Medicaid expenses take big bite

By: - July 21, 2005 5:25 am

Digital Courier

By JERRY STENSLAND Daily Courier Staff Writer

SPINDALE — Social Service officials got a look at the final Medicaid numbers for the fiscal year just completed as well as discussing two reports, one on child abuse and another on the methamphetamine problem.

The bottom line for 2004-05 was a nearly $700,000 increase in the local share of Medicaid expenses.

Overall, the agency spent approximately $13,581,000 of which the local share was $6,528,000.

Of the local share, Medicaid accounted for $4,013,000 or about 61.5 percent of the county’s costs.

"We were able to absorb the Medicaid increase, in part, by spending less in some of the larger areas particularly in foster care and to some extent in child day care," said accounting supervisor Terri Morgan. "We were able to maximize revenues drawing down every available federal and state dollar in just about every area."

The final Medicaid figure was more than $400,000 over what the county budgeted for the year, though spending on other agency programs was not over budget in total.

The current year’s budget was done differently, using the state’s recommended figure and includes an estimated increase of another $700,000 in local Medicaid spending.

North Carolina is the only state in the nation that still requires local governments to pick up a share of Medicaid costs, just over 5 percent of the total bill.

Board member Andy Blanton said "I hate to be the lone wolf in this" after hearing that New York was phasing out the local share leaving North Carolina alone.

The North Carolina General Assembly has considered a number of options to heed the local government’s request for Medicaid relief, but have only agreed on overall cost saving measures so far.

Board member Chuck Hill said there was an idea floated to remove the local share this year, but it did not get through.

"There had been some entertainment to eliminate it in one year," said Hill. "It created a political brouhaha in Raleigh. It was taking one cent of the (sales tax) money that comes back to the counties and taking that back to the state."

Hill noted that in previous years, trading a penny on the sales tax for Medicaid would have cost the county money, but 2004-05 was the first year it would have been a benefit.

Counties, mostly the state’s larger counties, that did not benefit from the trade helped kill the bill, Hill said.

DSS Director John Carroll and Program Manager Karen Adams walked the board through a recently released North Carolina Child Protective Service data report.

Carroll said because of extensive changes in the way counties report child abuse statistics, comparisons with other counties for current data are not possible any more.

The report covers 2002-03, the last year where some comparisons can be made.

Carroll said while the county ranked number one in the state in substantiated child abuse cases in 2002-03, child abuse cases have come down in the past two years.

Further details on those child abuse statistics will be included in a subsequent article.

Carroll and Adams also summarized a national survey on the impact of meth on counties. Rutherford County was one of the counties included in the survey.

Carroll said that for 2004, Rutherford County had 10 meth labs where children were living in the residence.

Those cases involved 24 children.

All children are required to removed from a house where a meth lab has been found. Of the 24, nine ended up in DSS custody while the remaining 15 were placed with other family members.

Through the first half of 2005, there have already been nine meth labs with 22 children involved, Carroll said.

Further details of that report will be included in a subsequent article.

In other business, a reduction in available foster parents was discussed.

Carroll said changes in the way foster parents are utilized in potential reunification with biological parents was seen as a challenge.

"Those changes involve getting the foster parent involved with the family and supervising visitations and having the foster parents be part of the reunification effort," said Carroll about the new state requirements. "It includes foster parents name and address on the family care plan and foster parents are afraid of that. We, along with a lot of other counties, voiced our concern with that because working with foster parents for 20 years you learn what they will and will not do."

Carroll hopes the issue will improve over time.

Adams said the shortage is causing problems.

"We’ve had to place some children outside of the county because we have lost local resources," said Adams.

Wednesday’s meeting was the first for new DSS Board members David Reno and Buck Petty, though Petty could not make the meeting.

They replaced David Walker and Amelia Wilkie.

Contact Stensland va e-mail at [email protected]

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Chris Fitzsimon

Chris Fitzsimon, Founder and Executive Director of N.C. Policy Watch, writes the Fitzsimon File, delivers a radio commentary broadcast on WRAL-FM and hosts "News and Views," a weekly radio news magazine that airs on multiple stations across North Carolina. [email protected] 919-861-2066