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Tensions high between lawmakers, DHHS chief

Posted March 27

Secretary of Health and Human Services Aldona Wos tells lawmakers during a Feb. 11, 2014, oversight committee hearing that North Carolina met a federal deadline to clear a backlog of food stamps applications.

— Tensions between state lawmakers and Department of Health and Human Services Secretary Aldona Wos reached a new high Thursday at a rocky meeting of the commission that oversees government operations. 

Lawmakers publicly aired their frustrations with a string of problems at Wos' agency, from difficulty getting budget data to IT problems affecting Medicaid providers and patients alike, and said it could jeopardize their willingness to move forward with the governor's Medicaid reform initiative. 

Wos responded that her agency is being "micromanaged" by state lawmakers. 

During her opening comments, Wos referred to Wednesday's announcement of a projected $130 million Medicaid shortfall – smaller than in recent years – as a success.

"DHHS has been in crisis management mode since Day One. No challenge was bigger than Medicaid, but due to the aggressive realignment, Medicaid finances and operations are substantially stronger today than when we arrived," Wos said. "We are finally approaching a steady state." 

But she also noted that "vacancies in key leadership positions" and a 20 percent vacancy rate in the Medicaid program staff overall is making the job more difficult.

"We must secure our workforce with proper compensation with proper skill sets," she said. "I beg you, step up to public service and apply for these jobs. Otherwise, we’re going to the outside consultants." 

Rep. Justin Burr, R-Stanly, a key DHHS budget writer, asked Wos the status of the candidate search for a new Medicaid director. 

Wos said the search has been ongoing, "working through outside private industry" nationwide. "Unfortunately, no one has been willing to step up to the plate."

She said the main obstacles to filing the position are "the salary, No. 1, and fact that we are fairly restricted in North Carolina. Very directly, it’s because we are micromanaged, and so, for someone coming from out of state, they may not see that they have an opportunity to succeed."

Asked to clarify, Wos said federal and state requirements for reporting are onerous, and lawmakers' additional requests for information are an extra burden. 

"We beg – ask only what you need from us and not more. We have an incredible amount of reports that we have to present to you," Wos said.

"Set your goals, set your expectations and allow us to get there," she told the panel, "allowing people to do what they need to based on their portfolios once you establish what you would like."

But lawmakers said they're getting too little information from the agency as is, especially in terms of budget forecasting data.  

Sen. Bob Rucho, R-Mecklenburg, said the information presented Wednesday should have been made available months ago, and he noted that it's still not detailed enough for a forecast.

"When will we get the numbers that we need to have so that we can have a good budget number?" Rucho asked. 

Wos said more information is coming in every day, and she noted that all three forecasting authorities – her department's, the governor's budget office, and the legislature's fiscal division – are "in the same range," which she called unprecedented.

"We wish that we would be able to get it perfect. We have a mutual goal. We wish it was quicker. Unfortunately, the timing and where everything unfolded with the IT problems and the (Affordable Care Act) did happen in 2013. That was not under anyone’s control, sir," she responded. 

Other lawmakers pointed to ongoing problems with NCTracks and NC FAST, the troubled systems that handle Medicaid billing and social services delivery, respectively.

"I still get calls. It's still a problem," said Sen. Harry Brown, R-Onslow. "Ernst & Young had a report saying (the Division of Medical Assistance) just can’t provide Medicaid forecasting." 

"Then we see a lot of people leaving – a lot of key people leaving has really put your department in a real tough position," Brown continued. "Now, we see a Medicaid reform bill coming out. How can we as a General Assembly feel safe or comfortable that you can implement a reform package when you have all these problems?"

Wos replied angrily, "It was us who had requested Ernst & Young to prove to the General Assembly and everyone else that yes, we are short-staffed, yes, we don’t have the talent, and yes, we do need reform.

"Anyone in the community who still has issues with NCTracks, we ask you to please identify yourself and come to us, and we will help you resolve your issues," she added. "We are asking you to please file your claims and make yourself known, if you have any issues."  

Rep. Nelson Dollar, R-Wake, the senior budget chairman in the House, rose to Wos' defense. 

"Everyone in this state is receiving their services. That needs to be clear. People are receiving their services," Dollar said. 

Although forecasting problems with budget cuts need to be resolved, he said, "I think it’s a great progress that we’re dealing in the range that we’re currently dealing with." 

The Republican leadership at the legislature "has fixed probably 90 percent of the problems we inherited," Dollar said.

33 Comments

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  • dmoore616 Mar 31, 9:06 a.m.

    Issues of incompetence or direct collusion?
    The same issues now dog republican officials in the State of Georgia; quoting the feds, " Federal officials are threatening to cut off up to $76 million in administrative funding if Georgia doesn't make big changes to its food stamp system".
    http://www.wtoc.com/story/25115388/feds-may-pull-funding-over-ga-food-stamp-problems

  • BlueForever Mar 28, 3:00 p.m.

    What bothers me about Dr. Wos is that she has kept certain people in key jobs who ARE the problem. These people for whatever reason don't want DHHS to improve. Dr. Wos doesn't really know what is going on. People are leaving as a result.

  • kenmorris Mar 28, 10:09 a.m.

    The North Carolina Legislature is against any aid to the needy. They want to spend our money where they can buy political contributions. There concerns only reflect that ideal. North Carolina used to be seen as the smart Carolina.

  • tllight Mar 28, 9:27 a.m.

    god...Wos is hanging her hat on $130 million Medicaid shortfall being less than last year?? Thats sad indeed, yes DHHS is in crisis mode and Wos cant fix it....fire her and her cronies

  • mandrigrill Mar 28, 7:45 a.m.

    "Rep. Nelson Dollar, R-Wake "Everyone in this state is receiving their services. That needs to be clear. People are receiving their services," Dollar said. Obviously Dollar doesn't read -
    How A Government Computer Glitch Forced Thousands Of Families To Go Hungry
    Huffington Post
    March 27, 2014
    http://www.huffingtonpost.com/2014/03/27/food-stamp-delays-north-carolina_n_4994822.html

  • nadamasx Mar 27, 9:37 p.m.

    The GOP doesn't want to govern, and they're intentionally terrible at it. They hate government, and they're determined to prove that we can't rely on it. All they've ever cared about is tax breaks for the rich. So, they have zero motivation to govern well and serve the interests of the majority. This interminable DHHS fiasco is utterly inexcusable. Don't forget this when you vote.

  • polecat1 Mar 27, 9:25 p.m.

    This woman is clearly over her head. She may not be stupid, but she is incompetent. The perceived arrogance may be a mask for her own fear of failure. Or, on the other hand...
    The longer she stays the worse the problems will get. ( I wonder if Mr. McCrory has ever read "The Peter Principle". If not, he should.)

  • unaffiliatedvoter2 Mar 27, 7:58 p.m.

    medicaid does not need a 'director' let the top 3 or 4 run it as a committee...problem solved. medicaid needs to be phased out over time now...

  • SaysWhoNC Mar 27, 5:38 p.m.

    And McCrory is on record as saying he thinks Wos is brilliant!

    — Posted by uBnice

    Well, it's all relative.

  • sisu Mar 27, 5:34 p.m.

    Is this article from the Greensboro News and Record that states that Wos declined a nice salary and is working for $1 not correct?

    http://www.newsobserver.com/2013/01/10/2598132/gov-pat-mccrory-gives-his-cabinet.html

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