NC FAST backlogs cost NC $21M and counting

Posted April 17, 2014

— Leaders of the Department of Health and Human Services said Thursday that problems with the state's new benefit system, NC FAST, have cost about $21 million to address – and that figure may be just the beginning.

At a DHHS legislative oversight hearing, state Division of Social Services director Wayne Black said counties across the state have spent about $14 million on additional staff, overtime pay and upgrades to equipment and bandwidth needed to deal with the state's recent backlog in its food stamp program.

DHHS Secretary Aldona Wos added that the state has spent an additional $7 million providing support and staff to struggling counties.

During the hearing, agency leaders said the chief challenge facing the NC FAST program is workload.

According to DHHS Chief Information Officer Joe Cooper, over the past five fiscal years, the food stamp caseload has ballooned by 75 percent, and the Medicaid caseload has grown 24 percent. Staffing in county DSS offices, however, increased by only 27 percent for food stamp services and by an anemic 4 percent for Medicaid.

Cooper said the problems with NC FAST are only "10 percent technology." The main issue, he said, is counties' difficulties at managing the changes in business process.

But NC FAST acting director Angela Taylor later told reporters the Affordable Care Act is to blame for the backlog and the added expense needed to clear it. She said the federal health care law required the state to add a Medicaid module to NC FAST on July 15, 2013, well before the state had planned to add it to the new benefits system.

"If you talk to a lot of the counties, they will tell you: before July 15th, they were doing very well. Things were running smoothly," Taylor said. "But when we had to put the new module in on top of that, it changed some of their screens and how that system was functioning."  

While the food stamp backlog has mostly been cleared, an even larger backlog is looming. Acting Medicaid Director Sandy Terrell warned lawmakers that nearly 86,000 Medicaid applications are delayed beyond federal processing timelines.

Of the 85,854 delayed Medicaid applications, Terrell said, 26,057 had come in via HealthCare.gov, the online enrollment marketplace for the Affordable Care Act.

Another 30,957 are delayed, she said, because of new federal rules for Medicaid eligibility, known as Modified Adjusted Gross Income.

An additional 18,978 applications are delayed in NC FAST, Terrell said, and 8,098 are delayed in the state's older Medicaid system, EIS, which is still being used in most counties to process most Medicaid applications and re-certifications. 

Overall, Terrell said, the state has received 95,000 Medicaid applications, representing 132,000 people, via the Affordable Care Act since October, and that number is likely to grow. 

"We do not know from the Centers for (Medicare and) Medicaid Services and will not know for some time how many applications they got in the rush at the end of the enrollment period," she warned. "Expect a significant number."

The surge of new Medicaid applicants, known as "woodworking," was expected as people signing up for insurance discovered that they're eligible for the federal program. But Rep. Jim Fulghum, R-Wake, expressed concern that the numbers may be higher than budgeted for.  

"This just does not seem like its very affordable," said Sen. Tommy Tucker, R-Union. "I think we’re going to find out the federal government cannot take over one-sixth of our economy and do it very well, and I regret the burden that it’s placing on a department such as yours."


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  • free2bme Apr 21, 2014

    The ACA has been around since 2010 but these folks did not have the common sense to prepare for it. NC needs new leadership yesterday. The NC GA and governor continues to point fingers and blame others instead of taking responsibility for their part in anything. They are costing us millions in tax dollars and just wasting needed money for schools, roads, etc. It is evident that there is incompetence that is being covered. It seems their has been poor planning and preparation when it comes to DHHS.

  • tllight Apr 21, 2014

    10% technology and the rest is change in business process...YES - as an IT Consultant, I hear this all the time. To prepare workers for business process change...you need training and more training...AND acceptance of the bus process change by Senior leaders...if this was short changed, then I understand why DHHS is having problems...you can be Penny wise and pound foolish.

  • George George Apr 21, 2014
    user avatar

    Honesty first "NC did not accept addition federal funding for medicaid so our numbers are low."

    You have no idea what you are talking about.

  • George George Apr 21, 2014
    user avatar

    rduwxboy "We'll hire another consulting firm on a high dollar no bid contract to determine how to deal with..."

    I am a consultant in the Healthcare industry. I can say this, CEO's, CFO's, CMO's hire consultants that agree with their thinking NOT consultants that do not. They use consultants as a mechanism to reinforce their message from a different/ outside angle thereby facilitating specific change. This is not just state govt, its hospitals and insurance companies.

  • Rebelyell55 Apr 21, 2014

    Any season Excutive, ,manager or quality professional will tell you that 80% of all agency problems are due to Management. They can point blame every where, but the bottom line it belongs to the over payed Managers running these county offices. Until they wake up to that fact and action taken, the problem will never go away.

  • Stephania Sidberry Apr 21, 2014
    user avatar

    View quoted thread

    I think what she's trying to say is that they had ample warning that this module was required by July 15, 2013.

  • Wheelman Apr 20, 2014

    View quoted thread

    "She said the federal health care law required the state to add a Medicaid module to NC FAST on July 15, 2013, well before the state had planned to add it to the new benefits system."

    This is the rest of her statement. She didn't lie. You just took part of her statement and twisted it.

  • Jackson Smith Apr 19, 2014
    user avatar

    NC did not accept addition federal funding for medicaid so our numbers are low. The folks at DHHS will say anything to blame others. Their is not way it is Aldona Wos's fault. (sarcasm) because it is McCrory that hired her.

  • rushbot Apr 18, 2014

    ANGELA TAYLOR LIES!!! the affordable care act was signed into law on 23mar2010...you can look that up!!!WOSGATE CONTINUES!!!

  • ALECarolina Apr 18, 2014

    Who knew that "fixing" NC's "broken" government would be so expensive?

    Didn't these ALEC puppets claim we were broke? Between the tax cuts for the rich, contracts-to-nowhere for their cronies, private lawyer fees to defend their indefensible laws, and failure to process food stamp applications, these "fiscal conservatives" are costing the taxpayers in NC a fortune.

    2014 and 2016 can't get here fast enough.........the fact that McCrory's handlers had to run campaign ads in his FIRST year in office was red flag #1.