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NC HHS Sec. Aldona Wos

NC HHS Sec. Aldona Wos

Yesterday, Governor Pat McCrory’s DHHS Secretary, Aldona Wos, unveiled the administration’s long-awaited reform plan for Medicaid.  One of McCrory’s favorite talking points on Medicaid has been how “broken” the system is and how he’s going to “fix” it.  Setting aside the past year of missteps in which McCrory and Wos did more than any Governor and Secretary in history to discredit and cause problems for NC’s award-winning Medicaid program, what does the administration’s plan yesterday tell us about the future prospects of Medicaid and health care for the poor in NC?  Here’s my take:

1. Surrender:  The Governor completely surrendered by backing down from his former big plans to sell off substantial parts of the Medicaid program to private, out-of-state insurance companies.  The proposal yesterday to use “Accountable Care Organizations” or ACOs is simply, at its core, a new way to pay existing or new networks of doctors, hospitals and other health care providers.  Paying health providers as a group for each illness a patient gets rather than piecemeal for every test and procedure is supposed to get providers focused on quality and efficiency, especially when payments go up if patients are healthier. ACOs represent gradual evolution in health care and not “major reform.”

2.  Missing the boat on Medicaid expansion: The Governor also made it clear that he has no intention of solving the coverage gap for the 500,000 poor North Carolina citizens who would be eligible for Medicaid coverage if he led the charge to expand Medicaid using the billions of dollars in federal money available to our state. Conservative governors and legislators around the country – whether in New Hampshire or Utah – are coming up with innovative solutions to cover their citizens with all the new federal money available.  By leaving an expansion proposal out of his plans to change Medicaid, our Governor is renouncing any claim to national moderate leadership on this issue, leaving billions of federal tax dollars collected from North Carolinians to go to states that do expand and hurting hundreds of thousands of his own constituents.

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The state’s health agency revealed its proposal yesterday of how to it wants to overhaul the state’s Medicaid system, giving a broad outline that appeased doctor and hospital groups and backed away from earlier promises of a privatized system.

In a meeting held Wednesday for a Medicaid reform advisory group, N.C. Health and Human Services Secretary Aldona Wos and her staff said they would, with the legislature’s blessing, move to a  model using Accountable Care Organizations (which can be groups of medical practices or hospital systems) to manage Medicaid patients physical health needs.

DHHS Sec. Aldona Wos

DHHS Sec. Aldona Wos

“What we are presenting today is a realistic and achievable plan that puts patients first, helps create a sustainable Medicaid program, and builds on what we have in North Carolina,” Wos said, in a press release about Wednesday’s meeting. “This proposal represents a fundamental improvement in how the state delivers Medicaid.”

Wos will present the plan March 17 to lawmakers, any changes will also need federal approval.

(Scroll down or click here to read the two-page handout on the proposal.)

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The director of the N.C. Health and Human Services’ troubled public benefits technology and food stamp system is leaving his state position for a job in private industry.

Anthony Vellucci, the program director for N.C. FAST (Families Accessing Services Through Technology) is leaving for a job in private industry, according to a DHHS news release sent out late Wednesday afternoon.

He is taking a position with Maryland-based EngagePoint, a private healthcare and IT software company, and his last day with DHHS is March 7.

Vellucci, 40, was making $168,000 a year, including a $23,384 raise he received from Health and Human Services Secretary Aldona Wos in June in order to counter a job offer. Vellucci’s raise was one of several $20,000-plus raises for top DHHS officials after N.C. Gov. Pat McCrory called for a salary freeze for state workers.

NC FAST has encountered significant issues over the last year, and the months-long delays for food stamps for thousands of struggling North Carolinians led the U.S. Department of Agriculture to threaten withdrawing administrative funding from the state. (Click here for more information about the backlog.)

The state agency had just met a Feb. 10 deadline set by USDA to resolve the backlog of thousands of high-priority food stamps cases, and is facing another deadline on March 31 to reduce the remaining backlog of cases.

Vellucci first came to DHHS in 2010, during Democratic Gov. Bev Perdue’s administration.

Angela Taylor, a DHHS employee since 1995 who joined the NC FAST team in August, will take over as NC FAST’s interim director.

 

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The state health agency plans to close three Eastern North Carolina offices that provide services for developmentally disabled infants and toddlers, a move that will eliminate an estimated 170 state jobs by July.

Documents obtained by N.C. Policy Watch show that budget cuts prompted the N.C. Department of Health and Human Services’ Early Intervention Program to call for the closure of three children’s developmental services agencies in New Bern, Rocky Mount and Wilmington.

The state agency will expand an existing contract with East Carolina University’s School of Medicine to continue providing services to families in the 21 affected counties, according to a Feb. 10 strategic plan written by Dr. Robin Cummings, the state’s acting health director, and obtained by N.C. Policy Watch.

ECU already has a contract with DHHS to provide early intervention services for several counties in the Greenville area.

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The backlog of North Carolina’s food stamps applications is continuing to go down, as county and state health and human services workers put in overtime to meet a Monday deadline set by the U.S. Department of Agriculture.

Revised numbers released Tuesday by the N.C. Department of Health and Human Services  how that there are still more than 4,000 applications pending statewide, including more than 800 that have pending for more than three months.

Click here and here to see DHHS’ county breakdowns of the existing backlog.

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