Direct Verification November 29, 2007 Presentation to School Nutrition Association

Direct Verification

November 29, 2007

Presentation to School Nutrition Association

What is Direct Verification?

• Using information from means-tested programs to verify school meal applications without contacting households

Authorized means-tested programs:

• Food Stamp Program (FS)

• Temporary Assistance for Needy Families (TANF)

• Food Distribution Program on Indian Reservations

• Medicaid (Title XIX)

• State Children’s Health Insurance Program (SCHIP) (Title XXI)

Goals For the Evaluation

• Evaluate DV-M Implementation

Is it feasible?

What types of systems work?

What are the challenges and lessons?

• Evaluate DV-M Effectiveness

What percentage of school districts use DV-M?

What percentage of applications are directly verified?

What do districts think of this tool?

• Participating States: Indiana, Oregon, South Carolina, Tennessee, Washington [Georgia in 2007]

Direct Certification and Direct Verification

Direct Certification Direct Verification

When? Before/during 1st month of school (can be repeated)

After selecting verification sample (October 1)

Data source?

Food Stamp, TANF, FDPIR Food Stamp, TANF, Medicaid/SCHIP

Purpose? Certify without application (& exempt from verification)

Verify application without contacting household

Scale? LARGE – attempt to match all children

SMALL – attempt to match children in verification sample

Why Use Direct Verification with Medicaid (DV-M)?

Potential Benefits of Direct Verification

1. Reduce workload and hassle for school district staff

2. Reduce burden and intrusion on families selected for verification

3. Reduce number of non-respondents and rate of benefit termination for non-response

4. Improve program integrity by checking eligibility with programs that document income information

Advantages of Medicaid/SCHIP Data

1. Directly certified FS/TANF children are exempt from verification.

• Thus, few applications will be directly verified with FS/TANF data.

2. Medicaid/SCHIP income limit exceeds Food Stamp income limits

• Limit at or above NSLP-RP limit (185% FPL) in 46 States.

Number of States by Medicaid/SCHIP Eligibility Limits

14

46

0

10

20

30

40

50

<133% 133-184% >=185%

Medicaid/SCHIP income limit (%FPL)

Nu

mb

er o

f S

tate

s

How Does Direct Verification Work?

Guidelines for Direct Verification with Medicaid

• Timing of data

– Use latest available Medicaid/SCHIP information, no more than 180 days prior to NSLP application date*

• Matching program data to NSLP applications

– Use names and other identifiers of children listed on the NSLP application.

– If Medicaid income limit <133% FPL, a match verifies NSLP-free eligibility. Else, Medicaid info about family income and family size (or income as %FPL) verifies eligibility for NSLP-free or RP.

• Using match results

– Match one child on the NSLP application and all children on the application are verified.

* Or use data from the month prior to application through the month of verification.

Alternative Ways for States to Implement Direct Verification

1. Send Medicaid/SCHIP data to districts

2. Collect application data from districts and match at State level

3. Develop a “look-up system” on the State CN/Education website

4. Provide direct access to existing Medicaid/SCHIP program data system

Level of effort:#1 – Low effort for State#2 – Most work for State (year after year)#3 – Upfront investment, low maintenance cost#4 – Low effort for State if available (depends on existing infrastructure)

Tennessee – Send Medicaid Data to Districts

• State divided file of Medicaid children by county and posted Excel® files on secure website

• Districts downloaded data file from State website and searched manually

• Identifiers: SSN, name, DOB, guardian name, address

• Districts verified NSLP-free eligibility by matching children to Medicaid file

Oregon – Send Medicaid Data to Districts

• State provided statewide file of Medicaid children via secure e-mail

• Districts downloaded data file, opened with their own software—usually Excel®—and searched manually

• Identifiers: name, DOB, FS/TANF #, guardian name, address

• Districts verified free/reduced-price eligibility with family income and household size from Medicaid file

Washington – Send State-Level Match Results to Districts

• State matched Medicaid children with statewide student database by name and DOB, created F/RP indicator based on Medicaid information

• State created Excel® files for selected districts and sent via email (web-based distribution planned for 2007)

• Districts searched manually and checked F/RP indicator

• Identifiers: name, DOB, gender, State student ID #, district student ID #, address, school code and name, Medicaid ID number

South Carolina – Collect NSLP application data from Districts and Match at State Level

• Districts created files of verification sample using State template

• State CN Agency collected disks from districts and sent file to Legislative Office of Research and Statistics (ORS)

• ORS matched verification sample data with Medicaid data by SSN, name, date of birth, etc.

• ORS sent verification sample files with match results to State CN Agency, which sent them to school districts

Indiana - Look-up System on State Website

• State provided form-based interface on secure website

• Query of FS, TANF and Medicaid Data (children eligible in July, August, September, or October)

• Districts login to website and search for individuals using:

– Student name & DOB (phonetic match)

– FS/TANF case #

– Parent/guardian name/SSN

• Search returned identifiers, F/RP status, reference number

Georgia - District Access to Existing Medicaid Data System

• Current Food Stamp/TANF/Medicaid eligibility data available via online inquiry system (“GO”)

• School districts obtained login and installed software to access GO system

• Query by child’s name, DOB (or age), and sex, or by case number, or parent’s SSN

• Case record indicated FS/TANF/Medicaid eligibility and listed case members

• Budget screen provided household income

1. Meet with State Medicaid AgencyDiscuss NSLP verification, direct verification, and data needs

2. Determine how DV-M system will workWhat Medicaid data to provide to districts and how; how to protect confidential data

3. Establish data-sharing agreementsSpecify data elements, formats, timing of exchange; define authority for exchange; provide assurances for protection of confidential data

4. Implement State-level processesDisseminate instructions and/or provide training to districts; prepare data; “go live” with website or by distributing data to districts; ongoing support

Implementation Process

1. Getting access to Medicaid data

Confidentiality issues in Indiana and South Carolina

2. Testing before going live

Income data gap found in Washington; incomplete file for State in Indiana

3. Making it easy for districts to use

Oregon file hard to use; batch matching helpful for large districts; include only the right amount of information

4. “Go live” by October 1

Districts need data and instructions before they start verification; State needs adequate lead time with room for delays

Implementation Challenges in 2006

Results of 2006-07 Survey of Districts

District Participation Varied Across States

27%

41%

100%

44%52%

63%68%

100%

0%

20%

40%

60%

80%

100%

Indiana (N=37)

Oregon (N=34)

Tennessee (N=17)

Washington (N=33)

Percent of all selected

Percent of respondents

Percent of Applications Directly Verified

Among Districts Using DV-M

18%14%

18%

3%

20%

10%

0%

10%

20%

30%

40%

50%

Tennessee Washington

All applications

Free applications

RP applications

Most Districts Found DV-M Easy

Was DV-M easy?

78%

56%

91%

67%

7%

9%22%

37%23%

10%

0%

20%

40%

60%

80%

100%

Indiana Oregon Tennessee Washington

Easy or very easy Indifferent Difficult or very difficult

Mixed Ratings on Usefulness of DV-M

Was DV-M useful?

25%37% 35%

62%5%

15% 26%

11%70%

48%39%

27%

0%

20%

40%

60%

80%

100%

Indiana Oregon Tennessee Washington

Useful or very useful Indifferent Not useful

Most Districts Expected to Use DV-M in 2007

Will you use DV-M next year?

52% 50%70%

84%

14% 22%

16%35% 28% 30%

0%

20%

40%

60%

80%

100%

Indiana Oregon Tennessee Washington

Yes Maybe No

Verification Cost Per Application: All Districts

$1.70

$18.50 $18.00

$0

$4

$8

$12

$16

$20

All districts(N=79)

Direct verif ication Household verif ication Total

Verification Cost Per Application in Districts with Applications Directly Verified

$1.71

$19.31$18.39

$0

$4

$8

$12

$16

$20

DV used,#DV>0(N=56)

Direct verif ication Household verif ication Total

• States have demonstrated technically feasible approaches to DV-M

• Challenges for implementation are mainly on the “soft side”—negotiating agreements, promoting district participation, setting and keeping schedule

• If the State offers DV-M and makes it easy to use, school districts are likely to use it

• Substantial percentage of applications may be verified if data are timely and complete

• Effectiveness of DV-M is primarily influenced by district participation and Medicaid income limits

• When DV-M is effective, it can save time for districts

Summary

Slides for Q&A

• Direct verification time/cost includes:

– Reading instructions and orienting to new process

– Accessing system to download data or search

– Searching for students listed on NSLP applications selected for verification

– Documenting results

• Household verification time/cost includes:

– Sending initial letters to households

– Answering queries from households

– Processing household documents, determining eligibility, and following up if documents are incomplete

– At least one follow-up contact with nonresponders

Time and Cost of Verification Activities - Definitions

Minutes Per Application: Direct Verification Saves Time When It Works

6 6

78

54

78

54

4

90

36

84

42

0

20

40

60

80

100

All districts(N=79)

DV not used(N=8)

DV used,#DV=0(N=15)

DV used,#DV>0(N=56)

DirectVerif.

Householdverification

Total