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Fix food stamp, other problems at DHHS

By Fannie Flono
Associate Editor
Jack Betts
Fannie Flono writes on news, politics and life in The Carolinas. Her column appears on the Editorial pages of The Charlotte Observer.

You get what you pay for.

That’s the conclusion many in this state might have come to about Dr. Aldona Wos, secretary of the N.C. Department of Health and Human Services, whose wealth allows her to work for the state for a salary of $1 a year.

She eschewed the $135,000 that GOP Gov. Pat McCrory offered her when he took office last January.

With a year under her belt, Wos seems to be overpaid at that buck a year.

Her short tenure has been rocky. She’s already cost the state more than the $135,000 she could have earned because of poor personnel decisions including excessive pay for young inexperienced staffers hired for jobs for which they lacked pertinent qualifications.

Last month, her department breached the confidentiality of nearly 49,000 child Medicaid recipients by mailing their personal information to the wrong addresses. The state had to notify Medicaid recipients of the mistake, re-mail new cards and agree to send recipients detailed accounts of charges to their cards to assure them no one else had or was using them. The costly blunder was a breach of federal HIPAA rules and opened the door for potential Medicaid fraud.

And two weeks ago, seven physician groups filed a class action lawsuit against DHHS over the faulty performance of NCTracks, the state’s Medicaid claim-processing system that was rolled out last July. The system has been plagued by errors and caused payments to providers to be delayed, unpaid or shorted by more than half a billion dollars in the first 90 days, the lawsuit said. Some providers have had to borrow to meet payrolls; others went out of business. Some were still experiencing late payments this month.

Said Robert Seligson, chief executive of the N.C. Medical Society, in support of the lawsuit: “NCTracks has inflicted real damage on Medicaid patients and providers across the state... Multiple state oversight agencies have identified problems and urged system improvements. Despite these efforts, progress is slow and problems remain pervasive... Legal action may be the only remaining option to remedy the harm to the Medicaid system and get NCTracks to function as advertised.”

The doctors said in their lawsuit that NCTracks “has been a disaster, inflicting millions of dollars in damages upon North Carolina’s Medicaid providers.” The suit is pursuing damages, declaratory relief and injunctive relief against the defendants. In other words, the state – that is, N.C. taxpayers – may have to pay through the nose for this bungled mess.

On top of all that, North Carolina could lose millions of federal dollars it gets to administer its SNAP program, better known as food stamps, if officials don’t significantly reduce a waiting list of thousands and get needed assistance to struggling North Carolinians.

Last week, the state got a second – yes, second – warning letter from the U.S. Department of Agriculture warning of a possible cut-off of administrative funds if the state didn’t get its act together. Wrote Robin Bailey Jr., regional administrator for the USDA’s Food and Nutrition Service: “[We are] alarmed by the persistent problems despite our extensive technical assistance and repeated communications concerning the severity of the situations. Citizens of North Carolina that need help putting food on the table are not receiving the basic level of responsiveness and quality of service that they deserver from their government. Continued delays create undue hardship for the most vulnerable citizens of North Carolina.”

The truly alarming part of the USDA’s letter last week is that it followed a warning letter in December that noted a backlog of over 6,000 waiting in North Carolina for more than three months to receive benefits. That number, by the state’s own data, hadn’t shrunk but grown to more than 8,000 waiting more than three months to receive benefits. Thousands more (more than 20,000, the USDA said as of Jan. 21; DHHS says it’s less now) have been waiting a shorter time for assistance but still longer than the 30 days from application allowed by federal law.

The federal government has given DHHS until Feb. 10 to significantly reduce the backlog including, crucially, erasing the waiting list of those who haven’t received benefits for 90 days. The department expects “full resolution of the remaining backlog” no later than March 31.

As with many DHHS problems, Wos has tended to deflect responsibility. Bailey read of her pinning the food stamp woes on requirements of the Affordable Care Act. ACA, with implementation woes of its own, has become a convenient target to pin blame on – and some observers might be inclined to buy that explanation.

But Bailey’s rejoinder is on point: “It should be noted,” he writes, “that many other states have implemented ACA without the dramatic impacts on SNAP that have occurred in North Carolina.”

DHHS responded to the USDA’s most recent letter with this from Sherry Bradsher, the N.C. deputy secretary for Human Services: “We strongly disagree with the federal government’s threat to withhold Food and Nutrition Service (FNS) administrative funds, which could adversely impact counties’ abilities to assist families in need. However, we are encouraged by positive conversations between Governor McCrory, Secretary Wos and the U.S. Agriculture Secretary (Tom) Vilsack that resulted in a verbal agreement of our plan to clear up outstanding FNS applications and recertifications. We will continue working closely with our partners in county government to solve this problem.”

Bailey will likely appreciate that cooperation. In his letter last week, he noted that “to date, DHHS has failed to provide [Food and Nutrition Service] with regular weekly status reports as agreed to in DHHS’ November 20, 2013, letter. On two occasions, the transmittal had multiple and contradictory data sets...”

The reason for the government’s “threat” becomes clearer.

DHHS had a troubled past before Aldona Wos. But under her leadership so far, things are worse not better. It is unacceptable when the state shorts medical providers on money for their services, and it’s unacceptable when families depending on food stamps can’t get them.

McCrory and Wos need to fix these problems with haste. Then McCrory needs to look elsewhere for someone to lead DHHS. And this time, consider that anyone who accepts only a $1 for their services might not be up to the job.

Email: fflono@charlotteobserver.com.
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