Testimony of Rachel Metz
Data and Research Manager
Performance Oversight Hearing
Fiscal Year 2022
Department of Human Services
Before the Committee on Human Services
Council of the District of Columbia
Thursday, February 24, 2022
Hello Councilmember Nadeau and members of the Committee on Human Services. Thank you for the opportunity to address the DC Council as it reviews the Department of Human Services (DHS) performance for Fiscal Year 2022. I am Rachel Metz, the Data and Research Manager at DC Action.
DC Action uses research, data, and a racial equity lens to break down barriers that stand in the way of all kids reaching their full potential. Our collaborative advocacy initiatives bring the power of young people and all residents to raise their voices to create change. We are also the home of DC KIDS COUNT, an online resource that tracks key indicators of child and youth well-being.
Councilmember Nadeau, we want to express our appreciation for recertification in the Healthcare Alliance being permitted entirely by phone this year, as well as for some improvements to accessibility on the DHS website as more documents are translated into Spanish. Our organization is invested in the effectiveness of the DC Healthcare Alliance because many families with children in the District utilize the program for much-needed health services since they are not eligible for Medicaid. While the phone recertification and additional document translations are important steps, we remain concerned about the challenges that many families faced with the Alliance once recertification requirements resumed at the end of the legal public health emergency period.
These are challenges that are well documented and acknowledged by Deputy Mayor for Health and Human Services Wayne Turnage, as we all learned when the CityPaper reported on an email of his that noted 7,000 Alliance enrollees - one in three - were decertified this fall. Though most were reinstated by DHS, the bureaucratic confusion and delays involved in the reenrollment process left District residents scrambling to address basic health needs. We are especially concerned about the potential impact on pregnant residents who may have missed out on prenatal care. While it was a positive move for DHS to reinstate these program participants, it is clear that longer-term systemic solutions are needed to ensure health equity moving forward.
One part of the solution would be to require recertification in the Alliance only once–rather than twice–a year. Even if recertification is only required once a year, however, it shouldn’t be hindered by language accessibility. To ensure that language barriers do not prevent residents from receiving health care, DHS must make several improvements.
- Consistently send participants notifications in their primary language instead of just in English. Anecdotally we have heard that this was a problem this fall.
- Make the web portal application and recertification forms available in multiple languages rather than just in English.
- Work to make linked documents available in Amharic and other regional common languages (though we appreciate the work to make more of them available in Spanish).
- Staff telephone lines at a level that allows applicants and re-certifiers to get support in their primary language immediately, or at least on the same day.
- Provide applicants with information about the status of their application or recertification. Many community members seek out support from community-based organizations when they do not hear back from DHS, only to discover that a document did not upload correctly, additional documentation is needed, or other issues–which are fixable if there is clear communication–have delayed their applications. This would require providing applicants with a confirmation number or receipt when they submit materials.
When these things don’t happen it has real world consequences. When agencies fail at something as basic as enrollment and certification, residents with physical disabilities, who are isolated and lack access to transportation, and residents with limited English proficiency are often the first to lose out. We all know that the reason District leaders instituted the Alliance in the first place is due to the xenophobia embedded into federal polices that make many immigrants ineligible for federal benefit programs including Medicaid. Its existence aims to close racial equity gaps in health outcomes: roughly half of Alliance participants are Latinx and just under one-fifth are Black. Let's make sure that the process of enrolling and re-certifying doesn’t undercut the goals of the program.
I cannot say why DHS struggled so much with Alliance recertification this fall; that is a question best directed to the agency. If, however, it is a capacity issue, we recommend increasing FTEs - for staffing levels, translation of materials, or whatever other areas the agency identifies as challenges - to address these issues.