(Alberta Ombudsman)

By rdnewsNOW Staff

MULTIPLE COMPLAINTS RECEIVED

Alberta Ombudsman investigation finds multiple issues with health benefit programs

Jul 17, 2024 | 4:05 PM

An investigation by the Alberta Ombudsman has found there are multiple systemic issues within the Alberta Adult Health Benefit program and the Alberta Child Health Benefit program.

Officials say the individuals accessing these programs are typically low income, have high and consistent prescription drug needs, or are pregnant. They cover needs like vision and dental care, diabetic supplies, ambulance services, and prescriptions.

According to officials, a jurisdictional scan of similar programs found the programs to be unique, and two of the most generous of their kind in Canada. However, the investigation identified several systemic problems:

• An unfair application process
• Inadequate communication with clients
• Ineffective IT infrastructure
• Lack of accountability and no complaint handling policy

Officials say the investigation concluded with 28 recommendations and five observations. The improvements are said to emphasize the urgent need for modernization and increased oversight within the programs to ensure equitable access to healthcare benefits for all eligible Albertans.

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The investigation was prompted by a series of complaints the organization received about the programs, including one from a father who applied for the benefits on multiple occasions due to serious health issues and never received word about a decision.

“It’s always particularly concerning when the complaints come from Albertans who are vulnerable or rely on social programs for assistance,” said Kevin Brezinski, the Alberta Ombudsman.

Investigators from the Ombudsman’s office interviewed Albertans facing financial hardship exacerbated by healthcare expenses. They also heard from the programs’ front-line staff who are committed to helping Albertans but struggle with outdated technology.

“I would like to acknowledge the frustrated Albertans who took the time to bring their concerns to my office,” said Brezinski. “Without their assistance, the problems and issues identified within these programs may never have come to light.”

Officials say both ministries responded to the report, advising the Ombudsman his recommendations will be considered. Alberta Health says it has committed to making amendments to policy, training manuals and public websites. The Ombudsman’s office says it will continue to monitor the programs and the departments’ implementation of the recommendations.

The full Alberta Ombudsman’s report can be found here.

Marie Renaud, Alberta NDP Critic for Community and Social Services, issued the following statement in response:

“Everyone who depends on these programs and those who advocate for low income Albertans know that the system is not working. The Ombudsman’s report re-confirms this.

“This is actually the third set of significant recommendations from the Ombudsman in a year-and-a-half regarding dysfunctional programs for low-income Albertans, including essential health services like dental care, diabetic supplies, eyeglasses and prescription drugs.

“At the same time the UCP is botching provincial programs, Danielle Smith is planning to deny Albertans access to a much-needed national dental plan. This plan is an opportunity for Albertans most at risk to get the care they need.

“The UCP government must immediately implement the Ombudsman’s 28 recommendations from this report and the previous two, and immediately scrap any plans to opt out of a national dental program.”

As an independent Office of the Legislature, the Alberta Ombudsman’s office responds to complaints of unfair treatment by provincial government authorities, municipalities, the Patient Concerns Resolution Process of Alberta Health Services, health professions and other designated professional organizations.

Section 12(2) of the Ombudsman Act provides the Ombudsman with the authority to initiate an investigation on his own motion should questions arise about the administrative fairness of a program.

The Ombudsman is also Alberta’s Public Interest Commissioner, acting under the Public Interest Disclosure (Whistleblower Protection) Act to facilitate a safe avenue for public service employees who believe wrongdoing is occurring in their organization.

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