May 20, 2019

Judge sees progress in state efforts on Medicaid, SNAP

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Photo Credit: Paul Sableman cc

U.S. District Judge Kenneth Gonzales laid out the stakes in a long-simmering lawsuitover the Human Services Department’s record of denying food stamp and Medicaid benefits to eligible New Mexicans during a status hearing Thursday at the federal courthouse in Las Cruces. 

He’d visited the HSD office on Utah Street in Las Cruces where he had looked over cases with a front-line worker there. One client was a single mom with two kids under 6. She’d lost SNAP benefits because she had not submitted documents that apparently were already in the system. Then her family lost Medicaid benefits, even though they weren’t up for renewal, because of the decision on food stamps — something that violates federal rules. Another mom with a teen daughter got benefits approved, but needed to wait more than two weeks for an EBT card. 

This story originally appeared at New Mexico In Depth and is reprinted with permission.

Gonzales said he was looking at the case files, but that’s not what he saw. 

“I was able to see the people,” he said.

That put a sense of urgency on a lawsuit that was originally filed in 1988. The state is accused of putting up systemic barriers to residents who apply for Medicaid and SNAP, formerly known as food stamps. A special master was appointed to monitor the department’s efforts to remedy the problems.

Gonzales, the supervising judge, set the hearing to get an update on what progress has been made to bring the department into compliance with a settlement agreement that could put an end to the decades old lawsuit, where progress has ebbed and flowed. A low-point came in 2016, when employees at HSD alleged they had been pressured to alter documents to reduce the number of backlogged cases.

Error-filled case files

Lawyers for the New Mexico Center on Law and Poverty said a review of randomly selected cases from a period between March and September 2018 show the state still has serious issues.

Among the problems they found included asking applicants for paperwork it already had on file, asking for verification information that isn’t required by federal rules, not telling applicants why they’ve been denied in a timely or easy to read manner, or with the calculations so that applicants could tell if there were errors and appeal the decision, and denying benefits to qualified residents in error. 

Of the 288 cases they looked at, the center found 182 legal violations, they told the judge, nearly two-thirds of the files. And in 30 percent of the cases, New Mexico residents experienced a loss or delay of benefits. 

“We understand that a lot of problems have been inherited by this administration, but we think there needs to be a fundamentally different approach,” said Sovereign Hager, a lawyer for the Center on Law and Poverty. “We want to arrive at something permanent and meaningful.”

Hager said the center would like to see a clear and simple manual for case workers to consult, a revamping of the IT system to help eliminate errors and better training for workers on eligibility requirements. They are seeking three working groups with HSD to address problems, rather than applying “band-aids for a system that is not working.”

A complex system

For his part, HSD Secretary David Scrase, a physician who is now charged with remaking the department, said he was not a “band-aid doctor.” He told the judge all the experiences he’s had during his career led to his appointment to HSD because he’s learned how to maneuver in complex systems — and HSD has 1,800 employees, a $7 billion budget, more than 60 benefit programs and about 1 million unique clients. 

Scrase is putting much of his faith for reforming the system on modernizing HSD’s computer system. 

He said what they know about their clients is that 95 percent have access to smartphones, and he envisions a system where front-line workers can FaceTime with clients, and if they notice there is a document missing, can ask applicants to shoot a picture of it with their phone and upload it to a dedicated app, rather than force applicants to come into the office multiple times to turn in paperwork.

“Investment in information systems is critical,” he said.

Scrase disputed the results of the case review and disagreed that the department had made little headway. He said from a 96,000 backlog in 2016, the department had gotten it down to 1,867 — about the amount of one day’s work.

Still, despite some disagreements, “we are fully committed to a non-adversarial relationship with the plaintiffs,” Scrase said. “Making sure every qualified New Mexican has timely and accurate benefits is what we have in common.”

Judge Gonzales agreed with Scrase that after a long and bumpy road, he was finally seeing some progress — especially because both sides were actually talking to each other. He said reports from the special master and regular updates on caseloads are showing improvements.  But he didn’t let Scrase off the hook.

“There are people who can not wait four months, not one month, not even one weekend to get food on the table,” Gonzales said.