Budgets Cut, People Bleed
The next time you hear a politician say, "We will not make budget cuts that hurt the most vulnerable among us," ask them about the Vermont Department of Children and Families/Economic Services Division efforts to modernize its application, eligibility and enrollment programs for the public programs it administers, including health care programs. "Modernize" has turned out to be a euphemism for the potentially fatal budget cuts that have harmed the lives of Vermonters. One of those modernization efforts has been to partially eliminate the human-to-human method of case management and turn it into an encounter in voice mail hell.
In years past, someone who was receiving any of a variety of essential human service support from the state would be able to make contact with a case manager, a real person who knew the system and who could help someone apply for benefits and stay with that person for the long run.
Now, when a person looking for state services make that first call, instead of being assigned a case manager or being able to have a consistent relationship with a knowledgeable person, they are required to deal with an automated voice mail system.
In an effort to save money the state has created call centers. Data for the week ending Oct. 22 indicate the average wait time on the phone was 7 minutes and the longest wait time was 27 minutes. The most alarming statistic is that 18 percent of people who call hang up before they get an answer.
According to one of my sources who has a long history of working with state programs and who directly asked state officials how they are dealing with these kinds of delays and problems, "The Department (of Children and Families) continues to say it has taken steps to address these issues, but these steps are not working and the problems are getting worse. The department has been saying for weeks that it has hired temporary staff and has staff working overtime and weekends. However, because the caseloads keep growing and new staff has to be trained, there has been no improvement. These steps are not adequate to resolve the problems. The number of incoming applications and case loads are too high. These delays are a clear example of the effect on Vermonters of the budget-cutting of the last few years, eliminating too many state workers."
"There are no longer enough state staff to handle the volume of work. It seems clear that new staff must be permanently hired and trained, and unfortunately, it takes a significant amount of time to train new staff on the various programs. The Department does not appear to be entertaining this as an option."
Then there are the resulting problems when people actually file an application for a health care program such as Catamount or VHAP. State and federal law requires that the state must make a decision on a new application within 30 days, but my sources tell me that this is only happening in 63 percent of cases. The delays are so bad that for the week ending Oct. 22, 21 percent of applications were taking 31-35 days and 16 percent took over 45 days.
This is a situation begging for a law suit. I have heard of cases where people applied for VHAP or Catamount health insurance and then were told their application was denied because it was not processed in the required 30 days. The delay was the fault of the state, not the applicant. The state claims they are working to resolve these problems, but some of their solutions seem like they will only create more frustration for those in need who are applying for help. If the intent of the state was to frustrate people so they would give up and not apply for benefits then they have succeeded.
State workers do carry caseloads but they are no longer geographically based. Someone in Brattleboro who applies for food stamps will have their application processed by a food stamp expert who could be based anywhere in the state and, if the same person also applies for VHAP, they will have to deal with another state worker somewhere else in the state.
Then there are the "community partners" plans. It is a way for the state to administer services in the most haphazard way possible without having to pay for the help. The state has asked community organizations and non-profits to help people with the application process for state programs.
When common sense is cast aside and the politics of budget cutting has a higher priority than the needs of vulnerable Vermonters, this is the mess we end up with. We can only hope that the new…administration will take a close look at this situation and figure out how to fix it.
We can still maintain fiscal discipline while not shredding the state’s social safety net. That is a challenge we can rise to meet.
Richard Davis is a registered nurse and executive director of Vermont Citizens Campaign for Health. He writes from Guilford and welcomes comments at firstname.lastname@example.org.
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