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An annual audit of North Carolina’s compliance with federal human services programs uncovered significant issues at the state’s health agency, including overpaying for Medicaid services and skipping a background check for adoptive parents.

The audit released on March 31 found problems with nearly every program they checked at the N.C. Department of Health and Human Services, from administration of the federal food stamps program to Medicaid billing and neglecting to spend a federal grant to help AIDS and HIV patients.

DHHSA DHHS spokeswoman said the agency has worked under in recent years under Secretary Aldona Wos to improve the management of federal programs, and plans on addressing the issues highlighted in the audit.

“The department has made significant progress improving its operations over the past two years and we continue to value the role that audits can play in further enabling us to do so,” DHHS spokeswoman Alex Lefebvre wrote in an emailed response to questions. “This annual audit will be used by the department to continue on the path of improved effectiveness.”

There were other findings that didn’t point to wasted money, but may have put children’s safety at risk.

The N.C. Department of Health and Human Services didn’t check to make sure prospective adoptive parents were clear of prior abuse allegations, by checking a registry of abuse and neglect allegations.

“The Department did not monitor that the child abuse registry was checked before a child was placed for adoption,” the federal compliance audit stated. “As a result, children could be placed in an unsafe environment.”

DHHS, in the response contained in the audit, said it thought county-level officials had ensured the abuse and neglect check had been done. Criminal background checks were conducted.

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Commentary

Medicaid expansionIn case you missed it over the weekend Ned Barnett of Raleigh’s News & Observer had an on-the-money column about the latest  bizarre claim from the McCrory administration that we can now expand Medicaid under the Affordable Care Act because they have “fixed” what was a “broken” system. As Barnett notes:

“It’s good news that the governor is now open to doing the right thing about Medicaid expansion. Even Tillis now says he might favor it. Refusing to do it could cost the state $51 billion in lost federal money over the next decade, according to a report from the Robert Wood Johnson Foundation.

But this change of position shouldn’t pass without a look at the rationale for not doing it in the first place. Wos’ reign at DHHS has been marked by massive provider payment problems, an exodus of staff, plummeting morale and expensive consultants hired to fill in the gaps. Now she’s saying that the administration of Medicaid has been fixed and it’s ready to take on a half-million new recipients.

If that turnaround is true, Wos has accomplished an amazing feat of introducing efficiency and accountability. Yet there’s nothing to suggest that is the case. DHHS under Wos remains an agency riddled by vacancies and burdened by a reputation for administrative dysfunction that has discouraged top applicants. But the Medicaid program itself was never “broken”. It has operated in North Carolina for decades and in recent years has successfully held down administrative costs compared with the national average. Medicaid’s “out-of-control costs,” which Republican legislators say busted the state budget, reflect wishful budgeting. Simply putting a number in the budget won’t hold down costs. People need treatment, and when there’s a recession Medicaid rolls grow. With the economy now improving, Medicaid costs are coming in under budget.”

In other words: It’s great that McCrory and Wos want to expand Medicaid and even fine if they want to delude themselves about the reasoning, but anyone who’s been paying attention knows their claims and rationales are bogus.
News

After last night’s historic ruling legalizing same-sex marriages in North Carolina, one county register of deeds says the McCrory administration unnecessarily delayed releasing gender-neutral marriage license forms.

Wake Register of Deeds Laura Riddick (photo from Riddick's office)

Wake Register of Deeds Laura Riddick (Photo from Riddick’s office)

Laura Riddick, a Republican first elected to county office in 1996, released a statement Friday saying that the N.C. Department of Health and Human Services refused her earlier requests for a copy of an existing gender-neural marriage license. DHHS is led by Aldona Wos, a Greensboro physician and wealthy Republican fundraiser appointed by Gov. Pat McCrory in January 2013.

Riddick kept her office open until after 9 p.m. Friday evening to issue marriage licenses after U.S. District Court Judge Max Cogburn Jr.’s order at around 5:30 p.m. that night declaring North Carolina’s ban on gay marriages unconstitutional.

Some of the first legal gay couples to marry in the state did outside Riddick’s office, including Wake County Sheriff Department employees Chad Briggs and Chris Creech who exchanged their vows as local news stations broadcast the union on live television.

Riddick, along with other Registers of Deeds across the state, hoped to have her department’s computer systems updated and ready when the expected federal court order legalizing same-sex marriages came down. (Click here for background on issue.)

DHHS withholding the form was “neither justified nor professional,” Riddick said in a statement.

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Commentary
DHHS Sec. Aldona Wos

DHHS Sec. Aldona Wos

If there’s anything positive about placing our state under the control of right-wing politicians, it might be this: the fact that it forces at least some people to, eventually, confront the hard reality that cut rate, on-the-cheap government rarely works. This fact is apparently being slowly brought home of late to North Carolina’s embattled Secretary of Health and Human Services, Aldona Wos.

As WRAL.com reports this morning, Wos is calling for millions of new dollars to be spent on the state’s troubled medical examiner system:

State health officials told lawmakers Monday that they need about $6 million more a year to fix the medical examiner system, which has failed to meet minimum national standards for staffing, training and facilities.

Lou Turner, deputy section chief for the state Department of Health and Human Services, told lawmakers that the agency has been asking for more money and staff for a decade but lawmakers haven’t listened.

“It did not get funded. It did not go forward,” she said.

Put simply, Wos and her team are learning what a lot of crusading anti-government ideologues learn when they are faced with actually making the trains run on time: Notwithstanding the propaganda from the right-wing think tanks, providing high quality public services costs real money.

Let’s hope state lawmakers respond favorably to the new DHHS request and, more importantly, that North Carolina’s elected leaders learn an important lesson from the experience — namely, that it’s shortsighted and destructive to try to run the public structures and services that bind our middle class society as if they were some kind of bottom feeding chain of retail outlets.

Commentary
DHHS Sec. Aldona Wos

DHHS Sec. Aldona Wos

Multiple newspapers have called for North Carolina’s Secretary of Health and Human Services Aldona Wos to resign or be fired during her first 20 months in office. Now, one of the first to speak out has done so again.

One year ago this week, the Henderson Daily Dispatch said the following:

Aldona Wos must immediately resign her position as the secretary of our state’s Department of Health and Human Services. If she does not, Gov. Pat McCrory has to make the decision for her.

Now, this week, after indulging in some amusing sports analogies, the paper renewed its plea/demand:

Wos’ department isn’t having a one-time issue. It has been a train wreck from the beginning.

She’s made bad hires that cost taxpayers in payouts against potential claims, put personnel in positions for which they are not prepared and awarded quarter-million dollar consulting work to her husband’s firm….

Taxpayers are bleeding from horrific mismanagement. Wos would have been long gone in any business other than politics. North Carolinians deserve better.

Hat tip: Logan Smith at Progress NC