Federal monitors and the state Department of Health and Social Services revealed a sad state of affairs this week: The state has neglected important responsibilities in the care of some of our most vulnerable citizens, elderly and disabled people. State programs meant to help them with care in their own homes are so poorly managed, according to the federal government, that the feds have ordered the state not to add any new people until it makes improvements. That could take four or five months.

Both of those situations -- the state's poor management and the federal plan to forbid new cases -- are hurtful to some of the state's neediest residents.

The programs are paid for by Medicaid. They allow people to get in-home help with daily activities ranging from taking medicine to cooking dinner. These home-care services, a joint federal-state responsibility, keep people out of nursing homes and save the state money.

The state estimates about 1,000 Alaskans will be stuck without in-home help by the moratorium on new cases. That means patients will be in 24-hour care facilities when they don't need to be. Others will have to rely on families and friends who struggle to care for them.

The state should quickly hire the staff it needs to fulfill its responsibilities, and quickly put safe procedures into practice.

The federal government has the state's attention and should not shut down the program completely for new people while the state works through all of its problems. That hurts the people who need service.

Two of the federal criticisms seem especially troubling:

• Uninvestigated deaths. Over 2 1/2 years, 227 adults getting services died while waiting for a nurse to reassess their needs and 27 died waiting for an initial assessment. "The state was not able to provide any information on the nature and causes of the reported deaths. They did not have any evidence that these deaths were investigated, nor did they have a critical incident reporting policy and procedure in place" at the beginning of the review, says the federal report.

In other words, the state doesn't know if its care, or lack or care, led to people's deaths. What an oversight.

• A huge backlog. The state has acknowledged a backlog of about 2,000 people waiting for a nurse to assess their needs. The backlog dates back to at least 2006, the federal report says. One apparent reason is that the state program calls for nurses to do the assessment. But with a national nursing shortage, about 40 percent of the nurse positions are vacant. The federal report says other professionals such as clinical social workers can do the assessments. The feds contend the state should have already made the switch.

Rebecca Hilgendorf, who has been director of Alaska Senior and Disability Services for just a few months, says the state is moving as fast as it can to create emergency regulations that will allow it to hire non-nurses and begin filling the dozen vacancies. That's a positive move.

The best that can be said about this situation is that state officials have publicly acknowledged serious problems.

Now both the state and federal governments need to step up and make sure the people who need to be served are hurt as little as possible.