Local Politics

Wake boosts staff to deal with Medicaid, food stamp backlog

Posted February 17, 2014

— One week after meeting a federal deadline to reduce a massive number of late food stamp cases, Wake county social services staff are preparing to deal with another backlog – this time with Medicaid.

Wake Assistant Human Services Director Liz Scott said Monday that the county is three to four months behind in processing applications for Medicaid, which covers health insurance for low-income children, parents, seniors and the disabled. County officials say a $1.7 million expansion in social services staff approved by the Board of Commissioners on Monday will help them catch up and keep current, but not until October.

"We have a very challenging Medicaid implementation ahead of us," Scott told commissioners Monday. "We are not currently meeting our deadlines for processing Medicaid applications."

Commissioners unanimously approved the proposal to add 36 full-time positions in the division to help keep up with growing demand for social services like nutrition and Medicaid benefits. About half of the funding will come from the federal government through Medicaid administration funds.

"To me, the biggest issue is that, as the county grows, we've seen a doubling of the clientele," Wake County Commissioner Joe Bryan said. "That's one of the major reasons we need to expand."

Scott said her staff has been overwhelmed by both the increase in social services cases and challenges with the rollout of the state's NC FAST system, implemented gradually in 2013 to help streamline the delivery of food stamps and eventually other social services, including Medicaid.

"We may hopefully see some efficiencies in the system. We are not seeing them as quickly as we initially thought," Scott said. "We would have had a different approach a year ago had we known then what we know now."

For several weeks in January and February, county case managers worked overtime and weekends alongside state support staff to clear the majority of the food stamp backlog by a Feb. 10 federal deadline.

Although workers met that deadline, set in place after months of warnings from the U.S. Department of Agriculture, Scott told commissioners the division needs until March 15 to completely clear the system of untimely food stamp cases.

But the implementation of Medicaid, she said, will prove even more challenging.

"We have learned that our Medicaid implementation is going to be different than it was for food and nutrition services," Scott said. "We are going to have to enter all of these cases individually as opposed to having an automated conversion."

Medicaid applications from the federal marketplace put in place by the Affordable Care Act, which have not yet arrived, will complicate things further.

But Scott said the root cause of problems with Medicaid predate both NC FAST and issues with the ACA. The biggest impact has come from the overwhelming growth of cases, which for family and children's Medicaid grew by almost 45 percent over the last five years, to about 53,000 annually.

"We have not really met the targets for Medicaid processing in a year," Scott said. "So, we've been pretty consistently behind."

With the boost to staffing, Scott told commissioners the agency would be able to catch up on the backlog in Medicaid cases by an internal goal of Oct. 1.

The expansion of Wake's Division of Social Services comes in addition to the $1.8 million commissioners originally approved through 2014 for the NC FAST transition. That funding covered temporary workers and overtime.

The new money will allow the county to pay $820,000 in overtime and temporary worker wages. About 65 percent of that one-time amount will be reimbursed by the federal government.

Another $870,000 will fund the 36 additional case managers, supervisors and administrative staff the division says it needs to keep up with demand. The new positions expand the size of the current staff by about 17 percent, to 248 employees. The county will cover about 57 percent of that cost, with the federal government covering the remainder.

Scott noted the maintaining the increased staff will bring additional costs for the 2015 fiscal year of about $1.96 million, although she said the new workforce will be evaluated annually to determine whether they're still needed.

"We're really looking at every process we have and sort of tearing it apart and starting over as to what the best way is to address this so we do not get a backlog again," Scott said.


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  • Susan Olvera Feb 18, 2014
    user avatar

    C-C_MAMA -

    But I do agree with you that some people will take a hand out and not work. Many will. Like someone my husband met who gets over $1000 in EBT money, a portion of it illegally via his uncle who's in jail for selling drugs who still has an EBT card. Then he turns around and sells it for cash. I actually used to work as a contractor with the DHA and was told they used to be able to remove people from public housing if they habitually would not work, etc, but federal laws changed that and now they HAVE to keep the apartments full or they lose funding.

  • Susan Olvera Feb 18, 2014
    user avatar

    I don't think "everyone" coming to the government is looking for a hand out. My husband and I both work very hard to support our family. We've scrimped and do without so many things most people consider mandatory like cell phones, cable television, we buy our cars second hand, have a vegetable garden so we can provide our son with healthy food. We were doing fine before health care reform, but have now been forced to put him on Medicaid because of Health Care Reform's laws raising our previously affordable premiums and deductible. We took pride in being able to provide for our family on a smaller budget and now this federal change has taken that from us. I feel like President Obama is in our living room making choices for our family. I believe the new extreme influx people are seeing in the Medicaid department may be reflective of what our family is experiencing. People who could afford their health insurance prior to reform now cannot.

  • C-C_Mama Feb 18, 2014

    FREEDOMRINGS, you are exactly right. Everybody that you can imagine is coming in Social Services, asking to apply for everything. I have heard it because I work at one of the agency's. Nobody wants to work, why, the government is going to take care of them. It makes me sick to see what I see on a daily basis, me working my butt off for the unappreciative, thinking the world owes them, clients. If only the tax payers knew what really goes on in DSS, they would be furious!

  • Susan Olvera Feb 18, 2014
    user avatar

    I have to make a comment on this because it's affected our family personally, For the record, I'm an independent voter, I have voted both republican and democrat. I voted for Perdue and McCrory, so I'm flexible. Healthcare Reform has forced us to put our son on Medicaid. I believe this is reason for the backlog. Prior to healthcare reform we could afford our premiums for our entire family, but now our insurance deductible ( through my husband's employer so he does not qualify for a subsidy ) is now 27.5% of our pre-tax annual income. We used to be on a major medical plan, so I priced that and it's more than doubled in 7 months. And my son does not qualify for a subsidy because our income qualifies him for Medicaid. Prior to all this we were proud to tell people you can get by with less ( our income puts us at 185% of poverty level guidelines) and don't need to take from the government. And now healthcare reform has made us my family an unwilling accomplice and I am livid.

  • Pirate01 Feb 18, 2014

    It is not shocking to anyone anymore how many more people are living out of YOUR pocket. So many people are now getting handouts that NO office can keep up with the demand. Not only are these freebies taking money out of public works and the school system now it is $2 million more out of these much needed projects just to handle the paperwork.

  • A person Feb 18, 2014

    The reason for the computer upgrades that Bev needed them to have so much was to lessen the need for more workers. I guess we should never trust anything out of a Democrats mouth ever again. Nothing they have ever said has ever come true

  • sunshine1040 Feb 17, 2014

    And guess who is going to pay for the additional staffing. It is not Barry or those that are trying to feed a family of 5 on a part time or minimum wage job

  • Carol Smith Feb 17, 2014
    user avatar

    This was not a problem until Wos took over.

  • cjw6105 Feb 17, 2014

    And just how much safer will this make the Wake Public Schools?

  • Bob Smith Feb 17, 2014
    user avatar

    Welcome to Obamaland where everyone depends on the government for their existence...