Social services obstacle course...

From Nina Slupphaug, MN2020

While severely compromised due to recent budget slashes, Minnesota does offer a wide array of vital programs for families in need of child care assistance, health care coverage, energy assistance and help with basic food needs. However, certain administrative requirements and a general user-unfriendliness complicate access and create barriers to participation, leaving many eligible and needy families without the support.

Children’s Defense Fund -  Minnesota has looked at selected federally funded programs run at the state level: Child Care Assistance, Medicaid (Medical Assistance in MN), State Children’s Health Insurance Program (CHIP), Supplemental Nutrition Assistance Program (SNAP) and Energy Assistance (LIHEAP) in Iowa, Minnesota, Montana, North Dakota, and South Dakota.

Key barriers to participation are co-payments and premiums for program participation. The report suggests that an increase in premiums of $10 can lead to a 3% decline in health coverage for children whose families have income below 400% of Federal Poverty Guidelines. A sobering thought for our state’s own Minnesota Care, a program where premiums range from $4 per month to $362 for a family of four.  Another big hurdle is the asset limits, which forces some families to spend-down savings in order to qualify, effectively exhausting what little safety net they have.

When it comes to childcare, there could be costly co-pays and gap payments. CCAP states the provider can charge parents the difference between the program subsidy and the cost of care.  In Hennepin County, weekly reimbursement rates for toddler care is $167.17.  For accredited care providers it’s $192.95. The average cost of toddler care is $265/week. In addition to paying the difference, parents also have a co-pay for participation in the program.  The co-pay is calculated based on income and family size, but for a family of three with an income of $27,365 (150% of FPG) the co-pay would be $71/month (2008). Of course, this is all moot unless you’re lucky enough to find a provider participating in the program and with availability for your child.

By the way, at the time of the survey (December 2009), the CDF found Minnesota was the only state with a waiting list for child care. The number: 6,623 eligible families.

Public health care programs in Minnesota, require a period of un-insurance, even for children. With an average pediatric hospital visit topping out at $11,000, it is irresponsible to expect families to keep their children uninsured for months in order to qualify for public health care.

Many program participants and caseworkers cited logistical issues as a big hurdle for families to enroll in programs. Some programs are run out of different locations, and often caseworkers are too overwhelmed to provide assistance with forms and help identifying other programs for which families might qualify. This is a problem identified by a previous MN2020 health care video illustrating troubles a southeastern MN family went through trying to decipher program requirements.

There is good news for Minnesota. It’s been identified as a leader in some aspects of easing accessibility to social safety nets, offering one form for multiple programs, home visits in areas with high transportation barriers, as well as phone interviews for SNAP interviews.

Solid public programs to help families and children in need are invaluable, but only if the people in need are able to access them and utilize them to their fullest extent. Minnesota has made great strides in ensuring this, but there are still improvements to be made. With more and more families struggling, we need to keep our children safe, healthy, and invest in early childhood development. All the above programs strive to do so, now we need to make sure they are accessible.