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North Carolina’s food stamps program continues to face major problems in how it operates and monitors federal funds for low-income families struggling to get food on their tables, according to a recent report by federal officials.

NC FAST logoA strongly worded management evaluation by the U.S. Department of Agriculture of the state’s Supplemental Nutrition Assistance Program  listed more than 38 faults with North Carolina’s system, ranging from “critical findings” regarding a lack of oversight at the state level to regulatory violations about what is included on applications for food assistance.

“There are critical findings in the Claims/TOP area that are related to a lack of State oversight and monitoring,” read one finding in the 19-page report. (Scroll down to read the report itself.)

The major findings also included a “lack of State oversight in Recipient Integrity” that led to instances of potential fraud not being referred to for prosecution and “serious findings” in the state’s employment and training program.

The Sept. 10 management evaluation rested on visits that officials from the USDA’s Food and Nutrition Service office made in May and June where operations were observed at the state level, as well as in social services offices in Guilford, Pitt and Wake counties.

It requires DHHS to provide a corrective action plan within the next 60 days.

The report came on the heels of a major breakdwon in North Carolina’s food stamps delivery system last year that left thousands of low-income families without access to food assistance for weeks or months. The problems were attributed to glitches in a new technology system, N.C. FAST (Families Assessing Services through Technology) and issues that county-level workers had in accessing the new system while struggling under heavy caseloads.

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North Carolina’s Health and Human Service Secretary Aldona Wos will be at the state legislature today, rolling out her plan to restructure the $18 billion state agency as well the state Medicaid program that provides healthcare for more than 1.5 million North Carolinians.

DHHS Sec. Aldona Wos

DHHS Sec. Aldona Wos

Wos, in a 14-page letter addressed to the heads of the Joint Legislative Program Evaluation Oversight Committee, reiterated to lawmakers that she came into her $1-a-year job to find the state’s largest agency in disarray.

“As you know, I inherited a department with a well-documented history of serious and chronic problems,” she wrote. “We have been on a path toward a sustainable department over the last 20 months and we have built the foundation for a stronger Medicaid program.”

She hopes the restructuring of Medicaid program will to fend off proposals in the legislature by Senate Republicans to move Medicaid, the massive $13 billion program that provides health care to low-income children, seniors and disabled residents – to its own standalone agency.

Wos, a wealthy Greensboro physician and prominent Republican fundraiser appointed by Gov. Pat McCrory in January 2013, has had a rocky tenure as the head of the DHHS, with controversies swirling over her granting big salaries and contracts to associates and McCrory campaign workers. Her first year on the job also saw botched rollouts of two technology projects that led to lengthy delays in medical providers getting paid for Medicaid services and in thousands of low-income families accessing food stamps

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The Charlotte Observer had an article yesterday about the nonprofit public hospital system Carolinas Health Care cutting $110 million from its budget next year, largely in management positions that are currently vacant.

The large hospital system cited the need for cuts as stemming from decisions by both North Carolina and South Carolina politicians to turn down federal Medicaid expansion dollars, as well as other decisions made at the state and federal level related to Medicaid and Medicare. The $4 billion hospital system — which operates 40 hospitals in the Carolinas and Georgia — says it’s been left treating large numbers of poor patients unable to access health insurance or pay their health bills.

North Carolina is one of 21 states to opt out of the Medicaid expansion, which would provide health care for an estimated 400,000 low-income North Carolinians who are currently uninsured. (Click here for updated list of where different states stand on expansion).

From the Observer article:

[Carolinas HealthCare CEO Michael} Tarwater blamed much of the financial stress on cutbacks in state and federal programs. For example, he said North Carolina legislators have for a second year declined to accept federal funds to expand Medicaid. That contributed to the system’s unreimbursed charges, which rose to $668 million in the first half of this year, an increase of 9.4 percent over last year.

“We’re not treating this as a crisis … but it is a challenge,” Tarwater said. “I can assure you we have a solid plan, and we have the team in place to carry it out. I’m certain that we’ll emerge stronger and more competitive.”

 

You can read the entire article here.

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The head of North Carolina’s troubled health and human services department told lawmakers Tuesday that moving the Medicaid program out from under her purview to a stand-alone agency would “be against common sense.”

“Absolutely not,” said N.C. Health and Human Services Secretary Aldona Wos in a response to a question about whether moving the $13 billion Medicaid outside of her domain would make things easier on the agency.

“To separate parts of [DHHS functions] out to the department will actually go backwards,” she said.

DHHS Sec. Aldona Wos

DHHS Sec. Aldona Wos

Wos made her comments Tuesday at a legislative oversight committee hearing. It also comes as lawmakers consider whether to embark next year on an ambitious plan by Senate Republicans to move the state’s Medicaid program to a standalone agency reporting jointly to the governor and state lawmakers.

A special program evaluation committee recently formed to consider different scenarios for Medicaid, an entitlement program that provides health care for the poor seniors, children and disabled residents, is funded through a mix of federal and state dollars.

Lawmakers have for years voiced frustration with faulty budget forecasts and unexpected cost overruns within the Medicaid program. Several Republican politicians — including legislative leaders and Gov. Pat McCrory — have held up the forecasting roblems as reason why North Carolina should not expand its Medicaid program, a move that would tap federal money to provide healthcare for an estimated 400,000 North Carolinians unable to afford their own insurance.

Wos, a Greensboro physician and wealthy Republican fundraiser appointed by McCrory to lead the state’s largest agency in January 2013, had plenty of other tough topics to cover with Tuesday’s legislative oversight committee. The tense reception has become a routine scenario for Wos as she’s grappled with negative coverage over high-dollar personal contracts and raises for close associates, as well as major disruptions in the state’s Medicaid billing and food stamp dispersal systems.

On Tuesday, Wos and her staff faced questions about a $6.8 million no-bid contract given to a consulting firm Alvarez & Marshal to advise and manage the Medicaid program.

Wos told lawmakers that she needed to hire the firm because she didn’t have any staff able to manage the program properly as she and other agency staff were developing a comprehensive Medicaid reform plan.

“We had an emergency,” Wos said. “We had to figure out how to get our daily work done.”

State law requires most contracts to go through a bidding process, in order to keep costs down and to allow for competition in lucrative contracts. Wos credited the consulting firm’s work with allowing the Medicaid program to meet its budget this year, and return $63 million to the state’s general fund.

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The achievement gap between black and white students was narrowed in college classes that stressed “active learning” over lectures, according to a study published this week by a University of North Carolina at Chapel Hill professor.

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Dr. Kelly Hogan Source: UNC-Chapel Hill

The New York Times had this article yesterday about the study conducted by UNC biology professor Kelly Hogan and Sarah Eddy of the University of Washington at Seattle.

The study found freshman students who were black or whose parents didn’t attend college had test scores rise (by an average of six points) when students took an introductory biology class taught through interactive methods — teamwork, in-class activities and online quizzes – over a class taught via lectures.

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