DSS system woes burden CT’s senior centers, aging agencies
People who work in senior centers, town social service offices and
senior housing complexes say the state Department of Social Services' new
system has led to elderly residents losing benefits, low-income clients having
to pay out-of-pocket for medication, and more of their own time devoted to
trying to fix problems caused by the new system.
By: Arielle Levin
Becker | February 17, 2014 CTMirror.org
http://ctmirror.org/dss-system-woes-burdening-senior-centers-aging-agencies/
The new
system for handling paperwork and centralizing calls to the state Department of
Social Services was intended to make it easier for clients to get services and
information.
But many
people who work in senior centers, town social service offices and senior
housing complexes say it’s instead led to more elderly residents losing
benefits, low-income clients having to pay out-of-pocket for medication while
waiting for their cases to be straightened out, and more of their own time
devoted to trying to fix problems caused by the new system.
“At least 50
percent of our membership has experienced wrongful termination of their
benefits,” Norwalk
Senior Center
Executive Director Beatrix Winter wrote to the council that oversees the
state’s Medicaid program. She said her staff spends two hours a day helping
seniors reach DSS to correct preventable problems.
At the
Davenport Dunbar senior housing community in Hamden, the staff devote one day
per week to calling DSS to help residents who have gotten notices that they
will lose their benefits, even though they sent in the forms needed to maintain
them, Blanca Toledo-Perez, resident service coordinator, wrote. Because DSS workers
have been told to help with one client at a time, she said, she and her
colleagues often wait on hold for hours to reach a DSS worker, resolve one
case, then have to hang up, call back and wait on hold again to help the next
person.
More than 50
people wrote to the Medicaid council in advance of a forum on the new DSS
system Friday. Many cited cases of people struggling because of problems with
the department's system: a man with diabetes who went without food stamps for
two months; a mother whose son had bronchitis but could afford to buy only a
few of his pills; seniors in tears or terrified because their benefits were cut
off despite having sent in the paperwork to keep them; cancer patients
undergoing chemotherapy losing Medicaid coverage; and workers at DSS offices
telling people who come in for help that only the first 50 will be seen that
day.
Darylle Willenbrock,
regional coordinator for the Western Connecticut Area Agency on Aging in
Waterbury, alluded to the volume of problems in a different way.
“I am not
going to start citing cases, I will be here all month,” she wrote.
DSS' delays
in processing applications have also left seniors who urgently need home care
to wait up to six months before getting help, said Julia Evans Starr, executive
director of Connecticut’s Legislative Commission on Aging. Some end up in
nursing homes while waiting for DSS to determine that they’re financially
eligible for a state home care program, she said, while others rely on
relatives who are stretched thin. “It creates a great deal of family strife,”
she said.
Christina
Crain, program director at the Southwestern Connecticut Agency on Aging in
Bridgeport, wrote that her agency doesn’t receive funding to address problems
with DSS, but that staff can’t turn their backs on clients who are “desperately
in need of assistance.”
“These cases
have been occupying much of our time for months now," Crain said. "We
have reached a breaking point but continue to do what we can to help these
clients because if we don’t who will?”
Commissioner: “Challenging”
The new DSS
system, launched statewide last July, includes a single, centralized phone line
for clients to call to reach a worker. Documents sent to the department get
scanned and entered into the computer system, allowing workers anywhere in the
state to process them or access them when a client calls. Clients have the
option of tracking the status of their paperwork online, or getting automated
information about their cases through the phone system.
Social
Services Commissioner Roderick L. Bremby acknowledged
Friday that the rollout of the new system, called ConneCT,
has been “challenging.”
The average
wait time to reach a worker at DSS’ call center is 54 minutes, but people
typically hang up after waiting 21 minutes, he said during a presentation to
the Medicaid council.
The
information technology system hasn’t been stable, Bremby
said, working fully during only 43 of the 105 workdays since it was launched.
He
acknowledged that the new system doesn’t work well for voluminous Medicaid
long-term care applications and that it had cut off the back-channel access
that many people in community agencies had come to rely on to get help for
clients with urgent needs. Both issues are being addressed.
But Bremby said that some of the problems are temporary and
others are being resolved.
Call volumes
and wait times are artificially high now and are likely to stabilize at lower
levels, he said. The department is working on a feature that will keep
inaccurate termination notices from being sent to clients who have submitted
their renewal paperwork. The department has added 220 new eligibility staff
positions since the start of 2012, and is working on a system to track
documents that get scanned to ensure that clients’ paperwork doesn’t get lost.
DSS is also planning to make more services available online so clients can
report changes and, eventually, apply for programs
electronically.
Longstanding problems
And Bremby said it’s important to recognize what the department
and its clients faced before the new system.
He read from
a letter from a client who twice sent in the needed paperwork to maintain
Medicaid but was nonetheless cut off and turned away from a doctor’s office for
lack of coverage.
Bremby said he received the letter the day he began work at DSS,
in 2011 -- well before the new system began.
“The problem
with the system is systemic. It’s longstanding,” he said.
While the
call center wait times are lengthy, Bremby said, in
the past, people would have called a worker at a regional office and most
likely gotten a voicemail box -- and often, it would be full.
And he said
there have been significant improvements in in-person service at the regional
offices. In the Hartford
office, more than 200 people walk in each day for service, and more than 85
percent leave with their situations resolved. Before the changes, he said, it
was less than 5 percent.
Clients turned away
But not all
clients have good experiences visiting DSS offices, Kristen Noelle Hatcher, an
attorney with Connecticut
Legal Services, wrote to the Medicaid council.
At the Bridgeport office,
clients who arrive with just a Medicaid application have been turned away and
told to go to an organization that signs people up through the state’s health
insurance exchange, Access Health
CT, she said. In some offices, people are told to
take a ticket with a number, and after 50 are drawn, the rest are told to come
back the next day. That's not consistent with the “no wrong door” approach to
accessing benefits envisioned in the federal health law, she wrote, and is
problematic for clients, many of whom rely on several buses, long walks or
transportation from a friend or relatives to get to a DSS office.
Bremby said that wasn’t the way the system was supposed to work,
and said he appreciated the feedback.
Workarounds severed
Evans Starr
told the Medicaid council that she recently got a phone call from a panicked
woman who lived out of state, whose mother had been receiving services through
the Connecticut Home Care Program for Elders. She had
recently received a notice from DSS saying she hadn’t submitted the paperwork
needed to stay in the program.
Evans Starr
said she got in touch with DSS and within two hours, the woman’s paperwork had
been located.
“But not
everybody knows how to navigate the system,” she said.
Over the
years, many people who work in community agencies developed their own channels
for resolving clients’ issues in emergencies, such as calling a specific worker
or supervisor. But the new system, which routes all client information to a
central location to be scanned and eliminated the practice of assigning
caseworkers to clients, effectively wiped out those methods for expediting
cases.
Bremby acknowledged that was a problem, saying that ConneCT had increased consumers’ ability to access
information but had displaced community agencies that often help them, a group Bremby said the department “desperately” needs.
To address
that, DSS is developing an “escalation center” for community organizations so
they can get timely access when needed, Bremby said.
He said he hopes it will be available by the end of March or April.
To address
the new system's problems with Medicaid long-term care applications, DSS has
been routing them to regional hubs rather than the scanning center, which Bremby said has helped.
Several of
those who wrote to the Medicaid council praised DSS workers, and some said
there need to be more of them -- a position taken in a lawsuit against the
department. In response to the litigation, Gov. Dannel
P. Malloy has proposed adding staff.
Bremby read the letter of a client whose frustration at waiting on
hold for 43 minutes was overcome by the helpfulness of the DSS worker who
finally took the call.
“While the
system is not where it needs to be, we are increasingly high touch and high
tech,” Bremby said.
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