An investigation by the Alaska State Ombudsman found the state's Division of Public Assistance has an application backlog, communication issues between the division and the public, and an inefficient model for managing clients' long-term care cases.
The ombudsman's office — which investigates citizen complaints about state agencies — received more than 400 complaints about the division from 2016 to 2017, according to a report on the investigation released this week. Ombudsman Kate Burkhart launched an investigation of the complaints in January.
The DPA administers several programs that provide public assistance benefits, including Medicaid, food stamps, senior benefits, Denali KidCare and more. It falls under Alaska's Department of Health and Social Services.
The three allegations against the Division of Public Assistance were that it doesn't meet mandated timelines for processing applications and recertifications for benefits as required by law; it doesn't consistently respond to phone calls, emails or other communication from the public; and its processing model for managing clients' long-term care cases is inefficient and ineffective.
The ombudsman's report found all three allegations to be justified, the report said.
Monica Windom, director of the DPA, said the division was already working on trying to resolve a majority of the problems noted in the report before the investigation.
"We agree with all the findings," Windom said. "I just appreciate the ombudsman's recognition that our staff is working as hard as they can with the resources they have and need help."
The division has had a backlog since about 2015 because of Medicaid expansion, Windom said, and most of the backlog is Medicaid cases.
"We have had a 25 percent increase in caseload since 2015," she said, "but we have not had an increase in staff."
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Most of the 400 complaints the ombudsman's office received involved complainants seeking help communicating with the division about their benefits. The second most frequent, according to the report, was related to application status or recertification of eligibility for Medicaid and food stamps. The third most frequent complaint was delayed payment of benefits.
One complainant waited several months for an eligibility determination and was "told by DPA staff that his application for his children's Denali KidCare had been lost and he would have to resubmit it," the report said. Efforts by a guardian for an adult experiencing disabilities to get in touch with the division's long-term care unit "went unanswered for four months," according to the report.
The division also has had difficulty recruiting and maintaining staff in existing positions, the report found, "leading to frequent and sometimes prolonged vacancies. The backlog itself contributes to staff attrition, which in turn exacerbates the backlog."
As a result of the investigation, the ombudsman laid out a host of recommendations for the DPA, including hiring more staff, strengthening quality assurance processes, and addressing obstacles to recruitment and retention for staff. The division is taking action on all of the report's recommendations, Windom said.
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The investigation is closed, and the ombudsman will monitor the agency's progress implementing the recommendations over the next year.