Securing the safety net: concurrent participation in income eligible assistance programs.

Participation in women, infants and children (WIC), supplemental nutritional assistance program (SNAP), temporary assistance for needy families (TANF), and medical assistance program (MAP) programs provide critical nutrition and health benefits to low-income families. Concurrent enrollment in these programs provides a powerful safety net, yet simultaneous participation is reported to be low. Underutilization undermines program objectives, client well-being and food security. This paper examines concurrent participation among the most needy WIC clients, those at/below 100% of the federal poverty level (FPL), in SNAP, TANF and MAP. We examined the Maryland state WIC program infant electronic database (N = 34,409) for the 12-month period ending September 2010. Our analysis focused on two-thirds of these infants (N = 23,065) who were at/below the 100% FPL. Mothers' mean age was 26.8 ± 6 years; 20.6% White; 52.7% African American, and 23.4% Hispanic. Approximately 10% of infants weighed <2,500 g and 1.5% weighed <1,500 g at birth. Average household income was $10,160; 55.7% were at/below 50% FPL. Two-thirds (68.4%) participated in MAP, 31% in SNAP and 9% in TANF. Only 8% were enrolled in all three programs whereas 28% were not enrolled in any. There was a statistically significant difference in mean age and household income between multi-program beneficiaries and mothers who solely participated in WIC: 25.6 ± 5 years and $7,298 ± $4,496 compared with 27.2 ± 6 years and $12,216 ± $6,920, respectively (p < 0.001). Among WIC families at or below 100% FPL, only 8% received multi-program benefits. Specific factors responsible for participation on an individual level are not available. To optimize enrollment, a coordinated effort is essential to identify and overcome barriers to concurrent participation among these families.