Economic

Research

Service

Electronic Publications from the Food Assistance & Nutrition Research Program

Seniors’ Views of the Food Stamp

Program and Ways To Improve

Participation—Focus Group

Findings in Washington State

Final Report

By Vivian Gabor, Susan Schreiber Williams, Hilary Bellamy, and

Brooke Layne Hardison, Health Systems Research, Inc.

ERS contact: Elizabeth Dagata

Abstract

This report explores factors that influence Food Stamp Program (FSP) participation among

the elderly and identifies ways to improve their participation based on findings from focus

groups of senior FSP participants and nonparticipants, community-based organizations, and

staff from local food stamp offices. While many seniors felt the FSP provided a valuable benefit, many felt that the benefit levels were too low to make the effort of applying worthwhile.

Two important barriers that seniors felt they faced when applying for food stamps were the

stigma attached to receiving what they see as "welfare" and misinformation about food stamp

rules. Many seniors also felt the application, eligibility, and certification processes were overly complicated and intrusive. Discussants suggested several options for improving access to

the FSP that included simplifying the application process, extending the recertification

process, and changing the delivery of food stamp benefits to make them more user-friendly.

E-FAN-02-012

June 2002

This report was prepared by Health Systems Research, Inc., under a

research contract from the Economic Research Service. The views

expressed are those of the authors and not necessarily those of ERS 

or USDA.
Acknowledgments ii

ACKNOWLEDGEMENTS

This report was prepared by Vivian Gabor, Susan Schreiber Williams, Hilary Bellamy and

Brooke Layne Hardison for the U.S. Department of Agriculture’s Economic Research Service

(ERS), Food Assistance and Nutrition Research Division. The authors would like to

acknowledge the valuable contributions of Elizabeth Dagata, the Project Officer, her colleague

Joanne Guthrie of ERS, and Pat Seward of the Food and Nutrition Service.

Additionally, we extend appreciation to the three other members of the focus group moderating

team--Chris Botsko of HSR; Ernesto Castillo, who moderated the focus groups with Spanishspeaking seniors; and Hyon Ro, who moderated the focus groups with Korean-speaking seniors.

We also would like to thank Lora Quintero of HSR, for her Korean translation of focus group

materials and Tamiko Gary, for her excellent production work on the final report.

This study would not have been possible without the generous commitment and assistance

provided by the Department of Social and Health Services (DSHS), the Children’s Alliance and

many community-based organizations working with seniors in Washington State. In particular,

we would like to thank John Atherton, Carole McRae, Amy Pearson, and field office staff from

DSHS. The focus groups and follow-up strategic planning process to design Washington Statespecific policy and outreach recommendations would not have been possible without the

volunteer efforts of the following advisors: Shelley Curtis and Linda Stone from the Children’s

Alliance, Lua Pritchard and Celeste Lee from the Korean Women’s Association, and Beth Frick

of Senior Outreach Services in Tacoma, Mike Moran and Francesco Guerrero from Cascade

Blue Mountain Food Share, Olga Guardado of La Clinica in Pasco, Celisa Brown and Phoebe

Nelson of the Yakima County Homeless Coalition, Shannon Schuldt of the Fremont Public

Association in Seattle, Patricia Manuel of the Seattle and King County health department,

Margaret Casey and Rosemary Cunningham of Aging and Disability Services, and Alice Kurle

of Hopelink, also in the Seattle area.

Most important, we would like to thank all of the seniors who attended the focus groups and

shared their personal life experiences, views and experiences with the Food Stamp Program. We

appreciate their enthusiasm, candor and creative ideas for improving access to the program for

seniors. 
Table of Contents iii

Table of Contents

Executive Summary .................................................................................................................... i 

Chapter I. Introduction and Background................................................................................ 1

A. Background on the Food Stamp Program and the Elderly.................................... 2

B. Research Questions ............................................................................................... 4

C. Designing and Planning the Focus Groups .......................................................... 5

D. Data Collection Procedures .................................................................................. 9

E. Characteristics of Focus Group Participants....................................................... 11

F. Analysis of Focus Groups and Preparation of the Synthesis Report .................. 13

G. Organization of the Remainder of the Report..................................................... 14

Chapter II. Seniors’ Overall Perceptions of the Food Stamp Program ................................ 16

A. Perceived Benefits of Food Stamp Program Participation................................. 16

B. Negative Perceptions of the Food Stamp Program ........................................... 22

C. Other Sources of Food Assistance and Their Perceived Strengths and 

 Weaknesses for Seniors...................................................................................... 25

Chapter III. Barriers Preventing Seniors From Applying for Food Stamps.......................... 29

A. Stigma and Cultural Barriers.............................................................................. 29

B. Misinformation .................................................................................................. 33

C. Transportation ................................................................................................... 37

D. Communication Barriers at Initial Contact with the Office .............................. 38

Chapter IV. The Food Stamp Application and Recertification Process ................................ 40

A. The Food Stamp Application Process................................................................ 42

B. Food Stamp Recertification and Reporting Requirements ................................ 57

C. Reasons Some Eligible Elderly Participants Leave the FSP ............................. 60
Table of Contents iv

Chapter V. Satisfaction with and Utilization of Food Stamp Benefits................................. 63

 A. Using the EBT System (the “Quest Card”)........................................................ 63

 B. Problems with the Food Stamp Benefit and Quest Card Reported by Seniors .. 70

 C. Other Concerns of Seniors Related to the Food Stamp Benefit and the Quest

Card.................................................................................................................... 73

Chapter VI. Outreach and Enrollment Assistance ................................................................. 80

 A. FSP Information and Enrollment Assistance Reported by Seniors .................. 80

 B. Overview of Washington State Food Stamp Outreach Program ....................... 87

 C. Discussants’ Suggested Outreach Strategies...................................................... 91

 D. Discussants’ Suggested Outreach Messages and Spokespersons ...................... 96

Chapter VII. Discussants’ Suggestions for Changes in Policy and Program Operations .... 100 

 A. State and Local Program Operations ............................................................... 100

 B. Federal Program Rules..................................................................................... 108

Chapter VIII. Key Policy and Programmatic Options............................................................ 113

 A. Options for Changes to Federal Program Rules............................................... 113

 B. Options for Food Stamp Program Outreach .................................................... 115

 C. Options for Improvements to State and Local FSP Operations....................... 116

 D. Conclusion ....................................................................................................... 120

References............................................................................................................................... 121 
Executive Summary v

Executive Summary

The Food Stamp Program (FSP) is a major source of nutrition assistance for low-income seniors

in this country. In Federal Fiscal Year (FY) 2000, 21 percent of all food stamp households had a

head of household 60 years old or older (the technical definition of "elderly" in the FSP), and one

in six food stamp households was comprised of an elderly person living alone. Though the FSP

serves a large number of seniors, the low participation rates, compared to children and adults

under 60 years of age, have long been a cause for concern.

To explore the factors that influence FSP participation among seniors and to identify ways to

improve their participation, the Economic Research Service funded Health Systems Research,

Inc. (HSR) to conduct a series of 17 focus groups with seniors, staff from community based

organizations (CBOs) serving seniors, and staff from local food stamp offices. The study

addressed three distinct groups of seniors living in three communities in the State of Washington:

1) English-speaking seniors, 2) Spanish-speaking seniors, and 3) Korean-speaking seniors.

Many of the Spanish and Korean-speaking seniors included in this study are immigrants eligible

for State-funded food stamps in Washington State. The findings from this study represent the

first published research that examines these issues after the implementation of welfare reform

and that explores FSP issues affecting non-English speaking seniors—a growing population in

this country.

The focus group discussions explored seniors’ views of the FSP, their views on how the FSP

compares to emergency food distribution programs, how seniors learned about the FSP, the types

of assistance they received in applying, and barriers they experienced in initiating and

completing the food stamp application process. Researchers also sought to learn how State and

local policies affected seniors’ continued food stamp participation and their utilization of, and

comfort and satisfaction with the relatively new electronic benefit transfer (EBT) system.
Executive Summary vi

Discussants were also asked to provide suggestions for improving the participation of eligible

seniors in the FSP.

Seventeen focus groups were conducted during the Spring of 2001 with one of three target

audiences. Specifically, six groups were conducted with eligible nonparticipant seniors, five

were conducted with seniors currently participating in the FSP, three were conducted with local

food stamp office staff, and three were conducted with staff from local community-based

organizations that directly serve or advocate on behalf of low-income seniors.

The study was conducted in close cooperation with the Washington State Department of Social

and Health Services (DSHS) and several nonprofit agencies working with seniors at the

community level. The input of staff from these organizations was critical to the development of

the study design and recruitment process, as well as the creation of an action plan based on the

study findings.

The remainder of the Executive Summary reports on the focus group findings with respect to the

key research questions set forth in the study plan. As the full report shows, 131 focus group

discussants from three different target audiences and three different language groups represent a

wide range of impressions, opinions and experiences about seniors and the FSP. However,

several themes were raised consistently across the different communities. In other instances, the

experiences and perceptions of food stamp participants and nonparticipants differed. Also, some

issues and experiences were unique to non-English speaking seniors, immigrants, and working

seniors.

Section A describes seniors’ perceptions of the FSP. Sections B through D address the major

findings related to seniors' decisions to apply for food stamps, the aspects of the application

process that affect their willingness or ability to complete the initial food stamp application

process, and the aspects of recertification requirements that can affect continued participation by

eligible seniors. Section E focuses on a new subject area in the research on food stamps--

seniors’ satisfaction with, and utilization of food stamp benefits under the new EBT system.

Sections F turns to the key options that follow from the focus group findings for changes to

Federal policy, outreach approaches and State and local program operations, food stamp outreach

and modifying program rules and operations to increase food stamp participation among seniors.
Executive Summary vii

The FSP is viewed as

an important and

greatly appreciated

source of financial

assistance.

When compared to emergency

food distribution programs, the

FSP provides seniors more

choice and the ability to obtain

more healthful foods.

A. Seniors' Perceptions of the Food Stamp Program

Seniors’ views on the overall benefits and negative aspects of the FSP are summarized in the

following section. The findings discussed here can be found in Chapter II of the full report.

1. Positive Views of the Program

Across all language groups and among both food stamp participants and nonparticipants, seniors

viewed the FSP as a very positive and beneficial program because of the needed food and

economic assistance it provides for seniors.

The main reasons participants and non-participants cited for applying

for food stamp benefits were to meet a financial need, to fulfill their

basic food needs, and, for some, to be able to buy more healthful

foods they could not otherwise afford and thus to promote healthy eating and good health.

Seniors participating in the program and those not participating said that food stamps were

particularly important to seniors because food stamps can free up available monthly income for

the rising costs of shelter and out-of-pocket costs for prescription drugs. The Spanish and

Korean-speaking immigrant seniors expressed the most appreciation for the FSP and extolled its

benefits. Several seniors said that the food assistance provided by the FSP is an example of the

generosity of the United States toward its people and seniors in particular.

Seniors who participated in both food stamps and received

commodities or other emergency foods from local food

pantries said that they depend on the FSP to meet their basic

food needs and to purchase fresh fruits and vegetables and

meats not available from these food distribution programs.

Several participating and non-participating seniors and CBO representatives said that food

stamps allow seniors to buy the foods they like, and to make their own food choices and thus

promote their independence.

The ability to use food stamps in small, ethnically oriented food stores was also cited by nonEnglish-speaking seniors and those who work with them as an advantage of the FSP over
Executive Summary viii

Some seniors say the

expected food stamp

benefit levels is not

worth the anticipated

difficulties of applying.

Seniors prefer the

more simplified

eligibility process used

by commodity

distribution programs

and other emergency

food providers.

emergency food distribution programs for immigrant seniors who tend to maintain their

traditional ethnic diets when they come to this country.

2. Negative Views of the Program

While both participants and eligible nonparticipants believe there are many benefits to receiving

food stamps, negative views of the program were also expressed by both groups.

Many participants and nonparticipants felt the benefit level they

receive or expect to receive is too low compared to the difficulties

of applying for food stamps. Nonparticipants had more negative

views of the benefit levels available to seniors and of the

paperwork and time required to apply for food stamps. They also

had less accurate information regarding the asset and eligibility rules of the program, compared

to current participants. In fact, several seniors cited the complexity of the application process

and confusion about program rules as the reason they did not apply for the FSP.

When comparing commodity distribution and other emergency food

providers to the FSP, both participants and nonparticipants felt these

programs were much more user-friendly for seniors and easier for them

to navigate. Though, as noted above, they feel food stamps are or could

be a much more dependable and preferable source of food assistance.

Many non-participants also raised concern that the FSP was more

oriented toward helping younger families on welfare than

helping seniors. Seniors voiced concern that they receive a lower

level of benefits and/or have a harder time obtaining food stamps

compared to younger people. Some eligible nonparticipating legal immigrants expressed

concern that newer immigrants receive more food assistance from the U.S. government than

immigrants who are in the country legally and are more settled.

Seniors believe they

are not getting their

“fair share” of food

assistance.
Executive Summary ix

Stigma and pride

prevent some

seniors from

considering the

Food Stamp

Program as a viable

resource.

Misinformation and

confusion about food

stamp rules

discourage some

from applying.

A lack of transportation,

especially in the rural areas,

serves as a barrier to the FSP

among the elderly.

B. Barriers Preventing Seniors From Applying for Food Stamps

Overall, senior focus group discussants had high regard for the FSP and its potential benefits for

low-income seniors. However, focus group discussants in all audiences indicated that some of

the most significant barriers to food stamp participation among seniors occur before they even go

to the food stamp office to initiate the application process. Discussants enumerated five major

barriers to contacting the food stamp office. These barriers are summarized below and are

discussed in greater detail Chapter III of the full report.

Stigma was the most common reason given for not applying for food

stamps. Discussants reported that it might be degrading or embarrassing

to some seniors if others in their families or communities found out they

were receiving food stamps. Some seniors who had worked most of

their lives and never needed government assistance other than Medicare

and Social Security, or who had been able to depend on their families

for assistance, said that asking for help from the FSP was a sign of failure or weakness. Some

seniors said it was pride in their ability to be self-sufficient that prevented them and other seniors

in their community from applying for food stamps.

Misinformation and confusion about the program's

eligibility rules and benefit levels was also cited as a

major reason eligible seniors chose not to apply for

food stamps. Interestingly, several non-participants

said they believed that the food stamp benefits are low for seniors because there are not enough

benefits available for all who need them and because seniors are a lower priority than younger

families.

A lack of transportation was most often cited by CBO representatives as a barrier to program

participation. In rural areas, in particular, the lack of

public transportation and limited transportation

assistance were cited by eligible nonparticipants and

CBO representatives as a significant barrier. Also, in
Executive Summary x

Some seniors are

confused about

stamp eligibility rules

for legal immigrants.

Non-English-speaking seniors have

difficulties reaching someone who

speaks their language when calling

their local food stamp office.

one of the two urban areas where focus groups were conducted for this study, several seniors and

CBO representatives said that the public transportation system is limited and that the bus stops

are not located within walking distance of the food stamp office.

Some legal immigrants were misinformed and/or confused about their food stamp eligibility and

the impact of food stamp participation on their sponsors and/or their ability to become permanent

residents. The three most common areas of misinformation that kept seniors from applying for

food stamps were: 1) The FSP eligibility rules for seniors

sponsored by their families and the liability of these sponsors

for paying back food stamp benefits; 2) confusion about their

eligibility for food stamps based on their previous experience

in other States or with the SSI program; and 3) concern that participation in food stamps would

affect their children or grandchildren’s ability to become permanent U.S. citizens.

Not surprisingly, language issues are a barrier for non-English or limited-English speaking

seniors initiating the food stamp application process. Many non-English speaking focus group

discussants said that when they called the office and

encountered an automated answering service, they just

hung up and did not try to reach the office again. Also,

representatives from CBOs said that Spanish- and Koreanspeaking seniors who call the FSO are often unable to talk

to someone who speaks their language and do not call again.
Executive Summary xi

C. The Food Stamp Application Process

While many of the operating details of the food stamp application process vary from State to

State and by local office, there are three basic steps an individual anywhere in the United States

must take to have food stamp eligibility and benefit levels determined. First, they complete and

submit an application form through the mail or in-person at the office. Second, they participate

in an eligibility interview, during which in-depth information is obtained to determine the

household's income, resources available and any potential deductions that would affect the food

stamp benefit level a household would receive. Lastly, the applicant must provide documents to

verify their household circumstances. Depending on the situation of the applicant, State and

local office policy, and to some extent caseworker discretion, the amount and type of written

verification required of an applicant can vary considerably.

Focus group discussants spent a considerable amount of time describing the aspects of the

application process that deter seniors from applying or that make the process burdensome for the

elderly, limited English-speaking, and immigrant populations. The problems they reported are

presented below in accord with the basic steps in applying for the FSP, starting with completing

the application form to providing documentation. More specific findings related to this topic can

be found in Chapter IV of the full report.

1. Completing the Food Stamp Application Form

The first in a series of steps, the senior applicant must obtain and complete an application.

English-speaking seniors (both current participants and nonparticipants) thought the food stamp application form was too long,

and the questions intrusive and more suited to families with

children. Some seniors also said that the questions and client

notices on the form made them feel guilty or ashamed for applying

for food stamps.

The application form is

perceived as lengthy

and designed to make

people feel ashamed

that they are seeking

food stamps.
Executive Summary xii

Translated application forms are

difficult to understand.

Many Spanish-speaking and Korean-speaking seniors, representatives from CBOs, and some

food stamp office staff also complained that the

Korean and Spanish-language versions of the food

stamp application were extremely difficult to

understand. They attributed the problem to both the quality of the translation and the limited

reading level of the senior applicants.

2. Seniors’ Experiences at the Food Stamp Office

After having completed the application form, seniors can elect to mail it in or submit the

application in-person at the food stamp office. They also have the option to have the application

submitted by another individual who they authorize to do so (an “authorized representative”).

Seniors in all language groups indicated they had or feared they would have uncomfortable

experiences at the food stamp office. Non-participants who

had previous experience with the FSO shared their negative

views about the rude, impersonal nature of the food stamp

staff. Also, a few of the English-speaking seniors reported

feeling uncomfortable due to the crowded nature of the food stamp office and the large number

of young children in the waiting area.

Seniors complained about the long waits they experienced

when they went to the food stamp office, whether to apply or

to complete their interview. CBO representatives noted that

though seniors have to wait in the same area as other younger

applicants, no special seats or other arrangements are made to accommodate the frail elderly

and/or those who are tired from travelling long distances to get to the office.

While the complaints outnumbered positive comments about the front office environment, the

food stamp office offered an important opportunity for socializing for some seniors. Several

English-speaking and Spanish-speaking seniors said they did not mind the wait because they

could see and talk to other people in the waiting room.

Many eligible non-participants

said the front office reception

area is an uncomfortable

setting.

Long waiting times are the norm

and burdensome for many,

though some seniors said they

used the time for socializing.
Executive Summary xiii

The interview process is long and

often unpleasant; however, most

non-participant seniors say they

would prefer face-to-face meetings

over telephone interviews.

Interpretation services are

usually available at food stamp

office, but food stamp workers

note some problems.

Eventually, senior FSP applicants are called from the waiting room and escorted to an office

where they meet with a caseworker and participate in an eligibility interview.

Seniors and the CBO representatives often reported that the eligibility interviews were

inconvenient, time consuming and unpleasant. Discussants’ comments were focused primarily

on the length of the interviews and the unnecessarily repetitive nature of the information being

requested.

However, when asked if they would prefer a telephone interview to a face-to-face interview at

the local food stamp office, most seniors seemed to prefer a face-to-face interview. The Englishspeaking and Spanish-speaking non-participants said that the

option of a telephone interview would not be an incentive to

apply for food stamps. They said they preferred a face-toface interview because it allows for a more personal

interaction with the caseworker and they could better explain

their circumstances in person than over the telephone. Several Korean-speaking seniors

remarked that the need for interpreters during the interview makes a telephone interview less

desirable than a face-to-face interview with an interpreter on-site.

Focus group discussions explored how widely the special medical expense deduction for seniors

and disabled persons was being utilized to determine eligibility for the FSP. Only a few senior

food stamp participants recalled being asked to provide information

on their out-of-pocket medical expenses. Local food stamp office

staff confirmed seniors’ lack of experience with this deduction,

saying that caseworkers do not routinely utilize this deduction because it is complicated to

administer and could therefore negatively affect a caseworker's food stamp payment error rate.

The State food stamp agency in Washington State requires

local food stamp offices to have an interpreter available at

the interview if a limited English proficiency applicant

needs help. Most non-English-speaking seniors in the

The medical expense

deduction is not often

utilized.
Executive Summary xiv

Requirements to obtain thirdparty verification documents are

a barrier to seniors’ food stamp

participation.

Seniors find the re-certification

process burdensome and redundant;

for some seniors its costs outweighed

the benefits of food stamp

participation.

focus groups reported that these interpretation services were available and helpful to them. The

availability of interpretation services seemed critical to their decision to apply. However, food

stamp workers said that many non-English-speaking seniors do not complete the food stamp

application process because using an interpreter is cumbersome, an interpreter is needed at every

stage of the process in all communications with the office, and interpreters are sometimes not

available when needed.

As with the questions asked during the eligibility interview, seniors found the documentation

requirements intrusive, unnecessarily repetitive, time consuming, and difficult to obtain,

especially when they had to be collected from a third-party, such as a bank or landlord. In the

focus groups with Korean-speaking seniors, several individuals

expressed their frustration with these requirements and described

the added difficulties they faced meeting them because they do

not speak English. Several Spanish-speaking and Koreanspeaking non-participants who had previously applied for food stamps, pointed to the onerous

verification requirements as the primary reason they did not complete the food stamp application

process.

D. Food Stamp Re-certification and Reporting Requirements

The initial application process is only the first hurdle to receiving food stamp benefits. To

maintain their eligibility, food stamp participants must re-certify for the program periodically

and those that are working—a large portion of the seniors in the non-English-speaking focus

groups with food stamp participants--must provide periodic reports of changes in their income.

Both current participants and eligible non-participants complained about the time-consuming and

frequent re-certification process. In most locations

where focus groups were conducted, the routine food

stamp certification period for all households, except

those on SSI, was three months. Seniors did not

understand why their caseworker needed to ask the

same questions again and again and request
Executive Summary xv

Some seniors left the FSP

when the benefits changed

from paper food stamps to

EBT cards.

the same forms and verification documents from them. Most seniors who were already

participating in the program wished the process were quicker and less burdensome. A few of the

eligible non-participants in the focus groups who had been on the program in the past indicated

that they left the program because of the paperwork and time required for frequent recertifications.

Working seniors also expressed frustration with the

burdensome nature of ongoing change reporting requirements

and the potential loss of benefits from one month to the next

due to minimal changes in the total hours they worked in a

month. This was expressed as a particular problem for seniors who are recent immigrants and

seasonal farm workers.

E. Satisfaction with and Utilization of EBT Food Stamp Benefits

Once seniors successfully navigate the food stamp application process and enroll in the FSP,

they are faced with a new set of issues related to using the benefits. In Washington State, as in

most States today, the food stamp agency issues its food stamp benefits through an electronic

benefit transfer (EBT) system. Once determined to be eligible for the program, seniors are

issued an EBT card with a set amount of food stamp benefits added to the card each month. The

key findings of the focus groups on seniors' satisfaction with and use of the EBT card are

summarized below. More detailed information and further findings can be found in Chapter V of

the full report.

Focus group discussants who either worked in food stamp offices or community-based

organizations observed that many seniors withdrew

their food stamp applications when the program

changed to the EBT system because they were confused

about how to use the "Quest" card. They reported that

EBT posed more of a problem for seniors than younger food stamp clients because many seniors

do not use debit cards and are intimidated by the technology.

Working seniors report that

change reporting requirements are

burdensome and a disincentive to

remaining on the program.
Executive Summary xvi

Most senior food stamp participants

prefer EBT to paper food stamp

coupons, though non-participants and

CBO representatives cite specific

problems for seniors.

Seniors who are accustomed to saving up

their benefits over several months are

confused by the time limit of benefits on

the EBT card, as well as the notices they

receive in the mail.

However, most current food stamp participants in the English-speaking, Spanish-speaking, and

Korean-speaking focus groups said they were comfortable using the Quest card, preferred it to

paper coupons, and thought that it reduced the stigma of

participating in the program, as well as the potential for

program abuse. Yet, representatives from CBOs,

several non-participants, and a few participants said the

EBT technology makes it harder for seniors to use food

stamp benefits. Drawbacks of the EBT card mentioned included: greater difficulty managing

their limited food stamp dollars; trouble remembering the PIN number; and a lack of certainty

about the remaining value of food stamp benefits still "on the card."

Another drawback of the EBT system that was cited by both food stamp participants and food

stamp office staff was the limited time period during which the EBT food stamp benefits must be

used to avoid “freezing” the benefits on the card. When food stamps were issued as paper

coupons, seniors who received a small amount

of benefits often saved up their monthly food

stamp allotment for larger food purchases.

However, under the EBT system at the time the

focus groups were conducted in Washington

State, State policy required that participants' food stamp benefits be frozen after 90 days of nonuse.

1 (This policy of time limiting the use of EBT benefits after 60 or 90 days is common in food

stamp agencies across the country.)

State policy also required that after two months of non-use, food stamp households were sent a

warning notice that their card would be frozen if they did not use the benefits within the next

month. According to the food stamp office staff and some comments from food stamp

participants, seniors were very confused by these notices. Food stamp office staff said that some

seniors call them with questions and think that their food stamp benefits are being cut off.

Others may never call in and just assume that their benefits have been taken away.

1 In Fall 2001, the State changed its policy on time limiting EBT benefits so that food stamp benefits would not be

frozen until 365 days of non-use.
Executive Summary xvii

F. Key Options for Changes in FSP Policy, Outreach and Program

Operations

The main body of the report discusses the factors that influence FSP participation among seniors,

and includes many suggestions from the focus groups for increasing FSP participation among

both English-speaking and non-English speaking seniors. The key options for changes in

Federal policy, outreach and State and local program operations that follow from the focus group

findings are summarized below. The body of the report provides more details on each of these

recommendations and their rationale.

1. Recommendations for Changes to Federal Program Rules

 Increase the minimum food stamp benefit level.

 Promote a one-stop application process for seniors who apply for other public benefit

programs and move the entire process out of the welfare office setting.

 Develop a pilot demonstration FSP for seniors that delivers food stamp services in a

nutrition and health setting like the Federal WIC program. Participating seniors would be

provided nutrition assessments, nutrition education and referrals to health and social services,

along with their food stamp benefits and education on how to use them.

2. Recommendations for Improved Food Stamp Program Outreach

 Use a combination of one-on-one outreach combined with informational sessions in small

group settings and individualized enrollment assistance.

 Involve community-based organizations and other senior FSP participants in the outreach

efforts.

 Use social marketing approaches such as advertising in local publications that target

seniors, ethnic community newspapers, and on ethnically-oriented media programs.

3. Recommendations for Improvements to State and Local FSP Operations

The following are a list of priority options developed during a one-day strategic planning session

in Washington State. The suggested options for changing State and local FSP operations reflect

the process of a consensus process involving State officials and representatives from community
Executive Summary xviii

organizations and advocacy groups working with and on behalf of seniors. The group’s

suggestions for actions are targeted to eight specific objectives. Each objective addresses an

aspect of FSP operations that was frequently raised as a concern during the focus group

discussions.

Objective 1: To make the food stamp application form easier for seniors to use and

understand by both English and non-English speaking seniors.

 Finalize DSHS' draft shortened and simplified food stamp application form. (See

Appendix E for a copy of the pending revised form.)

 Expand use of online food stamp applications so that more community groups working

with low-income seniors can help them complete a food stamp application and submit it

electronically to the individual's local food stamp office. (Note: this could be encouraged

through trainings across the State with staff from Senior and Disability Services and other

local organizations helping seniors to access public benefits.)

 Improve the efficiency of the online application for local food stamp office staff by

interfacing the online application with the State eligibility computer system.

Objective 2: To expand public awareness about and participation in Washington's

Combined Application Program (WASHCAP) for SSI and food stamps.

 Provide more information and training to local organizations working with

seniors as the new WASHCAP program is being implemented so that they can

better inform seniors about the option and answer their questions and concerns.1

Objective 3: To improve the front office environment for seniors.

 Provide additional and expanded training of receptionists to ensure that they are not

dissuading eligible people from applying, with a special focus on the needs of and

barriers to participation for seniors.

Objective 4: To improve the food stamp eligibility interview process for seniors.

 Promote the option of telephone interviews for seniors who have hardships

traveling to the food stamp office

1 Under a demonstration project authorized by the Food and Nutrition Service of USDA, this winter 2001,

Washington State is launching a multi-year program to simplify and coordinate the food stamp application process

with the Social Security Administration for SSI recipients. For this demonstration, eligible individuals are

unemployed SSI recipients who live alone or buy and fix their food apart from the other people they live with.

These seniors will be able to apply food stamps and SSI in one combined eligibility interview at the Social Security

office and will have a standard benefit amount provided to them.
Executive Summary xix

 Recognize that memory problems and other factors increase the risk that seniors

will miss their eligibility interview appointment, the State should ask local staff to make

reminder calls to senior food stamp applicants prior to their scheduled interview.

 Produce an educational video describing the steps in the food stamp application

process, including the information they will be asked to provide and the rationale for the

interview questions.

 Improve staff training and written information for applicants about what

verification should be required for different types of households.

 Expand use of the excess medical deduction for seniors eligible for this deduction.

Objective 5: To improve program participation among eligible refugees and immigrants.

 Develop updated written educational materials that address the rules for sponsored

immigrants and food stamps and the fact that receipt of food stamps does not threaten an

immigrant's ability to become a permanent resident in the future.

Objective 6: To provide improved translation and interpretation services for potential

food stamp applicants and those that do apply.

 Require local food stamp offices to post signs and instructions (e.g., where clients

need to go or whom they have to see to begin the process) in multiple languages.

 Require local food stamp offices to designate reception windows and up-front

reception staff available all day for non-English-speaking clients.

 Create a statewide 800 number system where non-English-speaking individuals

interested in applying for food stamps can dial into to get information about the FSP or

the application process once they have applied. (Note: Tis could potentially be expanded

for conducting telephone eligibility interviews.)

 Work with community-based groups to properly translate the new shortened

application into other languages.

Objective 7: To improve seniors' utilization of the EBT benefits.

 Train seniors on how they may obtain balance information on their EBT food

stamp accounts and distribute such materials to food stamp outreach contractors, and

workers in Home and Community Services. Eliminate the current State policy which

freezes food stamp benefits if they are not used for three consecutive months.
Executive Summary xx

 Design a method for seniors to more easily use EBT food stamps to make

donations for meals at congregate meal sites and for home-delivered meals.

Objective 8: To reduce the burden of the recertification process for elderly households.

 Lengthen the typical certification period for seniors to 24-months.

G. Conclusion

The findings and suggestions from this focus group research were specific to seniors in three

communities in Washington State. Nevertheless, the issues they raise likely resonate as factors

influencing English and non-English speaking seniors' FSP participation nationwide. The report

merits the attention of a variety of audiences, including Federal policymakers, State officials,

program administrators, and national, State, and community advocates who are interested in

improving access to the FSP for seniors. It is suggested that this report and its findings can spur

similar applied policy research to examine the direct experiences of FSP participants and eligible

non-participants and to identify and respond to the aspects of FSP program operations that can be

improved at the State and local level.
Chapter I 1

CHAPTER I

Introduction and Background

In Fall 2000, the Economic Research Service of the U.S. Department of Agriculture awarded

Health Systems Research, Inc. (HSR) a cooperative agreement to conduct focus group research

to explore the factors that influence Food Stamp Program (FSP) participation among the

elderly and to discover ways to improve their participation. The study examined these issues

for three distinct groups of senior citizens: English-speaking elderly, Korean-speaking elderly,

and Spanish-speaking elderly. The findings from this research represent the first published

research that examines these issues after the implementation of welfare reform and that

explores FSP issues affecting non-English-speaking seniors—a growing population in this

country. While looking at factors that affect all seniors, this study also explored the language

and cultural differences that may pose unique obstacles to FSP participation, as well as some

issues specific to legal immigrants.3

 In total, 17 focus groups were conducted in three

communities across Washington State during the Spring of 2001. The findings from the

research are summarized in the chapters that follow.

This study was conducted in close cooperation with the Washington State Department of

Social and Health Services (DSHS) and several nonprofit agencies working with seniors in

three targeted demographic communities. Their input and voluntary contributions of time were

critical to the development of the focus group protocols, the selection of the targeted

communities, and recruitment for the focus groups. Representatives from these organizations

also provided input to the study’s findings as discussants in the focus groups with food stamp

and community-based organization (CBO) staff. They were also the members of the group

that HSR brought together in fall 2001 to develop an action plan, based on the study’s findings,

 

3 FSP eligibility for immigrants in Washington State is broader than for the Federal program because the

State funds food stamp benefits for legal immigrants that became ineligible for Federally-funded food stamps

under the Personal Responsibility and Work Opportunity Reconciliation Act of 1996.
Chapter I 2

for modifying State and local FSP operations to improve participation among eligible seniors

in Washington State.

A. Background on the Food Stamp Program and the Elderly

Longer life expectancy, coupled with the aging of the “baby boomer” generation, is driving the

growth of the elderly population in the United States to record levels. Currently, persons over

age 60 make up 16.5 percent of the U.S. population. In less than thirty years they are expected

to comprise 20 percent of the total population (U.S. Bureau of the Census, 2000).

Despite the improved economic status of older persons as a group, in 1998 the poverty rate

among minority and urban-dwelling elderly was much higher than for the age group as a

whole. While the poverty rate for elderly whites was 8.9 percent, it was 26.4 percent for

elderly blacks and 21 percent for elderly Hispanics. In the largest urban areas, the overall

poverty rate among the elderly is 13.8 percent (U.S. Bureau of the Census 1999). As older

Hispanic Americans and elderly from other ethnic groups continue to make up an increasing

share of the elderly population, the poverty rate among the elderly is likely to expand (U.S.

Bureau of the Census, 2000).

The FSP is a major source of nutrition assistance for low-income elderly in this country. In

Federal Fiscal Year (FY) 2000, of the 7.3 million food stamp households, 21 percent (1.5

million) were elderly households (with the head of household being age 60 or older). One in

six (16.7 percent) food stamp households was comprised of an elderly person living alone

(Food and Nutrition Service, 2001).

Recognizing the particular living circumstances of many low-income seniors, including the

relatively higher proportions of seniors compared to younger adults whose health is frail and

have limited access to transportation, as well as their fixed incomes and dependence on

resources saved throughout a lifetime, the FSP has many special rules regarding eligibility and

benefit determination for elderly households. Many of these rules were specific issues

discussed during the focus group discussions about the food stamp application process and are

described in the findings of Chapter IV. A complete listing of these rules and their policy

rationale is provided by a recent publication of the Food and Nutrition Service, titled “Food
Chapter I 3

stamp special rules for the elderly or disabled,” and can be found on the FNS web site at

http://www.fns.usda.gov/fsp/MENU/ELDERLY/Specialrules.HTM. 

Though the FSP serves a large number of seniors and has built in program modifications

designed to improve program participation for this population, their relatively low participation

rates have long been a cause for concern. The eligible elderly are much less likely to

participate than are persons in other age groups. Recent data indicate that only 29.2 percent of

the potentially eligible elderly population participate in the program, compared with 88 percent

of eligible children and 71 percent of adults under the age of 60 (Castner and Cody, 1999). 

The low food stamp participation rate among the elderly is not a recent phenomenon. Actual

elderly food stamp participation was less than two-fifths of its potential throughout the 1980s

and 1990s. However, the published literature on the reasons for low FSP participation among

the elderly is relatively limited. The research that does exist focuses primarily on reasons

seniors choose not to apply and other factors that discourage participation. The available

research offers few insights on how specific aspects of the food stamp application and

recertification process influence seniors' willingness to complete the application process or stay

on the program once they are participants. There are also no published studies on seniors’ use

or understanding of the electronic benefit transfer (EBT) systems and the magnetic EBT cards

that have now replaced food stamp coupons in nearly all States. 

The most comprehensive recent qualitative research on reasons for nonparticipation in the FSP

was conducted by Ponza and McConnell. In 1996, these authors published research based on

six focus groups conducted with seniors in six States. The report summarizing these focus

group findings, titled Reaching the Working Poor and Elderly Study: What We Learned and

Recommendations for Future Research, is limited in its findings regarding the elderly because

the findings present the working poor and elderly as one single group (Ponza and McConnell,

1996; McConnell and Ponza, 1999). Thus, HSR’s study attempted to fill the gaps in this study,

among others.
Chapter I 4

B. Research Questions 

Early on in this study, the broad research objectives to document factors influencing seniors’

access and participation in the FSP and develop recommendations for improving their

participation were translated into nine research questions that guided the development of the

focus group protocols and the analysis of the focus group discussions. The research questions

are listed below in Figure 1-1, with a notation as to the chapter that covers the findings for each

question. 

For each of these questions, the research was designed to obtain findings on the particular

perspectives, experience, and concerns of non-English-speaking seniors who are noncitizens

and legal immigrants eligible for food stamps in Washington State.

Figure I-1.

Study Research Questions

1. How do seniors believe the FSP is or can be beneficial for them and others like them? 

 (Chapter 2)

2. What overall negative views do seniors have about the FSP? (Chapter 2)

3. What are seniors’ views on alternative food assistance benefits, such as emergency food

distribution programs? (Chapter 2)

4. What are the barriers that discourage seniors from contacting the food stamp office to apply

for benefits? (Chapter 3)

5. What aspects of the FSP application process are deterrents to seniors applying or

completing the application process once they begin? (Chapter 4)

6. What aspects of the recertification process may be affecting seniors’ willingness or ability

to continue to participate in the FSP? (Chapter 4)

7. What are seniors’ experience, satisfaction, and problems associated with the food stamp

benefit and in particular the use of the relatively new electronic benefit transfer (EBT)

system for food stamps? (Chapter 5)

8. How do eligible seniors currently hear about the FSP as a potential benefit for them and

what kind of enrollment assistance do they receive? (Chapter 6)

9. How could Federal policies, outreach strategies, and State and local program operations be

changed to improve FSP participation among low-income seniors? (Chapters 6,7 and 8)
Chapter I 5

In reviewing the study findings on factors influencing FSP participation among the elderly and

the summary of recommendations to increase FSP participation among seniors, it is important

for readers to note the strengths and limitations of focus group research. Focus group research

provides qualitative information from open-ended questions. Discussants for each focus group

are selected in a purposive manner to meet the criteria of each target group. In this study, no

attempt was made to select representative samples of FSP participants, eligible nonparticipants,

or the staff in the organizations working with them. Hence, the findings of this research are

neither representative for seniors nationwide nor the communities where the groups were

conducted. Rather, the findings of this study are intended to confirm previous quantitative or

qualitative research findings, generate new hypotheses, and develop new policy options for

consideration. These hypotheses and policy options can be further tested through more

extensive quantitative research, including surveys of a nationally representative sample of the

population of interest and/or evaluation research on the FSP participation impact of particular

changes in FSP policies or practices.

C. Designing and Planning the Focus Groups

As noted in the introduction to this chapter, HSR conducted a total of 17 focus groups. At

most of the sites, two focus groups were conducted with elderly FSP participants, two groups

were conducted with food stamp eligible seniors who were not participating in the FSP, one

group was conducted with staff from a local food stamp office, and one group was conducted

with staff from community based organizations (CBOs) working with seniors in that

community. Table I outlines the number of groups held with each type of audience.
Chapter I 6

Table I-1.

Focus Groups Conducted

Targeted Communities

Audience

English-speaking

seniors in Seattle

Spanish-speaking

seniors in Central

Washington

Korean-speaking

seniors in

Tacoma

All

Eligible

Nonparticipants

2 2 2 6

Participants 14 2 2 5

Food Stamp

Office Staff

1 1 1 3

CBO Staff 1 1 1 3

Total 5 6 6 17

The sections below describe how the elderly groups and target communities were selected and

the focus group recruitment process. 

1. Identifying the Target Groups and Sites

The focus groups with English-speaking seniors were conducted in Seattle; the groups with the

Korean-speaking elderly were conducted in Tacoma (a mid-sized urban area); and the Spanishspeaking elderly were from rural parts of central Washington, with the focus groups held in the

towns of Yakima and Pasco. In each of these communities, focus groups were also held with

local food stamp office staff and representatives from local community-based organizations to

obtain their perspectives based on their experiences providing food stamp services, outreach,

other direct services or advocacy for low-income seniors. 

The original study plan had not specified which Asian immigrant population would be targeted

for this study. The Korean-speaking population was selected based on informal interviews

with organizations in Washington State serving immigrants and refugees. These groups

identified Korean-speaking seniors as one of the population groups with the lowest FSP

participation rate among all Asian and Pacific Island immigrant groups in the State. 

After selecting the demographic target groups, one of the next steps in the focus group study

was to identify the communities where the focus groups would be held. To inform the site

 

4 Focus group recruiting was conducted for two groups of nonparticipants and two groups of participants

in each of the three communities. However, one FSP participant group in Seattle had to be canceled because too

few seniors were able to attend the discussion group that day.
Chapter I 7

selection process, HSR worked closely with the DSHS, representatives from the offices on

aging, and private non-profit community organizations working with seniors, including groups

that specifically work with Hispanic and Asian immigrant and refugee populations. HSR

considered a number of factors about each potential study site, including whether the site was

urban or rural, input from State agencies and community-based organizations serving lowincome seniors in Washington State, and the availability of an organization with bilingual staff

for recruiting Spanish-speaking and Korean-speaking discussants. After reviewing this

information, HSR proposed several potential study sites to DSHS. After further consultation

with DSHS, Seattle, Tacoma, and Central Washington were selected as the three final study

sites. 

2. Focus Group Recruitment 

The first step in recruiting the groups was to set very clear definitions for the characteristics of

the individuals who could be included in the elderly participant and nonparticipant groups.

The first aspect of the definition that needed clarification was the term elderly. To remain

consistent with the FSP, we used the program's definition of elderly, age 60 or older. Next,

because seniors who live alone or in households with only other seniors have lower FSP

participation rates than seniors who live with younger adults or children, only elderly who

lived alone or with other seniors were included in the groups. To identify eligible

nonparticipants, detailed and verifiable eligibility tests comparable to the FSP eligibility

determination process could not feasibly be conducted for focus group recruits, so a brief

screening questionnaire was developed to ensure that the eligible nonparticipant groups were

comprised of elderly who were "likely FSP-eligible" based on their income and assets. In

addition, any seniors who had applied for and been denied food stamps within the last six

months were not eligible for the nonparticipant focus groups. Finally, participation in both the

Korean-speaking and Spanish-speaking groups was obviously limited to seniors whose primary

language was Spanish or Korean and who spoke little or no English. A copy of the screening

questionnaires developed by HSR for recruiting elderly participants and eligible

nonparticipants can be found in Appendix B.

The food stamp participants and eligible nonparticipants were recruited by representatives

from nonprofit agencies working with seniors in the three targeted geographic communities
Chapter I 8

(advisory committee members). Each recruiter received a set of detailed recruitment

instructions, screening questionnaires to ensure that only persons who met the group definition

were invited to attend the focus groups, recruiting posters, and sign-up sheets to be returned to

HSR for review during the final two weeks before the focus groups were held. 

Based on their own experiences and resources in the communities they service, the recruiters

used a variety of outreach and networking strategies. In Tacoma, advisory committee

members recruited Korean-speaking food stamp participants primarily from existing lists of

clients who received food stamp outreach from the Korean Women's Association. In Seattle

and Central Washington, advisory committee members primarily depended on in-person oneon-one outreach at various community sites, including senior congregate meal sites, senior

centers, public housing projects, community health centers, food pantries, grocery stores,

churches, bingo halls, and nutrition education classes for seniors. Recruiters also advertised in

the community using posters, flyers, community newspapers, and radio public service

announcements to elicit calls for further information from low-income seniors. 

a. Recruiting Food Stamp Office Staff

The discussants recruited for the focus groups with food stamp office staff were caseworkers

and supervisors from the local food stamp office (called a "community service office" in

Washington State). The food stamp workers for the groups in Seattle and Pasco (in Central

Washington) were recruited from one community service office; workers for the groups in

Tacoma were recruited from two community service offices that serve a large share of the

Korean population and are located in the same building. The recruitment of food stamp

workers was conducted by HSR based on potential names provided by DSHS regional field

supervisors for each of the three communities. The recruitment lists were screened to ensure

that only caseworkers and supervisors responsible for intake and ongoing maintenance of

elderly food stamp cases were invited to participate in the groups. In the offices with smaller

food stamp caseloads usually all workers handling elderly food stamp cases were recruited to

attend the focus group for their site.

b. Recruiting CBO Representatives 
Chapter I 9

HSR staff also conducted recruitment for the CBO groups. The first set of recruits for these

groups was selected using contact names provided by the local advisory committee members.

These recruits were screened by telephone to determine whether they provide services that

administer programs to the targeted low-income seniors in their community. Additional names

for potential recruits were obtained from these primary contacts. Discussants in these groups

included individuals who work for senior centers, advocacy organizations, food stamp outreach

programs, health departments or clinics serving low-income seniors, senior information and

referral hotlines, and food banks, among others. (A list of the organizations participating in

each CBO focus group is provided in Table A-3 of Appendix A.)

D. Data Collection Procedures

The focus groups were conducted in a two-week period during the last week of April and the

first week of May 2001. HSR staff moderated and co-moderated all of the groups conducted in

English. A Spanish-speaking moderator was contracted to conduct the four groups with

seniors in Pasco and Yakima (Central Washington) and an HSR staff member who is fluent in

Spanish co-moderated those groups. A Korean-speaking moderator was contracted to conduct

the four groups with seniors in Tacoma, and an HSR staff member who speaks Korean comoderated. All of the sessions were tape recorded and then later transcribed for analysis.

Most of the groups with seniors and CBOs were held in conference rooms at community

centers. The groups with Korean-speaking seniors were held in a professional marketing

research center, so that the groups' comments could be simultaneously translated and taperecorded into English by a Korean-speaking interpreter in an adjacent room. The groups with

seniors and the CBO groups were purposely not conducted at a food stamp office in order to

draw a clear distinction between the researchers and the State food stamp agency. This

reinforced efforts to assure discussants that their responses would remain confidential and not

affect their food stamp benefits, potential eligibility, or working relationships with DSHS staff.

On the other hand, to ensure maximum participation of the food stamp staff, the groups with

food stamp caseworkers and supervisors were conducted in food stamp offices. 

The sessions lasted from one and one-half to two hours and low-income seniors were given a

gift certificate from a local grocery store (ranging from $35 to $50) at the conclusion of the
Chapter I 10

sessions.5 Each of the seniors were asked in advance if they needed transportation assistance,

and free roundtrip transportation to and from the focus group site by van, car, or taxi was

provided to those requesting it.

The focus group discussions consisted of a series of open-ended questions about which the

participants were encouraged to talk among themselves. The protocol was developed around

the ten research questions central to the study. A written protocol with specific questions and

probes was prepared for the moderators to use with each of the different groups. However, in

order to maximize participation from the group and to conform to the particular experiences,

size, and dynamics of each group, the discussions remained flexible in the order of the topics

discussed and the probes used for each topic. The probes in these protocols served as a guide

for the moderator to ensure that the same key questions and follow-up issues were addressed

with each group, though they were not actually questions that were read verbatim. (Appendix

C contains the eight protocols used in the focus group discussions.)

Elderly focus group participants in each audience type were presented with the same

introductory remarks, and were asked about similar topics. Only current and past participants

were asked in detail about their experience with the FSP application process. The

nonparticipant focus groups also addressed alternative food assistance resources and seniors’

views of these compared to the FSP, as well as their reasons for not participating in the FSP.

Discussions with Korean-speaking and Spanish-speaking groups included additional probes to

elicit discussions about language barriers and cultural concerns that may influence their

participation in food stamps and their use of food stamp EBT benefits. Views on how to

improve FSP participation were solicited from discussants in all the groups.

E. Characteristics of Focus Group Participants 

As noted above, 17 focus group discussions were conducted for this study: five in Seattle, six

in Central Washington, and six in Tacoma. In all, there were 131 focus group participants,

including 82 elderly persons, 26 food stamp staff from four food stamp offices and 23

 

5 Focus group discussants in Tacoma and Central Washington each received $35 in food gift certificates; focus

group discussants in Seattle each received $50 in food gift certificates.
Chapter I 11

representatives from 19 CBOs attended the focus groups. The general consensus in qualitative

research literature is that between eight and ten participants is the optimal size for focus group

discussions. On average, eight participants engaged in the focus group discussions for this

study.

1. Demographic Characteristics of the Elderly Discussants

Tables A-1, A-2, and A-3 in Appendix A summarize the demographic characteristics of the

focus group participants. The age of the elderly discussants ranged from 60 to 90 years old,

with the average age being 69 years old. Sixty-one percent of all of the senior discussants were

female. The demographic information of the discussants in the English-speaking, Koreanspeaking and Spanish-speaking groups are detailed separately below.

 English-speaking seniors. In the three focus groups with English-speaking

seniors there were a total of 19 discussants. Over two-thirds (13 of 19) of

discussants were female and 84 percent (16 of 19) had completed at least their

high school education, with five seniors completing at least one year of postsecondary education. 

 Korean-speaking seniors. There were a total of 29 Korean-speaking

discussants in the four focus groups with seniors in Tacoma. In these groups 27

individuals were born in Korea and two were born in Japan. Forty-five percent

(13 of 29) of these discussants were female. Fifty-nine percent (17 of 29)

completed at least their high school education, including five seniors who went

on to complete college. 

 Spanish-speaking seniors. The largest number of senior recruits were in the

Spanish-speaking focus groups, where the majority (19 of 34) were immigrants

from Mexico, two were from Cuba, one from El Salvador, and 12 were born in

the United States. Nearly three-quarters of these discussants were women. As a

group, their education level was much lower than among the discussants in the

other groups, with only 15 percent (5 of 34) having completed high school or

post-secondary education. 
Chapter I 12

2. Exposure to the Food Stamp Program

In the FSP participant groups the average length of the discussants' reported current

participation stay was 2.5 years, ranging from 1.5 months to over 10 years. When eligible

non-participant senior discussants were asked about their previous experience with the FSP, 59

percent (27 of 46) had received food stamps in the past (though more than six months prior to

the time of the focus groups). Yet, of the 19 currently eligible nonparticipants who had not

received food stamps in the past, the large majority had never been to a food stamp office or

even considered applying for food stamps. Thirteen of 19 had never been to a food stamp

office and 10 of those individuals had never even considered applying for food stamps before

the focus groups.

3. Seniors’ Social Support Networks

During our focus groups we asked questions about the social support networks of the elderly

discussants. Most of the senior discussants in the focus groups lived alone or with other

elderly family members, most commonly a spouse. Some lived with their children, though

they said they prepared meals separately from other members of the household, generally

because of their special food preferences or health issues requiring special diets. Though all

seniors in the focus groups bought and prepared food alone or with another senior, living with

their families was common among the Hispanic discussants in Central Washington, somewhat

common among the Korean-speaking discussants in Tacoma, and rare among the Englishspeaking discussants in Seattle. 

Among the English-speaking seniors, who mostly lived alone, many lived in senior housing

complexes, were very involved at their place of worship, or at senior centers. The staff and

other seniors at these sites seemed to be these individuals' primary source of social contact and

support. Some seniors living in public housing for mixed aged groups said they were afraid to

socialize with neighbors due to the risk of violence and other crimes.

In the Korean-speaking and Spanish-speaking focus groups, several of the seniors were

working at part-time jobs. These individuals tended to be legal immigrants who do not receive

private pension, SSI, or social security benefits. Korean-speaking and Spanish-speaking
Chapter I 13

seniors in the groups were also likely to be involved in language and culture-specific

community-based organizations. A few seniors in these groups also mentioned English as a

Second Language (ESL) classes as a way to meet people and make friends.

4. Demographics of the Food Stamp Office Staff

All but 3 of the 26 discussants in the three focus groups with food stamp staff were women.

The number of years they reported working with the FSP ranged from 1.5 to 30 years. In the

Seattle office, 5 of 8 staff discussants reported they speak an Asian language; in the Tacoma

office, 3 of 9 staff reported that they speak Spanish and 1 man reported that he speaks

Cambodian; in the Pasco food stamp office, which serves a large concentration of the lowincome Hispanic population in the area, 7 out of 9 staff reported that they speak Spanish. 

F. Analysis of the Focus Groups and Preparation of the Synthesis Report

After the groups were conducted, the focus group tapes were transcribed. The discussions

from these 17 focus groups generated nearly 550 pages of transcripts. These transcriptions

were reviewed by the HSR moderators and co-moderators for the focus groups, who were the

primary authors of the report. The authors developed a coding system containing roughly 60

codes that closely mirrored the topics and subtopics included in the focus group protocols. The

first three transcripts were reviewed and coded by two researchers to ensure that both

researchers were interpreting and using the coding system in the same manner. After these

researchers compared their coding of these first transcripts, they revised the coding scheme and

the remaining focus groups were coded. (A copy of the coding scheme used to analyze the

transcripts is contained in Appendix D.)

The coded transcripts were then entered into NUD*IST, a qualitative research software

package. HSR researchers retrieved and sorted passages from all 17 focus groups by codes in

the coding system. The authors of this report then summarized the information gathered

during the groups by subject matter, examined the ways in which participants’ beliefs and

opinions varied by audience type and by community, and identified representative quotes for

inclusion in the report. HSR elected to include many of these quotes from focus group

participants to give a voice to the seniors, the food stamp staff, and the representatives from
Chapter I 14

CBOs. The quotes, particularly from the seniors themselves, offer valuable insight into the

attitude of discussants and specific examples to the summary of the findings.

During the first week of October 2001, HSR held a strategic planning session with

representatives from the State DSHS office—including staff responsible for the State FSP

outreach program, FSP policy, and field operations—and nonprofit organizations that acted as

advisory committee members during the planning and recruitment process for the study. (The

October meeting participant list is contained in Appendix F.) The goal of this meeting was to

review the focus group findings and develop an action plan for specific changes in State and

local program operations that address the identified barriers to FSP participation among the

elderly (including recommendations specific to immigrants and the general population of nonEnglish-speaking seniors). The plan that resulted from this meeting included eight objectives

with specific recommended action steps for accomplishing each objective. Many of these

programmatic recommendations, while developed specifically for Washington State, were

based on operational FSP issues that may be common to other States and localities. These are

outlined in the final key recommendations chapter of this report. 

G. Organization of the Remainder of the Report

The remainder of this report summarizes the focus group discussions. Chapter II reviews the

findings regarding seniors' perceptions of the FSP and how nonparticipants view other forms of

food assistance compared to the FSP. Chapter III discusses the barriers preventing eligible

seniors from applying for food stamps, including misinformation they have acquired, issues

related to stigma and pride, transportation barriers, and their interaction with the food stamp

office by telephone. Chapter IV details seniors' experiences and views of the food stamp

office, the application process, and requirements for continued participation and how this

influences their participation decisions. Chapter V focuses on seniors’ understanding and use

of the EBT system that is intended to reduce the stigma associated with food stamp use at

grocery stores. Chapter VI summarizes how the seniors in the focus groups said they heard

about the FSP and types of assistance they have received during the application process. This

chapter also explores discussants' recommendations for messages and methods to reach out and

persuade eligible seniors to participate in the FSP. Chapter VII provides the discussants’

recommendations on how program rules should be changed to improve the perception of and
Chapter I 15

access to the FSP for seniors. When they exist, differences among participants and

nonparticipants and between the English-speaking, Spanish-speaking, and Korean-speaking

groups are noted. The final chapter summarizes the key recommendations for changes in

Federal policy, outreach strategies, and State and local-level program operations that follow

most directly from the study findings. The recommendations for specific changes in program

operations were developed during a strategic planning meeting with Washington State

officials, staff from community-based organizations and advocacy groups. While these

recommendations were developed for Washington State, many are applicable to any State or

local jurisdiction seeking to improve FSP participation among seniors. 
Chapter II 16

CHAPTER II

Seniors’ Overall Perceptions of the Food Stamp Program

This chapter includes a discussion of the perceptions of the Food Stamp Program (FSP) by

both eligible seniors who are aware of the program but not participating, as well as those who

currently receive food stamps. Because eligible nonparticipants generally had more negative

views of the FSP, the research also sought to understand where these low-income seniors

would obtain food assistance and how they assess these alternative sources of help. Some

information as to how community-based organizations and food stamp office staff believe

seniors view the program is also included here, though the primary emphasis of this chapter is

on the perceptions of seniors themselves.

A. Perceived Benefits of Food Stamp Program Participation

Focus group discussants were asked to describe the benefits of getting food stamps.

Participants were asked their views of the program's benefits for themselves, while

nonparticipants were asked about their perceptions of the benefits of the program for lowincome seniors like them. Despite concerns expressed regarding the difficulties and barriers

associated with enrolling and staying on the program (discussed in subsequent chapters of this

report), most focus group discussants viewed the FSP as a critical form of food assistance for

themselves and other low-income seniors.

When asked to describe the benefits of the FSP to themselves and others like them, seniors in

the focus groups provided a range of responses. However, most of the views expressed can be

grouped into the following five broad categories of benefits:
Chapter II 17

 Food stamps are an important and positive source of food assistance;

 Food stamps allow seniors to buy healthful foods they like;

 Food stamps promote independence for seniors;

 Food stamps provide needed economic assistance; and

 Food stamps are viewed as a health promotion program.

1. Food Stamps are a Positive and Important Source of Food Assistance

When asked to describe what the benefits of the FSP are, the most common response was that

food stamps allow participants to buy the food they need and want and would not otherwise

have access to. Several seniors who participated in the program made it very clear that they

depend on food stamps to meet their basic food needs.

“We are basically depending on food stamps for all our food because we are not able

to work.” (Tacoma participant, translated from Korean)

“If you go in the kitchen and look for just a biscuit and there isn’t any there, what are

you going to think about? Your food stamps.” (Seattle participant)

“It allows you to buy some food when you ain’t got none.” (Seattle participant)

“Food stamps keeps the wolf away from the door.” (Seattle participant)

Non-participants who had been on the program in the past as seniors said that when they were

on the program, the benefits provided assistance that they really appreciated and that was

critical to meeting their basic food needs. One nonparticipant said that if he could get on food

stamps he knew the benefit levels were likely low but they could provide a few weeks of

needed food assistance.
Chapter II 18

"(Food stamps) allow you to buy basic foods that you need just to live

everyday. That's about all there is in it, but to me that was great." (Seattle

non-participant)

“It’s giving you better food for survival.” (Tacoma non-participant,

translated from Korean)

“I would be able to have food for a few weeks if I could get food stamps.”

(Seattle non-participant)

Focus group discussants were asked their overall opinions, good and bad, about the FSP. The

Korean- and Spanish-speaking seniors, participants and nonparticipants, were so pleased and

grateful that they and other immigrants can receive this type of food assistance in America.

Their comments were so positive that they almost seemed confused by the question asking

them what they did not like about the program.

"If I were to live in Korea right now the senior citizens get free tickets to

subways, but that's about it. Now that I am in America you get food stamps

and you get Medicare. All I just want to say is that I am thankful and while

I live in America I will just abide by the American rules and regulations."

(Tacoma participant, translated from Korean)

"I was grateful for America. I was amazed that America provided such a

program." (Tacoma participant, translated from Korean)

"No, there shouldn't be any bad things (about getting food stamps). Think

about it... Why would it be bad to get help you need buying food?"

(Tacoma nonparticipant, translated from Korean)

"I saw it as a very good program for everybody because one was able to

buy without using cash. It was an excellent thing. I would like to meet the

person who created the program. They don't discriminate at all." (Yakima

participant, translated from Spanish)
Chapter II 19

2. Food Stamps Allow Seniors to Buy Healthful Foods They Like

In addition to providing assistance with the basic food needs of their household, many

participants and nonparticipants saw food stamps as a way to buy healthful foods that they

could not otherwise afford.

"(If I got food stamps) I would buy more fruits and vegetables.... I don't

know the last time I ate a slice of lettuce because at $1.39 a head.... And

the cost of apples sometimes just gets outrageous. Just fruits would help

me." (Seattle nonparticipant)

"It gives me money to go and buy meat. The things that I normally wouldn't

get at the food bank." (Seattle participant)

“When they started giving us the stamps I was able to buy fruit and

different things. Things like watermelon.” (Yakima participant, translated

from Spanish)

The ability to use food stamps in small, ethnically oriented food stores was also cited by nonEnglish-speaking seniors and those who work with them as an advantage of the FSP over

emergency food distribution programs for immigrant seniors who tend to maintain their

traditional ethnic diets when they come to this country.

"Food stamps allows the diversity of Americans to buy what they need for

their own ethnic choices...At their own ethnic stores." (Tacoma CBO)

3. Food Stamps Promote Independence for Seniors

Korean-speaking and Spanish-speaking discussants pointed out that using food stamps reduced

dependency on their families, who are also on limited incomes, and provided them with

personal choice over the food they buy and prepare.
Chapter II 20

"I can buy the things that I want to eat. I do the shopping for myself and I

like that I can take care of myself." (Tacoma participant, translated from

Korean)

"I was a bit hesitant in the beginning because I wasn't sure if I was eligible.

But then also my children had a difficult time living (financially) plus my

eating styles are very different from theirs, for meals and food. So I wanted

to cook something that goes with my appetite and that's why I applied....

But now with food stamps I can use it to buy and prepare foods that meet

my own health needs. So I am very grateful." (Tacoma participant,

translated from Korean)

4. Food Stamps Provide Needed Economic Assistance

Across all groups the main reason why eligible seniors said they applied for or would need

food stamps is financial need. For those no longer working, often there was a point after they

retired that they were able to support themselves. But, due to a personal illness or the death or

illness of a spouse, they were no longer able to afford the basic necessities.

Some of the seniors specifically said that getting food stamps could or already does allow them

to use their income to pay for other necessities, such as rising out-of-pocket medical expenses,

housing costs, and utility bills.
Chapter II 21

"If you pay the bills first then you don't have any left to buy food. (With food

stamps) you can pay the bills and use the stamps for food." (Yakima

nonparticipant, translated from Spanish)

"For the people who don't make money, food stamps are the only source of

daily life assistance. So that is why it is good." (Tacoma participant,

translated from Korean)

"Its getting to where we seniors either buy food or medicines. We can't do

both." (Seattle nonparticipant)

"I benefited from it in the sense that I had more money to buy food and with

the money I had left over I paid the rent and bills. I was able to provide

other things that my children and their families need, such as recreation.

We were able to do things together as a family." (Yakima participant,

translated from Spanish)

5. Food Stamps are Viewed as Promoting Good Health

Many seniors talked about the importance of eating the right foods for their health, particularly

those with high blood pressure and diabetes. Some nonparticipants strongly felt the need to eat

healthy foods, but felt unable to eat the proper foods due to financial constraints. Some said

that their doctors had recommended they eat more healthy foods, such as fruits, vegetables, and

certain types of fish, but found that they could not afford these foods.

"You eat what you have. It's been three months since the doctor put me on

a special diet. Vegetables, chicken, fish, milk, fruit, but the vegetables are

so expensive that one can't buy them. You have to eat what you have. Rice,

beans, whatever." (Yakima nonparticipant, translated from Spanish)

Interestingly, several nonparticipants and participants viewed the FSP not just as an income

supplement program or a way to buy more expensive foods, but as a program designed to

promote healthy eating and good health.
Chapter II 22

"Nutrition is one of the good things I see about getting stamps. The person

is going to be able to feed himself, be healthy and have energy to find a

job." (Pasco nonparticipant, translated from Spanish)

"I believe it is a public health program for low-income people." (Tacoma

participant, translated from Korean)

B. Negative Perceptions of the Food Stamp Program

When seniors (both nonparticipants and participants), representatives from community-based

organizations, and the food stamp staff were asked about the negative perceptions among

seniors about the FSP, four issues were raised in multiple groups.

 The expectation of low benefits compared to the difficulties of applying for

food stamps;

 The complexity of the program's eligibility rules and misinformation about who

the program currently serves or is designed to serve;

 The belief among working seniors that the program's rules unfairly penalized

them; and

 The belief that seniors are not getting their fair share of the food assistance.

1. Low Benefit Levels Compared to the Difficulties of Applying

Discussants in all of the focus groups assumed that most, if not all, seniors can only get $10 in

food stamps, the minimum benefit level. While this is true for a large portion of the elderly

who receive cash assistance in the form of Supplemental Security Income and Social Security,

it is not true for the average elderly food stamp household. Nevertheless, many eligible seniors

not on the program said they were sure they would not get more than $10, though they were

clearly confused by the program's complex eligibility and benefit determination rules (as

discussed below). Contrasted with the large amount of time and paperwork required to

complete the application process, the low benefits they expect make some nonparticipating

seniors take a very negative view of the program. Nonparticipants reflected this perception

when asked to discuss the program overall and why they did not apply.
Chapter II 23

"By the time you catch a cab or bus to get up there to see about it, well then

you have spent $10. Then what do you get? You get $10 worth of food

stamps. That's a loaf of bread, a gallon of milk, and a dozen or a dozen and

a half eggs." (Seattle nonparticipant)

"I would go through the trouble if I thought I would get enough to really

help me. But I wouldn't go down there and even sign up for $10. It's not

even worth it." (Seattle nonparticipant)

"Why bother for $10? I think it is too complicated and too cumbersome to

go through all that paperwork." (Tacoma nonparticipant, translated from

Korean)

"You send all this foreign aid to repressed countries, and yet our own

people who have worked and slaved and lived here, you give them $10 a

month and you tell them that's what they deserve." (Seattle nonparticipant)

Most caseworkers and representatives from CBO’s in Seattle confirmed that the relatively low

minimum benefit level is a major deterrent to seniors' FSP participation.

"Sometimes they only get $10 and they have to come in and they have to

give all this verification and they say it's not worth the time." (Seattle CBO)

"As far as what I have heard from people as to why they have not or do not

apply for food stamps, the amount that they expect to receive is so small for

the amount of trouble that it takes to apply." (Seattle CBO)

"It's almost disgracing for someone who's maybe worked fifty or sixty years

and who paid their taxes and who knows they are supporting a program like

this, to be so stringently means tested for ten dollars (a month)." (Seattle

CBO)

2. Complexity and Misunderstanding of the Program Eligibility Rules

Several English-speaking discussants that were eligible but not participating in the FSP talked

about the complexity of its eligibility rules as their primary conception of the program.
Chapter II 24

"I never ask for anything unless I need it. And I hate to ask for something

and be turned down. I hear people at the welfare office say you're not

eligible for this and that. I don't even know how it works. But I've needed it

a lot of times. I just did without because I didn't know." (Seattle nonparticipant)

In the non-English-speaking groups of eligible nonparticipants, several seniors thought the

program is only for people on welfare, families with children, or the disabled.

"I have no income. I have no job, nothing. I thought it (food stamps) was

only for the people who get welfare. I only get the medical benefits."

(Tacoma nonparticipant, translated from Korean)

"All I know is that if a person is disabled or has a lot of children and

insufficient money to support them then I thought they would qualify."

(Tacoma nonparticipant, translated from Korean)

"I thought they don't give you anything without a child." (Yakima

nonparticipant, translated from Spanish)

3. The Program Does Not Adequately Serve Working Seniors

In the two focus groups with Korean-speaking seniors participating in the FSP, several were

currently employed. Three of these individuals expressed specific concerns about the fairness

of the income and assets tests for determining food stamp eligibility.

"For a person who works, sometimes you work 80 hours a month,

sometimes 92 (depending on the number of weeks in a month), sometimes

even less. Just because you make a little more money in one month they say

no food stamps. Everything gets disconnected. So this month I am trying to

work less." (Tacoma participant, translated from Korean)

"You know, in America you need a car...So, with some money I have to

purchase the car. But if you purchase the car, that will make you

ineligible." (Tacoma participant, translated from Korean)
Chapter II 25

4. Seniors Are Not Getting Their Fair Share of Food Assistance

Several nonparticipants in all three subgroups (English-speaking, Korean-speaking and

Spanish-speaking seniors) voiced a concern that seniors only get a small amount of benefits or

have a harder time getting food stamps or food assistance than younger people who are on

welfare or who are recent immigrants.

"I have seen many couples, even with very few children, get welfare and a

lot of stamps. The women say they don't have a husband even when they do

and he's working." (Pasco nonparticipant, translated from Spanish)

"Food stamps are supported by the people who are working hard and

paying their taxes. If it only goes to needy people it will be good. But when

I see some of these people (at the grocery store) they are young people who

are healthy, energetic, still using these stamps I wonder why stamps are

given to those healthy people and not more seniors." (Tacoma

nonparticipant, translated from Korean)

"Sometimes I work until my bones shatter and I can't afford anything and

then I see some people who are taking all these benefits so I feel the

government is being unfair." (Tacoma nonparticipant, translated from

Korean)

"Someone arriving from another country has more opportunities than a

legal immigrant who already lives here. They can get a doctor, medicines,

transportation and money for food; they get help for the electricity, the

phone, and rent." (Pasco nonparticipant, translated from Spanish)

C. Other Sources of Food Assistance and Their Perceived Strengths and

Weaknesses for Seniors

Low-income seniors not participating in the FSP were asked to prioritize where they would go

for food assistance when in need and in particular how they perceived food banks and the local

commodity distribution program as sources of food assistance.

While there was overlap in the responses across the three ethnic groups (English-speaking,

Korean-speaking and Spanish-speaking groups), there were some clear differences between

responses from the English- and Spanish-speaking seniors compared to the Korean-speaking

seniors. Hence, their responses are presented separately below.
Chapter II 26

1. English- and Spanish-speaking Seniors

The English-speaking and Spanish-speaking seniors who were food stamp eligible but not

participating in the program most often reported that they could find emergency food sources

when in need. They most often go to a food bank or a senior center for a hot meal when they

run out of money for food. A few of the seniors in these groups also cited neighbors as a

source for emergency food assistance. Several of these seniors pointed out that they would not

go to their family, because they are not living close by or because they did not want to impose

on their families who had their own children to take care of.

"I go to the food bank because it seems to be my best outlet when you are

just absolutely down to nothing." (Seattle nonparticipant)

"The food bank helps senior citizens a lot. We've been there and have

gotten very good things." (Pasco nonparticipant, translated from Spanish)

"Sometimes before the end of the month I don't have enough money to eat

on at all. If you're a senior and check in and you get to know the people at

the front desk (of the senior center), when you say you don't have enough

money to eat on today you can get the tickets for the noon lunch. So it’s

keeping me fed all month long." (Seattle nonparticipant)

"It's pretty hard to be without food in our building. Because something

maybe you get from the food bank or commodities program and don't like,

your neighbor likes and you trade food back and forth." (Seattle

nonparticipant)

"I turn most to my neighbors when I need help." (Yakima nonparticipant,

translated from Spanish)

While the food bank and commodity distribution programs were cited as important sources of

food assistance by many discussants in the English-speaking and Spanish-speaking focus

groups, English-speaking discussants expressed some problems with the selection of food

items and the large packaging sizes of commodities distributed.
Chapter II 27

"I put food banks first (as the place I would go for food assistance) but they

don't give you enough. They only give you, say, just for a week or so, but

what's a person supposed to do the next 2-3 weeks, go hungry? And that's

where my situation is because I pay my bills on the 3rd, get them all paid off,

and then I barely have, say, $25-30." (Seattle nonparticipant)

"Yesterday was commodity distribution day and all I got was about 10

pounds of pasta... Now, what am I going to do with all that pasta?" (Seattle

nonparticipant)

(The commodity program) "sometimes gives you some big huge box or can

of one item, for a family of ten, but I have to leave it. I live alone and can't

use it." (Seattle nonparticipant)

2. Korean-speaking Seniors

Though several Korean-speaking nonparticipants said they went to the senior center once a

week for a hot meal, when asked where they would go first when in need of food assistance,

they most often said they would turn to family members. In contrast to the seniors in the

English- and Spanish-speaking nonparticipant groups, several of the Korean-speaking seniors

said that they would not turn to friends for food assistance because they did not have close

friends in this country with whom they would want to openly share their personal difficulties.

A few of the Korean-speaking nonparticipants said that food banks would be one of the last

places they would turn. Representatives from Korean-American community organizations said

that low-income Koreans don't turn to food banks or the commodity distribution program

because the foods available there do not conform to their traditional Korean dietary needs.
Chapter II 28

"The first place for me will be my family. Then after my family, I will go to

church, then the food bank." (Tacoma nonparticipant, translated from

Korean)

"My family is number one because family is the one that is the closest by."

(Tacoma nonparticipant, translated from Korean)

"With your family, you have no difficulties to communicate." (Tacoma

nonparticipant, translated from Korean)

"I don't have that many friends in America. If I do have friends then I

wouldn't share the difficulties I face with my friends." (Tacoma

nonparticipant, translated from Korean)

"When you have money, then friends are there. But when you are in urgent

problem I don't think friends are that needed." (Tacoma nonparticipant,

translated from Korean)

Another frequent source of food assistance help for nonparticipant seniors was the Korean

Women's Association (KWA), a community organization whose mission is to provide help to

the Korean community and that also conducts FSP outreach. There are individuals at the

KWA that the seniors seem to have a comfort level with in sharing personal information or

asking for help. The KWA also offers a special meal site once a week for the Korean elderly

community.

"The first place I would go would be the Korean Women's Association

because of the language barrier and all that... When you go to KWA and

you explain the circumstance that you are in, tell them that I don't have

food, then they will refer me to something." (Tacoma nonparticipant,

translated from Korean)

Regardless of where they receive their food benefits, seniors across the three ethnic groups had

similar positive and negative perceptions of the FSP. The next chapter explores the roots of

some of these perceptions further by explaining how members of the focus groups received

information about the FSP and its benefits and the barriers they perceive to applying for food

stamps.
Chapter III 29

CHAPTER III

Barriers Preventing Seniors From Applying for Food

Stamps

Focus group discussants were asked about the factors that influence seniors’ decision to

contact the food stamp office to apply for benefits. Understanding this aspect of seniors' food

stamp application decisions is key to strengthening the FSP to support increased participation

among eligible seniors. The findings are particularly relevant for understanding how to reach

eligible low-income seniors with effective outreach messages, methods, and services that

support the decision to apply for food stamps, and how these may need to tailored for English

and non-English speaking seniors. While most seniors had heard about the FSP before the

focus groups were held, the focus group discussants cited a number of barriers that prevented

them from immediately applying for food stamps after initially hearing about the program.

The most common reasons were the stigma and cultural barriers associated with applying for

the program. These barriers were acknowledged also by staff from the CBOs and food stamp

offices. Other barriers that affected eligible seniors’ decision to contact the food stamp office

included misinformation about the program's rules, availability of transportation, and

communication problems at the initial point of contact with the food stamp office. Each of

these is discussed further below.

A. Stigma and Cultural Barriers

Though food stamps are designed in part as a nutritional safety net for the elderly poor,

many seniors said they find it difficult to disassociate the program from the stigma of

government welfare. Some seniors said that they would not apply for benefits because

they felt they would be ridiculed, or looked down upon by others.
Chapter III 30

“And, this particular age group is extremely prideful, and it is humiliating

to be embarrassed sitting in a CSO [food stamp office] applying for food

stamps or any other service, I mean, they are proud people.” (Central

Washington CBO)

“Korean people have this tendency, their pride hurts. Food stamps kind

of hurts their pride. So, they say, what do you know about me? And they

get their pride hurt.” (Tacoma participant, translated from Korean)

Other discussant comments indicated that many seniors are too prideful to accept what they

consider to be a handout. While pride has been a known barrier to FSP participation for the

general food stamp recipient population, several issues of pride and stigma are specific to

elderly food stamp participant groups. Several participants and nonparticipants said they found

it very difficult to ask for help after having supported themselves for so many years.

“That was the hardest thing for me when I needed help... to ask for help.

I’ve never had to all my life. I take care of myself. And when the time

came I didn’t have enough money to eat on and didn’t have transportation

somewhere at certain times, it’s the hardest thing in the world for me to

ask for help, even at the volunteer services that are there to be the help.

It’s awfully hard for me to do. It’s pride, I think, more than anything. It’s

been awfully hard for me to face.” (Seattle nonparticipant)

“Going there, and also using food stamps, involves a certain amount of

humiliation. And, that may be a factor which sort of inhibits people from

going because you think if I get these I’m still going to tell the clerk at the

check-out counter, and not only that, but the people waiting in line might

hear you.” (Seattle nonparticipant)

CBO staff from Central Washington said that many in the generation of current seniors do not

believe in accepting public assistance, and would find it humiliating to have to apply for

benefits.
Chapter III 31

“Well the younger generation is...more aware of systems, you know, I

think the feeling is that this is something that’s here to help us and we can

use it, and there’s no need to be ashamed of it, as opposed to that age

group [seniors] that, no matter what you call it, to them it’s charity and

handouts and they don’t want it. They don’t want to take charities or

handouts.” (Central Washington CBO)

“And also the older generation, and we’re talking about people 60 and up,

probably weren’t raised receiving public assistance...” (Central

Washington CBO)

While stigma prevented some seniors from applying for food stamps, it was also a factor for

seniors who ended up deciding to apply for food stamps. Each of the English-speaking

participants who had not been on food stamps before said that they applied because they truly

needed the benefits, but they felt stigmatized and degraded for having to rely on food stamps.

“To me, I think it was sort of a degrading thing.”

“It is degrading.”

“It is. You worked all your life.”

“And you pay taxes all your life.”

“And then you end up and you got to ask for help.” (Seattle participants)

“One particular client...came in and cried throughout the entire interview.

Just cried throughout the entire interview. I happen to consider myself

very compassionate with people and I wasn’t able to console her at all.

And, she had sold her furniture, her jewelry, most of her dishes, and

everything she could think of before came into the office to apply. Her

home was in foreclosure and it was embarrassing to her. And, this stigma

that it’s going to bring her in front of her community as to how they’re

going to perceive her if they find out she’s receiving assistance.” (Tacoma

food stamp worker)
Chapter III 32

In the English-speaking groups, the perception that those who are unable to provide for

themselves or their families are lazy and unwilling to work diverted some seniors from

applying for food stamps; one senior who finally did apply for food stamps said this belief had

made it very difficult for her to apply.

“Well I was from the generation where...no way did you take that stuff.

You either worked for it or you did without it. And what they had there, I

used to go with my mother once in a while...but it was very much looked

down on. So I had to get up a lot of courage to just ask (for food

stamps).” (Seattle participant)

Cultural issues also prevented some seniors from applying for food stamps. In the Spanishspeaking community, the tradition of relying on the family to take care of one another acts as a

barrier to applying for food stamps. Receiving food stamps was thought to invoke shame on a

family by showing others that the family was not able to take care of the elderly person

properly.

“...Hispanics are very tied with culture and ideals and traditions. We are

very proud of our own. We believe in protecting our own, you know. This

is the way we were raised.” (Central Washington CBO)

Some Korean discussants, staff from CBOs and food stamp office staff said that the

children of Asian immigrant seniors sometimes dissuade their parents from applying

because of how it will reflect upon them.

“So they want to try (to apply for food stamps) But then their kids have

their pride and they don’t like the fact that their parents are getting it.

And then there are some people who cannot even help their parents out,

but because of the pride they are just discouraging their parents [from

applying for food stamps].” (Tacoma participant, translated from Korean)
Chapter III 33

Many Korean-speaking participant and nonparticipant seniors were afraid of putting too much

financial stress on their children by asking them for help, but did not want to go to the

government for assistance because they might bring shame to their family. As a result, several

discussants said that some Korean seniors who need help with food assistance don't seek it and

keep their need hidden from their family and community.

B. Misinformation

Consistent with current literature regarding seniors’ participation in the FSP, focus group

discussants identified misinformation about the FSP’s benefits and rules as a common reason

that eligible seniors do not even considering applying for food stamps. One possible indicator

of the prevalence of this misinformation is the fact that among the Spanish-speaking and

Korean-speaking senior discussants in the eligible nonparticipant focus groups, the majority of

those who had never been on the program in the past (9 of 17) had not even considered

applying.

In addition to traditional misinformation about the FSP rules for the general elderly population,

immigrants had multiple layers of misinformation regarding their eligibility for food stamps.

Their misinformation and confusion were both about Federal rules and State rules (since

Washington State provides State funded food stamps for all legal immigrants that were made

ineligible for the FSP in 1996.)

1. General Misinformation

Focus group discussants expressed misinformation related to benefit levels and eligibility

determination rules. Most prevalent among all groups of eligible nonparticipant seniors was

the assumption that all seniors can receive only the minimum monthly benefit level of ten

dollars in food stamps.

Misinformation about the limits on asset levels and the definition of a household for

determining food stamp eligibility were also indicated by several senior nonparticipant

discussants. Some assumed that in order to be eligible an individual or family has to sell their
Chapter III 34

house or car and then wait to apply until they spend that money. Others said they thought they

would automatically be ineligible because they live with their children regardless of whether

they purchase and prepare food separately from their family.

Some discussants were afraid to apply for food stamps, not because of the implications it could

have on them individually, but because of the implication it could have on others. For

example, several senior discussants and CBO representatives said that the elderly are

concerned that by accepting food stamps they might be taking them away from someone else

who needed them.

“Maybe that’s the reason there isn’t anything left because it is going to

someone else.” (Seattle nonparticipant)

“Something I come across, to, is that there is a sense of scarcity to the

funding for the program and that there’s more worthy people worth it.

And something I’ve come across, too, is the idea that programs like the

Food Stamp Program are largely for single women with children and that

it is not necessarily just a citizen, human being program. They are single

adults with no children and they don’t have access to the program, that it

is not for them, and there’s far more needier people and that they

shouldn’t take up any space in the program.” (Seattle CBO)

“Seniors that I have heard say, ‘I can make do.’ Since there is so little

money for people, I don’t want to be one of the ones that have to take it

out of the babies’ mouths. (Seattle CBO)

“They think they are taking it away from somebody more needy. I think

that’s the one I hear the most, ‘Oh, I don’t want to take it away from

somebody who needs it more than me.” (Tacoma CBO)

Staff from community based organizations and food stamp office workers said that because

most seniors learn about the program from family, friends, and neighbors, false information is

passed along with correct information about the program. They also indicated that this lowincome population has less information than younger adults do about the types of government

assistance they might be eligible for. Though these problems were expressed by staff working

with all groups of low-income seniors, it appears to be especially true for the non-English-
Chapter III 35

speaking community, where the volume of misinformation is greater and the sources of

information are more limited.

“General frustration and misinformation is spread from applicant to

applicant, which makes it more difficult for the food stamp educators to do

their jobs. The elderly are more likely to trust their peers and the

information they provide than info they hear from other sources.” (Central

Washington CBO)

The general population—at least the younger population—they can find

out other information. Whereas the elderly have less access to resources

and information so they ask their children and other family members.

And, sometimes, those family members have the wrong information.

(Seattle food stamp worker)

2. Misinformation Specific to Non-Citizens

Under the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA)

many legal immigrants lost eligibility for food stamps. Congress and the President enacted

partial restoration of these eligibility cuts in the Agricultural Research, Extension and

Education Reform Act of 1998. At the same time, the law also gives States the option to use

their own funds to provide food stamps to legal immigrants within their State. Washington

was one of the first States to choose this option and created the Washington State Food

Assistance Program for Legal Immigrants, which works under the FSP eligibility rules for

immigrants established in the Food Stamp Act prior to PRWORA.

Though the food stamp eligibility of legal immigrants did not change due to the changes in

Federal food stamp law, the focus groups revealed much confusion and misinformation about

the eligibility of seniors who are sponsored by their relatives and how their food stamp

participation might affect their children in their future or their potential to become permanent

citizens in the future.

Concern about sponsor liability and other negative effects on their families. Some

non-participant seniors mentioned that they did not want to participate in the

Food Stamp Program because they believed their children, who are their

sponsors, would be held financially responsible for repaying any State funded
Chapter III 36

food stamp assistance—even if their children’s families had low incomes and

might not in fact be held liable under immigration law. Others had heard that

their children or grandchildren would not be able to become naturalized, receive

financial assistance for college, or get a job in the future because they had

received food stamps. Some examples of the discussants’ comments on these

topics are included below.

“I heard about [food stamps] but they said something big will happen if

you receive it before your 3 year residency comes up. Somebody will be

damaged or someone will be hurting. They were saying because my sonin-law is a soldier, he has to pay back the benefits that I receive. That’s

why I didn’t apply.” (Tacoma nonparticipant)

 Waiting period before immigrants can apply for food stamps. In Washington,

where DSHS provides State-funded food stamps for legal immigrants, otherwise

eligible legal immigrants can receive food stamps soon after entering the

country. However, the complexity and quantity of rules surrounding

immigrants and eligibility for U.S. government assistance programs can be

daunting, not only to the non-English-speaking immigrants, but to advocates

and outreach workers from various community-based organizations as well.

There appears to be a great deal of confusion regarding when immigrants may

apply for food stamps, and what repercussions exist if they apply too early.

Some participant and nonparticipant discussants said that they thought they could not apply

for food stamps until they had been in the country for three years or sometimes for five

years.6

“My case too, green card I only received two years ago and I heard that

you have to be here for at least 3 years in the U.S. to be eligible.”

(Moderator): “Who told you that?”

“I don’t know. I just heard that.” (Tacoma nonparticipant)

6 The reasons for this confusion may be many, They may have heard that while they are sponsored in the

U.S. they are ineligible for food stamps. (However, sponsored immigrants can be eligible if their sponsor is lowincome and has limited assets or if their sponsor meets certain exemptions). It is likely that this kind of

misinformation is spread because many immigrants have difficulties obtaining the information they need from

their sponsors to determine food stamp eligibility. Or, they may be working under the assumption that they are

not eligible to receive food stamps until they have been in the country for five years or until they have worked 40

quarters, whereas in Washington State--which provides State-funded food stamps to income-eligible legal

immigrants--this waiting period is not required for receipt of food stamps.
Chapter III 37

 Misinformation regarding Food Stamps and “Public Charge.” Some

discussants believed that accepting food stamps would hinder their chances of

being granted U.S. citizenship, because it would deem them dependent on the

U.S. government and a “public charge” ineligible to receive a green card. In

fact, while receipt of SSI or other cash assistance will affect determination of

eligibility for Legal Permanent Resident (LPR) status, receipt of food stamps,

medical assistance, and other non-cash benefits can not affect individuals’

ability to obtain a green card.

“They fear their getting food stamps will affect their children or

grandchildren’s green card. I receive a lot of questions about how long

they have to wait to apply for food stamps so that it does not affect their

children or their family.” (Central Washington CBO)

C. Transportation

Many focus group discussants cited limited transportation as a barrier to seniors being able to

get to the food stamp office to initiate an application. Many of the elderly discussants were

unable to drive, and several of them found taking the bus to the food stamp office to be very

difficult. Seniors in less populated areas expressed a harder time trying to find transportation

help to get to the food stamp office. The representatives from CBO confirmed that

transportation was a significant barrier to getting to the food stamp office to apply for benefits.

“Especially if they live in the outlying areas and have to come in, you

know, some of them, even the trip itself can be stressful. Especially if they

are frail.” (Central Washington CBO)

“And it you live out in the country, well ... it is four bus rides sometimes.

Two (trips) in and two (trips) back home.” (Seattle CBO)

In Tacoma, many seniors explained that the public transportation system does not stop near the

food stamp office. In Central Washington, several discussants said there was no public

transportation available to seniors in most of the rural areas, and those that had transportation

available were limited to a service called Dial-A-Ride, which requires 24-hour notice and often
Chapter III 38

picks up seniors several hours before their appointment and drops them off several hours

afterward, in order to accommodate other passengers’ schedules.

“The elderly get Dial-A-Ride, but they forget to call the day before and

that’s a hassle and usually you need to call them to make the

appointment.” (Central Washington CBO)

D. Communication Barriers at Initial Contact with the Office

Language issues play a large role in hindering some non-English or limited-English speaking

elderly from applying for food stamps once they try and contact the food stamp office. Some

CBO staff explained that non-English-speaking seniors who call the food stamp office are

often times unable to reach someone who speaks their language and do not call again. Many

non-English-speaking elderly said that when they encounter the automated phone system they

just hang up.

One CBO discussant pointed out that many seniors, regardless of their primary language, have

a fear of new technology which makes using the automated telephone systems difficult.

“I think it is intimidating, the technology for them is intimidating. They

don’t want to be talking to a machine and then leave a message or

anything.” (Central Washington CBO)

In Central Washington, when no one can answer the phone, there is a telephone message first

in English and then repeated in Spanish. Some discussants reported that the Spanish-speaking

seniors are sometimes unaware that the messages are repeated in Spanish and hang up while

hearing the English message.

“You don’t know that there’s going to be a Spanish message if they are

not experienced enough to find out.” (Central Washington CBO)
Chapter III 39

This chapter has discussed the factors that can prevent food stamp eligible elderly from

contacting a local food stamp office and obtaining an application form or deciding to apply.

Societal and cultural factors, misinformation or confusion about the program's rules and

benefits, transportation, and communication difficulties with the food stamp office stop a

portion of eligible seniors from seeking a food stamp application or beginning the food stamp

application process. Those that do begin the process face additional influences that may affect

their decision or ability to complete the application and/or recertification processes. These

issues are the focus of the next chapter.
Chapter IV 40

CHAPTER IV

The Food Stamp Application and Recertification Process

The previous chapter focused on reasons that food stamp eligible seniors hesitate or fail to

contact a food stamp office to apply for needed benefits. This chapter presents the focus group

findings on the application and recertification processes for food stamps as they are perceived

by participants and eligible nonparticipants, and those who work with seniors at the food stamp

office and in the community.

The organization of the findings in this chapter correspond to the sequence of steps someone

must take to apply for food stamps. Figure IV-1 illustrates the three basic steps involved in the

FSP application process nationwide: 1) formal submission (“filing”) of a food stamp

application form, 2) the eligibility interview, and 3) submission of required verification

documents. The possible factors that may influence seniors’ decisions to continue the process

are listed in the diagram.

Section A of this chapter explores the FSP application process for seniors in more detail to

discuss how the factors listed above may affect seniors’ decisions to move through the process.

Section B explores issues related to reporting and recertification requirements for participating

seniors that may affect their decision to continue receiving food stamps. Section C provides

specific examples of how FSP program operations and policies have caused some eligible

seniors to leave the program.
Food Stamp

Eligible

Non-participant

Attend

Eligibility

Interview

Applicant Submit Food Stamp

Application

Sub

Verific

Factors Influencing Seniors’ Participation

Food Stamp Application Form Eligibility Interview Verification• Number of questions/form length• Tone of form (fraud detection)• Time to complete• Comprehension of form

• Desire to answer questions• Quality and availability of translations• Atmosphere in reception area

• Waiting time• Office atmosphere• Staff attitudes• Availability of transportation• Interview content• Awareness of use of telephone

Interview option

• Use and understanding of

excess medical deduction

• Immigrants fears of sharing

SSNs

• Number of documents re• Cooperation of third part• Time needed to obtain d• Availability of transporta• Availability of interprete

communications with baagencies, etc.)

Figure ΙV-1.

The Food Stamp Application Process

and

Factors Influencing Seniors’ Participation

Chapter IV 
Chapter IV 42

A. The Food Stamp Application Process

1. The Application Form

The first formal step in the food stamp application process is the submission of the application

form. When asked about seniors' experiences trying to apply for food stamps, there was

extensive discussion among seniors and the representatives from community-based

organizations about the food stamp application form. When probed about the application form,

seniors had much to say about its length, complexity, and types of questions asked.

Because the issues raised by the non-English- speaking groups differed somewhat from the

English-speaking groups, the analysis of the comments from these two groups are presented

separately below.

a. The English Version

English-speaking seniors talked most about the form being too long and having too many

seemingly irrelevant questions. A few also indicated that the form seemed to be designed to

make them feel ashamed about applying for food stamps.

"They ask you these questions that make you feel guilty. They make you

feel like a criminal. The questions they ask on the form make me feel like I

was taking something I shouldn't have taken. But I wanted and needed the

help." (Seattle nonparticipant)

"The application is very long and there are a lot of unnecessary questions

for the elderly." (Seattle nonparticipant)

"If you have no income, the form asks why? Maybe they want to get

someone a job. None of those questions about work apply to me." (Seattle

participant)

"My problems are different than somebody that has a new baby or a lot of

kids. Their problems would be different. Seniors should not have to

answer all the same questions that families with kids do." (Seattle

participant)
Chapter IV 43

Only one focus group discussant in the English-speaking group of participants said that she did

not have difficulty filling out the application form nor problems with its content.

b. The Korean and Spanish Translated Versions

While all non-English-speaking seniors said that the food stamp application form is available

to them in their language (Korean or Spanish), the seniors, representatives from CBOs, and

some food stamp staff agreed that the translated forms are very difficult to understand, in part

because of the quality of the translation and in part due to the reading level of the applicants.

"They probably translate the form too literally. For people to understand

the meaning, the whole sentence or whole paragraph needs to be

translated, not each word. A word-by-word translation can be very hard

to understand, even for me." (Tacoma CBO)

"A lot of the people we work with can't read in their own language so they

can't understand the form in whatever language it is written." (Tacoma

CBO)

"There is really no way for us to fill that out. I don't have the confidence."

(Tacoma participant, translated from Korean)

"There are all these instructions that come with it. There is no way for

you to be able to read it.” (Tacoma participant, translated from Korean)

"The application form is really hard. It includes too many questions.

Even though they get the Spanish version, they still don't understand the

questions. The application is full of big words and government language."

(Central Washington CBO)

"They usually rely on family members to fill out the form in English. If

they don't have family members that can speak English, it's hard for them

to fill out the application form." (Central Washington CBO)
Chapter IV 44

2. Seniors’ Experience Waiting at the Office

Seniors' comments about the application process focused principally on the atmosphere and

treatment they received in the front office when coming in to drop off their application or for a

subsequent meeting with a worker. They also complained about the waiting time for their

eligibility interview, and the process of the eligibility interview itself. Key findings from these

discussions are summarized below.

a. The Atmosphere in the Food Stamp Office

It is clear that many senior discussants from all three population groups have had

uncomfortable experiences or fear they would have uncomfortable experiences if they went to

the food stamp office, though the participants were much less critical of the office than the

nonparticipants and the Korean-speaking participants had the least criticism of the office

among all three groups in the study.

Indicating that this view of the office atmosphere is a major barrier to participation, the most

disparaging comments about the rude, impersonal nature of the food stamp office staff came

from nonparticipants who had attempted to apply in the past.

"Why is it that when you go there you have to talk to workers at those

open windows? People sitting behind you can hear your private business

and everything you say." (Seattle nonparticipant)

"The staff are very unfeeling and cold." (Seattle nonparticipant)

"I have a feeling that they are just so busy they don't care about anything."

(Seattle nonparticipant)

"When one asks for help they are rude. I ask for it, because I need it, not

because I want to. There was a lady working with stamps and she was

very mean with everybody." (Yakima nonparticipant, translated from

Spanish)

"The waiting room is very crowded and they just call you by a number, not

your name." (Tacoma nonparticipant, translated from Korean)
Chapter IV 45

Interestingly, a few of the English-speaking seniors (participants and nonparticipants) reported

feeling uncomfortable in an office crowded with young children or that the office placed a

priority on serving this younger population.

"It isn't very pleasant to see young girls who just had a baby sitting there.

It’s just uncomfortable." (Seattle participant)

"It seems like the office prefers people with little kids." (Seattle

nonparticipant)

Representatives from CBOs had similar views about the uncomfortable experience seniors

have in the front area of the food stamp office. One CBO representative from Central

Washington also pointed out that seniors applying for food stamps often have to travel far to

get to the office. Yet with the additional burden of transportation difficulties and physical

limitations, there are no special accommodations for them once they get there.

A few seniors had positive comments about their experience in the waiting room at the food

stamp office. Several English-speaking and Spanish-speaking seniors said they considered the

DSHS office as a place to meet and interact with others. One senior, who is partially disabled

and requires transportation assistance to come to the office, said he enjoys going to the office

because he sees people he knows. Another senior said that the wait goes quickly because you

can talk to people in the waiting room.

b. Waiting Time in the Front Office

When asked about the office environment and process, seniors in all the discussion groups (the

English-speaking, Spanish-speaking and Korean-speaking groups of participants and

nonparticipants who had been to the food stamp office to apply) complained about the long

waits they experienced when they went to apply and during subsequent visits when they were

scheduled for an interview.
Chapter IV 46

"You sign up and get in line with everybody else and sit down for a couple

of hours until they get to you. Or sometimes you wait all day and then

they tell you to come back the next morning early at 7:00." (Seattle

nonparticipant)

"When you go there, there are many people. You have to be there in the

morning and wait a long time. And then the staff have lunch hour from 12

p.m. to 1 p.m. and they don't start back until about 2:00 p.m." (Tacoma

participant, translated from Korean)

"You usually have to wait there all day." (Pasco nonparticipant, translated

from Spanish)

3. The Food Stamp Eligibility Interview

Once the application is received at a local food stamp office, applicants are given (either in

person or in writing) the date and time for an eligibility interview and should be informed

about the kinds of documents they need to provide to the office to verify the information on

their application form. In most of the local offices where the focus groups were conducted, the

eligibility interview is scheduled for a future date after the application is received. Most focus

group discussants did not raise any concerns or issues with the scheduling of the eligibility

interview. A few Korean-speaking participants indicated that the letter they had received to

schedule their interview was in English or difficult to understand if translated into Korean.

During the eligibility interview caseworkers are supposed to obtain detailed information

regarding the income, resources (e.g., value of vehicles owned, dollar value in bank accounts

or other assets), and expenses that can count as income deductions, such as shelter and out-ofpocket medical costs, among others. If the client has brought verification documents to the

interview, these are submitted and reviewed at this time.

The focus group discussions about the interview focused on five topic areas: 1) perceptions of

workers’ attitudes during the interview; 2) views on the content of the interview; 3) the use of

the telephone interview option for seniors with hardships; 4) the use of the excess medical
Chapter IV 47

deduction; and 5) special issues facing Korean-speaking and Spanish-speaking seniors. The

findings from the analysis of these discussions appear below.

a. Perceptions of Workers' Attitudes During the Interview

Many seniors who were current participants or eligible nonparticipants who had applied for

food stamps in the past commented that caseworkers were unfriendly and suspicious.

"The caseworkers are cold. Very unfeeling and cold."

(Seattle nonparticipant)

"They want to embarrass you, so you'll get up and walk out."

(Seattle nonparticipant)

"They act like it's coming out of their own pocket."

(Seattle nonparticipant)

"Everybody's out to steal and everybody's a thief, and that's the way they

make you feel..." (Yakima nonparticipant, translated from Spanish)

In response to the concerns of their peers, several of the senior discussants pointed out that the

treatment of elderly clients by their workers likely varies by office and worker.

b. Views on the Content of the Interview

Several senior discussants in the English-speaking and Spanish-speaking groups objected to

the amount of questions they were asked during the interview and felt that their privacy was

being invaded. A few participants suggested that the information being asked at the interview

should already be available to the workers from information they had provided when applying

for other programs like Social Security or Supplemental Security Income (SSI).
Chapter IV 48

"I got annoyed and mad because they should know everything they are

asking. They already have copies from Social Security and the copies of

birth certificates I gave them." (Yakima nonparticipant, translated from

Spanish)

"We've got to have a little bit of privacy in our lives. The government is

getting too much into peoples' private lives." (Seattle participant)

Defending the need to ask for very detailed information from food stamp applicants, several

caseworkers blamed this practice on DSHS requirements intended to lower the State's

previously high food stamp payment error rate. One caseworker said that workers are being

encouraged to ask detailed questions of all food stamp applicants and participants, including

the elderly, because their office is being closely audited for errors that could have resulted in

overpayments to food stamp participants.

c. The Telephone Interview Option

Recognizing the physical limitations and transportation difficulties facing many elderly in both

urban and rural communities, the Food Stamp Act of 1977 requires seniors with hardships to

have their eligibility interview conducted over the phone if they request it. Food and Nutrition

Service (FNS) regulations effective January 20, 2001 state that the food stamp agency must

notify applicants with hardships that they can have a telephone interview or presecheduled athome interview instead of a face-to-face interview in the office. The determination of a

hardship can be made on a case-by-case basis State agencies can choose to waive the face-toface interview in favor of a telephone interview for households with only elderly or disabled

members and no earned income. Washington State policy encourages the use of this option to

persons with hardships but does not require it.

To learn more about local office practices in the State, discussants in the food stamp office

staff groups were asked about the local policies and practices regarding this option. To assess

seniors’ interest in this option designed to improve their accessibility to the Food Stamp
Chapter IV 49

program, the seniors in the focus groups were asked if they were aware of this option and if

they would prefer a telephone interview to the apparent difficulties of getting to the office.7

 Food stamp office practices and staff views. In most of the offices in the

communities where focus groups were conducted, staff indicated that the office

practice is to schedule telephone interviews with seniors who request it. In one

office the staff reported that it is not uncommon for the front office staff to

suggest a telephone interview to seniors who don't request it if someone else has

dropped off their form for them or if they have mailed it in.

While all offices are supposed to offer this option to those who request it, the

frequency that telephone interviews are utilized varies widely across the three

communities involved in the study. In the Pasco office it appears to be a rarely

used option. In the Seattle office the staff say that it is commonly used. In the

Tacoma office it is commonly used with English-speaking seniors, because a

large number of these seniors request it on their application form. Food stamp

office staff in Tacoma and Pasco said that it was a rarely used option for nonEnglish-speaking clients. In all three offices, there were mixed opinions as to

the relative ease of the telephone interview for workers. Some workers said it

was just as easy or difficult as the in-person interview. Others expressed a

strong bias against telephone interviews. One staff person said that telephone

interviews often have to be rescheduled because seniors do not answer the

phone. Several staff in the Tacoma food stamp office focus group said they

don’t like telephone interviews with non-English-speaking clients because it is

very difficult to arrange a telephone interview with both the applicant and the

interpreter. One staff person in Pasco, where the option is rarely used, said it is

not widely used because caseworkers are required to provide detailed

documentation as to why the person could not come into the office for an

interview.

 Seniors' views on telephone vs. face-to-face interviews. While seniors do not

generally like the atmosphere in the food stamp offices, there were mixed views

in all the groups regarding their preference for telephone interviews instead of

the in-office interview. This preference was clearly stated by several Englishspeaking and Korean-speaking discussants. In the Korean-speaking group, one

man expressed concern that language would be a greater barrier for him over

the phone than in person.

7 In assessing the senior discussants' views on this policy, it is particularly important to remember that

while many of the discussants said they had difficulty obtaining transportation to the food stamp offices, none of

the groups included homebound seniors and very few discussants were very impaired physically or mentally.

Those with more functional impairments would likely respond differently when asked about their views on the

telephone interview option.
Chapter IV 50

“I like the face-to-face. Over the phone it’s push this button or push that

button. You can’t answer a question by pushing a button.” (Seattle

nonparticipant)

“I prefer face-to-face too. On the telephone, and its not the worker’s

fault, he or she will be sitting there with a checklist and that’s all he or she

would want to do is get through this checklist.” (Seattle nonparticipant)

“Rather than a phone interview I think its better to go there with an

appointment. Because you get so many different calls at home from so

many solicitors. I guess understanding the English would also be a big

problem (with the phone interview).” (Tacoma nonparticipant, translated

from Korean)

Those seniors who did express a preference for the telephone interview option were

those with greater physical hardship and those who believed it would be less time

consuming and would free them from the hassles and discomfort of having to arrange

transportation to the food stamp office.

d. Utilization of the Excess Medical Expense Deduction

The FSP has several special rules for determining eligibility and benefits for households with

seniors. First, the elderly and disabled are only subject to a net income test, while other

households first have to meet a gross income threshold. (Net income equals gross income

minus certain deductions.) The elderly and disabled also have a special deduction for medical

expenses that is not available to other groups. Medical costs that exceed $35 a month may be

deducted if the costs were paid directly by the applicant and not covered by insurance or

another person. This includes costs for medical bills, prescription drugs, and over-the-counter

drugs approved by a physician.

Given the concern expressed by many senior discussants about the high costs of their

medications and their increasing need to choose between buying food and paying for medical

expenses, along with the low benefit level they think they will get in food stamps, use of the

medical expense deduction takes on increasing importance in any effort to increase food stamp

participation among the elderly.
Chapter IV 51

Despite the potential importance of this deduction, it is widely believed that many, if not most,

elderly applicants are not taking advantage of this deduction. Reasons cited by FNS and by

senior advocates are that seniors are not informed of it and that gathering and analyzing the

necessary paperwork to document this deduction is difficult for the applicant and worker (FNS,

2000). These assumptions were explored in the focus groups with seniors, food stamp

caseworkers, and community-based organizations that help seniors apply for food stamps.

When asked whether they had taken advantage of the medical expense deduction when

applying for food stamps, most seniors did not recall being asked to provide information on

medical expenses for food stamp eligibility and did not know why it would be relevant to the

food stamp application process. The only ones who did recall supplying this information were

those who were also applying for Medicaid and had to document their “spend down” of

income for future medical expenses in order to qualify for that program. These individuals did

not know if the information was ever used to determine their food stamp benefit amount.

Caseworkers noted the difficulty of implementing this deduction and several admitted that

while many of the seniors they work with probably do have significant out-of-pocket costs for

prescriptions, the workers seldom try to seek the information necessary to calculate the medical

deduction because the rules are complicated making it difficult to calculate this deduction

accurately. Several workers in the Seattle food stamp office said they do collect this

information for seniors on SSI when they are applying for medical insurance coverage and can

calculate the excess medical deduction for these households easily. However, since they are

not routinely collecting this kind of information for elderly who are not on SSI, some

caseworkers said they are likely to overlook the medical deduction for these households.

"The medical expense deduction is an area that you don't deal with all the

time and so workers tend to forget to ask if they have out of pocket

medical expenses which could increase their food stamp benefit level. It's

just something that's overlooked. The rules are very complicated." (Pasco

food stamp worker)

"For elderly receiving SSI they do get this information, but this is only a

portion of the elderly who apply for food stamps." (Seattle food stamp

worker)
Chapter IV 52

One food stamp worker also suggested that workers do not implement the medical expense

deduction because it is a huge potential source of errors in food stamp calculations. Since

workers routinely have their cases audited for errors, they may choose to shy away from asking

questions about medical expenses because they feel the deduction is difficult to calculate and

document.

Representatives from KWA, which routinely assists the Korean-speaking elderly in the

Tacoma area with the food stamp application process, said they have helped only a few seniors

get the excess medical deduction because it is so difficult to get the needed documentation

from their clients.

"It’s a nuisance trying to claim the deduction, because if you want to you

have to come up with the records. And some of the seniors don't keep

records, or their records are not organized in one place." (Tacoma CBO)

4. Barriers Non-English-speaking Seniors Face in Completing the Application

Process

During the focus groups, several food stamp workers and community-based organizations said

that many seniors they work with often begin but do not complete the food stamp application

process, even though they are likely eligible. One primary reason for this may reside in the

complexity and availability of interpretation services. The second important, though less

commonly raised, reason was the fear that legal immigrants have in sharing their Social

Security Numbers.

a. Interpretation Services

The DSHS in Washington State requires local food stamp offices to have an interpreter

available at the interview if someone needs help. The interpreter can be present at the

interview or conferenced into the interview through a national telephone translation service

administered by AT&T. Some community service offices allow non-English-speaking clients

to bring a translator with them to the interview to interpret the caseworker’s questions, while

most offices have a policy that only a State certified interpreter can translate during the
Chapter IV 53

eligibility interview. When asked about this policy, one office worker explained that requiring

certified interpreters assures that the client gets correct information about the FSP

requirements.

When the non-English-speaking discussants were asked about the availability of interpretation

assistance, most who had experience with these services reported that interpreters were

available and they felt that the interpreter was very helpful to them. The availability of

interpretation services seemed critical to their decision to apply. One Korean nonparticipant

said that in general she is afraid to go out to places unless she is sure that someone there speaks

her language.

While Spanish-speaking participants all reported that the local office provided interpreters for

them, several of the Spanish-speaking nonparticipants did not know about the availability of

interpretation services at the food stamp office.

Interestingly, it was food stamp workers who most frequently said that despite the availability

of interpreters, many non-English-speaking seniors who begin the application process do not

complete it. The most common reason cited for non-English-speaking seniors not completing

the process was the fact that while interpretation services are available, their use can be

cumbersome. Workers said assuring interpretation for food stamp applicants is complex for

both the client and themselves because it is needed at every stage of the process, is sometimes

not available when needed, and they believed that clients sometimes were hesitant to talk about

their personal life circumstances with another stranger, who may even know someone in the

applicant’s community.

"A lot of times it’s just hard for them (non-English-speaking seniors) to

come to the interview to get $10-$20 of food stamps...They are eligible but

just because of the time it takes and because there are a lot of other people

involved who have to take their time to help them understand the forms

and take them around to get verification documents, that’s why they don’t

complete the application process.” (Tacoma food stamp worker)
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"Oftentimes there are caseworkers who speak English that don’t tell the

applicant, we have Spanish translation to help you with the interview.' So,

they are stuck trying to communicate with the caseworkers...Unless they

ask for it specifically, a lot of times the Spanish-speaking applicant

doesn’t get a translator. These people just don’t want to come back to the

office again and don’t get food stamps though they are eligible." (Central

Washington CBO)

"When we get our interpreter for them, we have brought a stranger to the

client and they don't feel that comfortable speaking with that person.

Then they might not come back. Whereas, if they could choose their own

interpreter to bring with them it would allow them more privacy."

(Tacoma food stamp worker)

"We have same-day appointments and application processing at our

office. When there is a language barrier the person is not able to

communicate with the financial workers at the front counter who usually

does the one-day processing and the process doesn't work for them."

(Tacoma food stamp worker)

The added complexity of the process for non-English-speaking seniors was summarized well

by one food stamp worker.

“Non-English elderly, not just Koreans, have difficulty coming to our office.

Their children have to take them to (a community organization that speaks their

language) where they fill out the application and then the agency has to contact

us and send us the application and then we have to schedule an appointment.

Then we have to schedule the interpreter for translation. It’s just too many

steps....At least 80% of Asian, non-English-speaking elderly in Tacoma are not

receiving food stamps because of all the time it takes and the many people

involved." (Tacoma food stamp worker)

b. Fear of Sharing Social Security Numbers

Focus group discussants who work with legal immigrants in Seattle and Central Washington

said that a common reason many seniors begin the process but do not complete it is because

they are concerned someone could commit fraud with their Social Security number.
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In fact, one woman working at a senior center in Seattle noted that a local agency serving

Asian immigrants trains their clients to never give out their Social Security number to people

that they don't know.

5. Submission of Verification Documents

The food stamp application process is finished when the applicant provides all supporting

documentation requested by the caseworker to verify their household circumstances. The

caseworker then determines the household's eligibility and, if eligible, the monthly food stamp

benefit amount. After all required documents are provided, the applicant can receive food

stamp benefits.

The focus group findings with food stamp participants indicated that the complexity and time

involved in getting needed verification documents was a large hassle and very frustrating. In

the focus groups with Korean-speaking seniors, several individuals expressed their frustration

with these requirements and talked about the added difficulties they faced meeting them

because they do not speak English.

"When your apartment landlord is American and the bank person is

American, you always have to bring someone with you to translate and

that translator has to be provided by me and that's inconvenient."

(Tacoma participant, translated from Korean)

"Bank statements were the hardest. I went to the bank and they gave me a

letter telling me that I am a customer. Then the food stamp office said that

was insufficient. So basically they returned the document to me and I had

to fill out another form with the bank and bring somebody with me who

could speak English." (Tacoma participant, translated from Korean)

Among several nonparticipants in the Spanish-speaking and Korean-speaking groups who had

previously applied for food stamps, the burdensome nature of the verification requirements

was the reason they did not complete the application process.
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"Last year I applied. I went twice, but each time I met with a worker they

kept asking for more and more papers. I just decided not to go back."

(Yakima nonparticipant, translated from Spanish)

"Why bother for $10? When I applied it was too complicated and too

cumbersome to go get all the paperwork that the woman asked for. So I

just didn't bother.” (Tacoma nonparticipant, translated from Korean)

"They asked for a letter from the landlord and he didn’t want to give it to

me. So I didn’t get food stamps." (Yakima nonparticipant, translated from

Spanish)

When staff at the local food stamp offices and community-based organizations serving the

elderly were asked in the focus groups if (a) the elderly are able to follow through and get the

documentation that is required and (b) if this poses a barrier to seniors completing the initial

application process, they consistently identified verification requirements as a barrier to food

stamp access for the elderly. The staff cited difficulties seniors have getting transportation to

the multiple sites where they have to go get forms signed, and additional language barriers for

non-English-speaking seniors as reasons the documentation requirements pose a barrier to

participation for senior food stamp applicants.

Also of interest was the point made by some local office staff in the Seattle focus groups who

said that seniors who purchase and prepare food separately from their children often have

difficulty getting verification of this or other help from their family because the children don't

want to be involved.

"Mainly the ones that don’t have trouble are the ones that live in senior

housing...but the ones living with their family, you don’t get many of them

completing the process. They want to apply but they don't want to involve

their children. I think they want to apply on their own so their children

won’t get and use their food stamps. These elderly who apply have more

problems with the process for food stamps." (Seattle food stamp worker)

"If they're living with their children, they don't want to bother or involve

them to sign forms or help them. The children say to them, ‘It's too much

hassle for me.’" (Seattle food stamp worker)
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B. Food Stamp Recertification and Reporting Requirements

Because the FSP participation rate has historically been low but relatively steady among

seniors and their income is relatively stable, one might assume that participation rates are

primarily driven by the number of new seniors who enter the program, not by seniors leaving

the program. However, recent quantitative research on food stamp leavers in Illinois indicates

that while the elderly turnover is not high, there is more turnover of the eligible elderly than

one might expect. The researchers found that four percent of the elderly food stamp caseload

turned over in 1997, the same exit rate as for welfare households that year. Of those seniors

who left the program, 18 percent of the elderly and disabled said their primary reason for

leaving the FSP was due to administrative difficulties once they on the program. More

disturbing is the fact that though elderly people who leave the FSP have other sources of

income, they typically remain poor and in ill health after they drop off the program (Rangarjan

and Gleason, 2001).

The focus group moderator guides were designed to probe participants and nonparticipants

who had been enrolled in the FSP in the past about their experiences with the program

requirements once on the program. Several issues were raised by seniors and those who work

with them regarding ongoing FSP participation requirements. The factors that influenced

seniors views of the FSP and their likelihood to continue program participation included: the

office policies on the length of the certification period, the use of telephone interviews for

recertification, the burdensome and redundant nature of the paperwork and information

requested at recertifications, and reporting requirements as they affected working seniors.

1. Length of Certification Period

It was very clear from the focus groups with food stamp workers in the three different regions

of Washington that the length of the food stamp certification period for seniors varies from

region to region and is shorter for seniors who are working. For example, in one office, the

certification period was routinely six months for most food stamp applicants, including seniors;

now it is every three months for those who are working. Those seniors whose sole source of

income is SSI or another fixed income have longer certification periods, but staff say these are

not the majority of their elderly cases. At another office, the staff said the certification period
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varies by the individual household's situation and type of income, ranging from three to 12

months for seniors.

2. Availability of Telephone Interview Option at Re-certification

In addition to differing recertification periods, the food stamp workers seem to adopt different

policies toward the option of telephone interviews for recertification of seniors. When asked

how often the elderly have telephone interviews for recertification in one office, a worker said:

"It depends on the worker. In our office, we were authorized to do phone

interviews if we felt comfortable with it. For a lot of my SSI clients that

I've had on my caseload for over a year, I mail them a letter with the

forms needed and they send it back. Then I will do a phone interview if

everything's pretty much the same and I have all their verification."

(Tacoma food stamp worker)

In another office, the workers say they tell seniors that they can recertify by telephone once

they see that someone is in poor health. When asked if the appointment letter for the

recertification interview that is sent to seniors informs them of this option, the staff in one

office did not know. In another office they said the information on this option was no longer

on the computer generated letter that goes to participants when their certification period is

coming to an end. According to caseworkers, clients can be and some are notified of the

telephone interview option in their re-certification notice, if a caseworker determines their

client needs to be offered this option and the worker adds a note to the letter before it is

automatically printed from the computer.

3. Burdensome and Redundant Nature of The Paperwork and Information Requested

at Recertification

Several seniors and representatives from the CBOs also complained that the recertification

process was burdensome and redundant for non-working seniors on fixed incomes. Frequent

recertifications require seniors to report much of the same information and obtain many of the

same verification documents that were provided at the time of initial application.
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"I have a person (at KWA) who helps me fill out the forms. But, if they ask

me to do it myself, well I don’t think I would do it because it’s just too

bothersome and too cumbersome.” (Tacoma participant, translated from

Korean)

"But when you reapply, like I said, I have to reapply every 6 months so I

have to actually go to the apartment manager or landlord and ask them

for actual paper that I reside there and that’s very difficult." (Tacoma

participant, translated from Korean)

"They send out a paper every three months. What I don’t like is that it’s

the same thing. What is the system, that you always get asked the same

thing over and over again?" (Pasco participant, translated from Spanish)

"They’ll go through the whole application process initially and then three,

six months later, they’ll go through the thing all over again ... and their

circumstances aren’t changing but they have to do this dance and it

involves filling out the six page application again and the four

supplemental sheets..." (Seattle CBO)

4. Reporting Requirements for Working Seniors

Different from assumptions about the primary sources of income for seniors in general, many

of the Spanish and Korean elderly immigrants in the focus groups were working and not

receiving Social Security income or very little of it. Hence, issues related to working FSP

participants were also affecting seniors in these populations.

Working seniors, who are usually required to come in and recertify every three months in

Washington State, complained not only about the frequency of the recertifications but also

their requirement to report only minor fluctuations in their income and that these might make

them ineligible for food stamps from one month to the next.

“People work a bit with the bare minimum wage per month...Some

months you have more hours of work and some you have less hours of

working. Just because you have more hours of working they just cut you

off and then next month you have to reapply. I really wish they wouldn’t

do that.” (Tacoma participant, translated from Korean)
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One man said he had considered giving up his job in order to ensure the stability of the food

stamp benefit.

"You are working not so much for the income, but for your health too. So

maybe you are thinking you just quit everything and depend on welfare."

(Tacoma participant, translated from Korean)

A discussant in the Central Washington CBO focus group said that the fluctuations in income

for seasonal farmworkers in Central Washington make it hard for them to stay on the FSP even

though they are still in need.

“A lot of the Hispanics, you know, are seasonal workers and they might

work three to five months out of the year, but it seems they always get their

recertification notice at the time that they're working. They don't take into

consideration that those five months of income need to be spread out

throughout the whole year...But they don't qualify (because the five

months of income is assumed to continue for the entire year).” (Central

Washington CBO)

C. Reasons Some Eligible Elderly Participants Leave the FSP

Similar to the analysis of why some eligible elderly do not complete the application process,

the focus group discussions indicated that some portion of seniors are leaving the program

while likely still eligible due to what they perceive as burdensome reporting and recertification

requirements. Some said that they had left the program because of the verification

requirements and other paperwork they had to fill out. Language barriers, lost forms, and the

complexity and amount of paperwork required were all mentioned by either seniors or the staff

who work with them as reasons some eligible seniors chose not to continue participating in the

FSP at recertification.
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Workers in one office said that seniors with language barriers have trouble deciphering the

appointment notices and if they don't have a family member who regularly keeps up with their

mail they miss their recertification appointment and are terminated. Given the complexity of

the application process for seniors, it is likely that many eligible seniors choose not to re-enroll

after they have been cut off.

Several seniors complained that they had to provide the same documentation forms at each

recertification and that they couldn't understand why they had to go through the same process,

answer the same questions, and bring in the same paperwork over and over again. Several

English- and Spanish-speaking seniors said they left the program while they were still eligible

due to the complexity of the paperwork requirements, the repetitive nature of the questions

asked, and the failure of the office to help through the process.

"When I finally got on food stamps they sent out the form I had to send in

every month to tell them how much money I had that month and my

medical expenses. I had to send it in and the paper said, ‘If you have any

questions call your caseworker.’ The phone number was on there. I

always got a recording and never did in six months get a call back. I

called every month. Finally, (at recertification) they dropped my food

stamps and I stopped trying to get back on." (Seattle nonparticipant)

"I am not on the program anymore because they send out a form for you to

update your application and me having the poor vision, it took me a long

time with my magnifying glass to fill out the form. I spent half the day

doing it. I filled out the form. I mailed it in and just recently got a notice

that they had dropped me from the program because I didn't return the

paper. And I did send it in." (Seattle nonparticipant)

“They ask the same questions over and over. If you go twice a week they

would ask the same questions.” (Yakima nonparticipant, translated from

Spanish)

“I got annoyed and mad because they know everything already. They

know how many children you have, how much you’ve worked, how much

you earn. They know everything because they have copies from Social

Security. You go and they ask the same questions.” (Yakima

nonparticipant, translated from Spanish)
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One Korean-speaking food stamp participant said that while he was still on the FSP, his

experience of the complexity of the recertification process compared to the small amount of

food stamps he received was making him consider foregoing food stamps completely this time.

"Well I am planning to (recertify), but because the money is so little and

the process so complicated, I'm still contemplating whether I should do it

or not." (Tacoma participant, translated from Korean)

These complexities of the application and recertification processes, coupled with the special

needs of non-English-speaking seniors, are the major reasons why many eligible elderly do not

complete the application process, or drop off the program while still eligible. The next chapter

addresses some of the challenges posed to seniors who do complete the application process and

remain on the program, in particular, how these persons handle the receipt of their food

benefits using electronic benefits transfer (EBT) cards.
Chapter V 63

Chapter V 

Satisfaction with and Utilization of Food Stamp Benefits

Once seniors successfully navigate the application process and enroll in the FSP, they are

faced with a new set of issues. Similar to how food stamp benefits are administered

throughout most of the country, DSHS issues its food stamp benefits through an electronic

benefits transfer (EBT) system. In Washington State, recipients get their benefits from the

system using an EBT “Quest” card. Once determined to be eligible for the program, seniors

are issued a Quest card and given varying levels of instruction on its use. 

This chapter will focus on the issues related to seniors using their food stamp benefit to

purchase food in grocery stores. First, the opinions of community-based agency staff and food

stamp office workers are presented to provide context for the subsequent discussion of seniors’

experiences using the Quest card. The discussion of seniors’ opinions on the food stamp

benefit and the utilization of the Quest card is presented separately for those eligible for the

program, but not enrolled, and those currently on the program. The problems that seniors most

commonly face when using the card are then detailed, followed by seniors’ perceptions of

program abuse and stigma associated with use of food stamps.

A. Using the EBT System (the “Quest Card”) 

FSP caseworkers and the representatives of community advocacy agencies that assist seniors in

applying for the program possess rich knowledge and experience about seniors’ experience

with the FSP. The opinions of these discussants are presented below to frame some of the

issues asked of seniors in the focus groups. Their comments are meant to provide context, as

well as an outsider’s perspective on some of the problematic areas of program implementation.

This first section addresses CBO staff and food stamp workers’ opinions of the initial

transition to the Quest card for seniors. Next, these advocates comment on what they believe
Chapter V 64

to be ongoing issues related to the Quest card, and finally, seniors’ perceptions of the Quest

Card are presented.

Based on discussants’ comments, the food stamp offices vary in the degree to which they show

seniors how to use the EBT card. The Seattle food stamp staff said that when the Quest card

was initially implemented, the food stamp office continually showed an instructional video on

the EBT system in the lobby of the food stamp office. They also provided all participants a

pamphlet about the EBT card. However, the discussants in the Tacoma CBO focus group said

that seniors are not shown how to use their EBT cards properly in the local food stamp offices,

but are only issued a personal identification number (PIN). As a result, staff from this

particular CBO personally escort seniors to the grocery store to show them how to use their

Quest cards. 

Focus group discussants in Seattle and Tacoma who either work in food stamp offices or

community-based organizations that assist with outreach to seniors observed many problems

when the State initially made the transition to the Quest card. “They dropped like flies,”

according to a representative of a Seattle CBO, when DSHS made the transition to the EBT

program.

“I had quite a few elderly clients withdraw their applications because they

were confused on how to use the debit cards to get their benefits.”

(Tacoma food stamp worker)

A discussant in the Tacoma CBO group said it was a “nightmare” during the transition because

many seniors do not use credit cards and were intimidated by the technology. The Seattle

CBOs also noted that they received a lot of questions from participants in the early days of the

Quest card. In response, they organized and delivered many presentations in the community

about the new card and how to use it.

However, food stamp office and CBO focus group discussants from Seattle and Tacoma

believe that seniors have “gotten used to the Quest card.” Discussants from the Tacoma food
Chapter V 65

stamp office noted a drop in the number of problems after the card had been in use for awhile

and say it’s either because the seniors learned how to use the Quest card or because they

decided to have a family member shop for them. Likewise, the Seattle CBOs reported that

after a while, they stopped receiving questions and calls from social workers about the Quest

card. While they would like to think that seniors learned how to use them, they wonder if, in

fact, the seniors are simply not accessing their benefits. A few suspect that this is the case and

asked if the DSHS is examining non-usage of benefit among seniors on the FSP.

1. Problems Related to the Quest Card as Perceived by Food Stamp Office and

CBO Staff

Though some believe seniors have learned over time how to use the Quest card, this section

addresses some of the issues that focus group discussants believe are ongoing for seniors who

are either eligible for, or enrolled in, the FSP.

Food stamp workers in Seattle thought most seniors do not know they will receive benefits

through an EBT card when they initially apply. However, they believed that the Englishspeaking seniors are relatively comfortable with the EBT card, because most of the seniors

they encounter have bank cards and are familiar with the concept. Workers in the Pasco food

stamp office believe that most elderly who apply have already heard of EBT and know that is

how they will receive their food stamp benefits. They also said that they believe many of the

Hispanic seniors they serve do not personally use their Quest cards, but instead send a family

member to the store to shop for them. Unlike the staff who work with seniors in Seattle, staff

from CBOs and food stamp workers in Tacoma and Central Washington believe the Hispanic

and Korean-speaking seniors are not accustomed to using credit card-related technologies.
Chapter V 66

“I think there’s been a few elderly people who have not applied because

it’s just too overwhelming for them to try it (EBT).” (Pasco food stamp

worker) 

“A lot of elderly people---they just can’t change their mind set. I mean,

from personal experience, my grandmother---I’ve shown her how to

pump gas I don’t know how many times and she refuses to do it. She

still goes to the bank; she won’t go through the drive-through. She

doesn’t have an ATM card; she goes into the bank. But it’s just a

generation thing.” (Tacoma food stamp worker)

“We had a client that was 101, 102...I did my best to explain to her what

an EBT card was and then I had to stop and think that when we got EBT

cards or ATM cards, this was 50 years at least before she had any

information on that. And so I actually had to end up talking with her

daughter, to have her daughter come in and get the card so that they

could use it for her. She said, ‘Well, don’t they just send me the little

coupons any more?’ She could relate to that, but she could not relate to

the EBT cards as you guys have pointed out.’ (Tacoma food stamp

worker)

In addition to seniors’ comfort level with the technology, CBO and food stamp office focus

group discussants expressed other problems that they believe seniors have with the Quest card. 

! In Pasco, participants must return to the food stamp office to establish their

Quest card PIN number, a potential hardship for some seniors.

! A representative from a Tacoma-based advocacy organization that works with

the Korean-Speaking community noted that if seniors lose their card, they must

return to the food stamp office, which may take a few hours and requires the use

of an interpreter. 

! Discussants in the Seattle and Tacoma focus groups with community-based

organizations believed that seniors have difficulty remembering their PIN

number. This seemed to be a strong theme in the focus group that addressed

Korean-Speaking seniors. 

! Discussants in the Tacoma food stamp office group believed that the EBT

technology might be more confusing for seniors with limited English. 
Chapter V 67

! A discussant in the Seattle CBO said while she thought the 60-year-old

participants could adjust to the technology, it would be much harder for the

older seniors to get accustomed to the Quest card.

Having offered the perspective of the food stamp caseworkers and the community-based

agencies working with seniors in the community, the following section addresses seniors’

personal opinions of the EBT system.

2. Perceived Advantages and Disadvantages to the EBT System as Reported by

Seniors

Awareness of how the food stamp benefit is currently delivered in Washington varied among

seniors who were eligible for the program, but not enrolled. It appeared that most, if not all, of

the Hispanic nonparticipants in Central Washington knew that the benefits are awarded

through the Quest card. They also knew that the Quest card had an accompanying PIN

number. In Seattle, some knew of the EBT system, while others had never heard of it. Many

of the Tacoma nonparticipants did not know how the food stamp benefits were distributed. 

However, after the moderator described the Quest card, a few said they thought they had seen

them. 

In the focus groups, seniors often compared the advantages and disadvantages of the paper

coupons to the new EBT benefits. The opinions of seniors are presented below, first for

nonparticipants and then for current program participants. 

 a. Non-participants’ views

Non-participants offered their views on what appeared to be the advantages of the Quest card

over the previous system of paper food stamp coupons. According to some nonparticipants,

the EBT system:

" Provides privacy so that others do not know how someone is paying for their

groceries;

" Saves the government money since they no longer have to print paper coupons (so

people may be able to receive more food stamp benefits);
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" Prevents theft of food stamp benefits, which occurred with food stamp coupons;

and

" Discourages abuse by making it more difficult to sell food stamp benefits in order

to Αbuy beer and cigarettes.≅

Perceived drawbacks of the card mentioned by nonparticipants included:

" Seniors may spend their allotment too easily with a credit card-type of payment

system;

“There are a lot of people in our housing complex over here that now use

that when they go to the store...They tend to overspend where they did not

do that when they were issuing those other paper things or whatever they

were. They were a little bit more cautious about what they spent than what

they are with that card...you buy more than what you would ordinarily with

those other food stamps.” (Seattle nonparticipant)

" Seniors do not know exactly how much money is on the card and whether or not, or

when, their benefit has been credited to their card each month.

“I feel you (would) have more control over it (with stamps) than the card.”

(Seattle nonparticipant)

“When you run out of stamps you know you run out.” (Seattle

nonparticipant)

" Seniors thought they would have trouble remembering their PIN number.
Chapter V 69

“You have a PIN number to press. With the card, you know, there are a lot

of older ladies who don’t know how to use it. And the cashier has to press

the number for them. And you know, you can lose your PIN number. And

what if the person right next to you sees it? It’s not good. So when you get

a card, people find it inconvenient. The company that makes the card is only

benefitting from this.” (Tacoma nonparticipant, translated from Korean)

b. Participants’ views

Most food stamp participants from the English-speaking, Spanish-speaking and Koreanspeaking groups said they were comfortable using the Quest card and preferred it to the paper

coupons. Participants seemed to feel that using the card was fairly straightforward and

convenient. They cited similar benefits to the EBT system as those mentioned by

nonparticipants: lack of stigma at the cash register, prevention of theft, the possibility of

recovering your benefits should you lose your card, and the fact that food stamps may be more

economical as all one’s benefits (even your change) are spent on food. 

“I think this program, as far as the card, is a lot better because I hated

getting change back because it always went somewhere else.” (Seattle

participant)

“With the card, they can’t tell if you are a business man or what. Just slide

that card.” (Seattle participant)

“Yeah, you feel better and the people behind you don’t know you are on food

stamps” (Seattle participant) 

“I think I like it (Quest card) better than actually paying with that paper

money. Because you know that paper money is a voucher. Sometimes you

are embarrassed. So, I like using the card. You swipe the card. It looks like

a credit card or any other card, so I feel less embarrassed and shy.”

(Tacoma participant, translated from Korean)

“I like the fact that they created the Quest program because if you don’t take

care of your stamps, someone may steal them or you can lose them. Not the

Quest card. You don’t see any money, you only use the Quest card and that’s

it.” (Yakima participant, translated from Spanish)
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However, a few participants said they would prefer to receive food stamps the way they used

to be allocated in paper coupons. They cited similar drawbacks to an EBT system as

mentioned by nonparticipants: reduced ability to manage their limited food dollars, trouble

remembering the PIN number, and lack of certainty about how much of their benefit remains

each month after having spent some of it. 

“People who are older, they cannot get this because they don’t know the

PIN number on the card. So people who are older, they can’t even

remember their kids phone numbers, so how can we remember the PIN

number?” (Tacoma participant, translated from Korean). 

The preoccupation with the troublesome PIN number seemed to be particularly high in the

groups of Korean-Speaking participants, though Korean-Speaking seniors did not claim to

have trouble personally; they projected this potential problem on others who might find it

difficult to remember a PIN number.

B. Problems with the Food Stamp Benefit and Quest Card Reported by

Seniors

Some of the aspects of the program that compromise seniors’ overall satisfaction are related to

the food stamp benefit level or the types of foods they can purchase on the FSP. Also, despite

what appears to be general satisfaction with the Quest card, seniors do experience some

problems when using the card. Specifically, the alerts of non-use and not knowing the exact

amount of money remaining on their cards can be troublesome for seniors.

1. Allowable Foods and Benefit Amount

Some of the sources of participants’ dissatisfaction focused on the food stamp benefit,

including the amount, allowable foods, and using the benefit in the store. Some seniors

commented on the fact that they receive a relatively small food stamp benefit each month:
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“Well, sometimes I spend my $39 worth of stamps and I still end up

spending my cash money.’ (Seattle participant)

“It seems like so little.” (Seattle participant)

In addition to the amount of the benefit, some seniors addressed the fact that they cannot buy

any product they want on the FSP. For example, a Korean-Speaking non-participant noted that

one cannot purchase anchovies, a food commonly used by Koreans to flavor soups. Englishspeaking seniors also mentioned the program’s limited benefit, though one individual appears

to be confusing the WIC program with the FSP and seems to think one can only buy certain

brands of food:

“One thing that surprised me is that I got something from the deli that’s all

fixed. But you can’t get that. So, I get to the check out and I thought well

that’s food. And like toilet paper. You need toilet paper, but you gotta pay

for it.” (Seattle participant)

“And certain brands of food. The lower price or store brand, and only

certain ones of those that you can have. You can’t just walk in and buy it.

Milk, everything is on a certain government list and you can’t step out. 

Cereal, all of it.” (Seattle nonparticipant)

2. Saving Up their Benefit/Alerts of Non-Use

Seniors in the focus groups said they sometimes like to save up their benefit, especially those

who only qualify for $10 per month, for special occasions, like Thanksgiving or Christmas. 

They were accustomed to utilizing their benefit in this way when they received paper food

stamp coupons. 

“I buy food every three months when I collect $30.00. What am I going to

buy with $10?” (Pasco participant, translated from Spanish)
Chapter V 72

However, with the EBT system, food stamp participants receive “alerts” or written notices in

the mail when they have not used their Quest card for 60 days. After 90 days of non-use, the

food stamp benefits are “frozen” and they cannot use their card. They can, however, have their

account reactivated at the food stamp office for up to one year. 

Discussants in the Pasco and Seattle food stamp offices say that these alerts confuse the

seniors, as they can be generated for a balance of just a few cents. Discussants report receiving

a lot of calls from seniors inquiring about these alerts and some even go to the office to talk to

their caseworker about these notices. The “lucky ones” have their children call the office to

clarify the meaning of the alert. 

The experience of the food stamp workers are confirmed by this quote from a Korean-speaking

food stamp participant living in Tacoma, who was clearly confused by such a notice:

“Last year, I went through surgery and I didn’t get that much food stamps.

It was $10. But I didn’t get to use that and I went through surgery and I

forgot about it...One day I received a letter saying that if I don’t need the

food stamp they will just take it back from me. 

They said you didn’t use the food stamp last month, how come why are you

not using it and they said they will just take it back from me...So I made a

phone call and found out about it...So I went to the store myself and asked

and they said that the month before had not been used and this month also

was not being used so they were going to take it back. That’s the

experience I had.” (Tacoma participant, translated from Korean)

3. Uncertainty of the Current Level of Food Stamp Benefits

In addition to the confusing notices regarding non-use of benefits, seniors complained that they

do not know the value of the benefits that are “on the card.” Some senior food stamp

participants living in Pasco said they have taken their card to the office to find out how much

money they have left on the card. Other participants said they are embarrassed when they are

told by the grocery store cashiers that they have no funds remaining on the cards. Still others

said they are not sure when their card receives the deposit each month. A nonparticipant in 
Chapter V 73

Seattle had heard of this problem from acquaintances on the program: 

“Some of the women (in my apartment complex) talk about how they

never know when their food stamp allotment or whatever it is goes to the

store. They have to go there and check. Get on the bus, go to Safeway

or whatever store they go to see if they come in or not. A lot of times

they go there and they haven’t come in.” 

(moderator) “You mean the card hasn’t been activated or something?”

“Yeah, they say they haven’t come in. Later on in the month, maybe 5th,

6th, 10th, 12th or something. And they don’t know unless they go there. 

Betty was telling me that she always would buy some little item if she

had the money to make sure that the money for her food stamps would

come in. It don’t make sense.” (Seattle nonparticipant)

C. Other Concerns of Seniors Related to the Food Stamp Benefit and

the Quest Card

Stigma and program abuse were raised in some of the focus groups when the discussion turned

to shopping in the grocery store and the Quest card. This section addresses each of these

issues in turn.

1. Stigma Related to Program Participation and Use of the Quest Card

The issue of stigma or embarrassment associated with using food stamps was discussed in all

the focus groups. This section offers the different perspectives of caseworkers, community

advocates, nonparticipants, and participants. The groups who had the least to say about this

topic were those currently enrolled in the program, perhaps because they had overcome their

fear of embarrassment to actually enroll in the program and use the benefit.

a. Caseworkers and Community-based Organization Staff

Some individuals who participated in the CBO and food stamp office focus groups believed

that stigma was a problem for some on the program, as well as for those who are eligible for

the program. A discussant in the Seattle CBO group thought that the elderly had to first get
Chapter V 74

used to the idea of accepting public assistance and then on top of that, have to deal with the

fact that others in the community are going to know they are receiving it, such as other people

in the grocery store.

“Sometimes when they are at the grocery store, people behind (them) always

have a comment, not always, but a lot of them have commented. You know,

being its taking so long or whatever it is to teach them or whatever it is, and

you know, they criticize and say, ‘huh, food stamps, you know, get a job, go

to work,’ you know. So that’s intimidating to them, too embarrassing.”

(Central Washington CBO)

One of the Pasco food stamp workers said he knows seniors who are eligible for only $10 who

have decided not to continue participating because the embarrassment of using the card and

having their friends know they are receiving food stamps is not worth $10. Also mentioned in

this group was the strong message in recent years of personal responsibility that makes people

feel they are in the situation they are in for their own shortcomings. One of the Tacoma food

stamp workers thought the Asian seniors are more likely to use their food stamps at Asian

grocers where many people use them, so they are not as embarrassed or don’t stand out from

the rest of the shoppers. 

In addition to stigma experienced in using the benefits in the grocery store, representatives

from community-based organizations voiced strong opinions about the negative impact of the

EBT system on seniors’ use of food stamps at congregate meal sites and home-delivered meal

programs. A representative from a senior center explained that under the previous system with

paper food stamp coupons, it was possible for seniors to make confidential donations at

congregate meal sites or the Meals on Wheels Program using food stamps. He believes it was

easier for the seniors to use food stamps to pay for these meals because they could put their

food stamps inside envelopes and drop them into the donation box and no one would know if

there was cash or food stamps in the envelope. 
Chapter V 75

He now argues that the anonymity is gone because the seniors must use a portable machine to

make donations using their EBT card. He explained: 

“If they are going to use the EBT at the congregate meal sites...They have to

stand up in front of everybody and it’s going to be known that they’re using

food stamps and it’s embarrassing, so they won’t use them. We haven’t even

pursued it. As far as we’re concerned we would rather received nothing at

all from that person for a meal rather than have to embarrass them or ask

them to be embarrassed.” (Pasco CBO)

Another individual from a congregate meal program in Seattle agreed with this discussant from

Central Washington. 

“Before they could just discreetly walk in, put their food stamps into a

confidential donation box, feel proud that they were contributing for their

meal, save their other discretionary money...The process now is they come

into a site and if they want to use food stamps, they have to find a staff person

to complete a voucher. That staff person or volunteer then has to call, lock

in the donation and it’s a very cumbersome, kind of embarrassing process for

the clients. Then the Meals on Wheels clients, probably 60 percent of our

meals are delivered by volunteers in their own cars who are peers of many

of the recipients. They walk up; it’s the same process...Somebody has to say,

‘I’d like to pay for my meal with food stamps.’ So, they are just not using

them in our program anymore...Same with our mobile market. So, even if

they are eligible, they’re not using them.” (Seattle CBO)

b. Nonparticipants’ Views on Stigma Associated with the FSP

It is interesting to note that most of the discussions in the focus group on the subject of stigma

occurred with seniors who are eligible for, but not participating in, the program. Some Seattle

nonparticipants thought that others in the community look down on those using food stamps. 

One woman who had food stamps in the past interpreted other customers’ impatience in the

grocery store as intolerance toward shoppers using food stamps. 
Chapter V 76

“When I was homeless, when I’d get in line with my food stamps, they start

cutting out (of line) because I might have a lot of items that can’t be

(purchased with food stamps), and then the clerk got to deduct and tell me I

can’t have this, push this over to the side. And so people get out of line.”

(Seattle nonparticipant)

However, a nonparticipant in Pasco thought the EBT system might mitigate this issue:

“I think it makes people feel less embarrassed because the card looks like a

VISA.” (Pasco nonparticipant, translated from Spanish)

Some seniors in the Seattle nonparticipant group said they thought they would feel

embarrassed to buy certain things like meat or snack foods with food stamps or to use them in

certain places like convenience stores where food is more expensive. 

“People watching you when you’re using food stamps at the check-out line.

And if you do want a piece of meat, you feel embarrassed that you’re getting

a piece of meat with your food stamps.” (Seattle nonparticipant)

Yet, others said they wouldn’t care about what other people thought. Stigma did not seem to

be as prevalent in the Korean-Speaking non-participant group. 

“If they give me anything, I take (it).” (Tacoma nonparticipant, translated

from Korean)

“People envy those who have food stamps. In my apartment, I am the only

person who is not getting it. I envy them.” (Tacoma nonparticipant,

translated from Korean)

“I don’t care about things like that. You are using it because you are

rightfully using it. You are entitled, so it’s okay.” (Tacoma nonparticipant,

translated from Korean)
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Another Korean-Speaking senior said that it may be embarrassing for younger people to use

the program, but not for seniors: 

“If they are a young person, they don’t look that good because that person

should work hard and should not be benefitting from a program like that. 

When that person looks like an able body, but when it is an older citizen, then

no problem.” (Tacoma nonparticipant, translated from Korean) 

Finally, an individual in the Yakima nonparticipant group indicated that the men who feel

embarrassed to be on the program send their wives to the store to actually use the card.

c. Participants’ views on stigma

Compared to the nonparticipants, there was relatively little discussion in the focus

groups with food stamp participants on the subject of stigma. Most participants said

they preferred using the card over stamps. Participants in Pasco said they were not

embarrassed to use the card, because they need to. One Korean-Speaking senior on the

program explained that he did not apply initially because his son told him that food

stamps were not “good” because when you used them in the grocery store, the

Americans would “not have a good image of you.” This senior applied for the program

subsequently when he and his wife were living alone. 

In addition to addressing stigma, some participants volunteered their opinions about the

extent of abuse in the program with participants sometimes selling coupons for cash. 

The advent of the EBT system they said has positively affected this practice.

2. Perceptions of Program Abuse 

Interestingly, seniors in Central Washington were extremely concerned about abuse in the FSP.

The topic surfaced in all three groups conducted in Pasco and Yakima with participants and

nonparticipants alike. 
Chapter V 78

Though they seemed to think program abuse and fraud was more prevalent under the coupon

system, they reported that food stamps continue to be bought and sold, despite the use of the

Quest card.

“There was more trouble with the stamps...A lot of people sold them. They

would tell you, ‘Give me $10 and I will give you twenty in stamps.” (Pasco

participant, translated from Spanish)

“There are people who get stamps and give them to someone else for half

the price, for their vices and getting drunk. I have seen them selling the

stamps at half the price because the Tucanes (musical group) are in town

and they want to see them. They don’t care if the children go without

eating or rent. They are women without scruples.” (Pasco nonparticipant,

translated from Spanish)

“They told my daughter, ‘I will buy you $40.00 worth of food and you give

me $20.00.’” (Yakima participant, translated from Spanish).

“They take the person to the store to pick out the food and then they get the

money outside.” (Pasco nonparticipant, translated from Spanish)

The focus groups with Tacoma nonparticipants uncovered a different perception of abuse. 

Some were unsure if you were supposed to receive cash back from a transaction from a Quest

card, but at least one participant thought this was a form of program abuse.

“So I am just saying the people who misuse the system will get the

remainder cash and then use it for something else. I heard that it

actually happens.” (Tacoma nonparticipant, translated from Korean).

Seniors’ satisfaction of the program is affected by their experience redeeming their food stamp

benefit in the grocery store. As discussed in this chapter, most seniors on the program appear

to be comfortable with the Quest card, after an initial period of adjustment. What is not

known, however, is the extent to which the transition to the EBT system serves as a deterrent

to those who may be eligible for the program. While community advocates suggest that it may

present a formidable barrier, nonparticipants in the focus groups did not appear to be overly
Chapter V 79

intimidated by the technology. However, it is important to note that seniors’ comfort level and

familiarity with debit cards and other modern banking technologies varied considerably by

audience group.

In the following chapter, seniors and advocates share their thoughts and suggestions on the

best ways to promote the FSP with other seniors. They discussed what they believe are the

best ways to present messages about the program, as well as the ideal information channels

through which to transmit information to seniors. 
Chapter VI 80

Chapter VI

Outreach and Enrollment Assistance 

Word of mouth, program outreach, and available assistance to guide seniors through the

complexities of the application process help shape seniors initial perceptions of the Food

Stamp Program and the likelihood that they will apply. This chapter discusses program

information and client enrollment assistance for seniors. Section A illustrates that low-income

seniors hear about the FSP through a number of channels and some receive assistance in

navigating the food stamp application process from people they know and community

organizations. Section B provides an overview of the food stamp outreach program in

Washington State in Fiscal Year 2000 and a description of the specific programs funded to

provide outreach to three distinct groups of seniors living in three communities in the State of

Washington: 1) English-speaking seniors, 2) Spanish-speaking seniors, and 3) Koreanspeaking seniors. The final section of the chapter presents what focus group discussants

suggested as outreach methods, including effective communication channels and persuasive

messages to reach, inform and motivate nonparticipating eligible seniors to apply for food

stamps.

A. FSP Information and Enrollment Assistance Reported by Seniors 

This section provides a summary of how seniors report first hearing about the Food Stamp

Program and the assistance they have received to help guide them through the application

process. 

1. How Seniors Heard about the Food Stamp Program

Senior focus group discussants generally heard about the FSP through two primary channels:

(1) friends and relatives, and (2) community-based organizations. However, there were

differences across the focus groups in how they heard about the FSP and where they obtained

information about the program. In particular, the non-English-speaking discussants had more
Chapter VI 81

contact with food stamp outreach and client enrollment assistance provided by communitybased organizations than the English-speaking seniors.

a. English-speaking Seniors

Among the English-speaking seniors, the most common method of learning about food stamps

was through word of mouth. Family members, friends, and other people receiving food stamps

often provide seniors both positive and negative information about the program. 

“I was homeless and other women in the shelter told me about it, that I

would be eligible for food stamps. So, I went out and I applied for them.”

(Seattle non-participant)

A few seniors learned about the program through flyers, community meetings, and other

outreach methods employed by community-based organizations. 

“Here recently, within the past year, I received a little slip of paper that

says: If you make under $900 of income a month you would qualify for

food stamps... It was handed out to the line of people waiting at the food

bank.” (Seattle non-participant)

Among the English-speaking seniors, some were unable to identify how they first heard about

the program, but noted that they had known about its availability for quite some time and that

they or their children’s families may have been on the program as younger adults.

“I’ve always just known it was there.” (Seattle participant)
Chapter VI 82

A few English-speaking seniors learned about the FSP when they came in contact with other

community-based services or agencies. Some received information about food stamps from

social workers when they were discharged from a hospital. 

“I think it was when I first came home from the hospital after having a

double bypass and ... the hospital arranged for me to have a caseworker

and she was telling me about all the different programs. And, I went on

getting food stamps.” (Seattle participant)

Other English-speaking seniors said they had heard about the FSP while applying for benefits

at the Social Security office.

b. Spanish-speaking Seniors

Many Spanish-speaking elderly identified social networks as their main source of information

about the FSP. 

“Friends tell you. They say go there, so they can help you.” (Pasco

participant, translated from Spanish)

“There were many people who would tell me, go there, they give stamps.

Even when you work, it is hard sometimes.” (Pasco participant, translated

from Spanish)

“Nowadays we let each other know.” (Pasco participant, translated from

Spanish)

Several Spanish-speaking seniors first learned about the program when they came to the

country as immigrants or as migrant farm workers.

“When we came from Idaho...an asparagus contractor told me about food

stamps. I thought they were stamps for mail.” (Yakima nonparticipant,

translated from Spanish) 
Chapter VI 83

Other seniors in the Spanish-speaking groups said they first learned about the FSP when they

inquired about applying for other government services. 

“I had two children in school. I was divorced so I went to get welfare and

they helped me with stamps and medical for the children.” (Pasco

participant, translated from Spanish)

“I found out that stamps existed when I applied for my social security

when I turned 65.” (Yakima non-participant, translated from Spanish)

“I went to unemployment and I didn’t qualify. They sent me to welfare.”

(Yakima non-participant, translated from Spanish)

However, the Spanish-speaking discussants differed from the Korean-speaking seniors, in that

most did not hear about the FSP from a bilingual community-based organization.

c. Korean-speaking Seniors

The majority of the Korean-speaking discussants first heard about the FSP through the Korean

Women’s Association (KWA). Level of involvement with the KWA also seemed to influence

the degree to which Korean-speaking seniors were familiar with the FSP. Korean-speaking

non-participants were generally not very involved yet with the KWA, and had less knowledge

about the program than other participant discussants in the groups

“I found out about the Korean Women’s Association in Tacoma. So, I

visited the KWA in Tacoma and I told them about my situation and

because my wife is sick and I’m also ill. I told them that I am not able to

work, so they applied (for food stamps) for me.” (Tacoma participant,

translated from Korean)

“I found out in ’97 through KWA. I also was feeling ill and I asked them

and they told me that I should go buy food with this and from then on I’ve

been using them (food stamps).” (Tacoma participant, translated from

Korean)
Chapter VI 84

“My experience has been that they usually find out through Korean

Women’s Association. I have a lot of Korean elderly clients that work

through KWA and that’s usually how they find out information and how I

find out information on my clients.” (Tacoma food stamp worker)

A few Korean-speaking discussants also learned about food stamps when they were applying

for benefits at the Social Security office.

“I went there for Medicare and then that’s when they gave me a card for

the Food Stamp Program.” (Tacoma participant, translated from Korean)

“I came here last October and I received SSI, SSA and as I was getting all

of that the Social Security office told me that they will give me the food

stamps.” (Tacoma participant, translated from Korean)

A lot of people get it [food stamps] through the Social Security office

also... It is a big referral for us. (Tacoma food stamp worker)

Many Korean seniors resisted contacting the food stamp office, as they were worried about

their limited ability to speak English. One gentleman who had been to the office stated that it

was difficult to get information and an application and the office staff were unable to help him.

(Further discussion of language barriers at the food stamp office appears later in this report.) 

A few Korean-speaking senior discussants explained that they first learned about the FSP at the

grocery store where they saw people using food stamps.

“I live in a Senior Citizen’s apartment. Some people were going to the

market because they were buying something there and I looked and I said,

‘Wow, it’s not even money. You get this?’ And they said, ‘How come

you’re not getting them?’ (Tacoma non-participant, translated from

Korean)
Chapter VI 85

“The way I found out about the food stamp program was that I once

visited this grocery market...And then there was, it was not the currency

that people use, but it was something else that people were paying with at

the grocery and I asked what it was and that person said it’s a food stamp.

So I was wondering how these food stamps could be given out. And when

I asked I was told that it’s only for the low-income people. But that’s all I

heard.” (Tacoma non-participant, translated from Korean)

2. Assistance to Help Seniors Through the Application Process

During the focus group discussions, seniors participating in the Food Stamp Program talked

about the assistance they received while accessing the Food Stamp Program. While there were

several English-speaking seniors who did not receive outside assistance of any kind when they

prepared their food stamp application, most of the seniors in the English-speaking and nonEnglish-speaking groups said that they required assistance in the application process from a

friend, relative, faith-based organization, or other community organization. Several pointed

out that this help was critical to their completing the application process. Specifically, most

sought help in filling out the application form. Many mentioned receiving transportation

assistance to the office, while several needed help in interpreting the forms and correspondence

they received from the food stamp office after they filed the application. 

a. Assistance from Friends, Relatives, and Faith-based Organizations 

Our discussants reported that the most common and reliable sources of help for seniors in the

food stamp application process are people they know. They turn to people who help them with

other activities in their daily lives, including friends, neighbors, family members, or a faithbased organization they belong to.
Chapter VI 86

"I have eye problems, and because of medications I don't write very well... I

called (the food stamp office) and asked for help and they wouldn't do it. So

I had to get someone else to fill the application out." (Seattle non-participant)

"My daughter fills it out because I can't read or write very well nor can I see

very well." (Tacoma participant, translated from Korean)

"What I did was I brought my church pastor and he helped me out." (Tacoma

participant, translated from Korean)

“Before one guy who was the assistant manager in my building used to take

me all the time. He died. Now I ask my friends." (Seattle participant)

"My son took care of everything. He told me where to go and when I have

to go there for the interview. He dropped me off and then the office

translator was waiting for me there." (Tacoma participant, translated from

Korean)

"(An elderly food stamp client who lives in elderly housing) helps many

seniors get on the program... I think more elderly from that senior housing

are on food stamps because he's helping them apply for benefits." (Seattle

food stamp worker)

b. Assistance from Outreach and Enrollment Assistance Staff at

Community 

Many of the non-English-speaking food stamp participants in the focus groups in Tacoma and

Central Washington said they initially filled out the application form with assistance from

community-based organizations (CBOs). In Tacoma, staff from the Korean Women's

Association (KWA) go to their homes to help them or the seniors go to the KWA

neighborhood site that is very familiar to Korean seniors and where staff are bilingual. KWA

staff fill out the application form for the seniors, often mail it in and help them gather the

documentation they need to bring with them to the eligibility interview. In Central

Washington, a food stamp outreach worker travels around this primarily rural area to food

banks and health clinics to conduct food stamp outreach. As part of his work he also helps

seniors fill out the food stamp application form. In Seattle, the representative from Hopelink

noted that she does provide a limited amount of one-on-one client enrollment assistance in

Seattle, but most of her work focuses on general outreach and education. 
Chapter VI 87

Staff in the food stamp offices in Seattle and Central Washington and in the community-based

organization focus group in Seattle mentioned that the Aging and Long Term Care Agency

offers home visits to help families secure access to needed home care and insurance coverage

as needed. These outreach workers also assist homebound seniors or their spouses in

completing the food stamp application form. However, their focus is primarily on assuring

access to home-based care and they do not have the resources devoted to provide follow-up

services that could assist throughout the food stamp application process, as do the food stamp

outreach organizations mentioned in the focus groups. 

The seniors who had received assistance from CBOs spoke positively about the help they

received from these organizations. One Korean-speaking participant pointed out that he is

more comfortable receiving the assistance from the Korean Women's Association than from

his family because of the organization's expertise in food stamps.

B. Overview of Washington State Food Stamp Outreach Program

Since 1990, the State of Washington has contributed a significant amount of State funds to

improve food stamp participation by funding non-profit organizations to conduct local food

stamp outreach activities with specific target communities. In Federal FY 2000, Federal

matching funds for food stamp outreach in Washington State totaled $1,125,767, giving

Washington State the largest food stamp outreach budget of any State in the nation. 

Below is a brief description of the primary agencies that are conducting food stamp outreach

for the elderly groups of concern in this focus group study. 

! English-speaking seniors in Seattle. In the DSHS region four, the main

food stamp outreach contractor is a community action agency named Hopelink.

For services to inner-city seniors and other low-income individuals, Hopelink

also subcontracts with the Fremont Public Association (FPA). FPA administers

food banks, emergency shelters, housing assistance, and home care programs in

the city of Seattle and conducts a fair amount of citizen advocacy, including

organizing seniors to have a voice in their communities. 
Chapter VI 88

! Korean-speaking seniors in Tacoma. In the DSHS region five the main

food stamp outreach contractor is Senior Outreach Services (SOS), which

conducts outreach at senior meal sites, senior centers, food banks, and lowincome housing units. For outreach to the Korean community, SOS

subcontracts to the Korean Women's Association (KWA). KWA serves the

limited-English and non-English-speaking Asian and Pacific Islander

immigrants in this region (except Southeast Asian refugees who are served by

the Indochinese Cultural and Service Center). KWA provides a wide-range of

services for Koreans of all ages, including ESL classes, domestic violence

services, and senior meals once a week. The bilingual staff provides food stamp

outreach as an integral part of the services provided to Korean households

through in-office contact, contacts in the community, home visits, group

presentations, and public service announcements. 

! Spanish-speaking seniors in Central Washington. In the DSHS region

two, the food bank named Cascade Blue Mountain Food Share is the food stamp

outreach contractor for the State. Food stamp educators visit food banks and

health clinics to provide one-on-one outreach to Spanish-speaking seniors to

assist with applications. Workers also visit radio stations to conduct weekly

interviews. The community health center in Pasco (La Clinica) and the Yakima

Homeless Coalition are two subcontractors who also work closely with the

Spanish-speaking population in this area of the State. 

The discussants in the CBO focus groups confirmed that these State-funded outreach contracts

are the major source of food stamp outreach being conducted in their communities. When

asked to describe the kinds of outreach activities they are engaged in with seniors, the

representatives from the CBOs in these three regions reported using various complementary

strategies, including: community presentations, direct mail, and distributing State-created

materials. Many CBO discussants described their efforts to link potentially eligible seniors

with information about the program. Outreach workers visit food banks, elderly housing units,

and congregate meal sites to help people understand how to apply for benefits. 

"We’ve done presentations at senior centers. We’ve come in contact with

a lot of seniors at food banks that we’ve gone to throughout King County

and we’ve also had meetings and participated in other food and nutrition

outreach at the Seattle Housing Authority." (Seattle CBO)

Discussants in the Pasco food stamp office focus group explained that some informational

outreach is being conducted by their own staff through radio stations. 
Chapter VI 89

"The radio station does do outreach programs on all of our programs so

that we might pick a topic like food stamps or something and then...Some

of our financial workers or any of our staff will go to this radio station

and do a question and answer thing." (Pasco CBO)

Many of the CBO participants viewed food stamp outreach as one piece of a variety of services

they provide. Often, providing information/reaching out to inform people about the FSP is

incorporated into other activities and supports. These organizations often refer potentially

eligible individuals to the FSP. 

"I would say we have several programs that we run within our

organization for seniors and disabled and our application covers whether

or not they are getting food stamps and what their income is. So every

application we take in for whatever program is screened for food stamps

and whether they would qualify based on their income guidelines and

household size. So then we send them out a card saying, 'It looks like you

may qualify for food stamps. Contact us if you are interested.' " (Tacoma

CBO)

“The Senior Information and Assistance Line is a clearinghouse for

community resources so we can help seniors. We help educate and inform

them about what’s available and help link them up with different

resources in the community including the Food Stamp Program.” (Seattle

CBO)

One CBO discussant from the regional office on aging explained that additional outreach is

conducted through their Meals on Wheels workers. Although these workers don’t directly

answer questions, they are able to link seniors with information/materials to find the answers.

"On all applications for Meals on Wheels and for the Mobile Market, we

have a question that asks, 'Do you receive food stamps? And if not, would

you like more information?' And for people who do want more

information, we link them with the information so that they can pursue it."

(Seattle CBO)
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In the Tacoma CBO group, discussants from Senior Outreach Services explained how their

agency provides food stamp referrals and application assistance for elderly who have difficulty

leaving their homes. 

"We do a lot of food stamp outreach in some rural areas as well as within

the city. And most of the outreach is done to elderly people whom, for

whatever reason, have a difficult time getting out of their home and need

someone to come in and fill out the forms and get everything they need to

get them on [benefits]." (Tacoma CBO)

While the CBOs and food stamp offices discussed a variety of outreach activities targeted to

seniors, very few seniors in the English-speaking and Spanish-speaking focus groups reported

coming in contact with the current food stamp outreach work of the DSHS contractors or

subcontractors in their community. Some individuals in the English-speaking groups did note

that they had attended food stamp informational presentations in the past, although the timing

of these presentations is uncertain. When they did remember having attended such a

presentation, many of these discussants enjoyed the interaction with other people and the social

aspect of the presentations. 

"They have come and had seminars in the local library...[It was a good

presentation because] he was so cheerful. He was real cheerful. Serving

coffee and donuts. They did taste good. There were very nice people."

(Seattle non-participant)

On the other hand, most of the Korean-speaking seniors described outreach activities that had

been conducted by the KWA, the sole food stamp outreach contractor for Koreans in their

community.8

 

8 The finding that more of these focus group discussants were exposed to food stamp outreach activities

may be related to the tight knit nature of the Korean community in Tacoma as well as the broad array of services

that the KWA provides to them. Further, all focus group discussants in this target group were recruited by the

KWA, whereas in the other two communities there were multiple community groups involved in the recruitment

effort. 
Chapter VI 91

They discussed their exposure to variety of outreach methods, such as presentations in the

community and public service announcements on Korean radio stations.

"At the KWA they advertise it on the radio and they are actually doing the

promotion." (Tacoma participant, translated from Korean)

C. Discussants’ Suggested Outreach Strategies 

Discussants offered a variety of ways to inform more eligible seniors about the FSP. Although

many of these strategies are used in other outreach frameworks, the focus group discussants

provided insights as to how these strategies might be tailored to fit the needs of seniors. Their

suggestions can be divided into one-on-one outreach, group presentations, media, print

materials, and outreach specific to non-English-speaking populations. These topics are

addressed in this section.

1. One-on-one outreach

Many discussants expressed that seniors often respond best to personalized outreach efforts.

As the food stamp application process and office are often perceived by seniors as

intimidating, one-on-one education and application assistance was suggested by many

discussants as an effective method of reaching eligible nonparticipating seniors. Providing

information by word-of-mouth allows the seniors to hear the message from someone they trust.

This, combined with the one-on-one context, allows seniors to be more comfortable asking

questions to understand the process. One Seattle food stamp worker suggested an incentivebased method to encourage friends and neighbors to conduct food stamp outreach with their

senior peers, with the motto “Refer a friend and receive $10.” 

When asked to explain what they meant by one-on-one outreach the discussants provided an

array of creative methods. 

“Many seniors are willing to use the food banks....we could have someone

there more frequently to answer questions one-on-one.” (Seattle CBO)
Chapter VI 92

"Find elders that will go door-to-door, or maybe if you’re interested give

a call and somebody can call back and we’ll send somebody out...That’s

private, it’s one-on-one." (Central Washington CBO)

"Go through an SSI list and see who’s on food stamps and who’s not on it.

Maybe give them a call." (Seattle food stamp worker)

"Like a campaign when you have somebody running for office, you know,

going door-to-door." (Central Washington CBO)

"Ask them (seniors) during the interview to think of others or to get the

word out to others." (Seattle food stamp worker)

"Take them by the hand and walk them there (to the office)." (Seattle

nonparticipant)

2. Group Presentations/Meetings

Personalized outreach in group settings was also suggested by many seniors as a way to reach

and gain the trust of seniors. When seniors are in places where they already gather, such as

senior homes or centers, they are more comfortable to listen, ask questions, and learn about the

FSP. Other possible locations for presentations included libraries, cafeterias, and churches.

One CBO discussant also suggested including participating seniors at these presentations so

they could provide testimonials of their experiences. Many seniors suggested providing lunch

or dinner as an incentive for individuals to attend.

"If food stamps would go to the senior centers, have a day where they

could go in and apply for food stamps ... because it’s not so embarrassing

if you’re going in there with a bunch of other seniors to do the same

thing." (Seattle nonparticipant)

"Keep it to small groups. If you keep them down to a small group where

they can ask questions and where you could answer them." (Seattle

participant)
Chapter VI 93

3. Media

Discussants in all groups recommended using various forms of electronic media, such as

television and radio. Utilizing the Internet, especially to target “younger” seniors, was also

suggested a couple of times.

"Get the radio involved, get the TV involved...You’ve got to get the

information out there and remove the stigma." (Central Washington CBO) 

"An awful lot of seniors have email and Internet on their computers. A lot

of seniors spend time on their computers now...I would think a web page

on food stamps directed more to seniors even, on the Internet would

contact unfortunate people all over the U.S." (Seattle nonparticipant)

Using the radio or television, however, received mixed reviews. A few discussants expressed

that radio or television might have limited value as outreach strategies when targeting seniors.

"Some people understand (the radio) well, but some people don’t

understand it quickly enough on the radio. So, I think it is better to have

written material and get it promoted and dispersed." (Tacoma participant,

translated from Korean)

"Even if they see on TV that they qualify, the income guidelines, and this

and that, they’re still going to call and want somebody to tell them. It’s

not going to matter what they see on TV or what they hear on the radio.

They still want to hear it out of somebody’s mouth that is talking to them

as a person and saying this is what it is. The personal one-to-one that you

do doing the outreach work." (Tacoma CBO)

Using newspapers was also recommended as a method of getting the word out to seniors.

Suggested newspapers included both large city-wide newspapers and ethnic newspapers that

target specific communities and neighborhoods.
Chapter VI 94

"The senior centers also have a newspaper that is sent out. They could put

a little blurb in there." (Central Washington CBO)

Additionally, to identify other potential information sources for seniors, participants and

nonparticipants were asked how they keep up with news events or hear about community

events. Many individuals reported newspapers, television, and radio as their methods of

obtaining current news. A couple of nonparticipant discussants expressed that they rely on the

senior center for updates. Several individuals from the non-English-speaking groups expressed

that they rely upon non-English television, radio and newspapers.

"If you go to the senior citizens association you get it all. All the daily

things regarding seniors. If you go to KWA they tell you all." (Tacoma

participant, translated from Korean)

"I listen to Radio Korea...that’s where I get a lot of information."

(Tacoma nonparticipant, translated from Korean)

4. Print Materials

Participants offered many suggestions for using print materials to inform more seniors about

the FSP. These strategies included the use of flyers, brochures, and posters being distributed

and hung in grocery stores, laundromats, churches, health clinics, community centers, and food

banks. A couple of CBO discussants also suggested including information about the FSP in

mailings, such as utility bills.

"The food bank. If you can get them little slips like you get when you go

down to the food bank. They’ll give you a slip as to when they’ll be giving

commodities out the next time." (Seattle nonparticipant)

"A flyer, too, for people on the Meals on Wheels, the homebound, send

them a flyer." (Central Washington CBO)
Chapter VI 95

“Putting information into utility bills. Whenever we advertise things in

utility bills we get calls all the time...When you put information in things

that are going to their house, especially when it is as important as a bill,

they’ll make sure to go through it.” (Seattle CBO)

"Have a sign up on the wall where they can read it. That would be the

best. (Put a sign up where you) walk in the supermarket. Outside when

you walk in the door. You can get the word out better that way than any

other way." (Seattle nonparticipant)

"We could put it on our bulletin board... (and at) all the rest of the senior

housings. There are six of them here with 100 apartments in each one."

(Seattle nonparticipant)

"In that little booklet that you get when you start getting near the age for

Social Security you receive a booklet about your benefits. Why not put it

right in there. Say, 'Also, you might be [eligible] or will be if you draw

this X amount.’ And when they list your benefits put food stamps there

and say, 'You also become eligible for food stamps.'" 

(Seattle nonparticipant)

5. Outreach for Non-English-Speaking Senior Populations

Culturally appropriate materials were also identified as critical components of the community

outreach framework, due to large ethnic populations across Washington State. The Spanishspeaking and Korean-speaking groups recommended advertising in Spanish, Korean, or multilanguages in ethnic newspapers, radio ads, and posters.

"If you take them [seniors] someplace besides the Tacoma Community

House, they don’t feel comfortable...If they go to the Tacoma Community

House, they see all the elderly and they see people that speak their own

language, they’re more comfortable, too." (Tacoma food stamp worker)

"If it is in Korean, yes I would read it. But, if it’s in English then it’s

difficult. Maybe they can put it in multi-languages...that would be so

much more convenient." (Tacoma nonparticipant, translated from Korean) 
Chapter VI 96

"I would post some posters and stuff at some of these little Hispanic

grocery stores." (Pasco food stamp worker)

"When they send you Medicaid [information] all the instructions are in

English, Korean, Chinese. So, likewise, if they make a [food stamp]

pamphlet like this and send it to Americans or Hispanics or Chinese I

think that everybody will be able to utilize it." (Tacoma nonparticipant,

translated from Korean)

6. Organizations to Involve in Outreach Efforts

When discussants were asked about additional organizations that could be included in outreach

efforts, many of the responses included places seniors already rely upon for information in the

community. Many individuals mentioned churches, senior housing, and senior centers.

Additional sites mentioned included health centers and clinics. One individual also mentioned

the Veterans Association, as many seniors are former members of the U.S. Armed Forces.

"Churches. Seniors mostly go to Sunday morning if they are going to

go...It would have to be after church on a Sunday morning." (Seattle

participant)

"Every Wednesday we (senior citizens association) have a meeting. About

150 people gather together. So if you pass out some papers like this it will

be very nice too." (Tacoma participant, translated from Korean)

D. Discussants’ Suggested Outreach Messages and Spokespersons

Not surprisingly, the messages discussants believe the State of Washington should emphasize

in its program outreach parallel many of the perceived barriers seniors encounter when

applying for food stamps. Frequently suggested marketing messages included the following:

! Outreach materials need to address the difficulties experienced by many seniors

in asking for assistance. Discussants suggested that materials should explain

how seniors have worked all of their lives, have paid their taxes and supported
Chapter VI 97

public programs, and are due to receive something back now that they are in

need of a little support themselves. One Tacoma food stamp office discussant

recommended writing “Take One for a Friend” on pamphlets and other packets

of information to reduce the stigma that elderly often feel when requesting

assistance for themselves. Examples of messages suggested by focus group

discussants are:

“You have earned this, it is not a handout.” (Central Washington CBO)

“Are you missing out on one of your rights?” (Seattle nonparticipant)

! Educating seniors that EBT cards are now the way food stamp benefits are

given out can counter the stigma seniors associate with using the food stamp

coupons at the grocery store. 

"These days it is like...a debit card so nobody would even know if you did

anything." (Tacoma CBO)

! Focus on health as a primary concern of seniors and stress the importance of

caring for themselves. One Seattle CBO discussant suggested that the FSP

could partner with other organizations promoting good health.

! Emphasize that food stamps are available to bridge the gap between rising food

prices and stable incomes.

“Could you be eating better for less?” (Seattle nonparticipant)

"Prices on food have gone up. The money that you receive hasn’t. Food

stamps are there to help bridge that gap." (Central Washington CBO)

! Stressing the importance of even the $10 in food assistance was suggested.

Every little bit helps to buy something extra. Discussants suggested messages

emphasizing that even if the benefits each month total only $10, these totals free

up money for other necessary expenses like medicine or utility bills. 

! Clarify program information and program intent, especially for non-citizens.

Some seniors are unfamiliar with the structure of government programs in the

U.S. and fear that receiving food stamps will either affect their status with the
Chapter VI 98

Immigration and Naturalization Service or that their children will one day have

to pay back the government for the benefits received.

Members of the Central Washington CBO also recommended targeting the outreach to seniors’

children, neighbors, and family members, as seniors often do not admit they need assistance.

As noted in Chapter III, seniors are most successful with the application process when they

have a family member or friend supporting them in the process.

"What is most successful is when you have a family member or somebody

that walks you through it and supports you, encourages you. That’s also

the person that is probably going to bring it (food stamps) to your

attention." (Central Washington CBO)

Focus group discussants were also asked who they believe seniors view as trusted sources of

information in their communities. Many discussants expressed that seniors rely upon

individuals that listen to them and make them feel comfortable. These trusted individuals often

include fellow seniors who are respected in their peer groups as reliable individuals that others

feel they can relate to. 

"Another senior. Someone from our own building. Someone you know

that you can talk to. Someone of your own class." 

(Seattle, nonparticipant)

Health care providers, such as doctors or nurses, were also cited by discussants as individuals

that seniors trust as reliable sources of information.
Chapter VI 99

"I think if it’s a physician that is still practicing in the community, and

they [seniors] know that physician, and they know that physician isn’t, you

know, the perception of the typical money-hungry doctor. If they have a

good rapport with the community, with their clients. If they have a lot of

senior clients I think it could be very effective." (Central Washington

CBO)

"Physicians from the clinics, it is obvious they are not there for the money,

they are there for the people. They are there to help people and I think

they would carry more credibility than a lot of other individuals in the

community." (Central Washington CBO)

"We have a doctor. He’s the chief doctor at Ballard Hospital and he came

around...He said he really enjoys seniors and he thought people should do

more for them. He’s trying to get more seniors more active in the

community. But they came and they made a dinner and they cleaned it all

up and it was wonderful." (Seattle participant)

Several discussants also reported that priests/ministers/clergy are viewed by seniors as trusted

sources of information, while a few suggested representatives from government agencies or

CBOs. One nonparticipant group in Seattle expressed that seniors view the local public

official as a trusted source of information. They explained how the mayor often stops by for

visits at the senior housing units and, instead of having a set agenda of his own, he is willing to

listen to any concerns the seniors bring to his attention. 

Focus group participants suggested a variety of creative methods of getting the word out to

seniors about the FSP. Using the information gathered during these focus groups, current

methods of outreach utilized by the State of Washington could be tailored to better meet the

needs of elderly populations. Many of the recommendations provide insights into the elderly

population and are strategies that can be incorporated into existing outreach. 

The next chapter presents focus group discussants' recommendations for improving the

program. In addition to the outreach recommendations outlined in this chapter, discussants

offered many specific suggestions for ways to improve FSP operations and program policies to

improve access and participation for eligible seniors. 
Chapter VII 100

Chapter VII

Discussants’ Suggestions for Changes in Policy and

Program Operations 

In addition to asking focus group discussants for suggestions of ways to improve outreach

methods and thereby increase the number of seniors participating in the FSP, HSR also asked

them what changes they would suggest be made to the FSP to make it more accessible to

seniors while better meeting their needs. 

A. State and Local Program Operations

Discussants suggested a number of ways the FSP could improve access and participation of

seniors. These included changes in the application and recertification process, and changes

to the delivery of food stamp benefits.

1. Changes to the Application Form

Many discussants reported that the existing application form was lengthy and burdensome for

seniors to complete. They said reducing the number of questions, especially those that do not

pertain to senior applicants, or creating a separate form for seniors would make it easier to

complete. 

"Simplify it. That way you don’t have to go to a lot of trouble filling out

forms. Then they send you to this agency and fill out the forms for this

agency, and then they send you to another agency. You fill out some more

forms.. oh boy!" (Seattle nonparticipant)

"There should be a short form. They’ve started getting short forms for

other programs but not one for Food Stamps." (Seattle CBO)
Chapter VII 101

"I think I’d recommend revising the application so that it would be only

one page long for seniors." (Seattle food stamp worker)

Additionally, some discussants suggested increasing the print size of the applications to make

it easier for seniors to read. 

"Recently, we’ve been getting applications from the QMB Medicaid

Program and they’re in larger print. That might help." 

(Seattle food stamp worker)

A few food stamp workers also suggested including a question on the application asking

whether or not seniors were interested in a telephone interview to make it easier for food

stamp workers to identify applicants in need of a telephone interview.

"I wish the application had something on it where it would say that you could

ask for a telephone interview...So I wish it would say, 'If you are over the age

of sixty-five or if you are disabled, ask for a phone interview.' " (Seattle food

stamp worker)

2. Improvements to the Food Stamp Office Environment

Suggestions were put forth by many discussants to improve the environment of the food

stamp office. Representatives from a couple of CBOs and food stamp offices suggested

incorporating training for workers to better understand the needs of elderly applicants and to

improve overall customer service. 

"How about if we do a little training on elderly sensitivity and maybe train

our workers to be a little more sensitive toward the elderly as to what their

needs are." (Pasco food stamp worker)
Chapter VII 102

Several other discussants suggested changing the physical characteristics of the food stamp

office. A couple of seniors suggested creating a separate senior section at the food stamp

office away from the families with children, and even food stamp workers acknowledged that

the front office as it is currently designed can be intimidating to seniors.

"The ones that belong to the welfare...go there. Keep them separate.

Don’t put them all together like they do down here. This building down

here is crowded upteen miles wide." (Seattle nonparticipant)

"We could soften our area out there. You walk in and you’ve got to come

through a counter, but if we soften the area where the person could walk

up to a counter where this person is sitting, that person would be able to

sit down and talk to them rather than me standing behind a counter this

high." (Tacoma food stamp worker)

3. Outstationing Eligibility Workers at Community Sites

Many seniors, food stamp workers, and representatives from CBOs working with seniors

suggested moving the application process away from the food stamp offices to other sites in

the community that are viewed by seniors as non-threatening, non-institutional settings.

Sending food stamp workers to these sites, including senior centers, CBOs, and senior

housing complexes, to process food stamp applications and conduct eligibility interviews

allows the seniors to remain in places where they are already comfortable and increases their

likelihood of participating. 

"I’ve got a neat place to go and apply for food stamps. At the senior

center here we have the legal clinic that’s free that you can make an

appointment to go talk to an attorney about things. One day a week right

now they have a specialist in supplemental health insurance for seniors

because that’s a program that’s hard to get started and everything. If the

Food Stamp Program would go to the senior centers, have a day where

they could go in and apply for food stamps...It’s not so embarrassing if

you’re going in there with a bunch of other seniors to do the same thing,

like it can be at other places. It can be set up very easily at all the

different senior centers, even." (Seattle nonparticipant)
Chapter VII 103

"I was in Colorado and I was actually outstationed at the Social Security

office to do disabled and elderly applications for food stamps....and it

works very well. And, in fact I was in Denver and we were also outstationed in hospitals and other community centers throughout the city so

that people did have quicker and less complication of a front desk or lobby

situation. We went in one-on-one to a person, got an application, set up

an interview possibly that very minute.” (Tacoma food stamp worker)

"I find that the embarrassment is one part of it, but the biggest thing is the

inconvenience ... about the translation and the transportation to get to our

office...Instead of having the elderly come to us, we should go to them."

(Tacoma food stamp worker)

"And they would be among their peers in the other outreach areas rather

than to come here in between crying babies and running children and

storming and stamping adults and that kind of thing." (Tacoma food stamp

worker)

A few food stamp workers did express concern that if workers were outstationed at other

community sites, it would be important to have workers at the off-site locations who

understand the eligibility and benefit rules. 

“Outstationing and outreach is really a good way to go. I have to say,

though, our senior outreach worker, because she’s not a financial worker,

sends up a lot of applications that are not eligible.... If she was a financial

worker, they wouldn’t have wasted their time or they get ten dollars and

they’re very disappointed.” (Tacoma food stamp worker)

A few English-speaking nonparticipants suggested moving the FSP application process

completely out of DSHS offices.
Chapter VII 104

“I think food stamps should move to its own program and I know that

they’d be able to take care of helping people with their applications. The

caseworkers at DSHS have so many rules and regulations for all things

that they have to keep track of that they just aren’t able to be exact on

following up on the questionnaires for food stamps.” (Seattle

nonparticipant)

“I honestly believe that if the Food Stamp Program was not handled

through DSHS, if it was a separate organization that did nothing but

worry about the food stamps and if somebody went to DSHS and they

qualified, then DSHS could get them their food stamp approval. But, I

think the Federal government ought to have the food stamps completely

separate from DSHS.” (Seattle nonparticipant)

4. Coordination with the SSI Application Process 

In FY 2000, Washington State received approval from FNS to implement a demonstration

project for the Washington State Combined Application Project (WASHCAP). The

demonstration project, not yet implemented, will test a method for SSI applicants who meet

food stamp eligibility criteria to have their eligibility and benefit amounts for food stamps

determined automatically when they apply for Supplemental Security Income (SSI) at the

Social Security Administration office. That information will be electronically transferred to

DSHS, so that individuals applying for SSI will be able to have their food stamp eligibility

and benefits determined automatically without having to fill out additional paperwork or

make a separate visit to the welfare office. 

Moderators asked seniors and representatives from CBOs what they thought about automatic

enrollment for food stamps through SSI. Overall, the response was very positive.
Chapter VII 105

“I would like it if I applied for something at Social Security if they can tell

or know by my income at that time that I’m eligible and they would send

me the forms or simplify it...Couldn’t it automatically come in the mail to

me that hey, now you are eligible for this, or this is what you might get?

But now I gotta leave that agency (Social Security) and go to another one

and stand in line, go in this big room, and cry my heart out to even see if

I’m eligible. It doesn’t make sense.” (Seattle nonparticipant)

"I think it would be a small step in the right direction. I think obviously

that if we did something like that, if it flourished and worked as it’s

supposed to, which it sounds like it probably would, but then it could be

moved beyond SSI to Social Security and then go from there." (Tacoma

CBO)

Many senior discussants would welcome the simpler application process and eliminated

visits to the Food Stamp office. A couple of nonparticipants believed it would be a more

private and easier process. 

Under the WASHCAP demonstration, seniors would have a standardized food stamp benefit

amount. This could mean reduced benefits for some seniors compared to what they would

get if they applied at the food stamp office and could benefit from all the detailed deductions

available. When participating seniors were asked about the combined process in the context

of a lower benefit level, seniors expressed that the convenience of the process was worth the

trade-off.

“I think that’s still better than telling us to come to the same place back

and forth, back and forth.” (Tacoma participant, translated from Korean)

“It doesn’t matter. I’ve been completely broke. At one point I was

homeless with five children and pregnant. I wish I could have had $5.00

to buy something because I had to go to the stores and ask for the food

they were going to throw away. I won’t die of hunger if they give me only

$5.00 when I need it.” (Yakima participant, translated from Spanish)
Chapter VII 106

While this suggestion was met with generally positive reactions, some food stamp workers

expressed concern about how much information SSI workers would have about the FSP to

answer applicant questions and who would be responsible for follow-up with clients.

5. Electronic Benefit Transfer (EBT) System

With the recent transition from food stamp coupons to EBT, many seniors participating in the

FSP have struggled to learn the new system. Focus group discussants provided

recommendations that included more support and education about the new system to

familiarize seniors with the changes. Many program participants expressed confusion

regarding the EBT system, especially with regards to keeping track of PINs and account

balances. One food stamp worker suggested that seniors should be educated at the grocery

store. Having someone accompany seniors while they figure out the system for the first time

provides an opportunity to further educate them about the system. Another discussant

suggested having a video at the time of application to demonstrate the process. Finally,

another discussant suggested demonstrating the process during Hispanic television programs

frequently viewed by seniors.

Focus group discussants also explained how the introduction of the EBT system has

restricted seniors’ access to congregate meal sites and home-delivered meals. When coupons

were still being used by the program, seniors would apply their benefits for use at congregate

meal sites and for home-delivered meals. Now, however, the EBT cards require meal

programs to have special systems in place to accept the cards as payment, and many sites

have been unable to fund these changes in their payment systems. Although payment is not

required at congregate meal sites, many seniors felt proud that they were contributing instead

of receiving a free hand-out. The stamps also gave providers partial reimbursement for

meals and constituted a part of their organization’s income stream. Without the use of paper

coupons at these sites, many seniors have opted not to utilize the meal services and many

providers have lost a part of the income they depended upon to support their meal programs.

CBO representatives in Seattle suggested either giving seniors the option of paper food stamp

coupons or simplifying the cards so that more congregate meal sites and home-delivered

meal programs could still accept food stamps as donations.
Chapter VII 107

"Simplify using those cards in more places if they’re going to insist on

having this system, if they really won’t give an option in paper, which I

still would support as my first option.” (Seattle CBO)

6. The Recertification Process

As noted in an earlier chapter, seniors often find the recertification process burdensome and

redundant. As the majority of seniors have fixed incomes and expenses, frequent

recertifications require seniors to report much of the same information and provide many of

the same verification documents that were provided at the time of initial application. Many

discussants suggested lengthening the certification period for seniors so they would not have

to reapply every three or six months. 

"I think that the certification should be put out as far as we can. Because

generally among our elderly, their income doesn’t change.” (Pasco food

stamp worker)

"The paperwork is too complicated for a person who works. I wish the

whole process was done once a year, not every six months. I think that is

just too complicated." (Tacoma participant, translated from Korean)

Additionally, a couple of discussants from the CBO group in Seattle expressed a desire for

the recertification process to be more accommodating for seniors. When seniors receive

recertification letters or packets in the mail, often the information is confusing. Few

understand the process or know where to turn for help. As mentioned in previous sections,

seniors respond better to one-on-one contact and more personalized treatment.

"I think it is really distressing to feel like you are doing what you are

supposed to be doing and then the computer-generated letters...are really

alienating. It just makes the whole program a little less userfriendly."(Seattle CBO)
Chapter VII 108

"If you’ve seen those letters, they’re written very much...’You are going to

be cut off on this date.’ And so it’s like you’ve already done something

wrong by the time you get that letter...” (Seattle CBO)

B. Federal Program Rules 

Focus group discussants also provided suggestions for ways to change the rules for

determining FSP eligibility and benefit levels. These topics are discussed below.

1. Increasing Food Stamp Benefit Levels and Cashing Out Food Stamps 

Since the Food Stamp Act of 1977, there has been a minimum benefit level amount in the

Food Stamp Program that provides any eligible applicant with a guarantee of at least $10 of

benefits. During the focus groups, many discussants expressed a need to increase this

minimum benefit to keep up with current food prices. Seniors and those who work with

them feel that the current $10 minimum level of food stamp benefits available to seniors

provides minimal support and, as described in Chapter III, many seniors often consider the

low benefit level not worth the cost of the application process.

"With the way prices are going today, I think we should start the program,

like say right now there are a lot of us getting $10. At least start the

program at $25." (Seattle participant)

"I think they should give one person at least maybe $125 worth of food

stamps. Or maybe $150 worth for one person." (Seattle participant)

"If the minimum was worth something, people would come in and take

time...to apply." (Tacoma food stamp worker)

"I think one way the Federal government could simplify the rules is that

once you reach a certain age and you are on a fixed income, you

automatically get something more than $10." (Pasco food stamp worker)
Chapter VII 109

A few CBO discussants expressed that seniors should be eligible for a greater benefit amount

compared to other program participants at the same income level. As seniors are often less

mobile, many tend to prefer prepared foods over preparing meals from scratch, which leads

to a higher food bill.

"One of the big issues for seniors, no matter what their income level, is

getting people to eat because it becomes too much trouble to eat. And one

of the ways that it’s not too much trouble to eat is if you can go to the

freezer and take something out and put it in the microwave and have it

ready to eat in, you know, ten minutes and it tastes good. But that’s more

expensive food." (Central Washington CBO)

A few participants expressed a desire to combine food stamp benefits with SSI benefits to

receive one lump sum of cash.

“I want them to add it to SSI. I think it will be more comfortable when it

comes to administrative procedures as well. And then for us too I think it

is easier too.” (Tacoma participant, translated from Korean)

“Why don’t they just give us everything in cash. Administratively it will

be easier and good for us, too.” (Tacoma participant, translated from

Korean)

2. Changes to Benefit and Eligibility Determination Rules

Several suggestions were put forth to change the food stamp eligibility and benefit

determination rules for seniors. Other suggestions were based on simplifying the eligibility

process and verification requirements in ways that would particularly benefit seniors. The

recommendations included:

! Providing a standard shelter deduction for everyone paying their own shelter

costs (including rent and utilities);
Chapter VII 110

“Another thing that would be helpful to the elderly clientele and to all

clientele is if they just said, ‘We don’t care if you are paying $50 or $500

for rent, here’s what the standard deduction is for everybody.’”(Pasco

food stamp worker)

! Allowing seniors to own higher valued vehicles; and

“In America you can not live without a car...if you pay $1000 or more

then you get a better car that doesn’t break down often so it is more

convenient. But, if the car is cheap than it is going to break down all the

time and that will cost a lot of money.” (Tacoma participant, translated

from Korean)

! Raising the upper limit on resources a senior can own. 

“It is a very low resource limit. $3000 for someone who is 65-70 doesn’t

go very far, but it disqualifies them from food stamps.” (Seattle CBO)

3. Other Suggestions

Focus group discussants also provided other interesting suggestions. These included:

! Both participants and nonparticipants expressed a desire to have greater

flexibility with their benefits. This would allow them to purchase items

separate from food with their benefits or deli/prepared foods.

"I think you should be able to buy health benefits with the food stamps,

such as your soap, toilet paper, dental supplies. I think you should be able

to buy that with the food stamps. What good is it going to do you to get

help when you need a roll of toilet paper in your house, or a bar of soap?

You gotta clean up what you mess up." (Seattle nonparticipant)
Chapter VII 111

! One non-participant suggested that he and his peers would be more likely to

apply for food stamps if potentially eligible seniors could apply for food

stamps whenever they have to go to the Social Security office to apply for

benefits or report any changes, not just when they apply for SSI.

“At the time when one applies at the Social Security Office for SSI or for

some other form of assistance, at that time a form should be included for

food stamps. It should be a one time, one stop effort for seniors. Not two

separate applications.” (Seattle nonparticipant)

! Focus group discussants proposed better coordination between Federal and

State governmental agencies as a way to alleviate some of the seniors’ burden.

By sharing information, seniors do not have to provide the same information

to multiple agencies.

"I would like to see more coordination with the various social service

agencies because I think with our cooperation we can certainly make it

run more efficient as far as getting people on food stamps and through the

process." (Tacoma CBO)

! As the WIC program is often viewed as a consumer-friendly program, several

discussants in the Seattle CBO group supported the creation of a senior WIClike program where participants would receive vouchers for food along with

nutritional assessments, nutrition education and referrals to other programs. 

“There could be a nutritionist they see every three to six months for an

assessment and we would know a lot more about the nutritional status of

our seniors... And, referrals, like the WIC program gives referrals. They

would have the face-to-face interview, be assessed, and get referred to

other things they need. That would be wonderful for seniors.”

(Seattle CBO)

Overall, focus group discussants provided some useful and creative insights that can be used

to strengthen participation in the FSP. These recommendations address various aspects of
Chapter VII 112

the FSP and include changes to program operations, the physical environment of the food

stamp office, the administration of benefits, and the recertification process.
Chapter VIII 113

CHAPTER VIII

Key Policy and Programmatic Options 

The previous chapters discussed factors that influence FSP participation among seniors, and the

many suggestions of focus group discussants for increasing food stamp participation among both

English-speaking and non-English-speaking seniors. This chapter will highlight the key Federal

policy, outreach, and program operations options that follow most directly from those findings.

Section A presents three options for Federal policy changes that would directly address the

mostly commonly cited barriers to participation by seniors. Section B presents suggested

approaches to reaching out to eligible low-income seniors to encourage them to apply and

encourage their completion of the application process. Section C focuses on improvements to

State and local FSP operations. These options were developed during a full-day strategic

planning session in Washington State that was facilitated by the HSR study director in October

2001. They build upon the focus group findings on the factors affecting seniors’ completion of

the application or recertification process and suggested program improvements raised by focus

group discussants.

A. Options for Changes to Federal Program Rules

1. Increase the Minimum Food Stamp Benefit Level

As discussed in Chapter II, eligible nonparticipant seniors in the focus groups expressed great

concern about the $10 minimum benefit level for food stamps. Though this is not the amount of

food stamps that most elderly households receive, because of the income they receive from other

sources, such as SSI or Social Security, approximately one in four elderly households on the FSP

receive only $10 in food stamps each month (Castner and Rosso, 2000). During the focus groups

with eligible nonparticipants, seniors said that although they believed they needed food

assistance, the administrative difficulties involved in applying for food stamps were not worth

the small amount of benefits they thought they could receive. Input from CBO representatives
Chapter VIII 114

during the focus groups also confirmed that the small dollar amount many elderly are eligible to

receive is a major deterrent to FSP participation for all seniors, whether they are eligible for only

the minimum or a higher level of food stamps. 

In response to this concern, the most common suggestion to promote FSP participation among

seniors was to increase the minimum food stamp benefit level, which has not been increased

from $10 since it was put in place in 1977. 

2. Allow Seniors to Apply for Food Stamps Where they Apply for Other Programs

Among the major factors dissuading low-income seniors from pursuing food stamps are stigma

and pride. The belief that receiving food stamps marks an individual as a welfare recipient who

is dependent on the government, combined with the discomfort many seniors expressed with the

welfare office setting and the application process they experienced there, lead to a suggestion to

move the food stamp application process for seniors to non-welfare agency sites. In this regard,

it is significant to note that English-speaking seniors in the focus groups said they did feel

comfortable with seeking benefits from the Social Security Administration or health insurance

benefits.

As a solution to these problems, and given their perception of Social Security as a more userfriendly system, several English-speaking seniors, both participants and nonparticipants,

suggested that seniors be able to initiate and complete the food stamp application process at the

local Social Security office (whether they are receiving SSI or only Social Security). CBO

representatives also suggested coordinated and automatic applications for food stamps when

seniors apply for Medicaid at non-welfare office sites.

3. Administer the FSP for Seniors as a WIC-like Nutrition and Health Program

When discussing the value of the FSP, it was apparent that seniors are quite interested in

nutrition and view the FSP as a mechanism to purchase more healthy foods. An interesting

suggestion that arose in the focus group with CBO representatives in Seattle was to create a new

model for the way food stamps are provided to eligible seniors. Noting the need for additional

nutrition education for the senior population in this country and the resistance seniors have to

going to welfare offices to apply for food stamps, several discussants suggested creating a
Chapter VIII 115

nutrition and health program for seniors, similar to the WIC program for mothers and young

children. A WIC-like approach would allow participants to apply for food stamps, receive

education about how to use their benefits, and obtain nutritional assessments, nutrition education,

and referrals to other health and social services. 

B. Options for Food Stamp Program Outreach 

Suggested options for Food Stamp Program outreach efforts to encourage participation by

seniors included one-on-one outreach combined with informational sessions in small group

settings and individualized enrollment assistance. Seniors felt that these settings should be in

locations where they or other seniors like them congregate, such as senior housing, senior

centers, ethnic cultural centers, health centers, libraries, cafeterias and churches. It was also

suggested that the most effective one-on-one outreach could be done by community-based

organizations with whom seniors are already affiliated, and by other seniors who are

participating in the FSP. 

Print media was also a frequently suggested outreach method, particularly local publications that

target seniors or particular ethnic groups or neighborhoods. Some discussants also suggested

including information about the FSP in personalized mailings from Social Security or utility

companies. 

Culturally appropriate materials were also identified as critical to the success of any food stamp

outreach effort. The Spanish-speaking and Korean-speaking groups (both seniors and those who

work with them) recommended placing advertising in these and other languages in ethnic

newspapers and on ethnically-oriented media programs. 

However, effective outreach to ethnic minorities and to seniors in general must go beyond

advertising and public information. For example, The Korean Women's Association (KWA) was

described as particularly effective in promoting FSP participation among seniors since the

agency provides not only public information campaigns but also intensive one-on-one client

enrollment assistance. The outreach staff help individuals with all stages of the food stamp

application process, including sitting down with them to fill out the detailed questions on the

application form, educating them about the eligibility interview process and what they need to
Chapter VIII 116

bring there, and helping seniors obtain follow-up verification documents if needed. This model

of client enrollment assistance may be a particularly useful model for other community

organizations around the State, serving both English and non-English-speaking populations.

C. Options for Improvements to State and Local FSP Operations

On October 4, 2001, at an intensive one-day strategy session, 21 representatives from DSHS'

Divisions of Employment and Assistance Programs and Home and Community Services, local

community organizations providing food stamp outreach to seniors, a statewide anti-hunger

organization, and the regional office on Aging and Disability Services came together to discuss

the findings of these focus groups and craft an action plan to improve access and participation in

the FSP for seniors in Washington State. (A copy of the participant list is in Appendix F.)

Over the course of this session, the group suggested 42 potential program improvements. Each

of these options responded to the specific findings outlined in Chapters II through VI of the draft

focus group report. However, to develop a practical action plan leading to significant changes

that could be implemented in a relatively short timeframe, the group prioritized and narrowed

down their initial proposals. The group's final priority options are outlined below and organized

by their common objectives. Each of the eight objectives addresses an aspect of program

operations that was frequently raised as a concern during the focus group discussions. 

Objective 1: To make the food stamp application form easier for seniors to use and

understand by both English and non-English speaking seniors.

 Action Steps: 

! Finalizing DSHS' draft shortened and simplified food stamp application

form. (See Appendix E for a copy of the pending revised form.)

! Expanding use of online food stamp applications so that more community

groups working with low-income seniors can help them complete a food

stamp application and submit it electronically to the individual's local food

stamp office. (Note: this could be encouraged through training across the

State with staff from Senior and Disability Services and other local

organizations helping seniors to access public benefits.) 
Chapter VIII 117

! Improving the efficiency of the online application for local food stamp

office staff by interfacing the online application with the State eligibility

computer system. (At this time, local offices receive a hard copy of the

online application for clients in their target area. The caseworkers must

then re-enter the information into ACES, the State eligibility computer

system.)

Objective 2: To expand public awareness about and participation in Washington's

Combined Application Program (WASHCAP) for SSI and food stamps. 

Background: 

As noted earlier in the report, under a demonstration project authorized by the

Food and Nutrition Service of USDA, in winter 2001 Washington State is

launching a multi-year program to simplify and coordinate the food stamp

application process with the Social Security Administration for SSI recipients.

For this demonstration, eligible individuals will be unemployed SSI recipients

who live alone or buy and fix their food apart from the other people they live

with. These seniors will be able to apply for food stamps and SSI in one

combined eligibility interview at the Social Security office and will have a

standard benefit amount provided to them. If they choose to participate in the

program, they will never have to go to a DSHS office or fill out the food stamp

application form. (Note: SSI recipients with high shelter and/or medical costs

will be advised that they could receive a higher benefit level if they applied for

the regular program through the more lengthy and detailed application process at

their local food stamp office.) 

Action Step:

! Providing more information and training to local organizations working

with seniors as the new WASHCAP program is being implemented so that

they can better inform seniors about the option and answer their questions

and concerns.

Objective 3: To improve the front office environment for seniors.

Action Step:

! Providing additional and expanded training of receptionists to ensure that

they are not dissuading eligible people from applying, with a special focus

on the needs of and barriers to participation for seniors.
Chapter VIII 118

Objective 4: To improve the food stamp eligibility interview process for seniors.

 Action Steps:

! Promoting the option of telephone interviews for seniors who have hardships

traveling to the food stamp office (Note: this could be facilitated by revising the

food stamp application form to include a box on the front page of the form

allowing applicants with hardships to request a telephone interview.)

! Recognizing that memory problems and other factors increase the risk that seniors

will miss their eligibility interview appointment, the State should ask local staff to

make reminder calls to senior food stamp applicants prior to their scheduled

interview.

! Producing an educational video describing the steps in the food stamp application

process, including the information they will be asked to provide and the rationale

for the interview questions. (Note: this video could be distributed to community

organizations conducting food stamp outreach and referrals and to all local food

stamp offices for display in the waiting area.)

! Improving staff training and written information for applicants about what

verification should be required for different types of households.

! Expanding use of the excess medical deduction for seniors eligible for this

deduction. (Note: this could be accomplished through trainings and guidance to

local food stamp office staff and community organizations providing food stamp

outreach as well as Federal policy changes that could simplify the deduction by

standardizing it and thus reducing the amount of verification documentation

required.)

Objective 5: To improve program participation among eligible refugees and immigrants.

Action Step:

! Developing updated written educational materials that address the rules for

sponsored immigrants and food stamps and the fact that receipt of food stamps

does not threaten an immigrant's ability to become a permanent resident in the

future. (Note: Some existing materials may be able to be obtained from

Immigration and Naturalization Service.)
Chapter VIII 119

Objective 6: To provide improved translation and interpretation services for potential

food stamp applicants and those that do apply.

Action Steps:

! Requiring local food stamp offices to post signs and instructions (e.g., where

clients need to go or whom they have to see to begin the process) in multiple

languages.

! Requiring local food stamp offices to designate reception windows and up-front

reception staff available all day for non-English-speaking clients.

! Creating a statewide 800 number system where non-English-speaking individuals

interested in applying for food stamps can dial into to get information about the

FSP or the application process once they have applied. (Note: This could

potentially be expanded for conducting telephone eligibility interviews.)

! Working with community-based groups to properly translate the new shortened

application into other languages.

Objective 7: To improve seniors' utilization of the EBT benefits. 

Action Steps:

! Training seniors on how they may obtain balance information on their EBT food

stamp accounts and distribute such materials to food stamp outreach contractors,

and workers in Home and Community Services. (Note: this training could be

done in collaboration with the retail stores where seniors purchase their food.)

! Eliminating the current State policy which freezes food stamp benefits if they are

not used for three consecutive months. (Note: In Fall 2001, the State issued draft

revised regulations allowing food stamp participants to maintain their food stamp

benefits on the EBT card for one full year and removing the freeze on benefits

after three months of nonuse.)

! Designing a method acceptable to both seniors and senior meal program providers

for seniors to more easily use EBT food stamps to make donations for meals at

congregate meal sites and for home-delivered meals. 
Chapter VIII 120

Objective 8: To reduce the burden of the re-certification process for elderly 

 households. 

Background:

In accordance with Federal law, DSHS allows local food stamp offices to certify

seniors for 24-month time periods. However, in the three communities where the

focus groups were conducted, the local practice appears to be to provide 3-month

certifications for most food stamp households, including elderly food stamp

households. These short certification periods are the result of State and local

concern for reducing food stamp error rates. The need for frequent

recertifications deters seniors from maintaining their involvement with the FSP. 

Action Step:

! Lengthening the typical food stamp certification period for elderly households to

24 months. (Note: To accomplish this the State agency could encourage local

offices to change the way they recertify seniors through written guidance,

training, and modifications to the automated eligibility system. The State could

educate potentially eligible seniors and current participants about this change

through direct mailings and other targeted outreach efforts. In addition, improving

staff training about what verification should be required for different types of

households, as suggested under objective 4 above, could also reduce the amount

of documents seniors have to obtain and deliver to the food stamp office at each

re-certification.)

D. Conclusion

The above suggestions to increase FSP participation were developed in response to concerns

raised by low-income seniors and those who work with them in three communities in

Washington State. Nevertheless, the issues they raise likely resonate as factors influencing

seniors' FSP participation nationwide. 

These suggestions clearly merit the attention of a variety of audiences, including Federal

policymakers, State officials, program administrators, and national, State, and community

advocates who are interested in improving access to the FSP for seniors. It is suggested that this

report and its findings can spur similar applied policy research to examine the direct experiences

of FSP participants and eligible nonparticipants and to identify and respond to the aspects of FSP

program operations that can be improved at the State and local level.
References 121

References

Castner, L., and Rosso, R. (2000). Characteristics of Food Stamp Households: Fiscal Year

1998. Alexandria, VA: Food and Nutrition Service, U.S. Department of Agriculture.

FNS Online (1999). Food Stamp Special Rules for the Elderly of Disabled. Alexandria: Food

and Nutrition Service, U.S. Department of Agriculture. Available at:

http://www.fns.usda.gov/fsp/MENU/ELDERLY/SpecialRules.HTM. 

Food and Nutrition Service, Office of Analysis, Nutrition and Evaluation, (2000). The

Nutritional Safety Net: Help for the Elderly and Disabled. Alexandria, VA: U.S.

Department of Agriculture.

Food and Nutrition Service, Office of Analysis, Nutrition and Evaluation (2001). 

Characteristics of Food Stamp Households: Fiscal Year 2000. Alexandria, VA: U.S. 

Department of Agriculture

General Accounting Office (2000). Food Assistance: Options for Improving Nutrition for

Older Americans. Washington: By Author. Report # RCED-00-238. 

McConnell, S., and Ponza, M. (1999). Reaching the Working Poor and Poor Elderly Study:

What We Learned and Recommendations for Future Research. Alexandria: Office of

Analysis, Nutrition and Evaluation, Food and Nutrition Services, U.S. Department of

Agriculture. Available at:

http://www.fns.usda.gov/oane/menu/published.FSP/Participation.htm.

Ponza, M., and McConnell S (1999). Reaching the Working Poor and Poor Elderly: 

 Draft Interim Report on Focus Groups. Alexandria, VA : Office of Analysis, 

Nutrition and Evaluation, Food and Nutrition Services, U.S. Department of

Agriculture.

Rangarajan, A., and Gleason, P. (2001). Food Stamp Leavers in Illinois: How Are They Doing

Two Years Later? Washington: Economic Research Service, U.S. Department of

Agriculture.

U.S. Bureau of the Census (2000). International DataBase, Population Pyramids.

http://www.census.gov/ipc/www/idbpyr.html.
Technical Appendices
Appendix 123

List of Appendices

Appendix A: Demographic Information on Focus Group Participants

Appendix B: Senior Focus Group Discussant Screening Questionnaires

Appendix C: Focus Group Moderator Guides

Appendix D: Focus Group Coding Scheme

Appendix E: Washington State Food Stamp Application Forms (Current and Pending)

Appendix F: List of Participants at the Strategic Planning Meeting
Appendix 124

Appendix A: Demographic Information on Focus Group

Participants
Appendix 125

Discus.

No. Age Gender Country ofBirth

Education

Completed

Length of

Current FSP

Participation

1 71 Female United States Some College 1.5 months

2 66 Female United States High School 6 months

3 69 Female United States High School 1 year

4 61 Female United States High School 5 years

5 78 Female United States High School NA

6 76 Male United States Below 3rd Grade 3 years

1 75 Male Korea High School 7 months

2 74 Male Korea College 2 years

3 74 Male Korea High School 5 years

4 72 Female Korea High School Over 10 years

5 74 Male Korea Middle School 8 years

6 66 Male Korea Elementary School 5 years

7 77 Female Korea Middle School 10 years

8 71 Male Korea High School 2 years

9 79 Male Korea Elementary School NA

10 81 Male Korea College Over 10 years

11 66 Male Korea College 4 years

12 69 Female Korea High School 2 years

13 73 Male Korea College 3 years

14 75 Female Korea Elementary School 4 years

15 75 Male Korea Elementary School 7 years

16 67 Male Korea Elementary School 1.5 years

17 70 Female Korea Elementary School 7 years

18 69 Female Korea Middle School 2 months

19 67 Male Japan Middle School 2 years

20 65 Male Korea High School 4 months

1 67 Female United States None 1 year

2 68 Male Mexico Below 3rd Grade 1 year

3 68 Female United States Middle School 10 years

4 64 Female El Salvador Below 3rd Grade 3 years

5 79 Female United States Middle School 3 years

6 67 Female Mexico None NA

7 66 Female Mexico Below 3rd Grade 4 months

8 72 Male Mexico Below 3rd Grade 3 months

9 65 Female Mexico Middle School 12 years

10 64 Female United States Elementary School Over 10 years

NA = Not Available

Tacoma

Central Washington

Table A-1

Demographic Information on Focus Group Discussants

Elderly FSP Participants

Seattle
Appendix 126

Discus.

No. Age Gender Country ofBirth

Education

Completed

Ever

Considered

Applying?

Been to

FS Office?

Ever

Received

FS?

1 65 Female United States Middle School Yes Yes Yes

2 67 Male England Masters Yes Yes Yes

3 78 Female United States High School Yes Yes Yes

4 60 Female United States Some College Yes Yes Yes

5 69 Male United States Some College Yes Yes Yes

6 63 Male United States High School Yes Yes Yes

7 76 Female United States Middle School No No No

8 NA Male United States High School Yes Yes Yes

9 60 Female United States High School Yes Yes Yes

10 71 Male United States College Yes Yes Yes

11 78 Female United States High School Yes Yes Yes

12 71 Female United States High School Yes Yes No

13 66 Female United States High School Yes Yes Yes

1 67 Male Korea College No No No

2 73 Female Korea High School Yes Yes Yes

3 61 Male Korea High School No No No

4 67 Female Korea High School No No No

5 64 Female Korea High School Yes No No

6 66 Female Korea High School Yes No No

7 72 Female Korea High School Yes No No

8 68 Female Japan Middle School Yes No No

9 66 Female N. Korea None No No No

Tacoma

Table A-2

Demographic Information on Focus Group Discussants

Elderly FSP Eligible Non-participants

Seattle
Appendix 127

Discus.

No. Age Gender Country ofBirth

Education

Completed

Ever

Considered

Applying?

Been to

FS Office?

Ever

Received

FS?

1 65 Male Mexico NA Yes Yes No

2 73 Female United States Below 3rd Grade Yes Yes Yes

3 69 Male United States None Yes Yes Yes

4 61 Male Mexico College Yes Yes Yes

5 64 Female Mexico Below 3rd Grade Yes Yes Yes

6 63 Female Mexico Middle School Yes Yes Yes

7 90 Male United States NA Yes Yes Yes

8 72 Female Mexico Middle School Yes Yes Yes

9 68 Female Mexico Middle School Yes Yes No

10 79 Female Mexico Below 3rd Grade Yes Yes No

11 62 Female United States Below 3rd Grade Yes Yes Yes

12 60 Female Mexico None No No No

13 71 Female United States Some College No Yes No

14 66 Female Mexico None No No No

15 75 Female Mexico Middle School Yes Yes No

16 66 Female United States Middle School No No No

17 68 Male United States Elementary School No No No

18 69 Female Cuba High School Yes Yes Yes

19 64 Male Cuba Some College Yes Yes Yes

20 74 Male United States None Yes Yes Yes

21 71 Female Mexico None Yes Yes Yes

22 60 Male Mexico Elementary School Yes Yes Yes

23 71 Female Mexico NA Yes Yes Yes

24 60 Female Mexico Some College Yes Yes Yes

Central Washington

NA = Not Available

Table A-2 (cont.)

Demographic Information on Focus Group Discussants

Elderly FSP Eligible Non-participants
Appendix 

D iscu s.

No. A ge G en der Jo b T itle N am e of O rg anizatio nal A ffiliation 

1 38 Fe m ale F inancial S ervices S p e c ia list S ta te D e p t. O f S ocia l and H ealth S ervice s (D

2 38 Fe m ale F inancial S ervices S p e c ia list IV D S H S 

3 30 Fe m ale F inancial S ervices S p ecialist II D S H S 

4 32 Fe m ale TO P S W o rker D S H S 

5 4 2 F e m a le F in a n c ia l S e rv ice s S p e cia lis t V D S H S 6 32 Fe m ale Fin ancia l S ervice s S p ecialist III D S H S 7 48 Fe m ale Fin ancia l S ervice s S p ecialist III D S H S 8 30 Fe m ale Fin ancia l S ervice s S p ecialist III D S H S 

1 62 Fe m ale A g in g & D isa b ilit y P la nner A g in g and D isa bility S ervices (R e g io n a l O ff

2 49 Fe m ale C om m un ity A d vocate Internationa l C om m un ity H ealth S ervices 

3 4 9 F e m a le N u tritio n C o n su lta n t S e a ttle /K in g County D e p a rtm e n t o f P u b lic H e 

4 39 Fe m ale P ro g ra m A ssistant H o p e lin k/F S E d u ca tio n P ro g ram 

5 3 7 M a le A d v o c a te S e n io r S e rvic e s 6 4 4 F e m a le A ss t. D ire c to r N u tritio n P ro je cts S e n io r S e rvic e s 

7 30 Fe m ale FS E ducation A d Frem o nt P u blic A sso ciatio n 

8 29 Fe m ale H ealth and W ell B ein g C o ordin ator S eattle H ousin g A utho rity 9 26 Fe m ale S enior N u trition S ite M ana g e r In te rn a tio n a l D istrict P re s e rv a tio n a n d D e ve lo p m e n 1 50 Fe m ale Fin ancia l S ervice s S p ecialist III D S H S 

2 32 Fe m ale Fin ancia l S ervice s S p ecialist III D S H S 

3 61 Fe m ale F inancial S ervices S p e c ia list IV D S H S 

4 34 Fe m ale F inancial S ervices S p ecialist II D S H S 

5 41 Fe m ale Fin ancia l S ervice s S p ecialist III D S H S 

6 54 Fe m ale Fina ncial S ervices S p e cialist S u p ervisor D S H S 7 56 M a le F inancial S ervices S p e c ia list D S H S 8 46 Fe m ale Fin ancia l S ervice s S p ecialist III D S H S 9 37 M a le F inancial S ervices S p e c ia list IV D S H S 

Food Stam p O ffice

C o m m un ity Based Org an izatio ns

Tacoma

Food Stam p O ffices

Table A -3

Demo g ra p hic In form ation on Fo cu s G rou p Discus

Staff From Local F ood Stam p O ffices and C om m unity -B ased 

Seattle
Appendix 

Discus.

No. Age Gender Job Title Name of Organizational Affiliation

How long

worked with

FS?

Lang

1 29 Female Office Manager Senior Outreach Services 10 years 

2 33 Female FS Outreach Korean Women's Association (KWA) 1 year 3 45 Female Executive Director KWA 22 years 4 42 Female FS Outreach KWA 1.5 years 5 44 Female Program Manager KWA 4 years 1 NA Female Financial Services Specialist III DSHS 12 Years 2 NA Female Financial Services Specialist DSHS 21 years 3 NA Female Financial Services Specialist III DSHS 13 years 4 39 Female Financial Supervisor DSHS 11 years 5 39 Female Financial Supervisor DSHS 11 years 6 39 Female Financial Supervisor DSHS 20 years 7 32 Female Leadworker/Trainer DSHS 3 years 8 36 Male Financial Services Specialist III DSHS 9 years 9 NA Female Financial Services Specialist III DSHS NA 1 27 Female Client Servies Coordinator Yakima Co. Coalition for the Homeless 1 year 2 61 Female Senior Peer Counselor Nueva Esperanza Counseling Center 4 months 3 40 Male Agency Director La Clinica 16 years 4 26 Female Executive Director Benton Franklin Volunteer Center 5 years 5 51 Male Director Yakima Co. Food Services Senior Nutrition 3.5 years 6 28 Male Credit Manager YVFWC 1 year 7 66 Female Information Specialist Aging and Long Term Care 12 years 8 29 Male Family Self Sufficiency/Resident Initiative Coordinator Yakima Housing Authority 2 years 9 55 Female Executive Director Yakima Co. Coalition for the Homeless 10 years 

Community Based Organizations

Tacoma (cont.)

Community Based Organizations

Central Washington

Food Stamp Office

Table A-3 (cont.)

Demographic Information on Focus Group Discussants

Staff From Local Food Stamp Offices and Community-Based Organizations
Appendix 130

Appendix B: Senior Focus Group Discussant Screening

Questionnaires
Appendix 131

Screening Questionnaire for Food Stamp Program

Participants
Appendix 132

ELDERLY FOOD STAMP FOCUS GROUP

SCREENING PROTOCOL

CURRENT FOOD STAMP PARTICIPANTS

Introduction

Hello. My name is ____ and I=m calling from ______. May I please speak to Ms. or

Mr. _______?

If an individual is not home, and you are speaking with someone else, please ask when

would be a good time to reach the person. If they ask who is calling tell them your name

and that you are calling from ________ about a discussion group that the person signed

up for.

I am calling you, Mr./Mrs./Ms. __________ because 1) you signed up at _________ as being

interested in participating in a group discussion (or) 2) or you called me and left a message that

you were interested in coming to the discussion group. The U.S. Department of Agriculture

has hired a research firm to conduct a study about how the elderly view the Food Stamp

Program and why they do, or do not participate in the program.

The researchers will be conducting group discussions with people from __________. If you

qualify to participate in this study, you will receive a grocery voucher for $35 from

___________ for your time.

May I ask you some questions to see if you qualify for the study?

[ ] Yes Continue

[ ] No Thank and Terminate

1. Are you currently enrolled in the Food Stamp Program?

[ ] Yes

[ ] No SWITCH TO THE NON-PARTICIPANT SCREENER

Did you receive Food Stamp benefits for this month or last month?

[ ] Yes

[ ] No THANKS AND TERMINATE

How old are you? _____ (TERMINATE IF UNDER AGE 60)
Appendix 133

Confirm that the person lives alone or

is the head of the food stamp household if living with non-elderly adults.

Do you live alone?

[ ] Yes GO TO QUESTION 10

[ ] No

Are you the person in the household who applied for food stamps when you got on the program?

[ ] Yes GO TO QUESTION 10

[ ] No

6. Who applied for food stamps for you?

[ ] A non-household member on their behalf

[ ] Another household member age 60 or older DETERMINE WHETHER THIS

PERSON MAY WANT TO PARTICIPATE AND GET CONTACT

INFORMATION; IF NOT, THANK AND TERMINATE

[ ] Another household member under

age 60 THANK AND

TERMINATE

7. Are all the adult members of your household age 60 or older?

[ ] Yes GO TO QUESTION 9

[ ] No

1. Do the people age 60 and older in your home buy your own food separately from the

non-elderly adults in your household?

[ ] Yes

[ ] No THANK AND TERMINATE

2. Do the people age 60 and older in your home fix or cook your own meals separately from

the non-elderly adults in your household?

[ ] Yes

[ ] No THANK AND TERMINATE

ONLY ASK QUESTION 10 IF NECESSARY.
Appendix 134

3. What language are you most comfortable speaking?

[ ] English

[ ] Other (please specify) ________________

Determine if the individual can come to the scheduled group.

Thank you for answering my questions. I would like to tell you a little more about the discussion

group now. The group will last about two hours and you will be asked a variety of questions

about your experiences on the Food Stamp Program. The group will consist of about 8 people

like yourself and a group discussion leader. Your comments will be confidential. Your name

will not be associated with anything your say in the group. At the end of the group, you will

receive a $35 voucher from ________, which can be used to purchase groceries in appreciation

for your participation.

The group takes place on ________ (date) at _______ (time) at _________________ (give

location and address).

4. Now that you know more about the discussion group, will you be able to attend?

[ ] Yes GO TO CLOSING

[ ] No

5. Would you be able to attend if the group was held at a different time?

[ ] Yes Availability: ___________________________________

[ ] No TERMINATE

13. Do you have transportation to the group?

[ ] Yes

[ ] No EXPLAIN THAT YOU HAVE OR ARE PLANNING

TRANSPORTATION ASSISTANCE AND WILL GET BACK TO THE

PERSON ABOUT THIS.
Appendix 135

Closing

We are counting on your participation, so please call me if something comes up and you are n longer able to

attend. Again, my name is ____________ and you can reach me at ___________.

Before we hang up, let me get the correct spelling of your name, your address and phone number so that I can

send you a confirmation letter with directions to our office (or information on transportation assistance) . Also, I

will call you the day before the group to remind you.

First Name: __________________

Last Name: __________________

Home Phone: ________________

Best Time to Reach You: ___________________

Street Address: ____________________

Town/City: __________

Zip Code: __________

Thanks again for your time. We look forward to seeing you at the group.

Questions for Screener:

Date of call: _________________

Name of person making the call: _____________________

Language screening interview conducted in: _____________

Does the respondent have trouble communicating? Yes No

Is he/she easy to understand? Yes No

Can they express themselves and their ideas relatively clearly? Yes No

Date of confirmation letter: ___/___/___

Date of reminder phone call: ___/___/___
Appendix 136

Screening Questionnaire for Eligible Food Stamp Program

Non-Participants
Appendix 137

ELDERLY FOOD STAMP FOCUS GROUP

SCREENING PROTOCOL

ELIGIBLE NON-PARTICIPANTS

Introduction

Hello. My name is ____ and I’m calling from ______. May I please speak to Ms. or

Mr. _______?

If an individual is not home, and you are speaking with someone else, please ask when

would be a good time to reach the person. If they ask who is calling tell them your name

and that you are calling from ________ about a discussion group that the person signed

up for.

If another elderly person answers the phone, you may continue with the phone call and

invite them to the focus group.

I am calling you, Mr./Mrs./Ms. __________ because 1) you signed up at _________ as being

interested in participating in a group discussion (or) 2) or you called me and left a message that

you were interested in coming to the discussion group. The Washington State Department of

Social and Health Services (DSHS) hired a research firm to conduct a study about how the

elderly view the Food Stamp Program and why they do, or do not participate in the program.

The researchers will be conducting group discussions with people from __________. If you

qualify to participate in this study, you will receive a grocery voucher for $35 from

___________ for your time.

Because I have to figure out whether or not you might be eligible to participate in the Food

Stamp Program, I will have to ask you a couple of questions related to your income and your

household resources. May I ask you some questions to see if you qualify for the study?

[ ] Yes

[ ] No THANK AND TERMINATE

1. Are you currently receiving food stamps?

[ ] Yes SWITCH TO CURRENT PARTICIPANT SCREENER

[ ] No

2. How old are you? _____ (If under age 60, THANK AND TERMINATE)
Appendix 138

3. Have you applied for Food Stamps in the last 6 months?

[ ] Yes

[ ] No GO TO QUESTION 5

4. Were you told that you did not qualify?

[ ] Yes THANK AND TERMINATE

[ ] No (Clarify why they did not enroll in Food Stamp Program and that

they have not been on the program for the past six months)

Confirm that the person lives alone or

is part of an elderly adult household buying and preparing food separately from others

5. Do you live alone or with others?

[ ] Live Alone GO TO QUESTION 10

[ ] With Others

6. How many adults in your household are age 60 or over? ____________

7. Are all the people you live with age 60 or over?

[ ] Yes GO TO QUESTION 10

[ ] No

8. Do you (and the other adults age 60 or over) buy your own food, separately from the

younger people in the house?

[ ] Yes

[ ] No THANK AND TERMINATE

9. Do you (and the other adults age 60 or over) fix or cook your own meals, separately from

the younger people in the house?

[ ] Yes

[ ] No THANK AND TERMINATE

Assess probable eligibility

10. Are you receiving Supplemental Security Income (SSI)?

[ ] Yes GO TO TEXT ABOVE QUESTION 13

[ ] No

11. Do your assets (bank account, other savings, investments) total more than $3,000-- not

including the value of your home?
Appendix 139

[ ] Yes THANK AND TERMINATE

[ ] No

12. What is the total gross monthly income of the people age 60 and over in your household,

(who buy and prepare food together)?

See response to question #6 for number of seniors living in the household

NUMBER OF SENIORS LIVING IN HOUSEHOLD MONTHLY INCOME

CEILING

Living alone $905

2 seniors $1,219

3 seniors $1,533

4 seniors $1,848

ONLY ASK QUESTION 13 IF NECESSARY.

13. What language are you most comfortable speaking?

[ ] English

[ ] Other (please specify) ________________

Determine if the individual can come to the scheduled group.

Thank you for answering my questions. I would like to tell you a little more about the discussion

group now. The group will last two hours and you will be asked a variety of questions about

your activities in the community, cooking and preparing meals, and the Food Stamp Program.

The group will consist of about 6 to 8 people like yourself and a group discussion leader. Your

comments will be confidential. Your name will not be associated with anything you say in the

group. At the end of the group, you will receive a $35 voucher from ______, which can be used

to purchase groceries in appreciation for your participation.

The group takes place on ________ (date) at _______ (time) at _________________ (give

location and address).

14. Now that you know more about the discussion group, will you be able to attend?
Appendix 140

[ ] Yes GO TO QUESTION 16

[ ] No

15. Would you be able to attend if the group was held at a different time?

[ ] Yes Availability: ___________________________________

[ ] No THANK AND TERMINATE

16. Do you have transportation to the group?

[ ] Yes

[ ] No EXPLAIN THAT YOU HAVE OR ARE PLANNING

TRANSPORTATION ASSISTANCE AND WILL GET BACK TO THE

PERSON ABOUT THIS.

Closing

We are counting on your participation, so please call me if something comes up and you are no

longer able to attend. Again, my name is ____________ and you can reach me at ___________.

Before we hang up, let me get the correct spelling of your name, your address and phone number

so that I can send you a confirmation letter with directions (or tranportation assistance if

applicable) to the focus group location. Also, I will call you the day before the group to remind

you about it.

First Name: __________________

Last Name: __________________

Home Phone: ________________

Best Time to Reach You: ___________________

Street Address: ____________________

Town/City: __________

Zip Code: __________

Do you have any questions you would like to ask me about the study or the group discussion?
Appendix 141

Thanks again for your time. We look forward to seeing you at the group.

Questions for Screener:

Date of call: _________________

Name of person making the call: _____________________

Language screening interview conducted in: _____________

Does the respondent have trouble communicating? Yes No

Is he/she easy to understand? Yes No

Can they express themselves and their ideas relatively clearly? Yes No

Date of confirmation letter: ___/___/___

Date of reminder phone call: ___/___/___
Appendix 142

Appendix C: Focus Group Moderator Guides
Appendix 143

Food Stamp Participants
Appendix 144

Elderly Food Stamp Participation in Washington State

Participants

Moderator’s Guide

A. INTRODUCTION (10

Minutes)

Welcome to this group discussion. Thank you for taking the time to participate in today’s

discussion about the Food Stamp Program in Washington State and in _______ specifically.

My name is _________ and I work for Health Systems Research, a public policy research firm

in Washington, DC. A great deal of our work is involved in helping public and private

agencies plan and implement improved services for low-income vulnerable populations. My

partner’s name is ___________. Our company was hired by the US Department of Agriculture

to talk to Senior Citizens about what they think about the Food Stamp Program. We are

interested in your thoughts and comments, and we will use them to improve the program and

tell other Senior Citizens about it.

As you can see, we are taping this session. We are doing this only so that we don’t have to

take detailed notes. Everything you say is important to us and we do not want to miss anything

than any of you say. But nothing you say will ever be associated with your name—your names

and opinions will be kept strictly confidential

I would like to review the ground rules for our discussion:

 There are no right or wrong answers. Remember that I don’t work for the Food Stamp

Program, so please feel free to tell me your thoughts, whether they are positive or

negative.

 It is okay to disagree with one another. We want to hear everyone’s point of view. If

you disagree, please remember to be respectful of each other.

 Only one person should talk at a time. We are tape recording this session so that we

don’t miss anything important. If two people talk at once, we can’t understand what

anyone is saying. I may remind you of this during the group.

 We would like everyone to participate. But, you each don’t have to answer every

question.

 We have a lot that we want to talk about today. So, don’t be surprised if at some point I

interrupt the discussion and move to another topic. But don’t let me cut you off. If

there is something important you want to say, let me know and you can add your

thoughts before we change subjects.
Appendix 145

 We will be using first names only today. Everything you say is confidential. After we

conduct several of these group discussions across the state, we will write a report for

groups in your area, the State and for the US Department of Agriculture. Your name

will not appear anywhere in the report. What you say today will not be attached to your

name at any point. Nothing you say today will affect your eligibility for the Food

Stamp Program, or any other programs through the Department of Social and

Health Services.

 Don’t worry about offending us. We really want to learn from you and find out what

you think about the issues we talk about tonight. Please tell us your honest opinions.

 I want to make a couple more points related to the tape recording. Please speak up. If

you speak too quietly, it will be too hard to hear you later on the tape. Also, please

don’t bump the table or tap your fingers on the table. Anything close to the

microphones will sound much louder later on the tapes and it will drown out your

voices.

 _________ is taking notes in case the tapes don’t come out clearly, and (s)he will be

handling the tape recorders. At the end of the session, (s)he will provide a brief

summary of what you all said today, so that you can correct anything we have

misunderstood, or clarify important points.

The group will last between an hour and a half and two hours. You will not get out any later

than ______. We will not be taking a formal break. If you need to leave for a restroom break,

the bathrooms are ________. Don’t feel that it is necessary to let us know that you are leaving.

Just quietly leave the table.

At the end of the session, we will give you a food voucher from _______ for your time and

expenses associated with coming tonight.

Well, if there aren’t any other questions, let’s get started! I’d like to begin by going around the

table and having each of you tell us a little about yourself. Why don’t you share your name,

how many children/grandchildren you have, and what your favorite activity is? I’ll start. My

name is _______, I have ______ children, and I love to ___________.

Start with the person on your right, and have them respond in a round robin fashion.

B. LEARNING ABOUT THE FSP AND DECIDING TO APPLY (15

MINUTES)

We want to start by discussing how you learned about the Food Stamp Program.

1. How did you hear about the Food Stamp Program? When did you hear about

the Food Stamp Program?
Appendix 146

2. What steps did you take to get more information about the Food Stamp Program

after you heard about it?

PROBE: Did you call...

A state hotline?

A community organization?

Another social service office?

3. What kinds of problems did you have when you tried to get more information?

4. Before you talked to someone about the program, did you think you were

eligible? (If not) Why not?

5. Did anyone talk to you before you applied for food stamps to figure out if you

might be eligible for the program? If so, please tell me about that process.

PROBE: How did this process of screening you for the program ahead of

time affect your decision to apply for Food Stamps?

6. What made you decide to apply for food stamps?

PROBE: What circumstances/events/reasons led you to consider applying for

food stamps?

7. How long did it take you to apply for food stamps after you heard about the

program?

8. What made you act right away? What made you wait awhile?

9. For those of you who are immigrants and not yet citizens, how did you think

applying for food stamps would affect your ability or your children’s ability to

become a citizen?

C. APPLYING FOR THE FOOD STAMP PROGRAM (30

MINUTES)

Now we would like to hear about your experiences applying for the Food Stamp Program.

1. How did you get an application?

2. What did you think of the application?

PROBES: Was it difficult to read or understand?

How helpful were the written and/or verbal directions you

received with the application?
Appendix 147

Did you have difficulty or feel uncomfortable providing any of

the information requested on the application?

If so, what questions were difficult to answer or made you feel

uncomfortable?

3. How many of you applied for food stamps at the food stamp office? (Ask for a

show of hands).

4. How many applied through the mail? (Ask for a show of hands).

Next, I am going to ask some questions about applying at the office. Then I will ask those of

you who applied through the mail a different set of questions.

Questions for clients who applied at the food stamp office:

1. How easy was it for you to get to the food stamp office?

2. How helpful was the staff at the food stamp office?

PROBE: What could the staff have done to help you more?

3. Did you bring someone with you to help you apply for the program? If yes, in

what ways was it helpful to bring someone with you?

4. How long did you have to wait in the food stamp office?

5. How did you feel while you were waiting in the reception area?

6. What are some good things about applying for food stamps at the CSO? What

are some bad things about applying for food stamps at the office?

[For Non-English Speaking Groups]

1. How were you able to communicate with the staff and apply once you got to the

office?

PROBE: Was there someone at the office who spoke your language and

who could translate the forms and information for you?

2. Did you bring a translator with you?

3. What else helped you overcome the language barrier so that you could apply for

the program and communicate with the office staff?
Appendix 148

Questions for clients who submitted their application by mail:

1. Who helped you complete the application by mail?

2. Did anyone else beside the food stamp office staff help you with the

application? If so, who offered you assistance?

3. What are some good things about applying for food stamps through the mail?

What are some bad things about applying for food stamps through the mail?

Thank you very much. Now the rest of the questions about applying for the program are for

everyone to answer.

Questions for all clients:

1. How would you describe the eligibility interview?

PROBES: What were some good things about the interview?

What were some bad things about the interview?

2. Were you asked about your medical expenses at any point during the

application process?

3. What kind of documents did you have to provide to complete the application

process? What kind of difficulties, if any, did you have getting these papers?

4. Was there anything (else) that made it difficult for you to complete the

application process?

5. What do you think should be changed to make it easier to apply for food

stamps?

6. If you and other seniors like yourself could apply for food stamps somewhere

other than the community service office, where would you like to be able to

apply?

D. PERCEPTIONS OF THE FSP (15

MINUTES)

Now we would like to ask you what you thought of the Food Stamp Program before you

applied and what you think of it now.

1. What did you think about the Food Stamp Program before you applied?

2. Who did you think the Food Stamp Program was for?
Appendix 149

3. Once you applied for and received food stamps, what things surprised you about

the program?

4. Please tell us how receiving food stamps has helped you?

PROBES: How have food stamps affected your daily life?

How have they affected the way you buy groceries?

5. What do you like best about receiving food stamps?

6. What don’t you like about the Food Stamp Program?

7. What are some of the things you expected to get from the Food Stamp Program

that you haven’t?

E. USING THE FOOD STAMP PROGRAM (10-15 MINUTES)

Now we want to hear about your experiences using the Food Stamp Program.

1. How easy is it to use the Food Stamp Program?

2. What is difficult or uncomfortable about using food stamps when you go

shopping?

3. Did you know that if you have difficulty getting to the store to buy food you can

appoint someone, such as a personal care assistant, to shop for you?

PROBE: Have you used this option?

If so, please tell me how it worked for you.

4. Please tell us what you think of the Quest Card (EBT)

PROBES: What do you like about the Quest card?

What don’t you like about the Quest card?

5. How did you learn to use the Quest card?

6. (Question for Seattle groups only). In Seattle there is a Gold Card that seniors

can get to obtain meals at congregate sites. Would you prefer it if the food

stamps and senior meals benefits were on one computer benefit card or does it

work well to have them on separate cards?
Appendix 150

F. REAPPLYING (7 MINUTES)

Now we want to hear about how you reapply for food stamps.

1. Since you have been on the Food Stamp Program, have you ever had to fill out

a form to reapply? (Ask for a show of hands.)

2. Was there anything that almost kept you from reapplying for food stamps?

PROBES: What made you consider not reapplying?

What made you reapply?

3. What would you like to change about the re-application process?

4. The State of Washington is thinking of making some changes in how people

who receive SSI re-apply for food stamps. For those of you who receive SSI

benefits, would you like to be automatically signed up for food stamps each

year when you are recertified for SSI? This would mean you would not have to

go to the separate community service office to reapply for food stamps.

PROBE (for those who answered yes):

What if automatic re-application through the SSI program would

mean you would receive slightly fewer food stamps each month,

would you still prefer to be automatically signed up through the

SSI reapplication process?

G. OUTREACH STRATEGIES AND MATERIALS (20

MINUTES)

Many seniors who are eligible to receive Food Stamps have not applied for the program.

1. SHORT GROUP EXERCISE

So let’s imagine that we have made some of the changes to the Food Stamp Program that you

all have suggested. Let’s talk about some ways to get seniors interested in the program and let

them know how to go about applying.

INSTRUCTIONS TO MODERATOR: Divide the group into two sections--the right hand side

of the table and the left hand side of the table. Ask the people on the right hand side of the

table to convince those on the left hand side to apply for the program:
Appendix 151

• If you were trying to convince these people to apply for food stamps, how would you do

that?

INSTRUCTIONS TO MODERATOR: Then ask the people on the left-hand side of the table:

• Which of the reasons for applying mentioned by the others was the most persuasive?

• What makes you say that was the most persuasive?

• What is the most important information a person should know about the Food Stamp

Program?

• What do you think would motivate other seniors to apply for food stamps?

Now we want to talk about how we can tell more seniors about the Food Stamp Program.

2. What do you think would be the best way to help other seniors like you find out

about the Food Stamp Program so that they can get help paying for their

groceries every month?

PROBE: If they haven’t mentioned these ask, “What about..

TV? What channels?

Radio? What stations?

Newspapers? Which ones?

Billboards? Where in your town would you put them?

Posters? Where should they be placed?

Brochures? Where should they be placed?

Transit Ads? (e.g. on Buses)

Direct Mail (e.g. as part of value-pack coupon mailings or along

with Social Security check)

3. Which organizations do you think could provide the best information about the

Food Stamp Program?

4. Which places are important to visit to inform seniors about the program?

5. Who do you think the seniors in your community trust most? Who would be

the best people to provide information about the Food Stamp Program?

PROBES: Doctors and nurses?

Nutritionists?

Social Workers?

Ministers?

Other senior citizens?

Others?

6. Have you received information about the Food Stamp Program through the
Appendix 152

mail? If so, please tell us about it.

7. Have you attended presentations on the Food Stamp Program? If so, what did

you think of the presentation? Where did they take place?

8. How do you keep up with the news? Where do you get information about

community events?

H. CLOSING (10

MINUTES)

Thank you very much for coming today. We enjoyed meeting with you and have learned a lot

about how to improve participation in the Food Stamp Program.

1. Is there anything I haven’t asked about that you would like to share about your

experience with the Food Stamp Program? Any additional comments you want

to make may be very helpful.

INSTRUCTIONS TO MODERATOR:

Ask the co-moderator to give a brief summary of participants’ main ideas

Ask the participants if they have any brief comments or questions. Stress that we don’t have

much time left.

Have the co-moderator distribute the food vouchers.

Encourage participants to take home whatever food remains.

After participants leave, debrief with the co-moderator while the tape recorder is on.
Appendix 153

Eligible Non-Participants
Appendix 154

Elderly Food Stamp Participation in Washington State

Eligible Non-participants

Moderator’s Guide

B. INTRODUCTION (10 Minutes)

Welcome to this group discussion. Thank you for taking the time to participate in today’s

discussion about the Food Stamp Program in Washington State and in _______ specifically.

My name is _________ and I work for Health Systems Research, a public policy research firm

in Washington, DC. A great deal of our work is involved in helping public and private

agencies plan and implement improved services for low-income vulnerable populations. My

partner’s name is ___________. Our company was hired by the US Department of Agriculture

to talk to Senior Citizens about what they think about the Food Stamp Program. We are

interested in your thoughts and comments, and we will use them to improve the program and

tell other Senior Citizens about it.

As you can see, we are taping this session. We are doing this only so that we don’t have to

take detailed notes. Everything you say is important to us and we do not want to miss anything

than any of you say. But nothing you say will ever be associated with your name—your names

and opinions will be kept strictly confidential.

I would like to review the ground rules for our discussion:

 There are no right or wrong answers. Remember that I don’t work for the Food Stamp

Program, so please feel free to tell me your thoughts, whether they are positive or

negative.

 It is okay to disagree with one another. We want to hear everyone’s point of view. If

you disagree, please remember to be respectful of each other.

 Only one person should talk at a time. We are tape recording this session so that we

don’t miss anything important. If two people talk at once, we can’t understand what

anyone is saying. I may remind you of this during the group.

 We would like everyone to participate. But, you each don’t have to answer every

question.

 We have a lot that we want to talk about today. So, don’t be surprised if at some point I

interrupt the discussion and move to another topic. But don’t let me cut you off. If

there is something important you want to say, let me know and you can add your

thoughts before we change subjects.

 We will be using first names only today. Everything you say is confidential. After we

conduct several of these group discussions across the state, we will write a report for

groups in your area, the State and for the US Department of Agriculture. Your name
Appendix 155

will not appear anywhere in the report. What you say today will not be attached to

your name at any point. Nothing you say today will affect your eligibility for the

Food Stamp Program, or any other programs through the Department of

Social and Health Services.

 Don’t worry about offending us. We really want to learn from you and find out what

you think about the issues we talk about tonight. Please tell us your honest opinions.

 I want to make a couple more points related to the tape recording. Please speak up. If

you speak too quietly, it will be too hard to hear you later on the tape. Also, please

don’t bump the table or tap your fingers on the table. Anything close to the

microphones will sound much louder later on the tapes and it will drown out your

voices.

 _________ is taking notes in case the tapes don’t come out clearly, and (s)he will be

handling the tape recorders. At the end of the session, (s)he will provide a brief

summary of what you all said today, so that you can correct anything we have

misunderstood, or clarify important points.

The group will last between an hour and a half and two hours. You will not get out any later

than ______. We will not be taking a formal break. If you need to leave for a restroom break,

the bathrooms are ________. Don’t feel that it is necessary to let us know that you are leaving.

Just quietly leave the table.

At the end of the session, we will give you a food voucher from _______ for your time and

expenses associated with coming tonight.

Well, if there aren’t any other questions, let’s get started! I’d like to begin by going around the

table and having each of you tell us a little about yourself. Why don’t you share your name,

how many children/grandchildren you have, and what your favorite activity is? I’ll start. My

name is _______, I have ______ children, and I love to ___________.

Start with the person on your right, and have them respond in a round robin fashion.

B. COMMUNITY LIFE (25 minutes)

We are interested in finding out a little bit of background about your living situation, your

social life, and your use of community-based services.

1. Do you live with anyone now?

2. Who cooks your meals?

3. Who do you usually eat with?

4. How do you meet or spend time with other people in your community?
Appendix 156

PROBES: What community centers or other community-based services do

you utilize? How often do you use these services?

Are you involved in any clubs or other activities?

5. We all need help from time to time. What kinds of help do you need now that

you are older?

PROBES: Special transportation, or shopping assistance?

In-home services, such as homemaker services, home-health aides, or visiting nurses?

I am going to present you with a scenario to help get the conversation going. We are going to

assume that it is towards the end of the month and you realize that you don’t have enough

money to cover all your bills and you don’t have enough for food for the rest of the month.

I am going to give each of you a set of cards. Each card represents a place where you could get

help in this situation. Please rearrange the cards to show where you would turn for help so that

you could pay your bills and make your budget last longer in the future. Please put the place

you are most likely to go for help as the first card and the place you are least likely to go as the

last card. I have included two blank cards so that you can write where you would turn for

help if this place you are thinking of is not already included on the other cards. I will ask

the group some questions after you are done putting the cards in order.

(The cards might include things like: 1. My family 2. My friends 3. My church 4. The Food

Stamp Program 5. The Food Bank. 6. Community Centers and two blank cards.)

1. Which card did you put first? What made you put that one first?

2. Which card did you put last? What made you put that one last?

3. What did you write on your blank cards?

4. Where in your set of cards did you put the Food Stamp Program? What made

you put it in that order?

5. What keeps senior citizens in your community from getting the help they need?

C. FOOD CONSUMPTION/ FOOD SECURITY (10 Minutes)

Now we would like to talk with you about your patterns of eating at home and diet.

1. Do you ever skip a meal when you are hungry? How often would you say you

skip meals?

2. What causes you to miss meals?
Appendix 157

3. How has this changed since you have gotten older?

4. Why is it important for seniors like you to get enough food every day?

5. Do you think that you are regularly eating the right foods?

6. What kinds of things keep you and other seniors from eating the right foods?

D. HOW PEOPLE HEAR ABOUT THE FSP (10

Minutes)

Now I’d like to find out how you heard about the Food Stamp Program.

1. In what ways have you heard about the Food Stamp Program?

PROBES: Have you seen or heard any commercials, Posters, etc.?

Do your neighbors talk about it?

Do the people at the (outreach center) talk about it?

Have you ever received information about the Food Stamp

Program in the mail?

Have certain organizations or people given you information about the program? Tell

me about it.

E. PERCEPTIONS OF FSP (30 minutes)

Now we would like to talk with you about what you know about the Food Stamp Program, as

well as what you think of it.

1. What do you know about the Food Stamp Program?

PROBES: What are food stamps?

Who is eligible?

How are food stamps given out?

Where do you apply and get food stamps?

2. Of the senior citizens you know, how many of them, do you think, are on the

Food Stamp Program?

3. Why aren’t you getting food stamps now?

PROBES: Do you think you don’t have problems getting enough food to

eat and so you don’t need food stamps?
Appendix 158

What about the benefits? How much do you think you could get

in food stamps each month? What do you think of that amount

(e.g. is that a lot or a little)? Is this amount worth your while to

apply for them and to be on the program?

How hard is it for you to get and pay for transportation to the

office?

What other responsibilities do you have (e.g. taking care of grandchildren) that make it

difficult to get to the food stamp office?

There is a lot of attention paid to why families with children are not participating in

public programs today.

4. We would like to know what you think are the reasons that might keep seniors in

your community from applying for the program?

Now I would like to turn to what you have experienced or heard about the offices

where people apply for food stamps. How many of you have ever been to the office

where seniors in your community apply for food stamps? (Ask for a show of hands)

5. For those of you who have been to a food stamp office, how would you describe

it?

PROBES: Is the office easy to get to?

What are the workers like?

How, if at all, are seniors treated differently than other people

applying for food stamps?

How many other people were there?

What was the waiting room like?

(For Non-English Groups) Could any of the staff speak

_______? Was it difficult to speak to the caseworkers?

6. For those of you who have NOT been to the Food Stamp Office, what else have

you heard people say about it?

7. We would like to know what you think are the reasons that might keep seniors

in your community from not completing the application process once they

contact the food stamp office to apply?

PROBES: Are documentation requirements a barrier?

What about confidentiality issues, such as the need to share

information about their children with whom they hold joint

checking accounts?
Appendix 159

8. Is being a non-citizen a barrier for legal immigrants?

PROBE: Can someone become a U.S. citizen if they have been on the

program?

9. What are some of the good things about getting food stamps?

PROBES: How does it help people make ends meet?

What types of food can you purchase with food stamps?

How could it improve the health and diet of seniors like you?

10. What are some of the bad things about using food stamps?

PROBE: How do you feel about the fact that Food Stamps are paid for by

the government?

11. What have you heard about the Quest (EBT) computer cards that hold the food stamp

benefits that people take to the grocery store instead of paper stamps?

PROBE: If the Quest card had other services or benefits on it, would that

make you more or less likely to apply and participate in the Food

Stamp Program? Why do you say that?

12. Did you know that if someone has difficulties going to the store to shop for food (for

example if someone is homebound or has a personal shopping assistant) they can

authorize someone to use their Quest card to shop for them?

PROBE: How did you know this? For those of you who know this, does it

make a difference in whether or not you apply for the program?

13. Do you think people in your neighborhood or community look down on people

who use food stamps?

14. What types of things would have to change about the program before you would

ever consider applying for the Food Stamp Program?

15. Would you be more willing to participate in the Food Stamp Program if you

could automatically enroll when you apply for other benefits like SSI or other

disability benefits?

16. Would you be more willing to apply and participate if you could have your

interview for eligibility conducted over the phone or at your home?

F. OUTREACH STRATEGIES AND MESSAGES (20

minutes)
Appendix 160

2. SHORT GROUP EXERCISE

So let’s imagine that we have made some of the changes to the Food Stamp Program that you

all have suggested. Let’s talk about some ways to get people interested in the program and let

them know how to go about applying.

INSTRUCTIONS TO MODERATOR: Divide the group into two sections--the right hand side

of the table and the left-hand side of the table. Ask the people on the right hand side of the

table to convince those on the left-hand side to apply for the program:

• If you were trying to convince these people to apply for food stamps, how would you do

that?

INSTRUCTIONS TO MODERATOR: Then ask the people on the left-hand side of the table:

• Which of the reasons for applying mentioned by the others was the most persuasive?

• What makes you say that was the most persuasive?

• What is the most important information a person should know about the Food Stamp

Program?

• What do you think would motivate other seniors to apply for food stamps?

Now we want to talk about how we can tell more seniors about the food stamp program.

2. What do you think would be the best way to help other seniors like you find out

about the Food Stamp Program so that they can get help paying for their

groceries every month?

PROBES: If they haven’t mentioned these ask, “What about..

TV? What channels?

Radio? What stations?

Newspapers? Which ones?

Billboards? Where in your town would you put them?

Posters? Where should they be placed?

Brochures? Where should they be placed?

Transit Ads? (e.g. on buses)

Direct Mail (e.g. as part of value-pack coupon mailings or along

with Social Security check)

3. Which organizations do you think could provide the best information about the

Food Stamp Program?

4. Which places are important to visit to inform seniors about the program?

5. Who do you think the seniors in your community trust most? Who would be

the best people to provide information about the Food Stamp Program?

PROBES: Doctors and nurses?
Appendix 161

Nutritionists?

Social Workers?

Ministers?

Other senior citizens?

Others?

6. Have you received information about the Food Stamp Program through the

mail? If so, please tell us about it.

7. Have you attended presentations on the Food Stamp Program? If so, what did

you think of the presentation? Where did they take place?

8. How do you keep up with the news? Where do you get information about

community events?

G. CLOSING (10 minutes)

Well, that is the end of my questions. I really want to thank you all for coming today. I think

we have had a really good discussion, and we have learned a lot about how to tell more seniors

about the program, how to encourage them to apply, and what types of things need to be fixed

or explained better.

1. Is there anything I haven’t asked about that you would like to tell me about your

thoughts on the Food Stamp Program or how to tell more seniors about the

program?

2. When you go home, what will you tell your spouse or friends about the

discussion tonight?

INSTRUCTIONS TO MODERATOR:

Ask the co-moderator to give a brief summary of participants’ main ideas

Ask the participants if they have any brief comments or questions. Stress that we don’t have

much time left.

Have the co-moderator distribute the food vouchers.

Encourage participants to take home whatever food remains.

After participants leave, debrief with the co-moderator while the tape recorder is on.
Appendix 162

Community Based Organizations (Seattle)
Appendix 163

Elderly Food Stamp Participation in Washington State

Focus Groups with Staff from Community Based Organizations

Seattle

Moderator’s Guide

A. INTRODUCTION (10 MINUTES)

Welcome to our group discussion. Thank you for taking the time to participate in today=s

discussion about elderly food stamp participation in Seattle. My name is _________ and I

work for Health Systems Research. My co-worker=s name is __________. Our company was

hired by the Economic Research Service of the U.S. Department of Agriculture to talk with the

elderly themselves and with program staff who work with the elderly to find out more about

their experiences in the program. We are particularly interested in what you think can be done

to improve program participation. We will use the information provided to us in the focus

groups to work with the State food stamp agency and organizations like yours to improve

outreach and access to the Food Stamp Program for eligible seniors in the area. The

information will also be made available to other States and communities who are trying to

increase food stamp participation among the elderly.

As you can see, we are taping this session. We are doing this only so that we don’t have to

take detailed notes. Everything you say is important to us and we do not want to miss anything

than any of you say. But nothing you say will ever be associated with your name—your names

and opinions will be kept strictly confidential.

I would like to review the ground rules for our discussion:

# There are no right and wrong answers. Remember, I don=t work for the

Washington State Food Stamp Program, so please tell me your thoughts,

whether they are positive or negative.

# It is ok to disagree with one another. We want to hear everyone=s point of

view. If you disagree, please do so respectfully.

# Only one person should talk at a time. We are tape recording this session so

that we don=t miss anything important. If two people talk at once, we can=t

understand what anyone is saying. I may remind you of this during the

discussion.

# We would like everyone to participate. But, you each don=t have to answer

every question. If, however, some of you are shy or I really want to know what

you think about a particular question, I may call on you.

# We have a lot that we want to talk about today. So, don=t be surprised if at

some point I interrupt the discussion and move to another topic. But, don=t let

me cut you off. If there is something important you want to say, let me know

and you can add your thoughts in before we change subjects.
Appendix 164

# We will be using first names only today. Everything you say is confidential.

After we conduct several of these group discussions across the state, we will

write a report that will be submitted to the Economic Research Service and an

advisory panel here in the State. Your name will not appear anywhere in the

report. What you say today will not be attached to your name at any point.

# Don=t worry about offending us. We don’t work for the Food Stamp Program.

We really want to learn from you and find out what you think about the issues

we talk about tonight. Please tell us your honest opinions.

# I want to make a couple more points related to the tape recording. Please speak

up. If you speak too quietly, it will be too hard to hear you later on the tape.

Also, please don=t bump the table or tap your hands on the table. Anything

close to the microphones sounds incredibly loud later on and it will drown out

your voices.

# _________ is taking notes in case the tapes don=t come out clearly and he/she

will be handling the tape recorders. At the end of the session, he/she will

provide a brief summary of what you all said tonight, so that you can correct

anything we have misunderstood or clarify important points.

The group will last an hour and a half to two hours. You will not get out any later than

_______. We will not be taking a formal break. If you need to leave for a restroom break, the

bathrooms are _____________.

Let=s get started. I=d like to start out by going around the table and having each of you tell us

a little about yourself. Again, my name is _____.

Start with the participant to your right. Have them respond in round robin fashion.

1. Please tell me your name, the organization that you represent, what your

responsibilities are regarding food stamp outreach to the elderly, and how long you have been

working with elderly food stamp recipients/persons eligible for food stamps.

B. HOW ELDERLY CLIENTS HEAR ABOUT THE FSP (10

MINUTES)

Let=s talk about how the individuals you work with find out about the Food Stamp Program.

1. How do the elderly individuals you work with hear about the Food Stamp

Program?

2. In your opinion, what motivates the elderly to apply for food stamps?
Appendix 165

C. BARRIERS TO PARTICIPATION (20-25 MINUTES)

Now I would like to hear about your views on barriers to participation for the elderly.

1. In your opinion, why don’t more elderly participate in the Food Stamp

Program?

PROBE: How do the reasons for nonparticipation vary for

different age segments within the elderly population? For

those in their sixties, for those in their seventies, and for

those eighty and above?

2. In your opinion, to what degree do the elderly feel a welfare stigma associated

with applying for food stamps? What makes you say that?

3. What about using the food stamps? How many of the elderly that you work

with do you think are embarrassed to use their food stamps?

PROBES: Why do you think they feel embarrassed?

What, if anything, can your organization do to reduce the

elderly’s feelings of embarrassment?

What could other people or agencies do to help?

4. To what extent do your elderly clients have transportation difficulties in getting

to the Food Stamp Office or other application sites to apply?

PROBES: How have you tried to alleviate this problem?

What else do you think could be done to help the elderly

get to places where they can apply for food stamps?

3. While working with the elderly, what kinds of myths or misinformation do you

encounter that prevent them or have prevented them from applying for food

stamps?

PROBES: What about fears that they must give up their home, car,

or other assets to get food stamps?

What about fears that their children will have to repay

any aid that they may receive?

What about the belief that they are only eligible to

receive a very small amount of food stamps each month

such as $10?

How does the misinformation among seniors differ from

the kinds of myths or misinformation you hear from the

general population?
Appendix 166

D. EXPERIENCES WITH THE APPLICATION PROCESS (10-15

MINUTES)

Now let=s talk about the elderly’s experiences with the Food Stamp Program application

process.

1. What role does your agency play in helping the elderly to apply for the Food

Stamp Program?

2. In your experience, what difficulties do elderly applicants have when applying

for food stamps in the office?

PROBES: What about completing the application itself?

What about problems obtaining documentation?

What about use of the excess medical deduction,

specifically?

What about being afraid to share information required for

the application, such as their social security number or

their checking account number if they hold an account

jointly with their children?

What about confusion with the eligibility rules?

What about immigrants believing that participation may

affect their future immigration status?

3. Federal regulations say that local food stamp offices can conduct the food stamp

eligibility interview by telephone or in their home if this is requested by a client

who has hardship getting to the office. Would you say that the clients you work

with know about this option and if so are the local offices conducting the

interviews by mail or in their homes upon request?

4. What kinds of special assistance does your local food stamp office give to the

elderly who are applying for food stamps?

PROBES: To what extent has this assistance been helpful?

5. In your opinion, how are the elderly treated by food stamp office staff?

PROBES: Do you think the elderly clients are treated the same as

younger clients? Do you think they should be treated the

same or differently?
Appendix 167

6. In your experience, what are the elderly’s attitudes towards the Food

Stamp Office?

PROBES: What about the staff?

How do you think the elderly feel about the staff in your

organization?

7. Do the elderly ask others to apply for them instead of going to the office

themselves?

PROBE: Is this option of an "authorized representative" applying for

someone discouraged or encouraged by the local food stamp

office?

8. What changes would you like to see made to the food stamp application process

for seniors?

9. Washington State is now designing an effort with the Social Security

Administration to automatically enroll seniors in food stamps if they are

receiving SSI. For seniors who receive SSI, there will be only a very short

application form mailed to them and no visits to the community service offices

will be required for certifications or recertifications. What are your views on

this effort?

10. How do you think this coordination of benefit enrollment could be expanded for

food stamp eligible seniors not participating in SSI, but who do participate in

other government assistance programs, such as veterans disability or Social

Security Disability Insurance (SSDI)?

E. USING THE FOOD STAMP PROGRAM (10

MINUTES)

Now let’s talk about the elderly and their experience using the Food Stamp Program.

9. To what extent do the elderly know how to use their food stamp benefits?

PROBES: What are some of the problems that they elderly have in

using their benefits?

What can be done to better educate the elderly on how to

use food stamps?

Do they know that they can have an authorized

representative shop for them?
Appendix 168

2. When elderly apply for food stamps for the first time, how many of them are

aware of the fact that benefits are provided on the Quest (EBT) cards?

3. To what extent do the elderly know how to use their QUEST cards?

PROBES: What do the elderly think of QUEST?

What can be done to better educate the elderly on how to

use QUEST?

4. In Seattle, seniors use an on-line Gold Card to get their meals at congregate

meal sites. Do you think that this card is well accepted and used by seniors?

How could this model be expanded or modified for food stamps?

5. In addition to what you have already discussed about changes to the application

process, are there any other ways that you think the Food Stamp Program could

better serve the elderly?

F. OUTREACH (20 MINUTES)

Now I would like to get your views on outreach methods to increase the participation of the

elderly in the Washington State Food Stamp Program.

1. What does your agency do to make sure that the elderly know about the

program and how to apply?

2. What other agencies are currently involved in conducting outreach to the elderly

about the Food Stamp Program and what do they do?

PROBE: What, exactly, do these agencies do with respect to food

stamp outreach?

3. What agencies are not currently involved in food stamp outreach efforts that

you

think should be? What should these agencies do?

4. If you had a very large outreach budget (think big!), what do you think would

be the best way to help the elderly to find out about the Food Stamp Program

and get them to apply? Here we are interested in very specific food stamp

outreach methods you would suggest.

PROBES: If they haven=t mentioned these, ask, ΑWhat about...≅

TV? What channels?

Radio? What stations?

Newspapers? Which ones?
Appendix 169

Billboards? Where in your town would you put them?

Posters? Where should they be placed?

Brochures? Where should they be placed?

Transit Ads? (e.g. on Buses)

Direct Mail (e.g. as part of "valu-pack" coupon packages,

along Social Security Checks?)

5. Who do you think the seniors in your community trust most? Who would be

the types of people who could be successful in encouraging the elderly to apply

for food stamps?

PROBES: Doctors and nurses?

Nutritionists?

Social Workers?

Ministers?

Other senior citizens?

Others?

6. Earlier we talked a lot about barriers and things that keep the elderly who are

eligible from applying for food stamps. What should the main message of an

outreach campaign/materials be to convince the elderly that they can/should

overcome these barriers?

PROBE: How might this differ for the younger elderly (ages 60-

70), middle group of elderly (ages 70-80) and the very

old elderly (over age 80)?

7. We also talked about what motivates the elderly to apply. Building on some of

the things you said earlier (provide summary to refresh their memories), what

positive things should an outreach campaign/materials focus on?

PROBE: How might this differ for the younger elderly (ages 60-

70), middle group of elderly (ages 70-80) and the very

old elderly (over age 80)?

G. CLOSING (10 MINUTES)

Thank you very much for giving us your input. We enjoyed the discussion and have learned a

lot about how to improve elderly food stamp participation.

1. Is there anything I haven=t asked about that you would like to tell me about

your experiences working with elderly food stamp recipients and persons

eligible but not participating in the program?
Appendix 170

INSTRUCTIONS TO MODERATOR:

Ask the co-moderator to give a brief summary of participants’ main ideas.

Ask participants if they have any brief comments or questions. Stress that we don=t have much

time left.

Have participants complete short demographic form.

Encourage them to take home whatever food remains.

After participants leave, debrief with moderator while the tape recorder is on.
Appendix 171

Community Based Organizations (Tacoma and Central Washington)
Appendix 172

Elderly Food Stamp Participation in Washington State

Focus Groups with Staff from Community Based Organizations

Tacoma and Central Washington

Moderator’s Guide

A. INTRODUCTION (10 MINUTES)

Welcome to our group discussion. Thank you for taking the time to participate in today=s

discussion about elderly food stamp participation in Seattle. My name is _________ and I

work for Health Systems Research. My co-worker=s name is __________. Our company was

hired by the Economic Research Service of the U.S. Department of Agriculture to talk with the

elderly themselves and with program staff who work with the elderly to find out more about

their experiences in the program. We are particularly interested in what you think can be done

to improve program participation. We want to focus today’s discussion on the

(Korean/Spanish-speaking Hispanic) seniors who are eligible for the program, but don’t apply

and those who are currently enrolled in the program. We will use the information provided to

us in the focus groups to work with the State food stamp agency and organizations like yours

to improve outreach and access to the Food Stamp Program for (Korean/Spanish-speaking

Hispanic) eligible seniors in the area. The information will also be made available to other

States and communities who are trying to increase food stamp participation among the elderly.

As you can see, we are taping this session. We are doing this only so that we don’t have to

take detailed notes. Everything you say is important to us and we do not want to miss anything

than any of you say. But nothing you say will ever be associated with your name—your names

and opinions will be kept strictly confidential.

I would like to review the ground rules for our discussion:

# There are no right and wrong answers. Remember, I don=t work for the

Washington State Food Stamp Program, so please tell me your thoughts,

whether they are positive or negative.

# It is ok to disagree with one another. We want to hear everyone=s point of

view. If you disagree, please do so respectfully.

# Only one person should talk at a time. We are tape recording this session so

that we don=t miss anything important. If two people talk at once, we can=t

understand what anyone is saying. I may remind you of this during the

discussion.

# We would like everyone to participate. But, you each don=t have to answer

every question. If, however, some of you are shy or I really want to know what

you think about a particular question, I may call on you.
Appendix 173

# We have a lot that we want to talk about today. So, don=t be surprised if at

some point I interrupt the discussion and move to another topic. But, don=t let

me cut you off. If there is something important you want to say, let me know

and you can add your thoughts in before we change subjects.

# We will be using first names only today. Everything you say is confidential.

After we conduct several of these group discussions across the state, we will

write a report to the Economic Research Service and an advisory panel here in

the State. Your name will not appear anywhere in the report. What you say

today will not be attached to your name at any point.

# Don=t worry about offending us. We don’t work for the Food Stamp Program.

We really want to learn from you and find out what you think about the issues

we talk about tonight. Please tell us your honest opinions.

# I want to make a couple more points related to the tape recording. Please speak

up. If you speak too quietly, it will be too hard to hear you later on the tape.

Also, please don=t bump the table or tap your hands on the table. Anything

close to the microphones sounds incredibly loud later on and it will drown out

your voices.

# _________ is taking notes in case the tapes don=t come out clearly and he/she

will be handling the tape recorders. At the end of the session, he/she will

provide a brief summary of what you all said tonight, so that you can correct

anything we have misunderstood or clarify important points.

The group will last an hour and a half to two hours. You will not get out any later than

_______. We will not be taking a formal break. If you need to leave for a restroom break, the

bathrooms are _____________.

Let=s get started. I=d like to start out by going around the table and having each of you tell us

a little about yourself. Again, my name is _____.

Start with the participant to your right. Have them respond in round robin fashion.

1. Please tell me your name, the organization that you represent, what your responsibilities

are regarding food stamp outreach to the elderly, and how long you have been working

with elderly food stamp recipients/persons eligible for food stamps.

C. HOW ELDERLY CLIENTS HEAR ABOUT THE FSP (10

MINUTES)

Let=s talk about how the individuals you work with find out about the Food Stamp Program.

1. How do the (Korean/Spanish-speaking Hispanic) elderly individuals you work

with hear about the Food Stamp Program?
Appendix 174

2. In your opinion, what motivates the (Korean/Spanish-speaking Hispanic)

elderly to apply for food stamps?

C. BARRIERS TO PARTICIPATION (20-25 MINUTES)

Now I would like to hear about your views on barriers to participation for the elderly.

1. In your opinion, why don’t more (Korean/Spanish-speaking Hispanic) elderly

participate in the Food Stamp Program?

2. In your opinion, to what degree do the (Korean/Spanish-speaking Hispanic)

elderly feel a welfare stigma associated with applying for food stamps? What

makes you say that?

3. What about using the food stamps? How many of the (Korean/Spanishspeaking Hispanic) elderly that you work with do you think are embarrassed to

use their food stamps?

PROBES: Why do you think they feel embarrassed?

What, if anything, can your organization do to reduce the

elderly’s feelings of embarrassment?

What could other people or agencies do to help?

4. To what extent do your (Korean/Spanish-speaking Hispanic) elderly clients

have transportation difficulties in getting to the Food Stamp Office or other

application sites to apply?

PROBES: How have you tried to alleviate this problem?

What else do you think could be done to help the elderly

get to places where they can apply for food stamps?

5. Before they even get to the food stamp office to apply, what kinds of problems

related to language or culture do the eligible (Korean, Hispanic) elderly

experience?

PROBES: What about complaints from the elderly that they cannot

understand the Food Stamp Office phone system or the

phone system in your agency? How can the phone system

be improved?

3. While working with the (Korean/Spanish-speaking Hispanic) elderly, what

kinds of myths or misinformation do you encounter that prevent them or have

prevented them from applying for food stamps?
Appendix 175

PROBES: What about fears that they must give up their home, car,

or other assets to get food stamps?

What about fears that their children will have to repay

any aid that they may receive?

What about the belief that they are only eligible to

receive a very small amount of food stamps each month

such as $10?

How does the misinformation among seniors differ from

the kinds of myths or misinformation you hear from the

general population?

D. EXPERIENCES WITH THE APPLICATION PROCESS (10-15

MINUTES)

Now let=s talk about the (Korean, Hispanic) elderly’s experiences with the Food Stamp

Program certification process.

1. What role does your agency play in helping the (Korean, Hispanic) elderly to

apply for the Food Stamp Program?

2. In your experience, what difficulties do (Korean, Hispanic) elderly applicants

have when applying for food stamps in the office?

PROBES: What about completing the application itself?

What about problems obtaining documentation?

What about the use of the excess medical dedication,

specifically?

What about being afraid to share information required for

the application, such as their social security number or

their checking account number if they hold an account

jointly with their children?

What about confusion with the eligibility rules?

What about immigrants believing that participation may

affect their future immigration status?

3. What kinds of barriers related to language or culture do the (Korean or Spanish

speaking) elderly experience when they go to the office to apply for food

stamps?

PROBES: What about problems with understanding their name

when it is called by staff members who may not know

how to pronounce their name?

What about communicating with staff during the

interview?
Appendix 176

Other problems?

4. What kinds of special assistance does your local food stamp office give to the

(Korean, Hispanic) elderly who are applying for food stamps?

PROBES: To what extent has this assistance been helpful?

5. In your opinion, how are the (Korean, Hispanic) elderly treated by Food Stamp

Office staff?

PROBES: Do you think the elderly clients are treated the same as

younger clients?

Do you think they should be treated the same or

differently?

6. In your experience, what are the (Korean, Hispanic) elderly’s attitudes towards

the Food Stamp Office?

PROBES: What about the staff?

How do you think the elderly feel about the staff in your

organization?

7. Do the elderly ask others to apply for them instead of going to the office

themselves?

PROBES: Is this option of "authorized representatives" applying for

someone discouraged or encouraged by the local food

stamp office?

8. What changes would you like to see made to the food stamp application process

for seniors?

9. Washington State is now designing an effort with the Social Security

Administration to automatically enroll seniors in food stamps if they are

receiving SSI. For seniors who receive SSI, there will be only a very short

application form mailed to them and no visits to the community service offices

will be required for certifications or recertifications. What are your views on

this effort?

10. How do you think this coordination of benefit enrollment could be expanded for

food stamp eligible seniors not participating in SSI, but who do receive other

government benefits such as veterans disability or Social Security Disability

Insurance (SSDI)?
Appendix 177

E. USING THE FOOD STAMP PROGRAM (10 MINUTES)

Now let’s talk about the elderly and their experience using the Food Stamp Program.

1. To what extent do the (Korean, Hispanic) elderly know how to use their food

stamp benefits?

PROBES: What are some of the problems that they elderly have in

using their benefits?

What can be done to better educate the elderly on how to

use food stamps?

2. When (Korean, Hispanic) elderly apply for food stamps for the first time, how

many of them are aware of the fact that benefits are provided on the Quest cards

(EBT)?

3. To what extent do the (Korean, Hispanic) elderly know how to use their Quest

cards?

PROBES: What do the elderly think of the Quest

Card?

What can be done to better educate the

elderly on how to use Quest Card?

4. We have talked about a few different aspects of the Food Stamp Program.

Overall, how do you think the program could better serve the (Korean,

Hispanic) elderly?

F. OUTREACH (20 MINUTES)

Finally, we want to get your opinions on outreach methods to increase the participation of the

elderly in the Washington State Food Stamp Program.

1. What does your agency do to make sure that the (Korean, Hispanic) elderly

know about the program and how to apply?

2. What other agencies in your community are currently involved conducting

outreach to the (Korean, Hispanic) elderly about the Food Stamp Program?

PROBES: What, exactly, do these agencies do with respect to food

stamp outreach?

What agencies are not currently involved that you think

should be? What should these agencies do?
Appendix 178

3. What agencies are not currently involved in food stamp outreach efforts that

you think should be? What should these agencies do?

4. If you had a very large outreach budget (think big!), what do you think would

be the best way to help the (Korean, Hispanic) elderly to find out about the

Food Stamp Program and get them to apply?

PROBES: If they haven=t mentioned these, ask, ΑWhat about...≅

TV? What channels?

Radio? What stations?

Newspapers? Which ones?

Billboards? Where in your town would you put them?

Posters? Where should they be placed?

Brochures? Where should they be placed?

Transit Ads? (e.g. on buses)

Direct Mail? (e.g. as part of “valu-pack” coupon

packages, along with Social Security Checks)

5. Who do you think the (Korean, Hispanic) seniors in your community trust

most? Who would be the types of people who could be successful in

encouraging the elderly to apply for food stamps?

PROBES: Doctors and nurses?

Nutritionists?

Social Workers?

Ministers?

Other senior citizens?

Others?

6. Earlier we talked a lot about barriers and things that keep the elderly who are

eligible from applying for food stamps. What should the main message of an

outreach campaign/materials to convince the elderly that they can/should

overcome these barriers?

PROBE: How might this differ for the younger elderly (ages 60-70),

middle group of elderly (ages 70-80) and the very old elderly

(over age 80)?

7. We also talked about what motivates the elderly to apply. Building on some of

the things you said earlier (provide summary to refresh their memories), what

positive things should an outreach campaign/materials focus on?

PROBE: How might this differ for the younger elderly (ages 60-70),

middle group of elderly (ages 70-80) and the very old elderly

(over age 80)?
Appendix 179

G. CLOSING (10 MINUTES)

Thank you very much for giving us your input. We enjoyed the discussion and have learned a

lot about how to improve elderly food stamp participation.

1. Is there anything I haven=t asked about that you would like to tell me about

your experiences working with elderly food stamp recipients and persons

eligible but not participating in the program?

INSTRUCTIONS TO MODERATOR:

Ask the co-moderator to give a brief summary of participants’ main ideas.

Ask participants if they have any brief comments or questions. Stress that we don=t have much

time left.

Have participants complete short demographic form.

Encourage them to take home whatever food remains.

After participants leave, debrief with the co-moderator while the tape recorder is on.
Appendix 180

Food Stamp Office Staff (Seattle)
Appendix 181

Elderly Food Stamp Participation in Washington State

CSO/Food Stamp Office Staff

Seattle

Moderator’s Guide

A. INTRODUCTION (10 MINUTES)

Welcome to our group discussion. Thank you for taking the time to participate in today’s

discussion about elderly food stamp participation in Washington. My name is _________ and

I work for Health Systems Research. My co-worker=s name is __________. Our company

was hired by the Economic Research Service of the U.S. Department of Agriculture to talk

with the elderly themselves and with program staff who work with the elderly to find out more

about their experiences in the program. We are interested in your thoughts and comments. We

will use them to improve outreach efforts in your area and to provide information to other

States who are developing elderly outreach programs.

As you can see, we are taping this session. We are doing this only so that we don’t have to

take detailed notes. Everything you say is important to us and we do not want to miss anything

than any of you say. But nothing you say will ever be associated with your name—your names

and opinions will be kept strictly confidential.

I would like the review the ground rules for our discussion:

# There are no right and wrong answers. Remember, I don=t work for the

Washington State Food Stamp Program, so please tell me your thoughts,

whether they are positive or negative.

# It is ok to disagree with one another. We want to hear everyone=s point of

view. If you disagree, please do so respectfully.

# Only one person should talk at a time. We are tape recording this session so

that we don=t miss anything important. If two people talk at once, we can=t

understand what anyone is saying. I may remind you of this during the

discussion.

# We would like everyone to participate. But, you each don=t have to answer

every question. If, however, some of you are shy or I really want to know what

you think about a particular question, I may call on you.

# We have a lot that we want to talk about tonight. So, don=t be surprised if at

some point I interrupt the discussion and move to another topic. But, don=t let

me cut you off. If there is something important you want to say, let me know

and you can add your thoughts in before we change subjects.
Appendix 182

# We will be using first names only today. Everything you say is confidential.

After we conduct several of these group discussions across the state, we will

write a report to the Economic Research Service and an advisory panel here in

the State. Your name will not appear anywhere in the report. What you say

today will not be attached to your name at any point.

# Don=t worry about offending us. We really want to learn from you and find out

what you think about the issues we talk about tonight. Please tell us your honest

opinions.

# I want to make a couple more points related to the tape recording. Please speak

up. If you speak too quietly, it will be too hard to hear you later on the tape.

Also, please don=t bump the table or tap your hands on the table. Anything

close to the microphones sounds incredibly loud later on and it will drown out

your voices.

# _________ is taking notes in case the tapes don=t come out clearly and he/she

will be handling the tape recorders. At the end of the session, he/she will

provide a brief summary of what you all said tonight, so that you can correct

anything we have misunderstood or clarify important points.

The group will last an hour and a half to two hours. You will not get out any later than

_______. We will not be taking a formal break. If you need to leave for a restroom break, the

bathrooms are _____________.

Let=s get started. I=d like to start out by going around the table and having each of you tell us

a little about yourself. Again, my name is _____.

Start with the participant to your right. Have them respond in round robin fashion.

1. Please tell me your name, how long you have worked with the Food Stamp

Program, and what your responsibilities are with respect to the Food Stamp

Program.

B. HOW ELDERLY CLIENTS HEAR ABOUT THE FSP (5-10 MINUTES)

Let=s talk about how the individuals you work with find out about the Food Stamp Program.

1. How do the elderly individuals that you work with hear about the Food Stamp

Program?

2. In your opinion, what motivates the elderly to apply for food stamps?
Appendix 183

C. BARRIERS TO PARTICIPATION (25 MINUTES)

Now I would like to hear about your views on barriers to participation for the elderly.

1. In your opinion, why don’t more elderly participate in the Food Stamp

Program?

2. In your opinion, to what degree do the elderly feel a welfare stigma associated

with applying for food stamps? What makes you say that?

3. What about using the food stamps? How many of the elderly that you work

with do you think are embarrassed to use their food stamps?

PROBES: Why do you think they feel embarrassed?

What, if anything, can you do as food stamp staff to

reduce the elderly’s feelings of embarrassment?

What could other people or agencies do to help?

4. To what extent do your elderly clients have transportation difficulties in getting

to the Food Stamp Office or other application sites to apply?

PROBES: How have you tried to alleviate this problem?

What else do you think could be done to help the elderly

get to places where they can apply for food stamps?

3. While working with the elderly, what kinds of myths or misinformation do you

encounter that prevent them or have prevented them from applying for food

stamps?

PROBES: What about fears that they must give up their home, car,

or other assets to get food stamps?

What about fears that their children will have to repay

any aid that they may receive?

What about the belief that they are only eligible to

receive a very small amount of food stamps each month

such as $10?

How does the misinformation among seniors differ from

the kinds of myths or misinformation you hear from the

general population?
Appendix 184

D. EXPERIENCES WITH THE CERTIFICATION PROCESS (45

MINUTES)

Now let=s talk about the elderly’s experiences with the Food Stamp Program certification

process. First, I am going to ask you about the elderly’s experience in applying at the office,

then I will turn to other options, such as applying over the phone, in their home, or using an

authorized representative.

1. Please describe the steps that an elderly applicant must usually take when

applying for food stamps in your office?

2. How long, from the time they walk through the door, to the time they go home,

are elderly applicants in the office?

PROBES: When they come to complete the entire process?

When they just come for an interview (e.g. they have

initiated their application through the mail)?

3. In your experience, what difficulties do elderly applicants have when applying

for food stamps in the office?

PROBES: What about completing the application itself?

What about problems obtaining documentation?

What about use of the excess medical deduction,

specifically?

What about being afraid to share information required for

the application, such as their social security number or

their checking account number if they hold an account

jointly with their children?

What about confusion with the eligibility rules?

What about immigrants believing that participation may

affect their future immigration status?

4. Of the problems you just described, how are the problems that seniors have

applying for the program different from those experienced by the general

population you serve in this office?

5. What kinds of special assistance does your office give to the elderly who are

applying for food stamps?

PROBES: To what extent has this assistance been helpful?

How can the certification process be made even easier for

the elderly?
Appendix 185

6. In your experience, what are the elderly’s attitudes towards the food stamp

Office?

PROBES: What about the staff? How do you think the elderly feel

about the staff in this office?

7. In some offices around the country the elderly can have an authorized

representative apply for them. How often is this practice used at your office?

PROBE: Why do you think it is used/not used very often?

8. Please describe other ways that the elderly can apply for food stamps without

coming to the food stamp office themselves.

PROBE: What is your office’s policy on telephone and in-home

application interviews?

If telephone or home interviews are an option upon

client request: Would you say that the clients you work

with know about this option and if so, how often do you

conduct the interviews by mail or in their homes upon

request?

9. In your opinion, how can the application process be made easier for the elderly?

E. USING THE FOOD STAMP PROGRAM (10 MINUTES)

Now let’s talk about the elderly and their experience using the Food Stamp Program.

1. When elderly apply for food stamps for the first time, how many of them are

aware of the fact that benefits are provided on Quest (EBT) cards?

2. To what extent do the elderly know how to use their QUEST cards?

PROBE: What do the elderly think of QUEST?

What can be done to better educate the elderly on how to

use QUEST?

3. We have talked about the different aspects of the Food Stamp Program from

applying to using the benefits. Overall, how do you think the program could

better serve the elderly?
Appendix 186

F. OUTREACH (20 MINUTES)

Finally, we want to get your opinions on outreach methods to increase the participation of the

elderly in the Food Stamp Program.

1. What do you think would motivate other seniors to apply for food stamps?

2. What does this food stamp office or other community agencies in this area do to

make sure that the elderly know where to go to apply for food stamps?

3. If you had a very large outreach budget (think big!), what do you think would

be the best way to help the elderly to find out about the Food Stamp Program

and get them to apply?

PROBE: If they haven=t mentioned these, ask, ΑWhat about...≅

TV? What channels?

Radio? What stations?

Newspapers? Which ones?

Billboards? Where in your town would you put them?

Posters? Where should they be placed?

Brochures? Where should they be placed?

Transit Ads? (e.g. on Buses)

Direct Mail (e.g. as part of "valu-pack" coupon packages,

along Social Security Checks?)

4. Who do you think the seniors in your community trust most? Who would be

the best people to provide information about the food stamp program?

PROBE: Doctors and nurses?

Nutritionists?

Social Workers?

Ministers?

Other senior citizens?

Others?

5. Earlier we talked a lot about barriers and things that keep the elderly who are

eligible from applying for food stamps. What should the main message of an

outreach campaign/materials be to convince the elderly that they can/should

overcome these barriers?

PROBE: How might this differ for the younger elderly (60-70),

middle group of elderly (ages 70-80) and the very old

elderly (over 80)?
Appendix 187

6. We also talked about what motivates the elderly to apply. Building on some of

the things you said earlier (provide summary to refresh their memories), what

positive things should an outreach campaign/materials focus on?

PROBE: How might this differ for the younger elderly (60-70), middle

group of elderly (ages 70-80) and the very old elderly (over 80)?

H. CLOSING (10 MINUTES)

Thank you very much for sharing your input with us. We enjoyed the discussion and have

learned a lot about how to improve elderly food stamp participation.

1. Is there anything I haven=t asked about that you would like to tell me about

your experiences working with elderly food stamp recipients and eligibles?

INSTRUCTIONS TO MODERATOR:

Ask the co-moderator to give a brief summary of participants’ main ideas.

Ask participants if they have any brief comments or questions. Stress that we don=t have much

time left.

Have participants complete short demographic form.

Encourage them to take home whatever food remains.

After participants leave, debrief with the co-moderator while the tape recorder is on.
Appendix 188

Food Stamp Office Staff (Tacoma and Central Washington)
Appendix 189

Elderly Food Stamp Participation in Washington State

CSO/Food Stamp Program Staff

Tacoma and Central Washington

Moderator’s Guide

B. INTRODUCTION (10 MINUTES)

Welcome to our group discussion. Thank you for taking the time to participate in today’s

discussion about elderly food stamp participation in Washington. My name is _________ and

I work for Health Systems Research. My co-worker=s name is __________. Our company

was hired by the Economic Research Service of the U.S. Department of Agriculture to talk to

individuals who work with the elderly who are food stamp eligible, and to ask you what you

think about the outreach efforts of the Washington State Food Stamp Program. In particular,

we would like to focus today’s conversation on the (Korean/Spanish-speaking Hispanic)

elderly that come in to your office, as well as (Korean/Hispanic) seniors who are eligible for

the program, but don’t apply. We are interested in your thoughts and comments. We will use

them to improve outreach efforts and to provide information to other States who are

developing elderly outreach programs.

As you can see, we are taping this session. We are doing this only so that we don’t have to

take detailed notes. Everything you say is important to us and we do not want to miss anything

than any of you say. But nothing you say will ever be associated with your name—your names

and opinions will be kept strictly confidential.

I would like the review the ground rules for our discussion:

# There are no right and wrong answers. Remember, I don=t work for the

Washington State Food Stamp Program, so please tell me your thoughts,

whether they are positive or negative.

# It is ok to disagree with one another. We want to hear everyone=s point of

view. If you disagree, please do so respectfully.

# Only one person should talk at a time. We are tape recording this session so

that we don=t miss anything important. If two people talk at once, we can=t

understand what anyone is saying. I may remind you of this during the

discussion.

# We would like everyone to participate. But, you each don=t have to answer

every question. If, however, some of you are shy or I really want to know what

you think about a particular question, I may call on you.
Appendix 190

# We have a lot that we want to talk about tonight. So, don=t be surprised if at

some point I interrupt the discussion and move to another topic. But, don=t let

me cut you off. If there is something important you want to say, let me know

and you can add your thoughts in before we change subjects.
Appendix 191

# We will be using first names only today. Everything you say is confidential.

After we conduct several of these group discussions across the state, we will

write a report to the Economic Research Service and an advisory panel here in

the State. Your name will not appear anywhere in the report. What you say

today will not be attached to your name at any point.

# Don=t worry about offending us. We really want to learn from you and find out

what you think about the issues we talk about tonight. Please tell us your honest

opinions.

# I want to make a couple more points related to the tape recording. Please speak

up. If you speak too quietly, it will be too hard to hear you later on the tape.

Also, please don=t bump the table or tap your hands on the table. Anything

close to the microphones sounds incredibly loud later on and it will drown out

your voices.

# _________ is taking notes in case the tapes don=t come out clearly and he/she

will be handling the tape recorders. At the end of the session, he/she will

provide a brief summary of what you all said tonight, so that you can correct

anything we have misunderstood or clarify important points.

The group will last an hour and a half to two hours. You will not get out any later than

_______. We will not be taking a formal break. If you need to leave for a restroom break, the

bathrooms are _____________.

Let=s get started. I=d like to start out by going around the table and having each of you tell us

a little about yourself. Again, my name is _____.

Start with the participant to your right. Have them respond in round robin fashion.

1. Please tell me your name, how long you have worked with the Food Stamp

Program, and what your responsibilities are with respect to the Food Stamp

Program.

B. HOW ELDERLY CLIENTS HEAR ABOUT THE FSP (5-10 MINUTES)

Let=s talk about how the individuals you work with find out about the Food Stamp Program.
Appendix 192

1. How do the (Korean/Hispanic) elderly individuals that you work with hear

about the Food Stamp Program?

2. In your opinion, what motivates the (Korean/Hispanic) elderly to apply for food

stamps?

C. BARRIERS TO PARTICIPATION (25 MINUTES)

Now I would like to hear about your views on barriers to participation for the elderly.

1. In your opinion, why are more eligible elderly (Koreans/Hispanics) not

participating in the Food Stamp Program?

2. In your opinion, to what degree do the (Korean/Hispanic) elderly feel a welfare

stigma associated with applying for food stamps? What makes you say that?

3. What about using the food stamps? How many of the (Korean/Hispanic)

elderly that you work with do you think are embarrassed to use their food

stamps?

PROBES: Why do you think they feel embarrassed?

What, if anything, can you do as food stamp staff to

reduce the elderly’s feelings of embarrassment?

What could other people or agencies do to help?

4. To what extent do your (Korean/Hispanic) elderly clients have transportation

difficulties in getting to the Food Stamp Office or other application sites to

apply?

PROBES: How have you tried to alleviate this problem?

What else do you think could be done to help the elderly

get to places where they can apply for food stamps?

5. Before they even get to the food stamp office to apply, what kinds of problems

related to language or culture do the eligible (Korean, Hispanic) elderly

experience?

PROBES: What about complaints from the elderly that they cannot

understand the Food Stamp Office phone system? How

can the phone system be improved?
Appendix 193

6. While working with the (Korean/Hispanic) elderly, what kinds of myths or

misinformation do you encounter that prevent them or have prevented them

from applying for food stamps?

PROBES: What about fears that they must give up their home, car,

or other assets to get food stamps?

What about fears that their children will have to repay

any aid that they may receive?

What about the belief that they are only eligible to

receive a very small amount of food stamps each month

such as $10?

How does the misinformation among seniors differ from

the kinds of myths or misinformation you hear from the

general population?

D. EXPERIENCES WITH THE CERTIFICATION PROCESS (45

MINUTES)

Now let=s talk about the elderly’s experiences with the Food Stamp Program certification

process. First, I am going to ask you about the (Korean/Hispanic) elderly’s experience in

applying at the office, then I will turn to other options, such as applying over the phone, in

their home, or using an authorized representative.

1. Please describe the steps that an elderly applicant must usually take when

applying for food stamps in your office?

2. How long, from the time they walk through the door, to the time they go home,

are elderly applicants in the office?

PROBES: When they come to complete the entire process?

When they just come for an interview (e.g. they have

initiated their application through the mail)?

3. In your experience, what difficulties do (Korean/ Spanish Speaking Hispanic)

elderly applicants have when applying for food stamps in the office?

PROBES: What about completing the application itself?

What about problems obtaining documentation?

What about use of the excess medical deduction,

specifically?

What about being afraid to share information

required for the application, such as their social

security number or their checking account number

if they hold an account jointly with their children?

What about confusion with the eligibility rules?
Appendix 194

What about immigrants believing that

participation may affect their future immigration

status?

4. Of the problems you just described, how are the problems that

(Korean/Hispanic) seniors have applying for the program different from those

experienced by the general population you serve in this office?

5. What kinds of special assistance does your office give to the (Korean or

Spanish-speaking Hispanic) elderly who are applying for food stamps?

PROBES: To what extent has this assistance been helpful?

How can the certification process be made even

easier for the elderly?

6. What kinds of barriers related to language or culture do the (Korean or Spanish

speaking) elderly experience when they come to the office to apply for food

stamps?

PROBES: What about problems with understanding their

name when it is called by staff members who may

not know how to pronounce their name?

What about communicating with staff during the

interview?

Other problems?

7. What kinds of special assistance are given to the immigrant elderly who speak

Korean (or Spanish) that come to the food stamp office to apply?

PROBES: To what extent has this assistance been helpful?

How can the certification process be made easier

for this group of elderly?

8. In your experience, what are the elderly’s attitudes towards the food stamp

office?

PROBES: What about the staff? How do you think the

elderly feel about the staff in this office?

9. In some offices around the country the elderly can have an authorized

representative apply for them. How often is this practice used at your office?

Why do you think it is used/not used very often?
Appendix 195

10. Please describe other ways that the elderly can apply for food stamps without

coming to the food stamp office themselves.

PROBES: What is your office’s policy on telephone and in-home

application interviews?

If telephone or home interviews are an option upon

client request: Would you say that the clients you work

with know about this option and if so, how often do you

conduct the interviews by mail or in their homes upon

request?

11. In your opinion, how can the application process be made easier for the elderly?

E. USING THE FOOD STAMP PROGRAM (10

MINUTES)

Now let’s talk about the (Korean/Spanish-speaking Hispanic) elderly and their experience

using the Food Stamp Program.

1. When (Korean or Spanish speaking) elderly apply for food stamps for the first

time, how many of them are aware of the fact that benefits are provided on

Quest Cards (EBT)?

2. To what extent do the (Korean or Spanish speaking) elderly know how to use

their QUEST cards?

PROBES: What do the elderly think of QUEST?

What can be done to better educate the elderly on

how to use QUEST CARDS?

3. We have talked about the different aspects of the Food Stamp Program from

applying to using the benefits. Overall, how do you think the program could

better serve the (Korean/Spanish-speaking Hispanic) elderly?

F. OUTREACH (20 MINUTES)

Finally, we want to get your opinions on outreach methods to increase the participation of the

(Korean/Spanish-speaking) elderly in the Food Stamp Program.

1. What do you think would motivate other (Korean/Hispanic) seniors to apply for

food stamps?
Appendix 196

2. What does this food stamp office or other community agencies in this area do to

make sure that the (Korean/Hispanic) elderly know where to go to apply for

food stamps?

3. If you had a very large outreach budget (think big!), what do you think would

be the best way to help the (Korean/Hispanic) elderly to find out about the Food

Stamp Program and get them to apply?

PROBES: If they haven=t mentioned these, ask, ΑWhat about...≅

TV? What channels?

Radio? What stations?

Newspapers? Which ones?

Billboards? Where in your town would you put them?

Posters? Where should they be placed?

Brochures? Where should they be placed?

Transit Ads? (e.g. on Buses)

Direct Mail (e.g. as part of "valu-pack" coupon packages,

along Social Security Checks?)

4. Who do you think the (Korean/Hispanic) seniors in your community trust most?

Who would be the best people to provide information about the food stamp

program?

PROBES: Doctors and nurses?

Nutritionists?

Social Workers?

Ministers?

Other senior citizens?

Others?

5. Earlier we talked a lot about barriers and things that keep the elderly who are

eligible from applying for food stamps. What should the main message of an

outreach campaign/materials be to convince the elderly that they can/should

overcome these barriers?

PROBE: How might this differ for the younger elderly (ages 60-

70), middle group of elderly (ages 70-80) and the very

old elderly (over age 80)?
Appendix 197

6. We also talked about what motivates the elderly to apply. Building on some of

the things you said earlier (provide summary to refresh their memories), what

positive things should an outreach campaign/materials focus on?

PROBE: How might this differ for the younger elderly (ages 60-70),

middle group of elderly (ages 70-80) and the very old elderly

(over age 80)?

G. CLOSING (10 MINUTES)

Thank you very much for sharing your input with us. We enjoyed the discussion and have

learned a lot about how to improve elderly food stamp participation.

11. Is there anything I haven=t asked about that you would like to tell me about your

experiences working with (Korean/Spanish-speaking) elderly food stamp recipients

and persons who are eligible but not participating in the program?

INSTRUCTIONS TO MODERATOR:

Ask the co-moderator to give a brief summary of participants’ main ideas.

Ask participants if they have any brief comments or questions. Stress that we don=t have much

time left.

Have participants complete short demographic form.

Encourage them to take home whatever food remains.

After participants leave, debrief with the co-moderator while the tape recorder is on.
Appendix 198

Appendix D: Focus Group Coding Scheme
Appendix 199

Coding Scheme for Washington State Elderly Focus Group Study

Community Life

homelife Respondents current living situation, whether they cook, etc.

community Describes seniors’ community involvement (e.g. Bingo, social gatherings)

Seniors Self-Perception of Need and Food Security Related Issues

Needhelp Types of help the respondent felt s/he needs on a regular basis, excluding food assistance

where4food Where they go for food assistance now AND how it compares to FSP

skipmeal Comments about if and why seniors skip meals

diet Respondent describes seniors’ diets, including whether they are getting enough to eat and

regularly eating the right foods

barriereat What keeps seniors from eating proper foods

How Elderly Hear About the FSP

howhear How elderly hear about the food stamp program

getinfoapp How/where elderly get more information about the food stamp program and the FS application

before they apply

whyapply Why seniors decide to apply for the food stamp program or what motivates them to apply

howlongwait How long do seniors wait before they apply for food stamps and why

Perceptions of the FSP/Satisfaction

eligben Passages about the elderly’s understanding about who is eligible for the FSP and what affects benefit

levels

fsgood What are the good things about the FSP

fsbad What are the bad things about the FSP

change How seniors’ perceptions of the FSP changed before and after applying for benefits

misdir Discussion about program benefits being misdirected/misallocated to younger individuals, noncitizens/immigrants and result in the elderly not getting enough

Barriers to Seeking Food Stamps

b_stigma Issues of stigma, pride, and embarrassment surrounding the receipt of FS (typically nonparticipants)

b_office Characteristics of/Contact with FSP office as barriers (e.g., CSO phone system, office structure)

before visiting the office

b_lowben Discussion about how the expected low benefit amount keeps elderly from applying for FS

b_langcult language and cultural barriers to applying for FS

b_noncit Issues surrounding non-citizens and the FSP

b_other Other reasons elderly do not apply, including transportation, misinformation, fear of

government, etc.

Completing the Application Form

appform General comments about how seniors view the application form and other related forms

Experiences of the Application Process

csosteps Detailed descriptions from CSO staff about the steps necessary in the FS application process

cboassist How CBOs assist elderly with the application form and process

friendassist Discussion about seniors bringing a friend/relative to the CSO to help negotiate the application

process, provide translation, or assist with transportation needs.

treatment How elderly view the FS workers and their treatment at the CSO, including how treatment of

elderly clients is different to treatment of general public
Appendix 200

language Passages related to spoken language and cultural barriers experienced by seniors at the CSO (e.g.,

ability to communicate with caseworkers, experiences with translators) If written language/culture

barrier, code passage in appropriate topic area even it not defined to capture language as a barrier.

For example, if talking about poor translation on the letters explaining their EBT benefits, code the

passage as ebt.

waitroom Comments about the waiting room at the CSO and waiting time

authrepapp Passages related to what seniors know and understand about using an authorized representative to

apply for food stamps

phonehome Discussions about the availability/usefulness of telephone or home interviews

mailapp General comments about the applying for FS through the mail

interview How seniors view the eligibility interview

verify Discussion about the verification documentation and required time/cost to complete

medexp Comments about use of the Medical Expense deduction for food stamps

specassist Special assistance provided to elderly at the CSO (not CBO related)

timeall Amount of time seniors must spend completing the process

privacy Discussion of privacy issues/concerns related to their situation or their family’s

otherconc Discussion about other difficulties or concerns when seniors apply for FS (as expressed by seniors,

CBOs or CSOs)

Experiences Re-applying for food Stamps

whynotreapp Reasons that make seniors not re-apply for food stamps

reapply General comments about the reapplication process

reappchange Changes needed to the reapplication process

Using the Food Stamp Program

ebt Discussion about seniors’ (participants and non-participants) use of EBT in the FSP

ebtinfo Knowledge about EBT (info, misinformation, and discussions about training recieved)

stigma Passages related to embarrassment surrounding use of EBT card at the grocery store

authrepebt Do they want/choose authorized reps to shop for them

homemeals Use of EBT benefits for home delivered meals

Current and Potential Outreach/Program Information

currout Passages about outreach currently conducted by CBOs and CSOs

convince Passages from the persuasion exercise

message Suggested focus of messages to motivate elderly to apply for FS

channels Suggestions for the best methods to get information to eligible seniors

outplaces Suggested organizations/locations to involve in outreach who are not now conducting outreach

or to visit to inform seniors about the FSP

trust Persons in the community who seniors trust the most

wherenews Where do seniors get information about community news

Recommendations for Program Improvements

r_appsite More convenient sites for elderly to apply for food stamps besides the CSO

r_appimprove Comments about how the application process at the CSO can be made easier for the elderly

r_coordSSA Discussion about how seniors could apply for food stamps while applying for SSI or other programs

offered by Social Security

r_benefits Recommendations for changes in the benefits (amount/cash, EBT vs. stamps) and communication

about benefits.

r_ebt Recommendations for improvements in EBT (client education, other)

r_eligrules Recommendations for changes in eligibility rules

r_other Discussion about other ways the program can be improved to better serve the elderly.
Appendix 201

Appendix E: Washington State Food Stamp Application

Forms (Current and Pending)
Appendix 202

Current Food Stamp Application Form
Appendix 203
Appendix 204
Appendix 205
Appendix 206
Appendix 207
Appendix 208
Appendix 209
Appendix 210
Appendix 211
Appendix 212
Appendix 213
Appendix 214
Appendix 215

Pending Revised Food Stamp Application Form
Appendix 216