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Other Matters: Interviews With Providers in the Special Supplemental Nutrition Program for Women, Infants, and Children Indicate That Other Barriers to Accessing Program Benefits May Exist.

Audit identified other barriers related to transportation and immigration issues.

Table of Contents

Transportation

According to Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) providers we interviewed, the largest barrier to benefit access that participants face is transportation. For participants who drive, parking is usually an issue, especially when they are visiting providers in urban areas. Other participants must rely on friends or family for rides or use public transportation. For those in rural areas, such as some locations in central and western Massachusetts, public transportation is generally less convenient; for example, parents and children may have to change buses several times or experience long wait times based on limited bus routes or schedules. Regardless of location, public transportation can be challenging for parents with young children in tow.

The Office of the State Auditor acknowledges that the Department of Public Health (DPH) has limited ability to resolve these issues, but some steps have been taken. In an effort to address transportation-related issues, some WIC providers have requested and received DPH’s permission to set up temporary (mobile) sites to use as WIC service centers as needed. One of these sites was placed in a hospital, which gave mothers with newborns better access to WIC services. Another provider set up a site in a women’s homeless shelter to give this population better access to those services.

Immigration (Public Charge)

Several providers stated that potential consumers may be apprehensive about participating in WIC because of the current political environment and a rule proposed by the US Department of Homeland Security that would add Medicaid and the Supplemental Nutrition Assistance Program (SNAP) to the list of programs that the government could consider when determining whether someone is likely to become a public charge. The website of US Citizenship and Immigration Services defines “public charge” as follows:

An individual who is likely to become primarily dependent on the government for subsistence, as demonstrated by either the receipt of public cash assistance for income maintenance or institutionalization for long-term care at government expense.

Additionally, some providers indicated that consumers are advised by lawyers or advocacy groups to refrain from using public benefits, including WIC benefits, to avoid becoming public charges. According to WIC providers, some participants say they choose not to purchase the groceries that have already been loaded onto their WIC electronic benefit transfer cards because they fear becoming public charges. WIC providers said that they tried to explain to participants that WIC was not part of the proposed rule and that participation in the program would not result in a beneficiary being considered a public charge. Despite providers’ best efforts, many applicants and participants remain concerned about how the proposed changes might negatively affect their immigration status. Since the purpose of the outreach program is to find and inform MassHealth and SNAP users when they are also eligible for WIC, some providers said they feared that the program would reach fewer people if MassHealth and SNAP membership decline. This would cause WIC enrollment to drop as well.

We recognize that DPH’s ability to quell these concerns is limited. However, according to a WIC provider in Lawrence, that city has not seen a noticeable decrease in program participation within the immigrant population as a result of the public-charge issue. The provider attributed this phenomenon to the city’s efforts to educate its population about what a public charge is and reassure them that participation in WIC will not affect a person’s immigration status.

Date published: September 9, 2019

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