Princess Health and Bevin administration is working to fix Benefind's technical glitches; 51,000 Kynect clients blocked from working with Kynectors. Princessiccia

Princess Health and Bevin administration is working to fix Benefind's technical glitches; 51,000 Kynect clients blocked from working with Kynectors. Princessiccia

Cabinet for Health and Family Services food stamps health insurance KCHIP Kynect Medicaid

Gusty 07:47 Add Comment

Update: 4/8/16 This story has been updated with comments from the Cabinet for Health and Family Services. 

By Melissa Patrick
Kentucky Health News

On Feb. 29, Gov. Matt Bevin's administration launched a new one-stop-shopping website for state benefits that was designed to make life easier for the one-fourth of Kentuckians eligible to use it. Instead, it caused an unprecedented disruptions of services after thousands received erroneous letters notifying them they would no longer receive their benefits.

Deborah Yetter of The Courier-Journal has reported extensively on the problem, with stories of Kentuckians who have lost their benefits and found it nearly impossible to get help because of hours-long waits in the state benefits offices and a phone system that tells them to call back later.

The website, called Benefind, can be used to apply for Medicaid, the Kentucky Children's Health Insurance Program (KCHIP), the Supplemental Nutrition Assistance Program (SNAP, once known as food stamps) and Kentucky Transitional Assistance Program (KTAP).

The problem goes beyond those programs. The 500 paid Kynectors, who help Kentuckians use the Kynect health-insurance exchange, have not been able to help because federal regulations require participants who use multiple services to first go though the Department of Community Based Services, the state agency that manages Benefind. As of now, Kynectors can only help Kentuckians who have never received other state benefits.

Health advocates have called the launch of Benefind a "disaster." At a March 31 news conference, Bevin, along with health officials from the Cabinet for Health and Family Services and a Deloitte Consulting official, acknowledged the widespread problems and said they were working tirelessly to correct them.

�Our primary focus is to ensure that we deliver, as seamlessly as possible, as safely as possible, as expediently as possible all the benefits that folks expect and need from the Commonwealth of Kentucky," Bevin said.

State officials at the news conference said they had worked with federal officials to extend benefits through April, so that no one should be cut off from Medicaid or SNAP if they qualified for those benefits in March. The state has also stopped automatic letters generated by Benefind.

In addition, they have updated websites and changed the phone message to better explain what is going on; extended the re-certification time frame for SNAP benefits from six months to 12 months, allowing those cases to continue with a simple review instead of a client interview; hired an additional 185 people to help with the deluge of telephone calls and visits to the local state benefit offices; and Deloitte has assigned trainers to every county to help the DCBS staff.

Officials have encouraged the public to log on to the Benefind self-service portal at https://benefind.ky.gov/ to ease the burden on processing centers.

So, what happened?

Deloitte built Benefind under the administration of Gov. Steve Beshear at a cost of $101.5 million to replace an outdated eligibility system. Deborah Sills of Deloitte said at the news conference that they believed the system was ready to launch at the end of February, but "there were some issues that didn't present themselves until after the system went live."

However, Ryland Barton of Louisville's WFPL reported that on Feb. 25, a 27-page "Worker Portal Defect Workaround Guide" was distributed to DCBS staff showing that the administration knew there would be problems with the rollout.

But the cabinet says a guide like this is standard procedure.

"Deloitte says a guide like that is standard operating procedure when you�re dealing with a huge system rollout like this," Doug Hogan, spokesman for the cabinet said in an e-mail. "It�s a new system and (this was) a guide to help staff navigate the system better and help them work though issues they might encounter. Additionally, there were these same types of documents for the original rollout of Kynect."

Bevin's administration explained that the problem has been caused by an automatic review of cases where information from Kynect and the old eligibility system didn't match.

�Cases where information between the Kynect case and legacy case did not match (for example, household composition or income) are required to be managed by a state agent before they can be acted upon by agents or Kynectors,� Jessica Ditto, Bevin�s communications director, told WFPL in an e-mail. �This constraint has been placed to protect program and data integrity � plus, this is required by federal law.�

Ditto told Barton about 51,000 cases are under review, and noted that once the conflicting data has been reconciled, "the cases will become open for Kynectors and agents again, just as before.�

Sills told reporters that Benefind had not been altered in any way from its original 2014 design and affirmed Bevin's stance that the move to Benefind had nothing to do with his administrations decision to close Kynect and move to the federal exchange.

"None of these issues are caused by any changes the current administration has made to the system's purpose or design," Sills said.

However, Beshear said in a news release that Kynect and Benefind were meant to work together, not for Benefind to take over signing people up for Medicaid.

"The Benefind program was developed to complement Kynect, the state-run exchange," Beshear said in the release. "Although he attempts to blame the 'prior administration,' Governor Bevin�s administration mismanaged the launch of this new system, and in doing so, created a disastrous situation for thousands of families in Kentucky."

Bevin and Deloitte say the system was always designed to support Medicaid enrollees. "Benefind is Kynect, Kynect is Benefind," Bevin said at the news conference.

Not really, says Kentucky Voices for Health, a coalition of groups supporting Kynect,  "For people needing Medicaid coverage and other social benefits right now, there is no right door for access, let alone 'one door'," the group said in a press release Wednesday. "Kynect was built to provide access to health insurance and Medicaid enrollment; and Benefind was built to enhance Kynect with additional social services benefits. While they�re part of the same system, they provide different essential functions."

However, Hogan noted  in the e-mail that page 15 of a training document for Kynectors originally posted November 2015 "clearly shows that Benefind was intended to process all Medicaid plans, even Qualified Health Plans...it was truly designed to process all benefits."

Beshear and his advocacy group, Save Kentucky Healthcare, have also released a one-minute video entitled "If It Ain't Broke Don't Fix It" criticizing the Bevin administration's rollout of the system.

Princess Health andStudy finds nutritious food costs more in poor, rural areas, suggests that SNAP (food stamp) policies be changed.Princessiccia

Princess Health andStudy finds nutritious food costs more in poor, rural areas, suggests that SNAP (food stamp) policies be changed.Princessiccia

food deserts food stamps nutrition research rural-urban disparities

Gusty 21:12 Add Comment

A study has found that nutritious foods are more expensive in impoverished rural counties than in urban counties, a phenomenon that doesn't help public health officials who teach healthy eating as a proven, effective strategy to prevent chronic diseases to rural Kentuckians.

"The results of this study find that individuals living in rural areas, particularly food desserts, may be at increased risk of negative health effects as a result of more limited access to higher quality foods compared to those living in urban areas," says the report of the University of Kentucky study, "Food Cost Disparities in Rural Communities," published in Health Promotion Practice.

Researchers analyzed the per-serving cost of 92 foods four times over a 10-month period in the primary grocery stores in four Kentucky counties, two rural and two urban. One rural county was considered a food desert, meaning that fresh produce isn't relatively available. The commonly purchased foods in the study were assigned to one of four categories based on their nutritional value.

Not surprisingly, the cheapest foods were those with the least nutritional value, such as canned fruit in heavy syrup, cereals with high-fructose corn syrup, and processed meats.

Foods that are a bit more nutritional, but mainly processed convenience foods, were more expensive in rural counties than urban counties.

Foods that were considered nutritious, but not the most nutritious, such as white rice, oats, whole-grain bran cereals and frozen fish, cost the most in the rural county with the highest poverty rate.

The cost of the most nutritional items varied by county, with the "most striking finding" being that "the rural food desert had significantly higher per-serving costs among the most nutritious food items, compared to the other three counties," 6 to 8 cents higher per item, the report said.

Within each county, the study did not find much difference in food cost among the foods in each of the four nutrition categories.

However, it did find that highly processed convenience foods in urban counties were more expensive than more nutritional foods, and suggested that those living in urban areas could afford more plant-based foods and fewer processed foods as an "effective strategy to improve overall dietary quality without increasing food budgets."

The study draws attention to the SNAP or food-stamp program, which makes no allowances for food cost differences between regions or counties, and suggests that its model be changed to be more like the Women, Infants and Children program, which uses a portion-based system: Participants buy a set number of ounces or servings of dairy products, whole grains, and fresh produce each month, irrespective of price. This approach "has the potential to adequately meet all participants' nutritional needs, irrespective of differences in food prices," wrote the researchers, Frances Hardin-Fanning and Mary Kay Rayens of the UK College of Nursing.

Princess Health and Princess Health andStudy: Banning sugary drinks from SNAP would reduce obesity and Type 2 diabetes; subsidy would boost fruit consumption.Princessiccia

Princess Health and Princess Health andStudy: Banning sugary drinks from SNAP would reduce obesity and Type 2 diabetes; subsidy would boost fruit consumption.Princessiccia

diabetes food stamps fruit nutrition obesity research sugar vegetables

Gusty 08:43 Add Comment

A measure preventing people from purchasing sugar-sweetened beverages through the Supplemental Nutrition Assistance Program, or food stamps, would significantly reduce obesity and Type 2 diabetes in adults under 65, and adding a subsidy for fruits and vegetables would more than double the number of SNAP participants who meet federal vegetable and fruit consumption guidelines, says a new study published in Health Affairs.

Research has shown that people on food stamps suffer diabetes, heart disease and obesity at higher rates than people who are in the same tax bracket but not on food stamps, Diane Jeanty reports for PBS Newshour. In 2013, these findings prompted 18 mayors from major U.S. cities to write to Congress with a push to ban the use of food stamps to purchase sugar sweetened beverages.

The American Beverage Association pushed back, saying "sugared beverages were being targeted and were not the only causes for obesity," Jeanty writes.

A research team led by Dr. Sanjay Basu, an assistant professor of medicine at the Stanford University School of Medicine, conducted the study to determine how banning sugared beverages could affect the SNAP population�s level of risk for these diseases, Jeanty reports. They used a survey by the federal Centers for Disease Control, which assesses the nutritional status of adults and children, and combined it with current information on SNAP.

The study had two models, one that banned sugary beverages�excluding 100 percent fruit juice�and another that offered an incentive for SNAP participants to receive a 30 cent credit for each dollar spent on fruit and vegetable purchases. The study factored in metabolism rates and demographics such as race, age, gender and income to test the effects of the proposed measures, Jeanty reports.

They found that with a simulated ban, a person would reduce his or her calorie intake by 24 per day. They also found that obesity rates decreased 2.4 percent and type 2 Diabetes rates dropped 1.7 percent�or 240,000 people�Jeanty reports. The simulated subsidy, did not, however, have a significant impact on overall diabetes and obesity.

The study also found that by adding a simulated subsidy on fruits and vegetables, SNAP participants increased their consumption from 1/4 cup to 3 cups per day. However, increasing the amount of fruits and vegetables consumed is not enough to influence the reduction of diabetes and obesity on a national scale, according to Basu. �There would also have to be further reforms to also reduce the consumption of sugary beverages,� Basu told Jeanty.

The Illinois Public Health Institute, addressing a proposed ban in Illinois, found that SNAP participants would still purchase sugared beverages with their own money, even if they were banned, Jeanty reports. But Basu says that his study accounted for this consideration. Basu said it is time to perform a controlled study instead of a simulation model, Jeanty writes.

Princess Health and Website eases application process for SNAP, formerly food stamps, and promotes healthy food .Princessiccia

Princess Health and Website eases application process for SNAP, formerly food stamps, and promotes healthy food .Princessiccia

Cabinet for Health and Family Services food food security food stamps healthy food public assistance

Gusty 12:15 Add Comment

With a federal grant, the state Department for Community Based Services has launched a customer service website to promote healthy foods by assisting the families receiving food benefits through the Supplemental Nutrition Assistance Program, formerly called food stamps.

The portal allows people to check their eligibility for SNAP and apply for benefits with a shorter application that will be followed by a DCBS interview. They can also check their benefit status, report changes and receive electronic notices.

The agency says an online application eliminates any transportation issues a family may have with visiting a DCBS office, and encourages applications. �Modern improvements like this make it easier for families to apply for benefits and ultimately increase access to healthy food,� said Audrey Haynes, secretary of the Cabinet for Health and Family Services, which houses DCBS.

�SNAP helps people of all ages afford healthy food,� said DCBS Commissioner Teresa James. �For some of our DCBS customers, it means the difference between having a family meal or nothing at all. This website makes applying for benefits, making updates or accessing information even easier since customers don�t have to make an office appointment or even pick up the phone to get help.�

Since the portal�s launch on March 11, DCBS has received more than 1,000 electronic applications. Click here to learn more about SNAP.