A year later the sign on the exterior of the building still reads “Department of Health and Social Services,” although the department no longer exists after being split into two departments with new names. In the departments’ offices and operations, the signs are also amiss.
One of those departments — now known as the Department of Health — has spent the past year plagued by headline-grabbing problems such as a massive backlog of food stamp applications. The other — the Department of Family and Community Services — made headlines when a U.S. Department of Justice investigation reported the state is unnecessarily and illegally institutionalizing children.
All in all, it’s not the start that leaders and plenty of Alaskans relying on the departments’ services were hoping for, since the split’s declared purpose was improving the quality and efficiency of operations. But the commissioners of both departments say many of the most notable problems are due to long-existing deficiencies and/or caused by external factors such as the COVID-19 pandemic, so fixes won’t be quick — and without the split things might have fared worse.
“I think that it was overdue,” said Heidi Hedberg, commissioner of the Department of Health, in an interview with the Empire. “And being in this position since mid-November I’m incredibly thankful that it’s a smaller span of control.”
A spokesperson for Department of Family and Community Services Kim Kovol said she was unavailable for an interview or to answer written questions submitted by Empire due to medical circumstances. Kovol did offer an assessment of the new department’s performance during a legislative confirmation hearing at the Alaska State Capitol in March.
“With this reorganization I’ve received feedback reinforcing my observations that our divisions and partners have had more opportunities to collaborate and focus on delivery services and exchanges,” she told legislators.
But DFCS still hasn’t posted a press release on its website since officially becoming a state department on July 1, 2022. People visiting the new department’s new office space in Juneau, in the building adjacent to where Department of Health operations remain, are greeted by unfinished facilities including a makeshift paper sign taped to a wall in the area that read “we might be here. Please knock with ‘gusto.’ We hope to have a doorbell soon, but we don’t have one yet.”
Brian Studstill, communications director for DFCS, said the sign “was meant to be a lighthearted, internal message” for employees, not the public. Also, he said any delays in response are “often because our IT team members are helping staff in other offices within the building.”
Some of the hallway and office space in the health department’s building also remain a work in progress. Hedberg said the past year has “been an exercise in patience” due to workforce issues and supply chain disruptions involving contractors, but the figurative and literal signs of a complete transition should be visible during the coming months.
“I would say that we’re nearing the finish line in terms of buttoning up a lot of the internal details,” she said.
Hungering for change
Crisis-level problems at the departments during the past year, such as tens of thousands of Alaska residents being cut off from food assistance, resulted in what agency officials and lawmakers called years of poor actions before the department split. As such, both critics and defenders of the agencies involved agreed quick fixes were unlikely regardless of whether the reorganization occurred.
More than 96,000 Alaskans were enrolled in the Supplemental Nutrition Assistance Program (SNAP) in March of 2022, for instance, while a year later the total dropped to about 29,000, according to the U.S. Department of Agriculture Food and Nutrition Service. The nearly 70% drop was by far the largest by state in the U.S., with Maryland tanking second with a 21% decrease.
Alaska’s dropoff was largely due to a backlog in processing food stamp applications by tens of thousands of residents that became public last September. While Hegberg and other department officials blamed decades-old computer equipment and a cyberattack in 2021 as causes of the backlog, other officials and some lawmakers cited employee shortage issues under Gov. Mike Dunleavy dating back several years.
The Alaska State Ombudsman in 2018 recommended the state Division of Public Assistance increase staff after an investigation revealed similar problems in processing aid applications, but instead the administration cut more than 100 public assistance division jobs in 2021.
The department is still trying to catch up with the backlog to SNAP and other public assistance programs, with remedies including more than $3 million in emergency funding approved this spring by the Legislature to hire additional employees.
Hedberg rejected the suggestion her department’s officials might have been able to better address issues such as the food stamp application backlog if they also weren’t dealing with work related to the administrative transition.
“I don’t think a delay (of the split) would have been helpful,” she said. “Again, I go back to span of control. When I started my position as commissioner for the Department of Health in November that’s when we started to hear the issues within the Division of Public Assistance. And because of a smaller department it really afforded me the time to really focus in on that.”
Accusations and answers about children’s programs
As with public assistance programs, child welfare services under the new DFCS were the target of attacks long before last year’s department split occurred. Similarly, DFCS officials state that problems gaining notoriety during the past year such as the Justice Department investigation aren’t something that can be quickly resolved or due to any issues related to the reorganization.
“DOJ’s investigation took place during the two most severe years of the COVID-19 pandemic,” a DFCS report issued in April in response to the investigation states. “The pandemic has resulted in catastrophic health care workforce shortages, universal experiences of isolation, limited transportation, and increased unemployment, which exacerbated the challenges rural areas were already facing.”
“Accordingly, the citations provided in the DOJ report do not provide information that is representative of that time period.”
Other ongoing complaints about DFCS programs, particularly the Office of Children’s Services, are continuing after the department split — and some residents and officials are expressing frustration that the promised improvements by creating the new department do not seem to be happening.
“I have not seen anything. I have not seen the action,” said Laurie Vandenberg, a registered nurse and former foster parent, testifying during Kovol’s committee confirmation hearing. “I’ve heard the talk and not heard the walk or seeing the walk. My heart breaks that she has two children that are autistic and that she has not stood up for the injustice that’s going on in the OCS system and there are changes that can be made.”
Kovol told the committee that she visited nearly all division sites in her department during her first few months and a key problem is a shortage of available employees, rather than those already working for the department.
“One case worker described to me their routine to plan, pack and travel to remote sites to visit, and assist families and children both by plane and by boat,” she said. “And this case worker told me they were exhausted. But they picked up that monster backpack again and again because it was their calling.”
Kovol said she’s also spent considerable time with people using the department’s services. “The youth and families from our child welfare agency contacts have been emotional, enlightening, constructive and critiques, and extremely moving,” she said.
One area of agreement Kovol said she shares with people voicing concerns is “it can’t stay status quo.”
“Having those contacts, having those conversations with the parents, reading the emails, having the phone calls, showing up the community meetings, meeting with our tribal partners, developing those relationships, it does take time,” she said. “This is not an easy fix overnight. But can we slow down and turn the ship? Absolutely. But I do want to do that in partnership with the governor, first and foremost.”
Meet the new boss, same as the old boss
Among the multi-year problems cited by critics of the agencies run by DOH and DCFS is Dunleavy, who sought large budget cuts in many programs after he took office in 2018 and critics say failed to sufficiently address problems that have surfaced.
As such, healthcare workers, social service organizations and tribal governments were criticizing the split of DHSS when it was still in the proposal stage.
“The rationale that the commissioner’s office continued to give…had more to do with the management of DHSS and not so much about in the best interest of serving children and families,” said Mary Johnson, director of Tribal Family & Youth Services for Central Council of the Tlingit and Haida Indian Tribes of Alaska, in an interview with the Empire in January of 2021.
Concerns are still being voiced that the two new departments, regardless of their defined role, are still under Dunleavy’s purview and thus his policies. While the governor has proposed and/or signed legislation addressing some shortfalls, such as the supplemental funding to address the backlog in public assistance cases, reports of problems involving issues the two departments deal with continue to accumulate.
A lack of child care is cited as a critical and growing problem during the past several years, due to issues ranging from low wages causing employee shortages to difficulties with state licensing requirements, which now fall under the jurisdiction of the Department of Health. A grim assessment of the overall situation was presented to a child care task force formed this spring by Dunleavy when members held their first meeting in June.
But the task force itself was criticized when it was formed by some lawmakers and child care advocates, who suggested Dunleavy was stalling meaningful action already proposed by giving the task force until July of 2024 to present recommendations. Dunleavy did subsequently approve some existing measures, including retaining a state budget allocation of $7.5 million during the next year to boost wages for child care providers.
However, Dunleavy did use his line-item veto on a number of allocations to the two departments, including eliminating a hiring technician for DOH intended “to address agency recruitment challenges.” State Sen. Jesse Kiehl, a Juneau Democrat, said a few such positions within state departments were cut by the governor.
“How does that help when people need to talk to somebody about their food stamp application?” Kiehl said when the vetoes were announced in late June.
Hedberg said the department split is doing more than a proverbial “shuffling of the deck chairs” while leaving the same captain at the helm. She said the child task force, which she is a member of, is evaluating new difficulties and possible solutions beyond what’s been examined in recent years, due to the state’s rapidly changing workforce and economic situation after the pandemic.
“I think it’s going to take public-private partnerships, and really looking at our methodologies and payment mechanisms to really create recommendations for the sustainability of access to quality childcare — so all of that work, that is new,” she said. “But it is taking into account the work from the 40 different stakeholders that created the Early Childhood Joint Task Force (in 2019-2020). They have that strategic plan. So everything is in alignment.”
Similarly extensive work is necessary with other programs such as Medicaid, with DOH in April beginning a year-long eligibility review of the roughly 263,000 Alaska residents receiving coverage through the program. Hedberg said officials are also examining reimbursement rates that healthcare providers call inadequate, which is another reason she’s grateful not to be focusing on programs now under the umbrella of DCFS.
“So again, the department reorganization was good,” she said. “Now we have time to really focus on these long-term standing issues.”
• Contact Mark Sabbatini at firstname.lastname@example.org.