TITLE
Title
DHHS- DIVISION OF SOCIAL SERVICES UPDATE ON THE ECONOMIC SERVICES DIVISION (FOOD AND NUTRITION SERVICES AND MEDICAID)
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SPONSOR
Sponsor
Heather Skeens (Elizabeth White)
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BACKGROUND
Background
Over the past several years, the Economic Service Division has gone through many changes due to the implementation of NCFast in Food & Nutrition Services (FNS), Medicaid and Workfirst; along with substantial changes to policy for determining eligibility for Medicaid, and changes to ABAWD policy in FNS. These changes have had direct impact to caseload size, retention of staff, and resulted in an increase in FMLA and leave usage. All of these challenges have demanded mandatory and/or voluntary overtime.
The current caseload for Family and Children’s (F&C) Medicaid is 43,448. Adult Medicaid caseload is 15,778 and Food and Nutrition Services (FNS) caseload is 45,032. These numbers include active caseloads only, and do not include cases that were denied or withdrawn. In FY2016, Guilford County denied a total of 5,068 FNS cases and 9,300 Medicaid cases.
In addition to processing applications and recertifications for both programs, eligibility staff performed approximately 45,000 changes to active cases per month and responded to the numerous returned mail and tax forms required for FNS and Medicaid eligibility.
In January 2016, to assist with the increase of workloads and the prior loss of eligibility positions due to budget cuts, we requested thirty-seven (37) eligibility positions for FY2016 and were given thirty (30). The increase in staff has assisted with the increase in caseloads, and greater than expected NCFAST processing times. However, these programs have still been unable to fully comply with federal regulations regarding timeliness.
Food and Nutrition Services (FNS)
The state is being released from a demand letter issued in July 2015 by the United States Department of Agriculture (USDA). That demand letter informed NCDHHS that the state was not in compliance with timely processing requirements for Food and Nutrition Services (FNS) applications. Processing timeliness averages were required and their goal dates to meet federal requirements: 85% effective July 1, 2015-December 31, 2015 and 95% effective January 1, 2016-June 30, 2016. Failure to comply with corrective action plans and achieve the timeliness goals would have resulted in the “suspension or disallowance of administrative funds in accordance with the code of Federal Regulation (CFR) 276.4”
We have been maintaining a timeliness rate for processing applications over the past year between 97-99%. However, where the division falls short is in recertifications. As the number of recertifications continue to rise, staff in this unit cannot keep up with the volume and each month fall short of the USDA’s requirement of 5% or less going overdue. Over the past six (6) months, updates have been provided showing overdue cases and that we have not been meeting the expectations.
Turnover
Turnover is being tracked within Economic Services. These positions can be very demanding and fast-paced. Over the past year, Economic Services (includes FNS and Medicaid) turnover rate was 13.5% which accounted for 79 positions. Of these 79 positions, 42 were voluntary resignations, 17 retirements and 20 involuntary separations. In addition, 28 employees were promoted within Economic Services during this time.
The top reasons for voluntary turnover include: other employment opportunities, leaving the locale and personal reasons. The reasons for involuntary turnover is due to Unacceptable Personal Conduct and failing to meet job expectations during the probationary period.
Overtime
Since January 2016, approximately $309,474.96 in overtime has been paid to eligibility staff.
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REQUESTED ACTION
Requested Action
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