Food stamp, Medicaid backlogs still loom large

Hungry Alaskans are threatening state employees about the month-long backlog in food stamp applications and a much larger-scale challenge involving Medicaid beneficiaries is looming in near future, so Department of Health Commissioner Heidi Hedberg told state lawmakers Tuesday she’s doing everything possible to remedy a situation plagued by obsolete technology and a shortage of workers.

At least 8,000 households applying for food stamps since September have faced processing delays of up to four months, ahead of the head of the state’s Division of Public Assistance being replaced this month. The division, under the umbrella of the health department, also handles Medicaid applications that are also backlogged and could face further snafus when the state is required to begin eligibility redeterminations for all enrollees on April 1.

About 80,000 Alaskans rely on food stamps, according to the most recent official figures. Nearly 260,000 Alaskans were enrolled in Medicaid in 2020, according to a health department report published last year.

Hedberg and other top department officials got their first grilling from state lawmakers about the backlogs during a Senate Health & Social Services Committee meeting Tuesday at the Alaska State Capitol. Among the particularly illustrative examples of issues she highlighted during the 90-minute meeting is a computer processing system that uses 1959 technology only one person can program and the computer relies on data from eight other computer systems.

The resulting inefficiency is causing an enormous amount of frustration in many forms, including a lawsuit filed against Hedberg last week by 10 Alaskans as well as residents whose threats to public assistance employees are making security officers one of the urgent staffing needs.

“People get upset when they’re hungry,” Hedberg said in an interview after hearing. “You get frustrated and say things you may not take action on, but we need to take it seriously.”

Federal law requires the state to provide food stamps — officially known as Supplemental Nutrition Assistance Program benefits — to eligible applicants within 30 days after the date of application, with a seven-day period for qualified expedited applicants. The lawsuit — whose plaintiffs are not asking for monetary damages — seeks to force the state to process applications as mandated, the ability for people to apply for benefits the first day they contact the public assistance division, and ensuring sufficient language interpretation services are available.

Backlogged applications from September have been processed and work on October applications has sped up significantly during the past week, Emily Ricci, deputy commissioner of the health department, told the committee,

“That said, I know we are near the end of January and we are still processing applications from October, which is not acceptable to those Alaskans who are in need and are entitled to benefits,” she said.

The same people processing SNAP applications also handle Medicaid applications and renewals, so there is a backlog in some of those as well, Ricci said.

Among the applications particularly affected are new applications not accompanied by a SNAP application at same time and applications currently stored in the aging “legacy” system, she said. In addition, the open enrollment period for the Federally Facilitated Marketplace between October and this month created a recent influx of applications.

A Virtual Call Center that went live in April 2021 “to serve the entire state equitably, including communities that do not have in-person lobbies available,” got overwhelmed with calls beginning October of 2022, with the roughly 2,000 daily calls up to twice the usual volume, Ricci said. She acknowledged that while the public assistance division is trying to reassign staff to the call center when possible, waits of several hours are still being reported by some residents.

Hedberg, in the interview after the hearing, noted the call center handles all 18 programs in the public assistance division.

During her presentation to the Senate committee she said she has spent considerable time visiting statewide public assistance offices and talking to staff since being appointed commissioner in November.

“I have listened to their stories,” she said. “I have also talked with and met with service providers who have seen the impacts from the delayed assistance.”

In a slide presentation, Hedberg explained there are three main causes of the SNAP backlog — and five solutions the state is attempting to implement immediately.

The first problem is the aging computer/software combo known as the Eligibility Information System, with a state fiscal crisis delaying modernization efforts, Hedberg said. She said during one of her visits to statewide offices she sat with an employee able to operate the machine and eight other systems with data that needed to be copied-and-pasted to process food stamp applications.

“I sat with her for 40 minutes and she still hadn’t completed a task,” she said, adding it wasn’t because she was interrupting with questions about the ancient machinery or the employee was slow, but simply because “that’s how long it takes to maneuver through these systems.”

Second, the COVID-19 pandemic prevented the automation of SNAP Emergency Allotments, forcing staff to manually issue benefits for more than two years, she said. Furthermore, when the state public health emergency declaration ended this summer, the restart of recerticiations of applications resulted in an immediate backlog.

The third major problem is a cyberattack in May of 2021 which, more than a year later, still has impacts because of increased manual processing of many public assistance functions and delays in various planned changes such as online forms, Hedberg said.

As for the five solutions the state is pursuing initially from a longer list, the first Hedberg mentioned is hiring contractors able to program the EIS system so it can be updated and migrated to newer technology. Similarly, a temporary staffing contract for the virtual contract center is also in the works “with a known vendor who already understands our systems.”

Department officials have met with, among others, union representatives of state employees about the hiring plans, Hedberg said.

“We did not take this decision lightly, we really wanted to look at every avenue,” she said. “But when Alaskans are going hungry (and) malnutritious we wanted to make sure we get those benefits out quickly.”

The other three solutions also involve hiring staff including “crisis communication” employees to provide improved public updates, permanent eligibility technicians — and security officers able to both decelerate situations and provide medical assistance in addition to protecting employees from threats.

“I want to make sure our staff feels safe going into the office,” Hedberg said.

Among the longer-term fixes, based on feedback from organizations partnering with the state’s benefits programs, is extending the recertification period to 12 months instead of the six months that most applicants are subjected to, Hedberg said. The current 24-month timeline for senior applicants will remain in place.

Reprogramming the EIS system is expected to take until March, and if testing goes smoothly should be ready to process applications by June, she said.

The first priority is the SNAP backlog, followed by ensuring Medicaid applications can be processed properly, especially when the eligibility redeterminations begin in April and must be completed within 12 months, Hedberg said after the hearing. She said that process will handle residents in the order they originally enrolled in Medicaid.

Delays and problems involving applicants in many of the 16 other public assistance programs are occurring, but Hedberg said those are not a foremost issue.

“It is true the other programs are impacted on a much smaller scale,” she said, but resolving the SNAP and Medicaid issues should also ensure the problems at the other agencies are manageable.

• Contact reporter Mark Sabbatini at mark.sabbatini@juneauempire.com