over the telephone and get questions answers because these are complicated programs and as we heard people can be denied and need help in sorting that out. I think we've all experienced how frustrating it is when you can't get through on the telephone to somebody to answer a question. And you keep pushing zero and you never get satisfaction. So I think that it's very important to consider those kinds of issues. I don't know if you have any. I'll just say one or two things. I suppose that there's some risk in closing if a state or an area aggressively closes offices that you may miss some people that way. But there's perhaps the good news for those of us that work in the business means we'll never be totally taken over by computers because we're needed for things like that for some of the visual cues where if you have say a worker has a paper application and the writing is pretty awful looking. And you say, yeah, because people usually don't come out and say, you know, I can't read. That's not the first thing out of their mouth. So there's clues you pick up on from the paper one. And there's also the groups, the community groups that come out there and help say out of food pantries and places like that that'll help folks file. And that helps mitigate the effects of literacy. Then we also have that though. We have sort of a double issue in cases where folks with English as a second language and they're not literate in their native language. So, you know, having a good translation service available to verbally talk you through is key there. I was recently in a state where they have a call center where if somebody's filling out an online application they can call and the worker can take it over at that point and do an assist, you know, sort of do an interview and fill it out for them. Which seemed to me like a really interesting innovative way of, you know, and this is a state that they happen to have a very high call answering rate. So you sort of get the feeling that that may work in that state where it might not work in other places where you'd have to potentially wait on hold for a long time. I just want to highlight how much states really are making these decisions right now with respect to their healthcare portals and how those are going to play out. So this is really a huge opportunity to weigh in and make sure that these issues that we're discussing are raised because, you know, this is going to be serving as in a very wide range of means and things and, you know, some of the draft questions ask things about, you know, well, does your employer provide health insurance and how much does it cost and people may not understand the question or have all the information at hand and making sure that people don't just panic and give up when they see questions that are like that and that they know that they can get help and that they don't have to start all over from scratch if they've gotten halfway through and gotten stuck. So just what you're hearing is really important design information to bring to the states. Hi, my name is Sarah Vidor and I guess I have two questions sort of building up to what Elizabeth just said. The first is, are any of the states that are using the health portal and the opportunities in ACA, are they only, are they primarily using that for eligibility or any states thinking about sort of this unified or comprehensive case management sort of keeping track or managing the person once they've been eligible. So they're sort of like a comprehensive case management approach. And then second, are there, this is more, I guess for Maryland, in your data matching efforts and outreach in that regard, have you run into any specific federal rules or regulations that have created problems with you maybe doing data matches across other programs but besides SNAP and LIHEAP? Oh well I would say that in terms of ongoing case management, yes. I mean many of the, some of the states that are thinking about having an integrated approach to an application and thinking of how you would use SNAP information to sort of fast track people into Medicaid coverage when you know they're certainly eligible are also thinking about that on an ongoing basis. So for example, one thing that strikes me as very promising is that SNAP requires either a recertification or new information every six months. And so some states are thinking about, well when I get that information for SNAP I'll just do an addition, you know, do ask the two other extra questions I may need or maybe I don't even need to ask anything else as I already know it and push forward the Medicaid eligibility period for the members of that SNAP household for another 12 months so that if somebody's up to date on their SNAP then they would never have to face a separate new eligibility determination for Medicaid as long as they remained eligible, those kinds of things. And many of the states that have online services also have the ability for people to go on and check their benefits and look and see when their next renewal is coming up and so forth. So I guess that promising yes answer should also come with the caution that there is a lot happening as Elizabeth mentioned and not all states have perfect communication between their human services agencies and their health exchange agencies. It's moving very, very quickly and decisions are being made sort of more with an eye to a coordination between the exchange and Medicaid than with other human services. Many states have a several phased plan where the first phase is aiming towards October of 2013 and there's a lot of pressure to get it up and running for the health insurance for understandable reasons and SNAP will be rolled in or other SNAP and other human services will be rolled in over the next couple of years and so the transition period even in some of the states that are thinking it through the most comprehensive ways it could be a rocky transition period before they have what they intend to have fully in place and then there are other states where as I said that communication has not really begun and so it's likely that there will be I think bigger problems in the short term and the longer term. On the data matching, in my experience the federal rules are not problematic. The barriers tend to be in doing those matches really finding the time, getting the right people to the table, getting people's attorney general's office or the law offices to talk to each other. So it's really a matter of getting the project traction sort of getting the bandwidth in the various organizations to kind of push this thing forward or more of a problem than the other. I mean we've doing matches say with corrections I mean you can go across agencies that you wouldn't intuitively think do a lot of work together and we haven't encountered those kinds of things. My name is Dahmer Hoskins. I realize that the thrust of the program today has been on state provided benefits but SSI has not been mentioned and there are about I think five million people receiving an SSI benefit every month, mostly disabled under age 65 people. How do you see SSI fitting into your package if we're trying to do outreach to the most vulnerable? It is a big program. I know in Maryland there was a couple elements that and I think in other states as well that brought SSI sort of gave it a role even though it's a federal program. One was the deficit reduction act, the rule changes to the TANF program incentivized states to look at their TANF caseload where either adults or children in the household if they were potentially disabled there was a lot of incentive there for them to invest in those families, help them get SSI. So there was outreach that way. A lot of states have general assistance programs. Again, if it's a choice and it really comes down who's going to make that monthly payment is a strong incentive for states to help develop folks applications and try to get them help if the budget allows. It's been pretty tough in the last few years but instead of say paying a state general assistance payment which is usually low to get these folks and if they're disabled long-term to get them over to SSI because we have a much larger check. I think that I mean SSI currently there are projects in a number of states that package SSI with SNAP together where when people apply for SNAP for SSI, I'm sorry, they get a streamlined access to SNAP. I think there's approximately 15 states right now that have those projects in place. I've also, I think there's opportunities for packaging social security and making sure that as social security, I know you're talking more about younger disabled adults but some of them do get OASDI and also Social Security for people who are elderly. I've seen interviews where somebody has a very, very low social security check and I'm quite certain they're eligible for SSI and it's hard for me to imagine how it is that that happens, that people don't get hooked up between those two social security benefits. And then in addition, there's also SSI recipients and most states are eligible for Medicaid automatically and there's pretty good connections there. But with the low income drug benefit, there are opportunities for states to streamline the coordination between when people apply for the low income drug subsidy under Medicare. They are also eligible for Medicaid, wraparound benefits potentially for SNAP and so forth and there are some pilots in some states that are looking at ways of streamlining that connection between state administered benefits and federally administered drug benefit under Medicare. So yes, I do think that this is particularly important because low income seniors and people with disabilities do have very low participation rates in some programs for which, and their benefits may be smaller, but when you package them all together, I think there's a big opportunity for improving people's wellbeing. Hi, my name is Sarah Bajé, I work with Families USA. I have two questions for Ms. Rosenbaum. In addition to Maryland, what other states are moving ahead with integrated applications, not just within health coverage, but across other programs? And then with the likelihood that the federal government will be significantly involved in at least half of the states in terms of setting up the health benefits exchange, what do you think are the prospects for integration across programs in that context? Well, I can tell you the six states that are in the WSS project. I know they're working on integrated benefits under healthcare reform. I mean, let me start by saying currently, I can't remember if this was in my presentation, but I don't think I said it. More than 40 states right now, when you walk through a human services door and you apply for help, you're able to access TANF, Medicaid, and SNAP. So most states right now administer those together. They may also have separate children's health insurance that comes through an online application or is processed centrally or whatnot. But most states do have them integrated right now. The six states that are participating in the WSS project, and you can find these on the Urban Institute website. There's a special website. Our Colorado, Idaho, Illinois, North Carolina, South Carolina, and Rhode Island. I don't think we know the answer to, you know, I mean, I could throw out some rumors sort of what I know about other states, but I think that in many places that these decisions are still being made. Even some of the states that currently administer things very separately, I mean, Rhode Island and North Carolina and South Carolina, which are states in this project, all currently are among the 10 states or 12 states or whatever it is that don't currently administer them together. And so they're moving to integrate. So I think that this is really a big opportunity and pressures are working in both directions. You know, there are people who see the opportunity and are really working to integrate in other places where things are being pulled apart. And it doesn't mean you can't link them up again later, but the risk is that you miss out on this once in a lifetime chance to take advantage of federal resources to sort of lift up all of the human services programs in creating the new eligibility systems and so forth. In terms of the exchange and the half of the states, I mean, several of the states in this project are gonna be in the federal exchange at least at the beginning. I think those details of how the state Medicaid programs in the exchange share information are yet to be worked out, but at some point that application becomes a Medicaid, you know, that they're going to get, if they get filtered through the exchange and get turned over to states for Medicaid determinations, that would be the opportunity to also inquire about interest in SNAP, or actually frankly, to then look at SNAP information and say, are you already participating in SNAP because if you are, which many of the people who are below 133% of poverty in the state that takes the expansion will be, you may not need to ask for any additional information. You may have, I guess my point is that many low income families don't file taxes. And so the information that is because they're not required to, not because they're out of compliance, but they may not be required to file taxes. And so SNAP information may be available in a way that you can fast track their Medicaid eligibility determinations because they provided recent information to the SNAP agency. So I don't think that that really complicates the opportunities for coordinating between SNAP and Medicaid significantly. Thank you very much. I am going to give our panelists an opportunity, if any of you have closing remarks that you'd like to jump in with before we wrap it up, or? Okay, well thank you all very much for coming. Thank you. Thank you all very much for coming. Thank you.