Claire Stremple

It was raining softly at the Douglas Harbor when Candi Spicer popped out of the 30-foot sailboat she just started renting. She grew up on boats in California and is used to being on the water.

“I think it’s a little rustic,” she said. “I love it though. I think it’s very nostalgic.”

Silver insulation lines the walls inside, but she has plans to cover that up. There’s a bed, a bathroom with a shower and a small kitchen. The stove doubles as a heater. She says it’s nice falling asleep to the gentle rocking of the water in the harbor.

Spicer is the latest recipient of an Alaska-specific grant that helps people who are homeless maintain one year of housing — even if it’s alternative housing, like this boat. She’s one of about 1,800 people statewide who have gone from insecurity to stable homes through the program.

Quarters on the boat are tight, but Spicer says it’s a big step up from the last two years. She was homeless after some relationship trouble when she first got to Juneau.

“I found myself walking down the street with a backpack, not knowing where I was gonna go,” she said.

She was new enough in town that she didn’t have a safety net of friends and family, so she ended up in the shelter system.

“The Glory Hall, the warming center and stuff like that — those are supposed to be stepping stones. They’re not supposed to be life choices,” Spicer said. “So two years ago, I was walking down the street. And now it’s like, I have a job. I have a car. I have a place of my own.”

A tailored solution, with a shortfall

The flexibility of the grant is unique — usually federal housing money can’t be used to rent non-traditional housing like boats, hotel rooms or rooms in a home. The program side-steps these requirements. The Alaska Housing Finance Corporation, the state’s housing authority, designed it specifically for Alaskans, and for the realities of Alaska housing.

Luke Vroman manages the grant program with Juneau’s homeless shelter. He says the Glory Hall has placed 175 people in the program, and it’s saved the shelter from overcrowding.

“We’re full as is,” he said. “So, you know, there’s 175 other homeless people in town this year.”

But a year may not be enough time for all of them to find longer term solutions.

This grant has been effective at getting people out of vulnerable or unsafe living situations, but keeping them on track for permanent housing is much harder to accomplish.

The typical path to long term stability from homelessness involves a Section 8 voucher, which is federal rental assistance. But the wait time has ballooned over the last year or so, according to Vroman.

“Since the program started, the waitlist has gone from 12 months to like 19 to 24 or something. So nobody’s name has come to the top of the list,” he said.

Even if some of the 175 people in the program had gotten Section 8 vouchers, Vroman says there’s simply not enough affordable housing for them. He estimates Juneau needs 300 more affordable units to solve the problem.

A problem that keeps getting worse

“It’s a national problem,” said Bryan Butcher, the Housing Finance Corporation’s executive director. He said that 30 – 40 years ago, there was a severe lack of housing in rural areas, but the crunch wasn’t as bad in bigger cities.

“That has changed. It’s now statewide, it’s in our regional hubs. It’s in our cities,” he said. “And as the affordable housing crunch has gotten worse in the larger areas, that tells you it’s probably and certainly gotten even worse out in the rural areas.”

Butcher said the program has been a good use of the federal funds. He said they’re already seeing people move out of the program into their own apartments because the stability of housing allowed them to find work and daycare — pieces that are almost impossibly hard to put in place while navigating homelessness.

He says the housing authority didn’t anticipate how many communities would participate, nor the number of people that would sign up.

“The positive is we’re able to help a lot of people,” he said. “The negative is there are a lot of people in this more dire situation that needed the help in the first place.”

Candi Spicer is a likely success story for the program. While the grant pays her rent for a year, she’s saving to buy the boat outright.

Bartlett Regional Hospital has lost an average of about $1.4 million dollars a month for the last six months. For the first time in the hospital’s history, its leaders will have to make major changes to stop the losses.

There haven’t been any layoffs yet, but they haven’t been ruled out either.

“We haven’t fired any staff,” said Chief Financial Officer Sam Muse, who joined the hospital this fall. This is his first week as CFO. “The hope is that we can figure this out in a way that we’re shuffling people around and finding good solutions for every home base staff here.”

He said the nationwide labor shortage makes it especially important for the hospital to retain its staff.

The hospital has been losing about $1 million a month since the summer of 2020, but temporary pandemic relief funding from the federal government masked the problem. The hospital received $12 million dollars a year in 2020 and 2021 and $6 million in 2022.

Muse said inflation and higher labor costs due to the shortage of health workers are driving the losses. The hospital’s costs are going up, but the amount it is paid by Medicare or Medicaid is not keeping up with inflation.

“It’s an issue that all healthcare systems across the United States and certainly in Alaska are trying to grapple with right now,” Muse said.

There are also effects from losing lower levels of medical care in the community. Wildflower Court nursing home has been operating at limited capacity and even had to close a wing in 2021. Hospice and home care programs from Catholic Community Services closed down in September because there wasn’t enough staff. 

That means some patients who should leave the hospital can’t. The hospital is not reimbursed for those hospital stays, which can be lengthy.

“We’re providing that care because the community needs that care,” Muse said. “We’re trying to fill gaps, but we also aren’t being reimbursed for it.”

Bartlett has a phased plan to start saving money, and it has already implemented the first two of three phases. Its goal is to begin the next fiscal year, which begins in June, without a budget deficit.

Current actions include hiring restrictions and overtime reductions. The hospital is also cutting incentive pay, reducing traveling and contract employees and offering incentives for retirement.

By the end of March the hospital may have to implement the third phase of its savings plan, which includes cutting programs and reducing its workforce.

In its Friday meeting, the hospital’s finance committee said it would recommend the board adopt the hospital’s plan to reduce costs.

“This is not going to be affecting any type of clinical staff or reduction in staff,” said Board President Kenny Solomon-Gross at the meeting. “The last thing that Bartlett wants to do is have a reduction in staff or lay off people. We might have to  retrain people in different areas and move them into areas of need.”

Muse says Bartlett does have cash on hand. Typically, hospitals like to maintain enough cash to operate for six to nine months. Bartlett has enough cash to run for seven months, about $42 million dollars.

Division of Public Assistance director Shawnda O’Brien is no longer in her post.

A voicemail message on O’Brien’s state cell phone on Monday said she was no longer serving as the division’s director.

“You’ve reached the voicemail for the Division of Public Assistance,” the message said. “This position is vacant, and the phone number is forwarded to the deputy director.”

State officials did not respond to KTOO’s requests for comment. But in an email sent to Department of Health staff Monday evening, Commissioner Heidi Hedberg thanked O’Brien for her decades of service.

The news comes as the division has been under fire for its failure to issue food stamps and Medicaid benefits in a timely manner.

In December, KTOO reported that thousands of Alaskans had been waiting months for their benefits. After state Health Commissioner Heidi Hedberg blamed the backlog on a 2021 cyberattack and a recent surge of paperwork, sources in the division told KTOO there were longstanding problems in the department, including chronic understaffing.

The division is still working through the September food stamp renewals.

Juneau resident Deb Etheridge will replace O’Brien. She was previously the assistant director of Southeast Alaska Independent Living and has worked for the state’s Department of Health before. She is scheduled to start on Jan. 17.

Thousands of Alaskans have been waiting without food stamps for months due to a backlog in the Division of Public Assistance. 

In December, Health Commissioner Heidi Hedberg said the backlog was caused by a 2021 cyberattack and a huge influx of paperwork after the state ended its public health emergency. But sources inside and outside the division say the problem goes back much further. They blame the backlog on chronic understaffing and say deep workforce cuts in 2021 sent the division into chaos.

Many of the thousands of Alaskans who rely on assistance say they’re desperate for relief. State workers say they have been harassed and even threatened with violence, making them feel unsafe at work.

KTOO spoke with two employees within the Division of Public Assistance who say mismanagement and short staffing are behind the months-long backlog for food stamps. They say this is a systemic issue that’s gone unaddressed for years. Their accounts are corroborated by union officials, case managers, and social workers at Providence Medical Center.

KTOO is not using their names because they fear they could lose their jobs for speaking out.

“We’ve been in a backlog for years,” said one state eligibility worker, who agreed to be quoted. Eligibility workers process paperwork for benefits like food stamps and Medicaid for the Division of Public Assistance. “This is not just the COVID thing ending. We have asked for help, and they ignored us.” 

Alaskans are paying for budget cuts

The eligibility employee said workloads got too high after the Dunleavy administration cut more than 100 jobs from the Division of Public Assistance in 2021, leaving offices short-staffed. 

But the state had been warned before that was a bad idea. 

First, in 2018, when the state ombudsman’s office investigated the Division of Public Assistance for similar backlog problems and recommended they increase staff. When the state followed that advice, complaints dropped significantly.

Then, in 2021 budget meetings, the Food Bank of Alaska asked the state to reconsider the cuts because it foresaw this very problem.

Cara Durr with the food bank warned the legislature that pandemic waivers cut down on how much work it takes to get Alaskans their benefits, but that the work would return when those waivers ended.

“We saw a first-hand example of how this played out from September – December last year when we opted not to renew these key waivers, and the result was dramatic increases in application times,” she wrote. 

The state cut the jobs anyway. 

There weren’t layoffs, according to Hedberg, the health commissioner. Instead, the posts were allowed to empty by attrition.

According to union numbers, the division’s workforce has shrunk by more than 60 employees since the beginning of 2021.

“The director said it would be fine, but it doubled my workload. I’ve had to work a hundred hours of overtime a month,” the anonymous eligibility worker said. 

Most recipients didn’t notice right away because the pandemic waivers meant the state didn’t have to re-certify people who received food stamps. That flexibility masked the division’s staffing problems at first, but they came to light when Alaskans had to refile their paperwork after the state’s public health emergency lifted this summer.

“It was the straw that broke the camel’s back,” the eligibility worker said.

Wait times ballooned over the summer, and Alaskans who depend on food stamps began to go months without aid.

The situation has gotten so bad that eligibility workers say Alaskans who need aid have threatened them in grocery stores, found their personal cell phone numbers, and harassed them online. They say they’re fearful for their safety at work.

“They’re desperate,” the eligibility worker said. “They’re crying on the phone because their children are starving. This is the worst I’ve ever seen it.”

Medical insurance also in jeopardy

It’s not just food stamps that are affected by short-staffing. Medicaid recipients are having a hard time getting approved as well.

“Unfortunately, it’s the elderly and the marginalized in our communities that don’t have a voice or don’t have a great representation,” said Heidi Young, who owns Island Health, a care center in Southeast Alaska. She works to get Medicaid for clients across the state.

“I just think that it’s high time that the Feds need to step in and issue emergency orders for Alaskans,” she said, referring to the kind of waivers the state government allowed during the pandemic. “Waiting for months for your Medicaid case, or your food stamp case — it’s just not acceptable.”

Young said some of her clients now have to choose between paying for medication or buying food. She said some people can’t get Medicaid forms approved after a hospital stay, so they get stuck there — without Medicaid approval they cannot be discharged to lower levels of care, like nursing homes. 

“We don’t get a response for 60, 90 days,” Young said. “These are people that can’t come home from the hospital.”

Young said she doesn’t understand why the state doesn’t extend emergency benefits while it gets the backlog under control.

“The legislature has been aware of this, and the Commissioner of Health and Social Services has been made aware of this on multiple occasions, and they keep passing the buck,” Young said, clarifying that she meant both former Commissioner Adam Crum and Health Commissioner Heidi Hedberg. “I just think Alaskans need more support than that.”

State workers are struggling

Eligibility workers and their union described stress in the public assistance offices that’s led to dozens of resignations.

“It’s a revolving door,” one worker said. “We’re dropping like flies. They’re not investing in retaining employees.”

Alaska State Employees Association Local 52 is the union that represents 348 Division of Public Assistance workers. 

“It’s not the employees there that’s created the backlog,”said Interim Executive Director MaryAnn Ganacias. “They’re doing all they can.” 

Ganacias said her members complain that the department is understaffed and they aren’t adequately compensated. But lately her primary concern is for worker safety. 

“Having them being yelled at and harassed by the clients is kind of a normal thing, but it’s escalated,” she said. She said the union asked for guards and bullet-proof glass at public assistance offices as precautions. 

Suzan Hartlieb works for the union and is on a special committee for Division of Public Assistance members. 

“They’re overworked, they’re tired. They’re being denied personal leave. You know, there’s not enough people in the workforce, and they’re just overwhelmed,” she said.

Hartlieb said there was an incident at the Juneau public assistance office last week where a client yelled at eligibility workers and threatened to bring a gun. The state has banned that person from all state offices, according to Commissioner Heidi Hedberg.

Hartlieb also said that back in October, an assault on a worker at the University Center in Anchorage was serious enough to require emergency medical attention.

Commissioner Hedberg said some offices do have security and the state is considering additional safety measures, but Ganacias said the state has not yet fulfilled the union’s requests for safety improvements.

To ease the burden on current employees and get Alaskans their overdue benefits, the state said it’s onboarding about 30 new workers. Ganacias is skeptical that will bring Alaskans the relief they need. She wants to know how the state plans to retain those workers when so many have already quit because of problems she said the state hasn’t fixed.

“Are they going to stick around if they don’t feel safe?” she asked.

Are you waiting for medicaid, burial assistance or heating assistance from the state? KTOO wants to hear from you. Send a message to reporter Claire Stremple using this form: 

In this newscast:

• The state says it has a backlog of thousands that are waiting for food stamps and it’s not expected to improve any time soon;
• Lawyers gave closing arguments Wednesday in a case aimed at disqualifying Rep. David Eastman from office due to his membership in the Oath Keepers.

The temperature in Soldotna has been dipping below zero at night, but Jo Lunstedt says she has had to skip paying her electricity bill to feed her family.

“I applied for benefits back on Oct. 27 of 2022. And as of today’s date, I still have not heard anything from them,” she said. “I have to make my food stretch longer. So, we don’t have seconds.”

Lunstedt is one of thousands of Alaskans caught in a backlog for processing food stamp applications, known as Supplemental Nutrition Assistance Benefits, or SNAP.

Alaska Department of Health Commissioner Heidi Hedberg said the problem goes back months, and her staff doesn’t expect it to improve any time soon.

Meanwhile, Alaskans from Anchorage to Nome say they’re choosing between paying bills or buying food. Some are skipping meals so their children have enough to eat.

“We’re working with the tools we have”

Hedberg says the department is hiring more people to process applications, but it will likely be months before hungry households have relief.

“We hear their frustration, we want them to have their benefits. We’re working with the tools we have,” Hedberg said.

It was only after multiple requests for comment from KTOO — and the publication of an initial story — that the department broke its silence about the delay. Applicants were left in the dark, too.

Kabrina Field got so hungry for answers that she called the offices of Gov. Mike Dunleavy and her state senator, Mia Costello. She said after the call to her senator she got a call back from the Department of Public Assistance.

“They were telling me that it will take 90 to 120 days before they even process my recertification. And they said that was the best they could do. And we’ve got to truck through with no food,” she said.

She and her three children haven’t gotten their food stamps since October. She’s been relying on friends, family and food banks.

“I have to keep my bills going,” Field said. “There’s no ifs, ands or buts. But as far as Christmas goes, it’s going to be very small. Very, very, very small.”

Staff shortage and cyber-attack slow benefits

The state usually recertifies families who receive SNAP benefits every six months, but that wasn’t required for the last two years during the COVID-19 pandemic. Alaskans had to refile their paperwork when the public health emergency lifted in June.

Division of Public Assistance Director Shawnda O’Brien says that led to a huge volume of applications at once — 8,000 in August. She noticed her department was falling behind and requested more staff.

“Our staff had to be retrained because many of the staff hadn’t been doing this for the last couple of years,” O’Brien said.

Hedberg says lingering effects from the cyber-attack on the health department in May of 2021 compounded the problem because the department has to rely on more manual paperwork.

The department’s own reporting from November shows that it’s processing only about a third of SNAP recertifications in a timely manner.

“We don’t want to see anyone go without food,” O’Brien said. “We definitely feel the pressure and have been working. Everyone has been working to find solutions.”

The state is in the process of onboarding 33 new staff, and O’Brien has requested 40 more. She said 30 positions are currently vacant.

In the interim, she said the department is devoting more time to processing applications, including a full day each week on Wednesdays. She said staff members who don’t usually process eligibility have been put on the job.

But the division is still processing applications from September. Hedberg says there’s a dedicated team working on those applications, while another team focuses on applications from October. Another team is processing current applicants.

O’Brien estimated the state has 8,000 cases to review, including 1,700 from September and 2,000 from October.

“I’m probably not going to see significant changes until maybe, you know, a couple months from now,” she said.

She recommended that people in immediate need call 211, the number for the United Way, a nonprofit that connects Alaskans with services.

A flood of complaints

There’s another resource if Alaskans feel the state isn’t holding up its part of the social contract: the ombudsman’s office.

It reviews complaints about state agency programs, like SNAP. It’s nonpartisan, independent and objective.

Alaska State Ombudsman Kate Burkhart said her office is investigating the complaints about the Division of Public Assistance.

“This year, today, we have received over 180 complaints related to delays, lack of communication, lack of adequate information, related to public assistance benefits,” she said.

She added that there is a deja vu quality to the complaints — her office investigated the Division of Public Assistance in 2018 related to reports of delays and lack of adequate communication.

Their report found that increasing staff would go a long way to solve the problem. The state did, and complaints dropped significantly for a few years.

“In 2021, we only received 83 complaints,” she said. “We are not quite done with 2022 and it looks like we’re probably going to see three times that.”

More than 80% of the complaints have come in since the state began recertifying SNAP recipients in July. She said in the last two weeks her office has gotten about three complaints a day.

Burkhart said she can’t fix the slowdown, but her office is working with the state. And it might be able to help people who are desperate in the meantime.

“If you have a problem and you have no idea what to do, you can call us,” she said.

The health department also offered some advice to help recertification paperwork go through more smoothly: try to submit the application in the middle of the month, double-check to make sure the application is complete and do not file the same application more than once.

Alaskans will receive retroactive benefits once they are approved, meaning people who sent in paperwork for a September recertification will get all the payments that were due, even if they come several months late.