Overburdened Rhode Island DHS Faces Renewal Crisis
By Steve Ahlquist For UpRiseRI
Unfortunately, under the administrations of former Governor Gina Raimondo and present Governor Daniel McKee, the Department of Human Services (DHS) has experienced a dramatic shortage of workers, which may cause the 300,000+ people in need of Medicaid renewal long wait times, unnecessary stress, and possible gaps in medical coverage.
An already
overburdened DHS will be seeing an increase of 15,000 renewal applications per
month, rising to 25,000 later in the year. With roughly half the renewals being
passive, that is relatively automatic, it still leaves DHS with 7,000-12,500
renewals per month, on top of the regular work they already do.
On March 8, Stacy Smith told the Rhode Island House Finance Health and Human Services Subcommittee that DHS is unprepared for the “tsunami” of Medicaid renewals that will be starting in April.
Smith is the President of Council 94 AFSCME/AFL-CIO Local 2882,
representing 280 workers who make eligibility determinations for programs such
as Medicaid, SNAP benefits [formerly food stamps], cash assistance, and child
care.
“While things have improved slightly under the McKee
administration, Director Brito’s leadership, and the General Assembly’s
required reports on hiring, we are still desperately short staffed,” said
Smith.
Speaker Joseph Shekarchi (Democrat, District 23, Warwick) held a Medicaid Renewal Information session for House members and reporters. Uprise RI asked Director Merolla-Brito about the 120 unfilled positions at DHS.
Director Merolla-Britto countered that the most recent numbers she had indicated that there are 117 open positions throughout the entirety of DHS, and 75 open positions that affect field operations, including eligibility technicians.
“It’s definitely an area of concern,” said Director Merolla-Brito. “We do feel as though we have the staff. We have ongoing efforts with recruitment and retention in process… We do have all of those covered, in terms of ‘in process’ for different stages of the recruitment process.
"We have
offers being made to at least 15-20 [potential employees] from this week to
last week. I cannot say that number will be zero when we get into the end of
April or May but I do feel that our workforce projections – the work that we
put into that model – does allocate the staff that we need to manage work
ahead, that we know through the renewal process and anticipated new work coming
in. [That] doesn’t mean it will be easy and it does mean we will need
additional support in terms of our interagency work and community providers and
such.”
Another issue when it comes to providing service is long
wait times on the telephone when utilizing DHS call centers.
Representative Edith Ajello (Democrat, District 1,
Providence) asked about this. Director Merolla-Britto
claimed that wait times were now down, on average, and that she has brought in
an MCO [Managed Care Organization] to help. An MCO is
an outside contractor.
“Our average, as of this week, I think, was 54 minutes,”
said Director Merolla-Brito. “And that is an average of all the different
program cues.
“We made some very hard decisions with [a letter we sent
out] to not list the DHS phone number on that letter. And we partnered with the
MCO … to help us take those calls because we didn’t want the experience for our
customers to be poor.”
During her testimony before the House Finance Subcommittee,
Stacy Smith provided a list of reasons why she sees possible disaster The
following has been adapted from Smith’s written testimony:
·
“The Bridges Program does not always work
properly, frequently making it hard to do our work. [Note: The Bridges Program
was provided by Deloitte, and had a disastrous roll-out
during the Administration of Governor Gina Raimondo.]
·
The number of cases are crushing.
·
My members are held to strict time limits to resolve a case
·
They are supposed to complete a case in 35 minutes maximum.
·
In our Call Center, my members often have only 20 minutes
to work a case, before a supervisor shows up to their cubicle and tells them
they have been on call too long and to wrap it up.
·
Determining eligibility is very technical and time
consuming work.
·
Often obtaining the necessary information from clients
requires extensive discussion.
·
Not to mention you have to know federal rules, regulations,
and policy for each program.
·
This type of pressure leads many employees to quit.
·
Working at the call center is especially challenging, as I
previously stated, having the added pressure of a Supervisor standing over you
with the clock ticking on the time you’ve spent on a case can be overwhelming.
·
While we want to help each and every client, strict time
allotments can make dedicating enough time and attention to complex cases
nearly impossible.”
Smith also outlined the additional pressures to come:
·
With the Covid Pandemic Public Health Emergency ending,
renewals will have to start once again.
·
Over 300,000 recipients’ eligibility will have to be
redetermined.
·
While DHS says half that amount will be passively
recertified that leaves over 150,000 individuals who will require renewal.
·
This amounts to a Tsunami like increase in workload.
·
With the state only adding net three positions in two
months, if they keep hiring at the current trend, I’m worried our agency will
get swamped.
·
While the Department is trying to hire, they are simply not
moving fast enough.
·
It’s like we, as Eligibility Technicians, are standing at
the shore watching the tsunami come at us, and management is debating how to
add a crew to combat it, but the wave will hit us first, and no one has a life
preserver.
·
What is also not helpful is that while we are meeting
regularly, for some reason the state is giving new hires up to six weeks to
separate from their old employer and come aboard.
At the end of last Thursday’s Medicaid Renewal Information session Representative David Morales (Democrat, District 7, Providence) stood up to ask his fellow legislators to support his bill to “provide stop gap health insurance coverage for anyone who is found to no longer be eligible for Medicaid due to the end of the Federal COVID Emergency funds.”
The Governor’s
budget provides for two months of stop gap coverage and is tied to eligibility.
Under the Morales bill the state would provide six months of stop gap coverage
with no eligibility requirements.
Capitol TV cut away from the
event as Representative Morales rose to speak, but Uprise RI was in the room
and has the video.
“I think the most important thing that the legislature can do, because we cannot legally stop the renewal process, is that we can ensure that everyone who gets terminated from their Medicaid coverage, regardless of their federal poverty level status, is guaranteed coverage through Healthsource with six months of premiums covered,” said Morales when asked to clarify.
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