Minutes 04-16-2013 - Laserfiche WebLink

Browse Search

• Partnerships with other county departments and outside private and nonprofit agencies • Education of clients, providers, partner agencies, and policy makers about possible transition issues Nancy Coston said that, regardless of whether Medicaid was expanded or not (it was not expanded in North Carolina) one of the requirements of the Affordable Care Act is a seamless opportunity to apply for Medicaid/Subsidized Healthcare. In North Carolina, this means DSS. She said this means that DSS must have a single way to help people who are not eligible for Medicaid but might be eligible for one of the tax subsidies. This interface is being built from the ground up. She said that DSS is naturally where lower income (250% and below poverty level) folks will come. She said the Affordable Care Act also requires that people be able to apply by phone, in person, on the computer, or by mail. She said that all of this is pushing the effort to get the conversion of NC FAST for Medicaid by October 1, as this is the date Affordable Care Act Subsidies can be accepted. She reviewed the coverage percentage graph on the second Affordable Care Act slide. She said the biggest hole is for the adults without children who make less than $12,000 per year. She said these people are not picked up by Medicaid and cannot get a subsidy because the law did not anticipate Medicaid not being expanded. Commissioner McKee asked what the option would be for these people. Nancy Coston said that the Department of Health and Human Services will send these people to rural health clinics, like Piedmont Health. Commissioner Pelissier asked if maybe some of the people who will be able to get insurance through the exchange, could go elsewhere so Piedmont Health could help the people who won't get subsidized. Nancy Coston said that is the hope, as this was all built to get more people insured, which would mean less people would have to be covered. She noted however, that Piedmont is a major recipient of Medicaid right now, and Piedmont says this is necessary to maintain a business model that works. She said the official word is to clean up Medicaid and then move forward. She said that the people in the 100% to 200% poverty level, who do not have health insurance, will get health insurance with a reasonable subsidy. This will be a new insured group as most of these have chosen not to have insurance in the past. Nancy Coston moved to the Work Support Strategies slides. She said this is a philosophy based on what the families need. She said that there will be opportunities, as NC FAST and EPass go live, to let people meet DSS wherever is most comfortable. She said there are minor changes being looked at for next year, including putting computers in the buildings that staff can use in teaching people about online resources. This will help more people utilize that option and free up staff to spend more time with the seniors and others who need the one on one time. She said that entering information into NC PASS allows it to trickle down to everyone in the DSS system and this frees up time on the part of both the applicant and the staff. She reviewed the items needed to be successful. She said the transition in Medicaid will be more difficult than the food and nutrition transition, as there is no simple solution to a medical emergency if cards are not generated fast enough, etc. Nancy Coston presented the following slides: 2. Budget Issues and Impacts Budget Issues and Impacts • Child Welfare Funding Cuts • Work First Cash Changes • Child Care Subsidy Funding