Summary

In response to a congressional request, GAO reviewed some of the problems associated with the different eligibility, implementation, and other requirements of the Aid to Families With Dependent Children (AFDC), Food Stamp, and Medicaid programs. Specifically, GAO reviewed the quality control (QC) systems used in the administration of these programs and the possibilities of integrating the QC systems.

The AFDC, Medicaid, and Food Stamp programs are jointly administered and financed by federal, state and, in some cases, local governments. Federal regulations broadly define AFDC and Medicaid program requirements which allow the states to structure the programs to meet their specific needs. In contrast, Food Stamp program requirements are defined nationally. At the state level these programs are generally administered through a single welfare department which translates federal and state regulations into program operating rules and procedures. Federal-state QC systems have been established for the AFDC, Food Stamp, and Medicaid programs to identify and measure the level of erroneous payments and to develop corrective actions to reduce them. According to the Texas Department of Human Resources, separate AFDC and Food Stamp programs: (1) require eligibility workers to know and apply different sets of criteria; (2) create the potential for misapplying rules and regulations; (3) cause duplication of effort; and (4) contribute to worker frustration. The Department favors better coordination and consolidation of the programs to improve their efficiency and effectiveness. The Office of Management and Budget, Department of Health and Human Services, and the Department of Agriculture have developed an integrated QC worksheet, sampling manual, and procedural handbook for the three programs which some states are using on a test basis. If the tests are successful, all states will be required to use the integrated systems.