In just the last three months, Missouri has come under fire from two federal agencies and a U.S. district court judge over how it administers programs designed to help the most vulnerable.
The state鈥檚 dysfunctional call centers serve to that is guaranteed to them by federal law, a judge ruled in May.
Missouri the Department of Justice concluded in June, rather than providing resources that could help them live in their communities.
And among the worst in the nation, violate federal rules 鈥� which pediatricians say is
The issues are years in the making 鈥� a product of decades of underinvestment and workforce cuts, advocates say.
And they鈥檙e not in isolation: There are also people to be transferred to psychiatric facilities, and that have caused backlogged child welfare investigations.
On Aug. 6, Missouri will hold primaries to nominate the next governor. Three Republicans are considered the frontrunners for gubernatorial nomination: Lt. Gov. Mike Kehoe, Secretary of State Jay Ashcroft and state Sen. Bill Eigel.
The two leading Democrats running are House Minority Leader Crystal Quade and businessman Mike Hamra.
The Independent asked each candidate what they would do about the various crises within the state鈥檚 fragile safety net.
Most agree that two broad issues lie at the root of these problems, particularly within the Missouri Department of Social Services: the fact that state workers aren鈥檛 paid enough and that the state has lagged in modernizing its technology.
The leading Republican candidates said they would invest more in workforce or technology, though at the same time to slash the income tax.
Democrats want to make similar investments without that cut to state revenue.
鈥淩egardless of who the governor is,鈥� said Casey Hanson, deputy director of Kids Win Missouri, a coalition of organizations that advocate for children and families鈥� wellbeing, 鈥渨e hope that they will come in with that mentality that we need to have systems that work in our state, so that when families need to access the safety net, they鈥檙e able to.鈥�
Workforce consideration
On the Republican side, both Kehoe and Eigel said they鈥檇 be open to supporting raises for state workers.
The laundry list of safety-net issues is 鈥渘ot an acceptable situation,鈥� Eigel said.
Broadly, Eigel said, more government spending has led to worse outcomes.
But asked about whether more money would be needed to, for instance, ensure child welfare workers have reasonable caseloads 鈥� which 漏 2024 外网天堂 has most recently reported on 鈥� Eigel said: 鈥淣o question and nobody鈥檚 proposing zero government.鈥�
Eigel would support raising salaries of child welfare workers 鈥渦p to $80,000 or $90,000 per person so we can really recruit at a level where we鈥檙e getting quality individuals to investigate child abuse.鈥�
鈥溾�nd to do that is a fractional line item in a multi tens of billions of dollar budget.鈥�
Entry level child welfare workers start at salaries of just over $44,000, DSS spokesperson Baylee Watts said.
Eigel said several of the issues 鈥渕ay require more direct resources鈥� but that he would also prioritize 鈥済etting rid of bureaucracy.鈥�
In terms of state pay, Kehoe said Missouri has come a long way in the last few years. But the state must continue to remain competitive with the private sector.
Kehoe has lived in Jefferson City for more than 30 years, and he says he鈥檚 seen firsthand how some state employees struggle to get by.
鈥淚鈥檝e been at Schnucks and watched someone take out a SNAP or food stamp card to buy groceries,鈥� he said, 鈥淎nd I knew that person had worked for the state for 25 years.
鈥淣ow, we shouldn鈥檛 have somebody work for the state of Missouri for 25 years and have to use an assistance card to buy bread at Schnucks,鈥� Kehoe said.
Quade served as House minority leader, and said her experience in that job gives her insight into the issues plaguing Missouri鈥檚 social services. She led hearings looking into people being kicked off Medicaid, and says she has met with numerous frontline DSS staff to hear concerns.
鈥淵ear after year,鈥� Quade said, 鈥淚 have led the fight to increase funding, not only for staff, but also things like our call centers鈥 can鈥檛 count how many hearings I鈥檝e been in where agency directors have begged for adequate funding so they can successfully help Missourians but have been ignored or disregarded,鈥� she added.
Quade said if elected, she鈥檇 meet with frontline workers and families who 鈥渉ave been left behind to ensure our state is doing all we can.鈥�
Hamra called the situation 鈥渦nacceptable鈥� and reflective of a lack of leadership.
鈥淚 will both provide staff the resources they need to do their jobs, and in return, demand that they provide the level of service Missourians deserve,鈥� Hamra said. 鈥淚 have a 20-year track record of running a large organization where I have put this approach into practice and would bring this same mindset to state government as governor.鈥�
Elsewhere in Missouri鈥檚 social services agency, benefits program workers in the Family Support Division start at just under $39,000 and youth services workers at the Division of Youth Services start at $42,000, Watts said. There are currently 252 job openings in the Family Support Division, 126 in the Division of Youth Services and 8 in Children鈥檚 Division, as of late May, Watts said.
And even if the agency could fill all its positions, it鈥檇 still be operating at a level far below where it used to be. Fifteen years ago, there were over 1,000 more staff members in the Department of Social Services than there are today, according to state budget documents 鈥� in part a result of substantial cuts under Democratic Gov. Jay Nixon.
Around One-third of Missourians will interact with the Department of Social Services, to agency leaders.
Watts said agency leaders 鈥渞emain committed to advocating for higher pay鈥� for staff.
The impacts of low staffing in the Family Support Division include delays for Missourians to access needed health and food assistance. A lack of benefits鈥� staff means various , Missouri told the federal government.
And a decline in staff has coincided with shifts away from person-to-person interaction.
The agency several years ago moved from assigning caseworkers to each benefits participant and toward a call center model, said Sarah Owsley, advocacy director for the anti-poverty nonprofit Empower Missouri, which she argues hasn鈥檛 proven successful in other states.
鈥淲e would love to see some resources put back into local offices where families can have a personal contact, a person they鈥檝e built a relationship with,鈥� she said, adding that data shows the person-to-person model helps families secure benefits and move toward self sufficiency, rather than simply being denied access.
In Missouri, call center wait times can be hours long, and the remaining in-person offices sometimes direct clients back to the phones.
The agency is working toward 鈥渋nnovative ways to provide 24/7 self-service options for the public鈥檚 convenience,鈥� Watts said.
She added that the agency is 鈥渁ctively monitoring and adjusting staffing to meet the demands of managing the call center and processing applications,鈥� and has seen a reduction in wait times in recent weeks.
DSS 鈥渇aces a challenge of increased workloads and call volumes while maintaining staffing levels for Medicaid applications and the call center,鈥� Watts said.
Technology modernization
Ashcroft and Kehoe said technology is another area they think could be improved to help these safety net issues.
鈥淭he state needs to do a better job with information. The state needs to do a better job of making it easier for individuals to communicate and have their say,鈥� Ashcroft said.
He would also undertake a broader reevaluation of state resources, he said 鈥� a 鈥渞eset of government departments.鈥�
Kehoe said Missouri hasn鈥檛 been able to keep up with technology compared to other states.
鈥淲e have to do that,鈥� he said, 鈥渁nd I think we have to make sure we get to a point where the right people are getting the right help. eliminate as much of the fraud as we can and the people who actually are able to go to work, get them opportunities in the workforce.鈥�
There have been longstanding tech problems within Missouri鈥檚 social services department, including antiquated software systems.
After the state launched a new eligibility verification system for Medicaid in 2018, it saw a huge drop in Medicaid enrollees. Officials largely the decline in participation to improved economic conditions, but there turned out to be significant system . of those drop-offs at the time.
A published in 2019 found Missouri鈥檚 Medicaid data system has around 70 components and was partially developed in a system that dates from 1979 鈥� which is 鈥渘ot positioned to meet both current and future needs.鈥� A 2020 concluded that for participants trying to enroll in benefits, 鈥渢he system feels like a secret and no one has the answer.鈥�
Lately, the state has seen significant in the number of Medicaid renewals it processes using existing data rather than requiring participant response, which it had long struggled with, called ex-parte renewals. Yet the remaining individuals who still need to send in their forms for processing and the advocates who assist them have reported a huge number of such as uploaded information being lost in the state鈥檚 online .
鈥淭o address children losing coverage,鈥� Watts said, 鈥渨e continue to educate community partners and participants on how to connect with FSD to apply, renew, and use the MyDSS portal, along with looking at ways to improve our ex-parte rates which will in turn decrease the numbers of renewal forms that must be sent out.鈥�
Watts said one tool that is in the works would automate more data entry 鈥渢o streamline processes and allow staff to focus on processing [applications] rather than manual entry.鈥� The full benefits from this are expected by late fall, she added.
And the agency leadership are committed to continuing to advocate for tech upgrades, she said.
Late last year director Robert Knodell the American Public Human Services Association that some of the problems that had plagued the agency included 鈥渄ecades of underinvestment,鈥� legacy technology systems, and the challenges of bringing new participants onto Medicaid after the voters
Advocates say they鈥檙e not just interested in governors鈥� policy proposals but what candidates think the purpose of these programs is.
They say one goal of public assistance is to help people become self-sufficient and the way to do that is to eliminate barriers to their getting help.
鈥淲hen those systems aren鈥檛 functioning properly, it puts more stress on families, but it also puts more stress on the state and state workers,鈥� Hanson said, pointing to the case of the education department鈥檚 since late last year when it moved from the social services department. Those issues have caused day cares to struggle to stay afloat, and daycares to submit more and more payment dispute forms to the state.
鈥淎nd then that creates a backlog, and then the already overburdened state staff are then faced with that backlog in addition to their regular work,鈥� Hanson said.
And for families, she said, 鈥渨e hear about parents who have to turn down work or turn down jobs because their subsidy wasn鈥檛 approved in time.鈥�
Others have to wait hours on hold to access food benefits, sometimes missing work to do so.
Owsley said she hopes lawmakers think about what purpose it serves to impose barriers for people to access these programs.
鈥淔amilies in poverty in Missouri needs support,鈥� she said. 鈥淭hey don鈥檛 need more burden, and when they鈥檙e reaching out for that assistance, it鈥檚 because they need it.鈥�
This story was originally published by The Missouri Independent. Jason Hancock and Rudi Keller contributed reporting.
