Individuals seeking financial assistance with a funeral or burial will call into our partner organization's hotline and will be directed to the funeral and burial assistance team. The client will be told about the burial assistance program, the research study, and what documents must be provided for participation. These include finalized invoices for burial and funeral expenses, a document confirming household income, a signed consent form to participate in the program, and a voluntary consent form to participate in the study if they are deemed eligible. With this paperwork complete, the intake staff will complete a short Qualtrics survey over the phone. This survey consists of two sections: eligibility and intake.
There will be two separate components to the eligibility screen: eligibility for the program and eligibility for the study.
- Callers will be eligible for the burial assistance program if they meet the following criteria:
- Have household income at 40% AMI or below
- Deceased is not an honorably discharged veteran (honorably discharged veterans will be referred to the Veterans Funeral Assistance program)
- Have an invoice of $12,000 or below
Our partner organization will confirm callers’ income by asking them to provide proof of income (for example, pay stub, benefit letters, letters from employer, etc.), or, if they do not have proof of income, asking them to complete a self-attestation form. They will ensure that they have a copy of a caller’s invoice and that the invoice is within the program’s eligibility range before they begin intake with the caller. In addition to these forms, callers will complete program consent forms and consent forms for participation in the research study.
Implementing this income threshold will allow us to target the program to those who are most in need. Past research has shown that people with income in the lowest quartile see the most significant impacts of financial shocks. However, because this financial shock is larger than shocks in previous research, we expect there to be a wider population that experiences prolonged negative financial outcomes. In particular, we have chosen the cutoff of 40% AMI because past program experience has shown that 30% AMI cutoffs make it difficult to recruit enough people into programming, while 50% AMI cutoffs screen out very few people. We have chosen 40% AMI as a midpoint between these two, and we will closely monitor intake data at the beginning of the study to determine if this threshold needs to be adjusted.
The goal of the $12,000 upper bound is to prevent very large bills, and if a caller has a bill above this threshold, our partner organization will work with the caller to determine if there is anything that can be done to reduce the bill. Placing this limit on the size of invoices that are eligible for the program will also serve as a second way of ensuring that the program is targeting those most in need, in addition to the income requirement. $12,000 was chosen as the cutoff as it was approximately equal to the largest historical requests.
Clients who are eligible for the program will complete the intake portion of the Qualtrics form with a staff member by phone. This form will collect baseline demographic information on callers, their household, and the deceased, including their race, gender, age, and income.
- Callers will be eligible for the study if they meet the following criteria:
- Are eligible for the burial assistance program
- Consent to participate in the research study
- Have an invoice of $3,000 or more
The requirement that invoices must be $3,000 or more for the client to be eligible for the study serves two purposes. First, it ensures that the program is targeted towards those who are experiencing a more significant financial shock (and thus have higher need). Second, the cutoff increases statistical power by ensuring that there is a substantial difference between the financial assistance provided to treatment and control groups.
Those who did not consent to the study, including those who are ineligible for the study, will automatically receive $750 of assistance, while those who did consent will be randomized to receive either $1,000 (control group) or a higher amount of financial assistance (to be revealed at study completion).
All program-eligible callers will receive a minimum of $750, including those who do not consent to the study. This amount is large enough to provide substantive benefit to those who do not consent to participate, but also is small enough that the majority of limited resources go towards those in the study. To prevent coercion, we set the difference between the payments of the control group and non-consenting group at $250. Importantly, all enrollment and consenting materials do not mention the potential of the higher treatment group payment, and instead informs potential participants that they may receive an additional $250 or more if they participate in the study. This design was approved by the Institutional Review Board at the University of Notre Dame. This design allows us to test a high “dosage” of financial support that eliminates debt for the overwhelming majority of the treatment group. Inclusion of an upper bound prevents very large individual payments and allows limited financial resources to assist as many people as possible.