PROGRAMS ADRIFT
Complaints to the Ombudsman Reveal Systemic Issues
In Kevin Brezinski’s latest public report, systemic issues were uncovered within the Alberta Adult Health Benefit program and Alberta Child Health Benefit program, operated jointly by Alberta Health and Seniors, Community and Social Services (SCSS).
The Albertans accessing the programs are those with lower income who may be pregnant or have high ongoing prescription drug needs. The Ombudsman’s office received a number of complaints related to the programs which led to this investigation. Notably, one complaint of unfair treatment came from a father who applied for family benefits on multiple occasions due to serious health issues. However, he did not receive a decision on any of his applications.
“It’s always particularly concerning when the complaints come from Albertans who are vulnerable or rely on social programs for assistance,” said Brezinski.
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 They also heard from the programs’ front-line staff who are committed to helping Albertans but struggle with outdated technology.
A jurisdictional scan of similar programs found the programs to be unique. As detailed in the full report, the programs are 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
The Ombudsman concluded his investigation with 28 recommendations and five observations. The improvements emphasize the urgent need for modernization and increased oversight within the programs to ensure equitable access to healthcare benefits for all eligible Albertans.
“I would like to acknowledge the frustrated Albertans who took the time to bring their concerns to my office. Without their assistance, the problems and issues identified within these programs may never have come to light.”
Kevin Brezinski, Alberta Ombudsman
Both ministries responded to the report, advising the Ombudsman his recommendations will be considered. Alberta Health has committed to making amendments to policy, training manuals and public websites. The Ombudsman’s office will continue to monitor the programs and the departments’ implementation of the recommendations.
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The Alberta Ombudsman’s report can be found here.
Backgrounder
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.
The Alberta Adult Health Benefit program and Alberta Child Health Benefit program are designed to support low-income families with essential health services such as dental care, eyeglasses, prescription drugs, and diabetic supplies.
More about the role of the Alberta Ombudsman:
https://www.ombudsman.ab.ca/about/about-the-alberta-ombudsmans-office/
Latest news and updates from the Ombudsman’s office:
https://www.ombudsman.ab.ca/news/
Information for Albertans about the Ombudsman’s complaint process:
https://www.ombudsman.ab.ca/complaints/before-filing-a-complaint/
Media inquiries
Amanda Clements-Harvey
Communications Manager, Alberta Ombudsman
780.427.2756
