Shared caseload system prompts concerns, complaints about county’s HHS
BEMIDJI – After the Beltrami County Board spent more than an hour in its work session Tuesday with an update from the county Health and Human Services Income Maintenance Division, commissioners heard complaints about the agency from several people during the board’s regular meeting.
A year and a half ago, the agency switched from a case management model, in which staff members are assigned to clients, to a case banking model, in which staff members share caseloads.
John Pugleasa, Beltrami county economic assistance director, said the key piece to a successful transition is implementing an electronic document management system. This system is part of the 2013 budget the board will consider in December. Pugleasa said the EDM system would likely cost about $290,000, after state reimbursement of 46 to 47 percent of the cost.
The case banking model is meant to be used in a digital environment, Pugleasa said. “It was never meant to be paper-based. … Probably the biggest loss is the role of the case aide. We have spent a vast majority of case aide time chasing paper.”
The case aides should be providing customer service for routine questions to take the load off eligibility specialists, but instead, the aides have been inundated by paperwork, he said.
Pugleasa acknowledged “case banking as a model is less relational. That has been hard on some of our staff and some of our clients.”
Commissioner Joe Vene said he finds it disconcerting to move to a system that is “less relational, less personalized.”
Pugleasa said the county wasn’t able to do a good job with the workload under the case management model. Without many additional staff, he said, it could not have provided the atmosphere Vene envisions.
In the transition, “Our staff has been fabulous,” Pugleasa said. “They have worked diligently and consistently looked for solutions. It’s not been easy, yet they’re stuck it out and done a fabulous job.”
He said that of the state’s 87 counties, 47 have switched to case banking, and only one is returning to case management.
Commissioner Quentin Fairbanks said he gets three or four complaint calls a week about the agency, from both employees and clients.
He told Pugleasa and HHS Director Mary Marchel that he informs them of complaints, but sometimes he can’t get a call through.
Frost, however, said he has had “excellent response from John and Mary” when he has passed along complaints. “I’ve been very pleased.”
“I have not received that many (c omplaints), but the ones I’ve received, I’ve turned back to you folks,” Commissioner Richard Anderson said.
Commissioner Jim Lucachick suggested an internal review to look at how things are done within the county HHS.
“I personally feel we need a second opinion,” Lucachick said. “I would really like to see another entity look at their system, how things are being done, and bring that back to the board.”
Commissioner Jack Frost asked Pugleasa to give the agency a letter grade for its performance.
“I would give us an ‘Incomplete,’” Pugleasa responded. “If I evaluate myself, I’m not pleased with where we’re at right now. We’re not done.”
“If we’re going to spend half a million dollars of taxpayer money (between the county and state portion), I think it behooves us to spend a little time to see if we’re going in the right direction,” Fairbanks said.
Lucachick said that an internal review should involve anonymous input from staff and clients, “so they feel open and free. We all want the same thing – we want this to work.”
The closing of the Redby office in March had a huge impact on clients, former Redby supervisor Georgia Downwind said during the portion of the regular meeting in which citizens may make comments.
“When you guys had the Redby office open, we had a really good office,” Downwind said. “We treated our clients with respect. We did the best we could to get them their benefits on time. … I don’t think there was an impact study done on how it’s going to affect the Red Lake people. I would like to see you guys at least come and talk to the people.”
She said people are waiting two or three months for benefits.
Downwind, who now works with Temporary Assistance for Needy Families in Red Lake, said she an independent audit in which staff and clients can talk freely and anonymously would be beneficial.
“I think the Red Lake people need to be heard, and that hasn’t happened,” she said. “They need to have a voice in it.”
Carol Charnoski, who works with the Leech Lake Health Division, said she worked for Beltrami County for years. “We did everything by hand. The client was in and out in a day or two,” she said. “Now we have computers. What the hell is the problem?”
Changes are needed, Charnoski said, pointing out clients must stand in long lines at one window while the other stays closed.
“Put more people up front, and for goodness sake, put a smile on their faces,” she said. “It really makes me angry. When I worked for Beltrami County we didn’t treat people like that.”
Audrey Thayer, who worked with Charnoski a number of a years ago and now deals with the agency as a foster parent, said the new system is poorly handled.
“I will not tolerate not getting responses,” Thayer said. “I will call Mary Marchel or (other) people I know and say this is what is going on.”
Thayer, director of the American Civil Liberties Union of Minnesota’s Greater Minnesota Racial Justice Project, feels communication problems are the true issue. She suggested a community meeting or survey to assess how people feel.
“I’ve heard over and over from the staff, ‘we’re working on it,’ but meanwhile we have the people in the community who need help.”
Elsie Strong currently works for the HHS and said she gets about 200 phone calls a day from clients, many of whom take their frustrations out on her, often calling her names.
“Case banking is not going to get better,” she said. “It’s always going to be behind, two months or three months.”
Beltrami County Auditor-Treasurer Kay Mack said in an interview that some delays are unavoidable.
“There are standards that are in place as part of the state laws and rules,” she said. “We apply them evenly, regardless of the situation. ... It’s not just an issue for Beltrami County.”
She added that the county has “a huge number of people” who haven’t called in, because, presumably, things are going well for them.
“So we have to keep it in perspective,” she said.
Downwind agrees with Pugleasa about at least one thing: the paperwork.
“Something needs to change,” she said. “Case banking is not the answer. If you’re going to do case banking, it needs to be paperless. There’s a large volume of paper, and things get lost.”