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For 17 years, Amy Zdrazil has been getting the same prescription — a cream for a chronic skin condition. 

Zdrazil gets health care coverage through Medicaid in Ramsey County. At the end of 2024, the county sent her a notice that she was being switched to a new plan. That was fine by her — but three weeks into the new plan, her card still hadn’t come in the mail. Her prescription sat on a shelf in the pharmacy.

She called the county’s benefits line to ask when her card would arrive, and whether she needed to do anything to get it. But an automated message said there were too many calls in line, and the call dropped. She couldn’t find any information online, either.

Whenever she called back, she was put on hold for up to an hour. She always had to hang up before she could be connected to someone who could help.

“I have two part-time jobs, I am a single mom, and so to find daytime where I have an hour to just sit on the phone — it just doesn’t exist in my life,” Zdrazil said.

Eventually Zdrazil called her insurance carrier directly. They were able to provide her insurance information so she could get her prescription.

But Zdrazil said the county needs a better system.

“They’re asking a lot of people who already are under strain,” Zdrazil said. 

Ramsey County officials are tracking a backlog of financial assistance applications, paired with long waits on the phone. County Manager Ling Becker says the county is taking longer to process applications than its goal time — 60 days or less.

Part of the problem, she says, is the volume.

Applications for benefits like SNAP and Medicaid have shot up since the start of the COVID-19 pandemic. Before 2020, Ramsey County usually got about 500 or 600 new cash assistance and SNAP applications every week, according to the county’s

About 200,000 residents got some form of financial assistance last year, Becker said — more than a third of the county’s population. The county has also struggled with staffing.

And the county is now having to process more renewal paperwork than it did in the first years of the pandemic. A federal rule change suspended renewal requirements until 2023; now, recipients need to submit regular renewal paperwork. 

Counties around the state are seeing the pandemic-induced uptick in applicants, Becker said — especially in the Twin Cities metro.

“Everything that’s a pain point is sort of increased here in our county because of the volume, but we’re doing our best to try to continue to improve,” Becker said. 

The county has made progress on the backlog in cash assistance and SNAP applications in the past two years, according to the county’s data. Two years ago, the county reported more than 7,000 applications awaiting review; it fluctuated between a few hundred and 2,000 in the past year. 

A county spokesperson said initial action has been taken on every medical assistance application from the past 60 days as of early February.

Becker said the county has hired more staff. It’s also made improvements to the phone line to connect callers to the right information faster.

But some advocates and clients say it hasn’t fixed the problem.

Michele Gran is a board member for the Ramsey County affiliate of the National Alliance on Mental Illness (NAMI). She helps set up benefits for her adult son, who lives with mental illness. 

Like Zdrazil, she ran into problems in the past year, too. Before her son’s renewal deadline in the fall of 2023, she helped prepare and mail his paperwork. But after sending it in, he got a letter from the county saying they hadn’t received it and that his benefits would be canceled.

Gran dropped everything to chase an answer. She called her son’s caseworker and even her county commissioner. They were able to make a few calls and verify that his paperwork had been submitted on time — it just hadn’t been processed on time. 

That happened again the following spring. His benefits weren’t canceled either time. But Gran said the county needs a better system, instead of relying on clients to make a slew of phone calls.

“That helps my son,” Gran said of all the phone calls she made. “It doesn’t help the people that I’m advocating for in addition to my son — those people who don’t have moms who get activated by this kind of thing.”

Last spring, Gran mentioned the problem to other parents she knows through NAMI. Several of them said they’d gotten the same notices. They’ve formed a task force, meeting with Ramsey County officials and legislators to try to figure out a solution. 

Gran said everyone, from clients to case workers to officials, seems to be aware of the problem — but no one seems to know the solution. She’s not satisfied with that answer.

“You have to fix the problem,” Gran said. “If it’s lack of money, OK, let’s find a legislative solution for that. Let’s get the county commissioners alerted and on board immediately. Let’s escalate this. Because we can’t let people fall through the cracks like this.” 

Becker, the Ramsey County manager, said the county has limited options because public assistance comes from state programs. Counties have to use the state’s technology, which isn’t always compatible with their own systems; staff sometimes have to re-enter information by hand, slowing down the process. Any new staff also have to follow the state’s training schedule. 

“We really are part of a statewide system,” Becker said. “It would be difficult to try to parse out a different process for one part of an 87-county system.”

A spokesperson for the state’s Department of Human Services says they’re tracking the backlogs in medical assistance applications. The state gets a weekly update from each county on its application processing status. The state’s Department of Children, Youth and Families administers SNAP and cash assistance programs, and does quarterly reviews of counties.

“If an agency indicates they are struggling to keep up, DHS reaches out to see how we can help,” a DHS spokesperson said in a statement. “We have assisted counties in a variety of ways, including new application processing, renewal processing, additional training, and report work.” 

Gran said she wants county and state officials to devote more resources to the problem. She’s hoping that next time an application deadline rolls around, her son can get through the process without spending hours on the phone — again. 

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Since the start of the COVID-19 pandemic, applications for public assistance — like SNAP and Medicaid — have gone up in Minnesota. In Ramsey County, that’s led to a backlog, leaving clients with questions and without coverage while they try to find help. 

Ramsey County benefits recipients struggle amid application backlog

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Ramsey County benefits recipients struggle amid application backlog

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