Appendix E. Frontline Staff Interview Guide

OMB Approval No. 0584-####

Expiration Date: XX/XX/XX

Appendix E. Frontline Staff Interview Guide

This information is being collected to assist the Food and Nutrition Service (FNS) in understanding Supplemental Nutrition Assistance Program (SNAP) and Medicaid coordination. This is a voluntary collection and FNS will use the information to aid in the administration of SNAP. This collection does request personally identifiable information under the Privacy Act of 1974. According to the Paperwork Reduction Act of 1995, an agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a valid OMB control number. The valid OMB control number for this information collection is 0584-[xxxx]. The time required to complete this information collection is estimated to average 55 minutes (.9167 hours) per response, including responding to recruitment outreach, participating in interviews, and reviewing and providing feedback on process maps. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: U.S. Department of Agriculture, Food and Nutrition Service, Office of Policy Support, 1320 Braddock Place, 5th Floor, Alexandria, VA 22306 ATTN: PRA (0584-xxxx). Do not return any completed materials to this address.

Frontline Staff Interview Protocol

Introduction

To start, we would like to ask for some background information about you, your role, and an organizational overview.

1. What is your current job title or position?

2. How long have you been in this position?

3. What are your primary responsibilities?

   1. What clients do you work with (e.g., SNAP clients, Medicaid clients, both)?

   2. [If staff works with both Medicaid and SNAP clients] Did you receive any kind of coordinated training on Medicaid and SNAP processes, or was it separate training for each client type?

Application/Eligibility Determination Process

Now we’re going to ask a series of questions about coordination activities between SNAP and Medicaid. We are particularly interested in MAGI Medicaid participants. When we use the word “coordination” we’d encourage you to think of that term broadly – it could encompass anything from policies, to procedures, to IT solutions to communication strategies that a state might use to coordinate between two programs. We are particularly interested in activities that have been shown to improve efficiency, customer service, accuracy, and/or program access.

Next, I’d like to ask you to provide some information on how the application and eligibility determination process works.

1. To start, can you walk us through the application process for SNAP and MAGI Medicaid participants?

1. How do participants complete applications (e.g., in-person, call-center, online, hybrid)?

1. Is one method better for participants applying to SNAP and Medicaid?

2. Do you offer a combined application?

1. [If yes]: Can you describe how the application collects information and documentation needed for both programs?

2. [If no]: Are participants required to submit the same documents and information multiple times?

3. Are the online/paper/telephonic application the same?

4. What are the interview requirements for both SNAP and MAGI Medicaid participants?

5. [If not combined application] How long does it typically take participants to apply for [SNAP or Medicaid] benefits alone?

6. [If combined application] How long does it typically take participants to apply for both SNAP and Medicaid using the combined application?

7. Is the application process different for SNAP and non-MAGI Medicaid participants

2. What features help SNAP and MAGI Medicaid participants streamline the application process when applying for both programs (e.g., auto filling relevant information)?

1. What impact do the features have on beneficiaries?

2. What impact do features have on case management?

3. Is there anything you would change about SNAP and Medicaid application?

Eligibility Redetermination Process

Next, we’d like to ask you to provide insights into the eligibility redetermination process.

1. Can you walk through the process of recertifying/renewing SNAP and MAGI Medicaid participants?

1. How do clients recertify/renew (e.g., in-person, call-center, online, hybrid)?

   1. Which method is the most common?

2. What information is required?

2. What strategies are used to align the SNAP and MAGI Medicaid renewal process? Which are the most promising for aligning the renewal process?

1. Probe on:

1. Aligning Medicaid renewals during SNAP recertification (probe on what this will look like after the unwinding period ends and regular operations resume)

2. Auto or ex parte renewals

3. Synchronized certification periods

4. Express lane eligibility

1. When do these strategies occur in the renewal process?

2. Are these strategies also used to align the SNAP and non-MAGI Medicaid renewal process? If not, how do they differ?

3. What have been the impacts of coordination efforts (e.g., increased retention rates, decreased churn, reduced staff workload and beneficiary burden)?

   1. Have you examined the impact of these processes on specific disparities/inequities in the population you serve?

Communication

Next, I would like to learn more about how you support communication with participants.

1. How are participants notified if they are eligible for both programs?

1. What information is provided about Medicaid to SNAP applicants? What point in the process is this information provided?

2. What information is provided about SNAP to Medicaid applicants? What point in the process is this information provided?

2. Did the State agency provide guidance on communicating this information? If yes, what type of guidance was provided?

3. Are methods of participant communication coordinated across Medicaid and SNAP?

   1. [If yes] Are beneficiaries given a choice in how they receive notices (e.g. electronic notices, text messages, mail, etc.)? Which mechanism is the most common? Have you found one to be more successful? Why or why not?

   2. Are notices understood by participants?

   3. Is there anything you would change about the notices?

Lessons Learned

To close, we would like to learn about any additional lessons that you have learned from coordinating SNAP and Medicaid processes.

1. What lessons have you learned coordinating SNAP and MAGI Medicaid?

1. What advice would you give to other agencies working to coordinate the two programs?

2. Are there any promising practices or lessons learned from coordinating SNAP and non-MAGI Medicaid participants?

3. What opportunities are there to advance equity by coordinating SNAP and Medicaid?

2. Have there been any unintended consequences of coordinating SNAP and MAGI Medicaid?

3. What changes, if any, would you make to State policies to improve the coordination of SNAP and Medicaid?

4. How could the State agency help support successful coordination of SNAP and Medicaid in your State?

5. Is there anything we did not ask about you think is important for us to know?

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