Low-Income Home Energy Assistance Program (LIHEAP) Clearinghouse acf home privacy policy
spacer_line

Iowa's Outreach and Targeting Study

Entity
Iowa Department of Human Rights, Division of Community Action Agencies, the LIHEAP grantee

Goal
In early 2000, as part of the Division's review of its performance relative to outreach and targeting both statewide and in individual service territories, the state hired Roger Colton, of Fisher, Sheehan and Colton, Public Finance and General Economics, to investigate mechanisms through which Iowa could seek to enroll additional low-income households in LIHEAP, as well as to reach certain sub-segments of the total population which the program had chosen to target as high priority benefit recipients:

  • the lowest income households;
  • households with children age 6 or younger;
  • households with elderly members (defined in Iowa as aged 60 or older); and
  • households with disabled individuals as household members.

Background /State Issues
The study was completed in the fall of 2000 just as energy prices began to rise in Iowa, additional LIHEAP funding became available, and the state began to experience one of its worst winters in history. As of the end of February 2001, the state's LIHEAP participation had increased by 32 percent due to the combined forces of higher energy prices, extreme weather, additional funding, and increased media attention.

As of March 2001, the state was considering many of the study recommendations, but was withholding decisions on implementation pending more information about 2002 LIHEAP funding.

Outreach Study
Colton's recommendations, published in September 2000 in the paper titled Outreach Strategies for Iowa's LIHEAP Program; Innovation in Improved Targeting, were divided into two parts: (1) those that can and should be pursued at the statewide administrative level, and (2) those that can and should be pursued at the local level. Many recommendations were taken from recent publications and studies on improving the outreach and enrollment in children's health insurance programs (both Medicaid and the Children's Health Insurance Program (CHIP).

Recommended Outreach Activities

At the state administrative level, Colton recommended the following activities for the Iowa LIHEAP:

  1. Adopt adjunctive eligibility in as many situations as reasonable. "Adjunctive eligibility is similar to categorical eligibility, which has been used by some LIHEAP programs since its inception. Recently it has been used by many states to streamline enrollment of low-income, uninsured children into Medicaid or the state funded Children's Health Insurance Program (CHIP.) Through adjunctive eligibility, children already enrolled in other low-income, publicly funded programs such as Head Start or school lunch, would have their eligibility expedited because they do not need to provide duplicative income information in order to qualify."  Adjunctive eligibility can be implemented through two strategies common in other means-tested programs:

    a) Use a joint application for multiple programs, as a number of states do for TANF, Medicaid and Food Stamps.

    b) Target outreach to income-comparable programs: "For example, a state agency administering a program that reaches families with incomes similar to LIHEAP can send all enrolled persons an application, application instructions, and a letter informing them about the availability of LIHEAP benefits. On the other hand, when applying for benefits through an income-comparable program, applicants can authorize the sharing of their names and addresses with LIHEAP, so that LIHEAP staff can then contact them and provide them with applications and assistance in applying." A number of examples of how to obtain authorization are given.

  2. Increase reliance on "outstationed" outreach and enrollment. "In the context of increasing children's health insurance enrollment outstationing has meant locating eligibility workers in places other than welfare offices to take applications. In the Iowa LIHEAP context, outstationing would mean locating intake workers outside of a Community Action Agency. While the CAAs would make the final eligibility determination, the outstationed workers could engage in the initial processing of applications." A variety of states have aggressively implemented the strategy of outstationing intake workers or eligibility workers for Medicaid and other purposes.

  3. Increase LIHEAP's administrative support for non-traditional outreach entities "One of the primary "lessons" to be learned through the considerable effort expended on improving the outreach for children's health insurance programs (both Medicaid and CHIP) is the benefit of expanding the number, and type, of entities that will be used to take enrollment information. Proposals to increase the enrollment of low-income children in both Medicaid and CHIP are equally applicable to LIHEAP in Iowa. One common set of proposals includes expanding the types of entities that can determine a child to be presumptively eligible for Medicaid. States may use additional entities than those that are currently permitted, such as public schools, child care resource and referral centers, and child support enforcement agencies, to determine presumptive Medicaid eligibility for children."

Included in nontraditional outreach entities should be faith-based organizations, Colton wrote, adding that the Iowa LIHEAP program should expressly permit LIHEAP subgrantees to use faith-based services providers as community-based intake sites, and should provide training and technical assistance to support such service providers. He cited a 1998 Washington DC study that showed that a majority of religious congregations offer services to anyone in need; about 70 percent of all congregations service low-income individuals and families; more than one-third of congregations offer services to the residents of the community; and fewer than 10 percent limited services to their members only.

 Recommended Targeting Strategies
Targeting strategies, while initiated at the state level, are often implemented at the local level. Enrollment of any special populations (elderly disabled, etc) into LIHEAP should be built on a strategy of pursuing increased coordination with other public assistance programs, Colton wrote, adding that the targeting recommendations to Iowa were based on the overall philosophy of "go to them; don't make them come to you."

Following are outreach targeting recommendations for specific populations:

Targeting Recommendations For Iowa's Children

  1. Develop targeted outreach for both school-age and non-school-age children through Free and Reduced Price School Lunch Program.
  2. Develop adjunctive eligibility for non-school age children through WIC.
  3. Develop targeted outreach for Food Stamp recipients.
  4. Either (a) contract with school-based centers to engage in outreach; or (b) outstation outreach workers through school-based centers.
  5. Either (a) contract with health-facility-based centers (including local health agencies) to engage in outreach; or (b) outstation outreach workers through health-facility-based centers.
  6. Work with state officials implementing CDC-based programs to encourage each of its grantee agencies to ensure that a low-income child's household is enrolled in LIHEAP every time a child is seen for whatever reason.
  7. Work with state-assisted subsidized child care programs to establish adjunctive eligibility and to enroll child care program participants in LIHEAP.
  8. Enter into an interagency Memorandum of Understanding with the Iowa child support enforcement agency to target outreach to low-income households identified by the agency.
  9. Enter into an interagency Memorandum of Understanding with the Iowa Department of Health to have agencies performing FIPS home visits enroll FIPS participants in LIHEAP at the time of the home visit.

 Targeting Recommendations For Iowa's Elderly

  1. Contract with AOA-funded service providers to deliver outreach while delivering Cluster 1 services.
  2. Contract with AOA-funded service providers to deliver outreach while delivering AOA outreach.
  3. Enlist physicians and other health care professionals in outreach efforts, such as encouraging them to advise their low-income patients to apply for LIHEAP;
  4. Coordinate outreach with other programs providing assistance to low-income older persons. For example, elderly pharmacy assistance programs can help identify individuals with ongoing prescription drug needs, who are potentially eligible for LIHEAP.
  5. Coordinate outreach through local "community health centers" funded through the federal HRSA.
  6. Coordinate outreach with other programs providing assistance to the elderly, in particular, including the U.S. Department of Agriculture's Emergency Food Assistance Program and the USDA's Nutrition Program for the Elderly.
  7. Enter into an inter-agency Memorandum of Understanding with the Iowa Department of Insurance to provide LIHEAP outreach to persons inquiring about QMB/SLMB through SHIIP.
  8. Coordinate LIHEAP outreach with the Iowa Department of Health through its Home Care/Chore and Senior Health programs.

Targeting Recommendations For Iowa's Disabled

  1. Develop a working relationship between the Iowa Department of Revenue and Finance as a means of targeting low-income elderly and disabled residents through the state "circuit breaker" program.
  2. Local LIHEAP agencies should work with county officials to direct local LIHEAP outreach to recipients of property tax relief.
  3. A list of which Parent Information Centers, if any, funded under the Individuals with Disabilities Education Act (IDEA), are located in Iowa should be developed. These centers should be incorporated into the LIHEAP outreach network.
  4. A list of state and local programs funded through the federal Developmental Disabilities Assistance and Bill of Rights Act of 1990 should be developed. Service delivery agencies should be incorporated into the LIHEAP outreach network.
  5. LIHEAP should implement adjunctive eligibility for recipients of benefits through the Supplemental Security Income (SSI) program.

In summary, Colton noted that while above-described outreach mechanisms can be undertaken statewide, they need not all be done everywhere. "Some LIHEAP subgrantees may choose to develop closer relationships with AOA-funded programs (seeking to increase senior LIHEAP enrollment), while other LIHEAP subgrantees may wish to work more closely with school lunch programs (seeking to increase the enrollment of households with children). Some LIHEAP subgrantees may wish to work closely with their local public health programs, while others might wish to work more closely with health centers and health care providers (in support of outreach to either seniors or households with children)."

Contact
Mr. Jerry McKim
Chief, Bureau of Energy Assistance
Division of Community Action Agencies
Department of Human Rights
Lucas State Office Building
Des Moines, Iowa 50319
TEL: (515) 281-0859
FAX: (515) 242-6119
E-MAIL: jmckim@radiks.net


Page Last Updated: December 7, 2005