INDIANAPOLIS -- A pregnant woman's trouble trying to get a doctor's appointment is symptomatic of numerous issues with the state's troubled welfare program.

IBM Corp. handles about a third of the Indiana's 1.2 million-person welfare caseload. A 12-week review resulted in more than 200 recommended changes to improve training, reduce turnover and introduce more technology to speed application approval.

If IBM doesn't submit a corrective action plan and make improvements by the end of September, the state has threatened to cancel its 10-year contract.

Stacie Kelly, 27 weeks pregnant, desperately wants and needs to see a doctor, but she doesn't have health insurance. Her efforts had been thwarted by a very slow, tedious process of approving Medicaid coverage.

"It's just really hard to be excited about having a baby when you're worried all the time," she said. "There are all kinds of medical tests that I should have had run."

Kelly said she submitted a Medicaid application and documents to the Family and Social Services Administration two months ago, "and then basically they dropped off the face of the planet."

"I haven't heard anything since then, and so I called my caseworker and left numerous messages," Kelly said. "They don't return your calls."

Kelly went to an FSSA office for a face-to-face meeting.

"I asked her what the status of my case was, and she said it was sitting on the state's desk for approval," Kelly said.

FSSA spokesman Marcus Barlow said that an old system in use in Marion County has been problematic. It's a paper-based, file cabinet stored system, with one caseworker often handling 400 clients.

"Our focus is to get this system better for our clients and for our taxpayers that are funding this system," he said.

The issue is more immediate for Kelly.

"I just want to go to the doctor. That's all," she said.

Kelly is due to give birth on Oct. 1. She fears that she may not even have health insurance by the time her child is born.

"I don't know what I'm supposed to do, and I've asked them what I'm supposed to do and they tell me they don't know," she said.

Kelly finally got scheduled to see a doctor on Wednesday, through the Hoosier Healthwise "Presumptive Eligibility" program, which allows pregnant women to receive services while their Medicaid application is pending.

Kelly said she found out about that program elsewhere, not from her caseworker, but it will only cover her for a month.