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MedicaidAs Governor McCrory and his HHS Secretary Aldona Wos convene a rather strange closed door “listening  session” on Medicaid in Greensboro today (it’s scheduled to last all of 45 minutes), let’s hope they both took the time over the weekend to read an excellent, “from-the-trenches” essay by Goldsboro physician Dr. David Tayloe in Raleigh’s News & ObserverIn it, Tayloe explains the importance of preserving and improving North Carolina’s homegrown “medical home” model for delivering Medicaid services (Community Care of North Carolina) rather than falling for the false promises of out-of-state HMO companies that have been trying to muscle their way into the state.

CCNC is rooted in care coordinated by providers, not insurance corporations. By keeping care decisions in the hands of those most qualified to make them, medical home models improve health outcomes for North Carolina’s Medicaid population. Doctors, care managers and pharmacists across provider-led networks share data and best practices to provide efficient and high-quality care to patients, decreasing emergency room visits and reducing wasteful spending.

The CCNC model is the result of decades of work that has consistently generated positive results in North Carolina. An HMO takeover of this system would mean higher administrative costs to the state and billions of taxpayer dollars leaving the state to pay corporate shareholders. Under federal Medicaid rules, the additional money required to pay HMOs can come from only one place – sharp cuts to provider payments. When physicians choose not to participate in Medicaid, patients neglect preventive care and head to the emergency room in crisis, raising state costs while producing less positive health outcomes. Read More

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MedicaidThere’s new and compelling evidence that North Carolina’s model for delivering Medicaid (Community Care North Carolina -CCNC) is a winner — notwithstanding the often-bumbling oversight provided by embattled state DHHS Secretary Aldona Wos and the attempt by Senate leaders to sell the program off to a private managed care company. (It’s worth noting that the flawed sell-off idea was once also touted by Gov. McCrory and Sec. Wos as well until the two gradually came to their senses over the past year).

Today, in a letter to state Medicaid directors throughout the country, the Centers for Medicare and Medicaid Services at the national DHHS announced today that they are launching a new national collaborative initiative called the “Medicaid Innovation Accleerator Program.” The goal of initiative is “to improve care and improve health for Medicaid beneficiaries and reduce costs by supporting states in accelerating new payment and service delivery reforms.”

The letter announcing the initiative holds up three examples of state innovation success in Ohio, Washington and North Carolina. Here’s what it has to say about North Carolina: Read More

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Medicaid 3As state lawmakers and Gov. McCrory argue about ways to cut public outlays for Medicaid — the public health insurance system for people of low income — the lead editorials in North Carolina’s two largest newspapers offer some straightforward and compelling truths this morning that ought to guide their discussions:

1) Service cuts harm real people in need and 2)  Things ain’t gonna’ improve as long as Dr. Aldona Wos runs the show.

As Raleigh’s News & Observer reminds us, when legislators cut services to save money (even though, as the editorial notes, per person costs are down and quality of service is up) they make life hell for people like Mason Leonard and his mom Colleen:

“Mason Leonard, 14, of Cary is severely disabled. He was brain-damaged at birth and cannot care for himself. He can’t be left alone, can’t feed himself or look after any of his needs.

But thanks to a few Medicaid services, he receives therapy, gets out a little, gets trained in things like making his bed, which, when he accomplishes it, is considered a big step….

A Medicaid policy change last year, for example, eliminated weekend hours for teaching Mason how to function with basic skills. His mother understandably fears what new hardships further “reform” will produce.

Here is what the public needs to understand about the budget cutting and reform conducted under the banner of ‘efficiency.’ For each cut, for each decision to eliminate some benefit, a disabled person such as Mason Leonard or a poor person with no alternative for care except what Medicaid provides and their caregivers and family members suffer discomfort or pain.”

And then there’s this bit of plain truth from the Charlotte Observer: state Health and Human Services Secretary Aldona Wos simply has to go. As the Observer notes: Read More

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DHHS Sec. Aldona Wos

DHHS Sec. Aldona Wos

[Update: This post originally stated that 41,000 children were on the state's waiting list for childcare. Advocates in the childcare advocacy community have since contacted N.C. Policy Watch to let us know that this number, which dated to 2013, has been reduced to the much-lower, but still too-high, figure of approximately 22,000. We regret the error but stand by the premise of the story.] 

A special press release from the office of state Health and Human Services Secretary Aldona Wos provided yet another powerful example today of the disconnect between the policies of the McCrory administration and the reality “on the ground” for struggling North Carolinians.

According to the release, the Secretary will help celebrate the “Week of the Young Child” by reading to children at a Raleigh childcare center.

To which, all a body can say in response is: Uh, pardon us if we don’t start popping champagne corks. No offense Madam Secretary — it’s a nice gesture — but is that really all you got? If it is, you might want to check out today’s edition of the Fitzsimon File in which Chris explains that the waiting list for North Carolina’s  inadequate, but better-than-nothing-if-you’re-poor childcare subsidy program that you oversee has now reached an amazing and depressing 22,000.

In other words, reading to them a handful at a time is your solution for what ails our kids, you had better get busy.

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From the good people at UE local 150, N.C. Public Service Workers Union:

UE 150 protestA new report released by UE local 150, N.C. Public Service Workers Union highlights the need for ‘Safety, Rights and Raises’ for state DHHS employees.  The report details new information about horrible understaffing, vacant positions not being filled,  alarming turnover rates, along with Department of Labor wage data showing how far behind state employees are with their salaries.

DHHS employees, all members of UE local 150, N.C. Public Service Workers Union from Cherry Hospital, Caswell Developmental Center, Central Regional Hospital and Murdoch Center but representing workers in all state operated facilities, met with DHHS Sec. Wos and her administration yesterday.

‘We are glad that Sec. Wos is committed to continue to dialogue with workers, ‘ stated Regina Washington, developmental technician from Caswell Center. ‘However we are upset by her insistence that certain upper classes of workers deserve raises compared to direct care staff, who are the lowest paid and who receive the bulk of the injuries and stress. ‘ Read More