Time for State Employees to Walk in Others’ Shoes

I sent the e-mail below to the Medicaid Expansion Coordinator and the DPA Director, Sean O’Brien as a follow up to my prior investigation. It has only been a couple of days, but I suppose I really am not expecting much of anything with respect to a substantive response.  Like so much else, we have here a potentially great idea, with simply horrendous implementation.

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Dear Ms. Martin,

While I have been more than willing to accept what the Chris
Ashenbrenner had to say about the problems with the roll-out of the
Medicaid Expansion, any experience dealing with the claimant side of the
system is immediately explanatory of why there are so many people angry
and frustrated  with that system.

To start with, much of the information received by applicants from DPA
offices, or provided on the ARIES website, is inaccurate or misleading.
When I have tried to bring that to the attention of agency personnel, I
have been blown off, with the result that to my way of thinking,
nothing is ever going to be done to fix it. By way of example, if you
are dumped into ARIES by healthcare.gov, your application does not show
up in ARIES, even AFTER someone has looked at the file and sent you a
demand for verification letter.  If you have an application on file, you
must be able to confirm the status of that application through ARIES.
Period.

Anyone who thinks this

That was not the greatest explanation, so let me try again.  
The number you reported prefixed with a T is a temporary 
application number while the application is in processing.   
No access is available at the self-service portal (where 
application was made) while in this temporary status.  
The application has been transferred (electronically) to 
an office for processing.  After the case is processed and 
approved it will be assigned a permanent number starting with 
a 3.  This permanent number can then be used to access features 
provided on the portal. 
is in any way explanatory (or satisfactory) needs to see a mental health
professional. Let's see... it suggests that the application number does
not become an application number until the application is not longer an
application, and suggests, contrary to what the ARIES site says, that
you can see the status of your application based on your application
number...  but of course since the only number you get while your
application is an application is the application number and that
application number is not an application number, it is fairly obviously
that most of what one might have tried to do for an hour trying to use
web tools to determine the status of an application has been totally
wasted.  Moreover, any attempt to speak to someone at the DPA office
results in you being put in a queue to leave a message which is never
returned.

As far as the back log is concerned, since it is fairly evident that no
one is doing triage on the applications, and a call to the published
telephone number about emergent issues results only in an e-mail to an
office manager who already is failing to triage applications, it is
pretty clear why applicants are getting steamed. For example, waiting 6
or 7 weeks to THEN tell an applicant he has 1 week to send in dozens of
documents while making it impossible for the applicant to discuss with
anyone the document request is, in a word, bizarre. And YES, that
is exactly what DPA is doing.  Calls to claim workers are not returned.
When they are, no message is left. And no call backs are ever attempted.

Indeed, as relates to FFM referrals, since data will in fact be sparse
because it is all electronic and no documents are accepted, you know
that no application will be accepted without receipt of additional
documentation where there is any evidence of self-employment, and yet
you sit on those applications.  Where gross FFM income is below $19000
you STILL sit on those applications, and eventually ask the applicant to
prove expenses, when it makes no difference what the expanses were if
the gross income was below the target income level (if I have $12000 in
W2 income and and $6000 in gross self employment income, it doesn't make
any difference what my business expenses are, I am still eligible).

And what IS one supposed to do in response to a request that simply
says, "Provide documentation of expenses." What expenses? What kind of
documentation? Questions? Sorry, you may NOT speak to anyone who can
answer them 

As far as published data, it is frankly unbelievable, and while there
may be an explanation for why it seems incredible, the Department does
itself no service by not providing same.  By way of example, consider
this data:

                             "Jan-16"   "Feb-16"  "Mar-16"
"Incoming Work"              "4,352"    "3,672"    "4,501"
"Work Completed              "5,136"    "5,075"    "5,042"
"True Application Backlog"   "2,692"    "1,573"    "2,053"

How can you have an Application Backlog of 1573 in February, complete
541 more applications in March than came in, and then have a resulting
backlog of 480 more than you had in February?

And providers. I have spoken to quite a few over the last several
weeks.  Many are just fed up and are ready to quit accepting Medicaid.
Yes, they have been told to go ahead and treat as Medicaid will
eventually pay (really?), but all the provider has is a voice on a
telephone, and that does not pay the bills if payment is in fact NOT
forthcoming. Thankfully, many will simply hold the bill for 30 days.
And if a provider won't hold the bill, and won;t serve you because
Medicaid can't provide even a claimant number?  Well, you are in a sense
worse off than you were before Expansion, aren't you?

The system simply is not working well for those who need it to work for
them, in no small part because communication is non-existent, and
urgency is treated with casual disregard by the system.  We can do better.

Marc

Marc Grober, Esq.
5610 Radcliff Dr.
Anchorage Alaska 99504
email: marc@interak.com
cell:  (907)2272417

One comment on “Time for State Employees to Walk in Others’ Shoes

  1. Steve says:

    I not only agree with you, I think you GREATLY underestimate the seriousness of the problem. It isn’t a one time thing. Yes, you describe a real problem, but you describe in detail what one ant in the backyard is doing, and I have 4 million ants in my backyard that are doing equally poorly at their governing duties.

    In other words, there is a larger picture. Things are breaking down. For really. The difference is now when things break people were expecting it to break and had zero expectations of honesty and integrity in public service. Before, people actually at least acted like they expected the gov. to do the right thing. No more. And they don’t even try to make it look right anymore; there’s no need to hide under cover of darkness, the corruption and incompetence are so common now that they’re the norms, not the exceptions.

    Widen the focus of that bright flashlight of truth you shine upon them, Marc.

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