A Poor Measure of the Wrong Thing: The Food Stamp Program\u27s Quality Control System Discourages Participation by Working Families

This Note examines how the Food Stamp Program\u27s quality control system has contributed to an unprecedented drop in the number of households receiving food stamps. Since the only practical measure of the program\u27s effectiveness is the rate of error in distributing benefits, state administrators face tremendous pressure, in the form of fiscal sanctions from the federal government, to reduce errors. That emphasis has resulted in state policies designed to eliminate errors, but these state policies have had a harmful side-effect in discouraging, if not preventing, otherwise eligible households from participating in the program. This is due, in part, to the changing composition of households seeking food stamps. In particular, more eligible households are working at least part-time, yet remain poor enough to be eligible for food stamps. These households have complicated income characteristics that are a fertile source of administrative error. The states that have begun requiring households with earned income to recertify for the program more frequently have seen participation among these households decline notably. A number of similar state policy responses have resulted in a quality control system that favors the government interest in payment accuracy at the cost of unfairly burdening those participating and potentially eligible for the program. While merely adjusting the sanction policy would provide relief to states with high error rates, a more substantial overhaul of the measures used to monitor the Food Stamp Program would provide a more useful assessment of state performance and remove unnecessary barriers to participation

Getting more than they realized they needed: a qualitative study of women's experience of group prenatal care

<p>Abstract</p> <p>Background</p> <p>Pregnant women in Canada have traditionally received prenatal care individually from their physicians, with some women attending prenatal education classes. Group prenatal care is a departure from these practices providing a forum for women to experience medical care and child birth education simultaneously and in a group setting. Although other qualitative studies have described the experience of group prenatal care, this is the first which sought to understand the central meaning or core of the experience. The purpose of this study was to understand the central meaning of the experience of group prenatal care for women who participated in CenteringPregnancy through a maternity clinic in Calgary, Canada.</p> <p>Methods</p> <p>The study used a phenomenological approach. Twelve women participated postpartum in a one-on-one interview and/or a group validation session between June 2009 and July 2010.</p> <p>Results</p> <p>Six themes emerged: (1) "getting more in one place at one time"; (2) "feeling supported"; (3) "learning and gaining meaningful information"; (4) "not feeling alone in the experience"; (5) "connecting"; and (6) "actively participating and taking on ownership of care". These themes contributed to the core phenomenon of women "getting more than they realized they needed". The active sharing among those in the group allowed women to have both their known and subconscious needs met.</p> <p>Conclusions</p> <p>Women's experience of group prenatal care reflected strong elements of social support in that women had different types of needs met and felt supported. The findings also broadened the understanding of some aspects of social support beyond current theories. In a contemporary North American society, the results of this study indicate that women gain from group prenatal care in terms of empowerment, efficiency, social support and education in ways not routinely available through individual care. This model of care could play a key role in addressing women's needs and improving health outcomes.</p