DSS prepares for 'perfect storm' as 35,000 become eligible for Medicaid in Cumberland County
More than 35,000 Cumberland County residents will become eligible for Medicaid on Dec. 1, and the Cumberland County Department of Social Services took its first step last week to prepare for what Director Brenda Reid Jackson has described as a “perfect storm.”
Jackson made a successful request at the Cumberland County Board of Commissioners’ Oct. 16 meeting for additional computers, hardware, software, equipment and accessories for a new call center and self-service kiosks at the department's offices on Ramsey Street. The $344,633 approved by commissioners will be covered by $269,909 from the state for recertifying residents’ Medicaid eligibility and $272,000 from the state's American Rescue Plan Act funds for the Supplemental Nutrition Assistance Program, which can be used for expanding and improving call centers, according to DSS documentation.
Jackson told the board that her department’s need for the additional call center and new kiosks stems from three different challenges.
The first challenge, Jackson said, is related to the outcome of the Franklin v. Kinsley class-action lawsuit. According to court documents, the suit, first known as Hawkins v. Cohen, was filed in federal court on Nov. 21, 2017, and was settled on Jan. 13, 2023. The complaint, which later became a class action suit, saw those who had been removed from Medicaid or were in danger of removal suing North Carolina Department of Health and Human Services Secretary Kody Kinsley. The plaintiffs argued that DHHS violated Medicaid recipients' rights by failing to "reasonably accommodate persons with disabilities" and creating "barriers for persons with limited English proficiency," according to the complaint.
The January settlement requires DHHS and all Departments of Social Services in the state to follow detailed instructions for reaching out to residents whose Medicaid eligibility may be in jeopardy and communicating in a timely and accurate manner with residents about their coverage, according to court documents.
Jackson said that those requirements have created a heavier workload for her staff, who could not remove anyone from Medicaid during the COVID-19 pandemic while it was classified as a public health emergency.
Now, Jackson said, her staff must review everyone who was allowed to remain on Medicaid during the pandemic to determine if they are still eligible, noting that the Franklin v. Kinsley settlement “requires increased, stringent telephone response to Medicaid recipients” during that review.
“It still is a demand on our telephone system and a demand on staff,” Jackson said.
The second challenge that the Department of Social Services faces is the requirement to recertify everyone currently on Medicaid, Jackson said.
“We’re talking 97,000 active cases that we have on Medicaid right now,” she said.
Jackson said her team was notified in February that they had to begin those review processes in April. According to Jackson’s presentation, recertifications will gradually be completed over a 12-month period, through April 2024.
The third challenge Jackson’s department must tackle is the coming expansion of Medicaid, she said. Though the department estimates that up to 40,000 Cumberland County residents will be eligible, Jackson anticipates they will receive about 75,000 applications, because 50% of Medicaid applications are typically approved, she said.
“As a result of these changes, we anticipate an overwhelming increase in the workload of Cumberland County’s Medicaid program,” Jackson’s presentation stated.
'Gamechanger'
Vivian Tookes, assistant director of economic services for the Department of Social Services, said Friday that Medicaid expansion is her staff’s biggest challenge at present.
“We’ve got to look at, how do you handle all this massive work?” she said. “A lot of what we’re doing now is preparing for the expansion and how we will do it and how we will ensure that benefits are issued to customers in this county.”
Tookes said her staff has yet to receive a finalized policy on the Medicaid expansion.
“We’re looking forward to getting some final training,” she said. “Workers are really anxious and want to know, what will the policy look like?”
Jessica Bullock, the department’s Medicaid program manager, said that the expansion has historic implications for many North Carolinians.
“In the past, you had to be the caretaker of a child under the age of 19 or you had to be disabled or over the age of 65 in order to receive Medicaid if you were an adult,” Bullock said. “This program is going to cover that gap in the population of 19- to 64-year-olds who were not otherwise covered by Medicaid unless they had a minor child. It also increased the income limit a lot.”
According to documents from the North Carolina Department of Health and Human Services, the new income limits for Medicaid coverage are:
$20,120 annually for a single adult
$27,214 for a family of two
$34,307 for a family of three
$41,400 for a family of four
$48,493 for a family of five
$55,586 for a family of six
Though the expansion will challenge her staff, Tookes said that it will be transformative in many ways.
“This program will be a true game-changer in the way we operate, in the way we do business and also for the good of the community,” she said.
Got a tip for a follow-up on this story? Government watchdog reporter Lexi Solomon can be reached at ABSolomon@gannett.com or 910-481-8526.
This article originally appeared on The Fayetteville Observer: Cumberland County Department of Social Services faces Medicaid expansion
