Government-administered benefit programs: missed opportunities to address poverty in the NICU

BACKGROUNDPoverty, and associated financial strain, disproportionately affects families with children in the neonatal intensive care unit (NICU), resulting in multigenerational effects on infant/family health and well-being [1].Numerous effective government-administered benefits programs combat poverty and its effects but are underutilized by eligible families [2], representing thousands of dollars per family per year in unclaimed benefits.We sought to determine eligibility for and successful receipt of government benefit programs for families with infants hospitalized at a large and well-supported level IV NICU in Ohio. METHODSWe approached families in a one-month period with children in the NICU identified by social workers as potentially eligible for any government benefit program.Roughly 60% of families in this NICU use Medicaid as their primary payor for hospitalization.Most patients are transferred from an outside hospital.We asked families to complete an electronic survey (Supplemental Instrument 1) focusing on utilization and barriers to utilization of government benefits.Participation was compensated with a $50 gift card.Benefits of interest included refundable tax credits (Earned Income Tax Credit (EITC)), nutrition assistance (Supplemental Nutritional Assistance Program (SNAP) and the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC)), home utility assistance (Low Income Home Energy Assistance Program (LIHEAP)), and childcare payment vouchers.We collected demographic information, including income, to estimate eligibility for each program using state-specific criteria.We also queried interest in receiving in-hospital-based assistance to help families access these benefits.The survey explained each benefit, and families received a United Way resource to help identify and access eligible benefits.We used descriptive statistics to enumerate survey responses.