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?”
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.
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.
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.