BY Madeline DeMarco, Aditi Vasan, and George Dalembert
Aug. 30, 2024
During a recent appointment with their pediatrician, a West Philadelphia parent shared how the family’s electricity had been shut off, endangering their children’s health just before an upcoming heat wave. The physician quickly referred this family to our clinic’s Medical Financial Partnership (MFP), where our navigator used a local nonprofit’s screening tool to learn that the family was eligible for 15 public benefits, including an electricity subsidy. With support from our team, the family has already applied for five of those benefits — getting closer to accessing the help they need to keep their children healthy.
Stories like this are common for families seeking care at Children’s Hospital of Philadelphia (CHOP) and across Philadelphia. Through a partnership with Philadelphia’s Benefits Data Trust (BDT), our team could use a BDT screening tool that helped families learn if they are eligible for 29 public benefits, and support them through the application process, ensuring they receive the support they deserve.
Unfortunately, BDT ceased operations on August 24. This sudden closure represents a huge loss for Philadelphia citizens and the fight for better health and less poverty.
Since its inception in 2005, BDT has connected over one million households in Philadelphia to more than $7.5 billion in public benefits. Connecting families to public programs like Medicaid, the Supplemental Nutrition Assistance Program (SNAP), the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC), and the Low-Income Heat and Energy Assistance Program (LIHEAP) can improve their health and well-being. Studies have found that enrollment in these programs comes with improved self-reported health, less depression and anxiety, fewer low birth weight and preterm births, and less child injury, child maltreatment, and food insecurity.
Government benefits can be hard for families to access due to the big bureaucratic burdens they impose. These include:
These factors may pose a particular barrier for minoritized individuals. In one recent study, Black and Latinx adults were more likely than White adults to report unfair treatment when accessing public assistance, and more than 40 percent of those who experienced unfair treatment reported not getting services they needed.
BDT’s work helped to ease these inequities. Its closure means that thousands of families per year will no longer receive much needed help.
The impact on CHOP families alone is significant — in the last year of their partnership with BDT, MFP navigators helped caregivers identify that they were eligible for more than $2.7 million of eligible benefits. Without BDT, there’s a strong likelihood that fewer families will get help that’s essential to their children’s health, and families and government agencies will bear increased administrative burdens in processing applications.
Fortunately, several Philadelphia community groups have started to fill the void. The Campaign for Working Families — which champions the financial well-being of individuals through tax preparation services — supports applications for public benefits. The Philadelphia Office of Community Empowerment and Opportunity has also been steadfast in their anti-poverty work through the BenePhilly program.
BDT paved the way to improving access to benefits and erasing racial inequities. Health systems can continue to close the racial wealth gap by reducing families’ expenses, maximizing their income, and reducing their debt while increasing savings. By developing cross-sector collaborations with community groups — like CHOP’s MFP — they can plug the gap left by BDT.
In addition, health systems should use their role as anchor institutions to encourage states to implement streamlined, simplified multi-program benefits application processes. Systems should also encourage state agencies to use cross-sector data sharing to identify patients and families who may be eligible for benefits, and then conduct proactive outreach to support them through the enrollment process. While universal application and proactive outreach strategies may incur costs in the short term, these investments will likely pay dividends over time, in the form of improved health outcomes — and lower health costs.
We can’t let the closure of BDT set us back. Together, health systems and community groups here and across the state must come together to promote child and family health and help families get the government benefits they need.
George Dalembert MD, MSHP and Aditi Vasan MD, MSHP are Senior Fellows at the Leonard Davis Institute of Health Economics at the University of Pennsylvania. Dr. Dalembert is Founding Director of the CHOP Medical Financial Partnership and Associate Director for the Center for Health Equity at Children’s Hospital of Philadelphia; Dr. Vasan is Faculty Lead for the Health Equity Portfolio at PolicyLab at CHOP and Assistant Professor of Pediatrics at Penn’s Perelman School of Medicine. Madeline DeMarco is a resource coordinator at PolicyLab and Clinical Futures at CHOP.
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