Alaska is scrambling to clear a monthslong food stamp backlog as major Medicaid change looms

A month after a major backlog in Alaska’s food stamp application processing surfaced publicly, state officials are scrambling to hire emergency workers to address delays reaching crisis levels for Alaskans who depend on the federal program to feed their families.

Public frustrations have become so high that the state is hiring security guards to protect existing workers, officials with the state’s Department of Health said.

Meanwhile, another hurdle for the understaffed and overwhelmed Alaska Division of Public Assistance lurks around the corner: recertifying Medicaid applications for the first time since the COVID-19 pandemic began three years ago.

Officials say delays are currently extending to nearly all aid programs administered by the state’s public assistance division. Along with Medicaid and food stamps, those programs also include senior benefits, heating assistance, Temporary Assistance for Needy Families and basic emergency needs assistance for thousands of Alaska families annually.

To address the food stamp backlog and prepare for the Medicaid transition, the state is finalizing an emergency contracting process to hire workers who can sort out applications for benefits, Heidi Hedberg, the state health department’s commissioner-designee, said during a recent presentation to the Senate Health and Social Services Committee. The emergency contract, through the Alaska Department of Law, is expected to condense a two-year training for eligibility workers who process benefits across 18 programs down to two months, with new hires focusing solely on food stamps and Medicaid.

While Division of Public Assistance workers have made some progress working through the delays, Hedberg said, there’s still no firm timeline for clearing the food stamp application backlog.

The division has only finished processing applications through the month of September, she said. Nearly 900 applications for food stamps remain from October, plus an unknown number from November, December and January.

The public’s frustration with the delays causing some to go hungry is spilling over to the people trying to process their applications.

The department is finalizing a contract to hire security guards for the state’s 11 Division of Public Assistance offices, Hedberg said, later adding she was aware of at least five threats to staff, though there may have been more.

“Alaskans are frustrated they don’t have their benefits,” she said. “When you’re hungry, you get really frustrated and you say things that you may not take action on — but we take everything seriously. We need to make sure that we protect our staff, so that they feel safe in their work environment.”

Short staffing and ‘antiquated’ IT

The extent of the food stamp application processing problem first surfaced in late December when multiple Alaska news outlets, including the Daily News, reported on major delays within the public assistance division, which processes the applications.

Thousands of Alaskans in many cases had already been waiting months to receive their federally funded food stamp benefits, also referred to as the Supplemental Nutrition Assistance Program, or SNAP. They also reported spending hours on hold with the state’s virtual call center only to be told there was nothing they could do to speed up the process.

Many of the Alaskans calling about food stamps are also experiencing delays for other types of public assistance, including senior benefits, Medicaid and heating assistance, according to the state ombudsman’s office, an independent agency that investigates complaints against the government.

State officials attributed the food stamp application processing delays to a staff shortage, a cyberattack that disrupted online services for months, and an influx of recertification applications in early fall when an emergency pandemic-era program expired in September. The program made it easier for Alaskans to receive maximum benefits without annual recertifications. It ended with the state’s emergency declaration, which wound down in July.

Since December, the director of the Division of Public Assistance has been replaced, and 10 Alaskans have filed a lawsuit alleging that the delays were a violation of federal law.

But Hedberg said that at this point, the state doesn’t know just how many food stamp applications still need to be processed: Getting a clear picture of the size of the backlog is complicated by the state’s “antiquated” IT system used to process benefits.

Right now, just one state IT employee, who happens to have experience with an outdated coding language, is able to maintain the food stamp system, she said.

The health department is looking to issue contracts to hire more programmers and eventually start processing benefits with a new IT system, she said.

Staffing recommendation ignored

The public continues to report major problems with the state’s public assistance program.

Kate Burkhart, the Alaska ombudsman, says her office is still receiving between 70 and 100 calls a week about delays with public assistance — amounting to nearly 300 since the beginning of this year, with as many in the month of January as her office received in all of 2022.

The ombudsman’s office helps connect callers to the Division of Public Assistance if they have waited more than 30 days for assistance, Burkhart said. Staff also have been referring Alaskans to local food banks and pantries while they wait, she said. But not all communities have that resource.

“What we have learned is those programs are extremely packed right now,” Burkhart said. “If you live in a community where there’s no food bank, what do you do?”

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Burkhart also cited the state agency’s failure to increase staffing — the public assistance program lost 100 positions in 2021 — even after a 2018 investigation by her office that followed very similar complaints about the Division of Public Assistance, including lengthy delays and spotty communication.

“There’s a reason we recommended adequate staff and maintaining of staffing to address the backlog, and to make sure it didn’t happen again,” she said. “And here we are now.”

A ‘huge’ Medicaid challenge

Once the Department of Health clears the food stamp application backlog, it faces another hurdle: the looming change to Medicaid eligibility, which could soon pose challenges for recipients as well as program operators, Hedberg said. Medicaid, which helps low-income and disabled Americans with health care costs, is operated by states and the federal government.

That issue is expected to come to a head in the coming months.

In exchange for extra federal COVID-19 funding, states agreed in 2020 to keep Medicaid recipients enrolled in the program until the end of the public health emergency. A federal spending bill passed in December ended that moratorium, and normal Medicaid eligibility requirements will resume in April.

Those pandemic-era Medicaid requirements saw a jump in the number of enrollees nationwide. The Kaiser Family Foundation, a nonprofit that studies the health care sector, found that there was a 27.9% increase in enrollments between February 2020 and September 2022.

In Alaska, just over 213,000 people were enrolled in Medicaid as of April 2019. The latest Department of Health data from December showed that over 260,000 Alaskans — or over 35% of the total population — received Medicaid, an increase of 22%.

Starting April 1, the state will need to determine if all of the low-income Alaskans receiving Medicaid are still eligible to receive benefits, a process that will be phased out over a year with monthly reporting requirements as federal Medicaid contributions to the state are also scaled down.

“It’s huge,” said Hedberg.

[Alaska’s Medicaid backlog violates federal and state law, attorneys say]

Alaskans who lose Medicaid coverage would be eligible to receive benefits through the federal health insurance marketplace, but gaps are possible.

In June 2022, the Department of Health sent a letter to all Medicaid recipients warning them of the upcoming changes. Beneficiaries were told to check that their current mailing address and other contact information was still current, and to check the mail for a letter to re-apply for Medicaid.

Hedberg said the department is looking to contract extra staff to help with the Medicaid recertification process starting in April, but the ongoing food stamps backlog is taking precedence and outreach efforts have been delayed.

As the flood of calls has continued, a virtual call center launched in 2021 has seen its role change as staff became overwhelmed. Previously used by technicians working remotely to process applications from beginning to end, the call center now handles only basic functions, such as callers checking on the status of their applications, Hedberg said.

For now, the plan is for that shift to be only temporary.

Annie Berman reported from Anchorage and Sean Maguire from Juneau.