Similar decreases in Medicaid and food stamps can be attributed to a myth that they are a part of welfare, because the term welfare is used generically, said Stephen Zuckerman, health economist for The Urban Institute.

But even in State College, there are agencies working to counter this trend by educating recipients about the difference between assistance programs.

Although Pam Santavicca, executive director of the Food Bank of the State College Area, 208 W. Foster Ave., has not seen an obvious change in the number of visitors to the local food bank, she is trying to fight the confusion.

The food bank distributes a seasonal newsletter listing the groceries recipients can pick up four times a year. It includes advertisements educating the recipients about free assistance they are unaware of or believe to be welfare, including earned income tax credit, free lawyer service and health coverage for children.

The main confusion is caused by the fact that welfare is cash assistance, which is separate from any other more specific program.

"You can get Medicaid without cash assistance if you have a low income," Zuckerman said. "It definitely looks like the numbers receiving Medicaid assistance are going down with welfare, which is a problem. No one really wanted this."

Santavicca decided to distribute information after she watched recipients she came to know from her seven years at the food bank end their cash assistance and find minimum-wage jobs.

"The jobs usually have no health benefits," she said. "The amount they are earning is not enough to support themselves alone."

Food stamp coverage has also decreased because it has been erroneously connected with welfare, Harold Leibovitz, director of communications for the institute, said.

Educating the public about who can receive different kinds of benefits is a major challenge for each state, Zuckerman said.

"Case workers (statewide) are working to inform the public of changes," said Jay Pagni, spokesperson for the Pennsylvania Department of Public Welfare. "I would recommend people speak with a case worker to discuss their various options."