Audit of the Executive Office of Health and Human Services - Barriers to Access to Public Benefits
September 9, 2019 · Executive Office of Health and Human Services—Barriers to Access to Public Benefits · Read the full official report on mass.gov ↗
Published September 9, 2019 Audit covers July 1, 2015 – December 31, 2017 Under Suzanne M. Bump · 2011–2023
source
“This audit was designed to determine whether there are any barriers deterring or preventing people who are eligible to receive public benefits from accessing those benefits.”
Read the plain-English breakdown
This is a 2019 performance audit of the Executive Office of Health and Human Services, focused mainly on how the Department of Public Health ran access to WIC during the audit period.
“I am pleased to provide this performance audit of the Executive Office of Health and Human Services.”
WIC helps eligible families get food support, health referrals, and nutrition education, so barriers can affect parents and young children who qualify for help.
“WIC provides supplemental food, healthcare referrals, and nutrition education to eligible women, infants, and children who are found to be nutritionally at risk.”
If you or someone you know may qualify for WIC, this audit highlights practical problems that could make it harder to find a provider, understand what foods are allowed, or learn that benefits are available.
“The objectives of this audit were to determine whether there were any barriers affecting eligible persons’ ability to access WIC benefits and whether various state agencies—including the Department of Transitional Assistance (DTA), the Office of Medicaid, and DPH—were sharing information to identify and notify people who were eligible but had not applied for WIC benefits.”
The auditor found three main problems: some WIC materials were not available in participants’ languages, the WIC website had incomplete provider information, and outreach to people who may qualify was not working well enough.
“Below is a summary of our findings and recommendations, with links to each page listed.”
The report recommends that DPH translate more materials, fix and monitor its WIC website, include more benefit recipients in data sharing, test better outreach methods, and improve data matching.
“DPH should adopt the revised data-matching method it found to improve the results of data matching.”
The report matters because eligible people could miss help they qualify for if the state does not clearly communicate, keep location information accurate, and effectively identify and contact people who may be eligible.
“As a result of the above issues, many program participants who are not fluent in English may not be able to use the available information to effectively identify WIC-approved foods.”
WIC is the federal nutrition program for eligible women, infants, and children; DPH is the state Department of Public Health; EOHHS is the Executive Office of Health and Human Services; SNAP is food assistance; TAFDC is cash aid for families with dependent children.
“WIC Special Supplemental Nutrition Program for Women, Infants, and Children”
What the Auditor checked
- Did not comply Are there barriers preventing eligible people from receiving benefits from the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) administered by the Department of Public Health (DPH)?
- Partially Do the Department of Transitional Assistance (DTA) and the Office of Medicaid share applicant information with DPH to identify and notify people who are eligible to receive WIC benefits?
What the Auditor found
Why it matters: Participants who are not fluent in English may not be able to effectively identify WIC-approved foods.
Standard: Massachusetts State Agency Plan of Program Operation and Administration for the WIC Program for Federal Fiscal Year 2017 ( Massachusetts State Agency Plan of Program Operation and Administration for the WIC Program for Federal Fiscal Year 2017 )
2 recommendations
- DPH should assess the resources needed to provide translated versions of shoppers’ lists to WIC participants, attempt to acquire these resources, and then provide the shoppers’ lists in the appropriate languages.agency: disagreed
- DPH should continue to identify the languages that are most commonly spoken by WIC participants and publish the Massachusetts WIC Approved Food Guide in additional languages as needed.agency: disagreed
Agency response & Auditor reply
Agency: "DPH disagrees with the finding that "DPH does not ensure certain information about the Special Supplemental Nutrition Program for Women, Infants and Children is available to participants in their native languages.”"
Auditor: "As noted above, during our audit period DPH did not ensure that certain information about the WIC program was available to participants in their native languages."
Why it matters: Incomplete and inaccurate provider information may inhibit people from applying for WIC benefits.
Standard: DPH is responsible for administering WIC benefits to all eligible Massachusetts residents, including people with physical disabilities.
3 recommendations
- DPH should update its WIC website to include all WIC provider locations and identify all provider locations that are wheelchair accessible.agency: already implemented
- DPH should develop policies and procedures to ensure that WIC provider information is updated on the website as it changes.agency: agreed
- DPH should implement controls to ensure that the provider location information on the WIC website is periodically reviewed for accuracy.agency: agreed
Agency response & Auditor reply
Agency: "DPH acknowledges that at the time of the audit, the Massachusetts WIC website did not list all WIC provider locations or identify all wheelchair accessible provider locations."
Why it matters: Some WIC-eligible people may not be identified or effectively notified about their eligibility.
Standard: DPH data-sharing agreements with the Office of Medicaid and DTA require targeted outreach to families eligible for WIC benefits. ( Data-sharing agreements with the Office of Medicaid and DTA )
3 recommendations
- DPH should modify its data-sharing process to include TAFDC recipients.
- DPH should implement a process to analyze whether postcards are an effective method of contacting potential WIC enrollees compared with other possible options, such as emails or text messages.agency: partially agreed
- DPH should adopt the revised data-matching method it found to improve the results of data matching.agency: disagreed
Agency response & Auditor reply
Agency: "DPH disagrees that WIC’s process for identifying and notifying people who may be eligible for WIC benefits is not effective."
Auditor: "Although we do not dispute DPH’s assertion that it is committed to ensuring that all women and infants who are eligible receive services, our audit identified a number of issues with the process DPH uses to identify and notify people who may be eligible for WIC benefits, which in OSA’s opinion raises concerns about the effectiveness of this process."