Five questions DHHS oversight may (or may not) answer

Lawmakers are eager to hear about problems with two massive benefits systems as well as recent news concerning highly paid staffers and whether the agency is carrying out a legislative mandate to carry out drug testing of welfare applicants.

Posted 8:53 p.m. Oct 7, 2013 — Updated 10:09 p.m. Oct 7, 2013

Mark Binker

RALEIGH, N.C. — It hardly sounds like the venue for a blockbuster meeting: The Joint Legislative Oversight Committee on Health and Human Services.

But Tuesday's all-day session has the makings of pop-the-popcorn, appointment viewing for the state capitol set as top executives of a troubled agency that has been in the news for a myriad of wrong reasons, including DHHS Secretary Aldona Wos, meet a group of skeptical lawmakers.

The morning session, scheduled to begin at 8 a.m., will focus on two major IT systems meant to help deliver benefits to those in need and reimburse health care providers for services rendered to low-income patients. Both have been the subject of vociferous complaints by those who use them.

The afternoon session, scheduled to begin at 1 p.m., will begin with an update on the department's budget and questions about the governor's agenda to remake Medicaid, the joint federal-state health insurance program for the poor and disabled.

Wos is then scheduled to field a potpourri or questions about high salaries given to former campaign aides to Gov. Pat McCrory and high-dollar, no-bid contracts given to politically connected individuals, ongoing changes to the state's mental health program, whether the department has been able to carry out legislative changes to the state budget and whether the department is carrying out drug screenings of those who apply for some benefits, something McCrory said he would not do.

It's almost a sure bet that some questions will go begging on Tuesday. But there are a few big questions the pair of hearings might at least begin to answer:

1) What exactly is wrong with NCTracks and NC FAST, and when will they be fixed?

NCTracks is the system responsible for paying doctors, hospitals and other health care providers when they take care of someone insured by Medicaid. NC FAST is the portal through which those seeking help buying food apply for benefits. Neither have opened to rave reviews.

"Every legislator across the state has been hearing concerns from their medical professionals," Rep. Justin Burr, R-Stanly, said in a recent interview regarding NCTracks.

Burr and other lawmakers report they have been on several recent conference calls with DHHS, during which officials pointed to a number of things they thought were going well and gave optimistic forecasts for the two systems.

Those assessments from the department, lawmakers say, have not comported with what they are hearing from constituents and medical providers.

Mike Gaffney, a representative of Computer Sciences Corp., is due to be on hand to answer questions regarding NCTracks. Buffie Rodri of Accenture and Rick Helfer of IBM, the companies that built NC FAST, are scheduled to appear as well.

Following both presentations, Wos is scheduled to answer questions about the systems.

2) What exactly does the McCrory administration plan to propose with regards to Medicaid?

For weeks, McCrory has been saying that big changes are coming to Medicaid, and all signs point to a continued push toward hiring private managed care companies to run the system. But lawmakers say they're unclear on what McCrory has in mind and point to budget provisions that keep the administration from moving forward with any plan without legislative approval.

The "Office of the Governor" is supposed to give a status update on Medicaid reform.

3) Will the governor and his secretary openly defy the legislature on drug screening for benefits?

McCrory vetoed a bill that would require those applying for cash welfare benefits to undergo drug testing before the state would process their application. The legislature overrode that veto, but immediately after the override vote, McCrory called the bill an "unfunded mandate" and said he would refuse to enforce it.

Tuesday is the first formal, public meeting between lawmakers and a high-ranking member of the McCrory administration. Will Wos stick by McCrory's message of defiance when she's called on to address the issue?

4) What is the state of the Medicaid budget?

Among the advantages NCTracks was supposed to provide to the state was better reporting of how quickly the DHHS was spending Medicaid money. But lawmakers have quietly grumbled that the quality of information they're seeing has gotten worse, not better.

This is particularly problematic with the $14 billion Medicaid budget, where even a 1 percent forecasting error can mean a $140 million swing in state spending.

Pam Kilpatrick, with the Office of State Management and Budget, is scheduled to provide lawmakers with an update. The less certain she can be about the state of Medicaid spending, the more likely the General Assembly will once again have to make up for cost overruns that sent budget writers scrambling for more than $500 million in last spring.

5) How much longer will Aldona Wos keep her job?

Several lawmakers, speaking on background, said they are generally inclined to give McCrory the benefit of the doubt when it comes to who he hires and fires. But mixed in with the problems revolving around NCTracks and uncertainty around Medicaid reform, six-figure contracts for politically connected figures and {{a href="blogpost-10-"}}hefty raises for young former campaign workers{{/a}} have added to a drumbeat of negative stories emanating from DHHS.

Adding to those were the loss of the state's Medicaid director, Carol Steckel, who is leaving to take a post at a managed care company. Steckel was supposed to be the architect of a new, more cost-efficient system. and there are unanswered questions about why Wos' first chief of staff was paid $37,000 in severance after only a month of work and why the administrator Wos originally hired to run early childhood programs was the author of reports opposing government-run pre-kindergarten programs.

Wos is a former ambassador and medical doctor, but she has never headed an organization as large and complex as DHHS. She was a major donor and fundraiser for McCrory and is working for $1 per year. McCrory has expressed his full faith in Wos, but if she cannot convince lawmakers all is well at the biggest state agency, General Assembly leaders could push for change.

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