Bipartisan skepticism spells trouble for state DHHS’ Wos

October 12, 2013 

The curious early days of Secretary Aldona Wos at the state Department of Health and Human Services and her hiring of a couple of barely-out-of-college staffers at $85,000-plus salaries – along with the resignations of some top career people – have roiled the waters at DHHS, and the waves don’t appear to be calming down.

Wos and her subordinates did not have anything that could remotely be called a triumphant appearance before state lawmakers last week when the DHHS crew underwent about nine hours of questions and comments from lawmakers. Doubtless to the surprise of Wos’ champion, Gov. Pat McCrory, Republicans were among the department critics, and the appearance isn’t going to lessen their concerns.

It also turned out that a response to a state audit of the state’s Medicaid program allegedly was “strategically edited,” as the Associated Press reported after initial reports from North Carolina Health News. The January audit was the foundation upon which McCrory pitched the idea of privatizating Medicaid, a risky notion indeed, and it seemed to strengthen the governor’s oft-repeated campaign chorus of government being “broken.”

The edits to a response to the audit prepared by Medicaid agency staff were made, the nonprofit Health News website reported, by Carol Steckel, hired with fanfare by Wos to run the Medicaid program. Steckel has left to work with WellCare Health Plans, a for-profit managed-care company likely to seek the business of running North Carolina’s Medicaid.

Wos told lawmakers she hadn’t read the reports from Health News but stands by her response to the audit.

State Auditor Beth Wood, the AP reported, said in her findings that the state’s administrative costs for running Medicaid were 38 percent higher than in other states and that there had been more than a billion dollars in cost overruns. Wos endorsed the audit. So did McCrory.

Health News found, however, that records show Steckel cut passages in the department’s response that questioned the accuracy of the audit’s conclusions. Also allegedly cut were analyses that showed North Carolina’s administrative costs were much lower and that Republicans in the General Assembly had been cautioned by then-Gov. Beverly Perdue that the Medicaid budget they were endorsing was much too low. What happened? Costs ran over, which was inevitable given the anemic budget.

Wood’s office, which is independent of DHHS, looked again at the audit and questions some of the claims made by Wos and other DHHS officials. But Wood stands by her conclusions regarding administrative costs.

The obvious issue is whether McCrory’s DHHS wanted the audit to tell the story it preferred, to confirm the governor’s criticisms of the Medicaid program. The governor also used the audit to justify not accepting several hundred thousand more North Carolinians into the state’s “broken” Medicaid program even though the costs would have been carried by the federal government.

When DHHS officials were sitting before legislators of both parties, questions were raised about those high salaries for young staffers (no one appeared satisfied with inadequate explanations) and consulting contracts worth hundreds of thousands of dollars for former Republican State Auditor Les Merritt and someone who is a vice president of a company owned by Wos’ husband.

And doctors and hospitals and other medical-related firms were angry about the inefficiency of a Medicaid claims payment system that isn’t working as it was supposed to.

This is a department not just under a cloud but in a storm that shows no signs of passing. Clearly formal, organized and exhaustive investigation is needed, and Wos needs to stop passing the buck to others or being shielded by staff members from more probing questions. She may be working for $1 – something the governor likes to stress – but that really doesn’t mean much in terms of how well the department is being run or not being run.

Perhaps lawmakers now have the attention of department officials. But do they have the governor’s attention? He needs to address the clear and present crisis at DHHS with more than platitudes and rhetoric. He said for years, through two campaigns, that government was broken.

It seems that in this particular corner of the McCrory administration, if it weren’t broken before, it is now.

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