By Rachel Tellez, MD, pediatrician at HCMC
Nearly 15 percent of Minnesota’s children live in poverty, with children of color being disproportionately affected: nearly half of African-American children, one-third of American Indian children, one-third of Hispanic children, and one-fifth of Asian children live in poverty. Living in poverty can result in poorer health outcomes for children, including negative effects on physical health, nutritional status, socioemotional development, language development and educational outcomes. Additionally, more than one-third of Minnesota children (419,000) live in low-income households that struggle to provide basic needs and opportunities resulting in similar long-term outcomes, according to Kids Count.
The March 2016 AAP policy statement “Poverty and Child Health in the United States” recommends that pediatricians advocate for families on the clinic, local, and national levels: “Pediatricians have the opportunity to screen for risk factors for adversity, to identify family strengths that are protective against toxic stress, and to provide referrals to community organizations that support and assist families in economic stress.” Recognizing the needs of children in poverty and the challenges faced by pediatricians, Minnesota AAP members have asked the MNAAP to help identify resources to assist pediatricians in helping these families.
One potential resource to help low-income families is the “Bridge to Benefits” free online screening tool mn.bridgetobenefits.org developed by the Children’s Defense Fund-Minnesota (CDF-MN). After entering information about family size and income, the screening tool determines potential eligibility for a number of public work support programs, including Medical Assistance, MinnesotaCare, Child Care Assistance, Energy Assistance, Supplemental Nutrition Assistance Program (SNAP), School Meals, WIC, as well as some tax credits. The website does not actually enroll families in these programs, but refers them to county-based organizations that can then follow-up to assist with the application process.
Elaine Cunningham, Outreach Director for CDF-MN, explains that the website was developed “to improve the economic stability of low income families by enrolling them in an array of public work support programs.” Economic stability is important, she says, because even small increases in a family’s income is linked to improved educational, health, nutritional and behavioral outcomes in children. Thousands of Minnesota families are eligible but not enrolled in these important support programs, she adds, mainly due to the multiple barriers families face in applying: complex application processes, differing eligibility rules, stigma, and literacy, and language. In 2015 there were 37,000 Bridge to Benefits screens completed, covering 106,000 family members.
The Bridge to Benefits website is worth a visit by every pediatrician, at the minimum for educational purposes. In addition to the screening tool, there are descriptions of all the programs such as “What is SNAP” or “What is Energy Assistance,” as well as more specific information such as how immigration status affects eligibility for the programs. There is also a “Find Other Help” section that includes additional resources on disability services, early childhood education, employment, housing, etc.
While the online screening tool is designed to be quick and easy, it may still prove a bit cumbersome for some families. CDF-MN recommends training clinic staff to help navigate the screening tool with patients. Once staff are familiar with the tool, it takes about 5 minutes to enter the information and get results on which programs a family may be eligible, the approximate benefit amount the programs will provide, and which local organizations can assist with the application processes.
More than 300 organizations in Minnesota use the screening tool, yet few are medical clinics. Bridge to Benefits could be a valuable tool in helping to address the effects of poverty on pediatric patients and families. Please consider contacting Elaine Cunningham ecunningham@childrensdefense.org to discuss best practices for implementing Bridge to Benefits in a variety of health clinic settings or to set up a training for your organization.
Thank you to Elaine Cunningham for her contributions to this article.
