Democrats renewed their call for the leader of the state health agency to be replaced after the department violated federal privacy rules by sending nearly 50,000 children’s insurance cards to incorrect addresses last week.
But Republicans, led by the governor, said the mistake is yet another example of how dysfunctional the Department of Health and Human Services had become under previous Democratic administrations.
“There’s been 10 years of operational neglect – not only in that department, but others,” Gov. Pat McCrory said Monday. “You can’t fix that in one year.”
DHHS, one of the largest state agencies, is at the center of many of the partisan divisions in the state. Democrats and Republicans differ not only over agency management but also over its goals. For example, some Democrats disagree with the administration’s move toward managed care for Medicaid.
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McCrory joked that anyone who believes such a large and complex department could be fixed so quickly “has probably spent time in Colorado in the past week.” He was referring to the legal sales of marijuana for recreational use in Colorado, which began last Wednesday.
DHHS has been the focus of several high-profile missteps in the past seven months. The mistakes, which have led to delays in Medicaid claims being paid and food stamps being delivered, have led Democrats to call for the agency’s secretary, Dr. Aldona Wos, to be dismissed.
“There’s obviously no administrator over there making sure the nuts and bolts get done every day, and we need to hire someone to do that,” said Senate Minority Leader Martin Nesbitt, an Asheville Democrat.
But McCrory continues to support his appointee.
“I’m confident in Secretary Wos and her staff,” he said. “They are working hard to resolve this problem and find out what happened.”
‘Human error’ blamed
Last Friday, DHHS acknowledged that it sent 48,752 children’s Medicaid cards to incorrect addresses. The cards include names, dates of birth and Medicaid numbers, information classified as private under federal rules.
In a statement Monday afternoon, DHHS pinned the mistake on “human error in computer programming and the quality assurance process in printing the new Medicaid identification cards.”
The new Medicaid cards were printed for children who were moved from Health Choice, a government-subsidized insurance program, to Medicaid, as required by the Affordable Care Act. A computer program used incorrect names and addresses for parents or responsible adults, DHHS said in its statement.
Wos has asked the state Office of Information Technology Services, another agency under McCrory, to conduct an external review into the privacy breach focusing on “processes and procedures,” the statement said. State employees are responsible for the programming. Wos has also told the department’s Human Resources office to “conduct a personnel investigation into this incident.”
McCrory spoke about the issue after giving a speech at the 12th annual Economic Forecast Forum, sponsored by the N.C. Bankers Association and the N.C. Chamber.
DHHS discussed the privacy breach with legislators in a conference call Monday afternoon.
Wos, a former U.S. ambassador to Estonia, is a major Republican donor who helped McCrory raise money for his 2012 campaign. He has called her a mentor.
But Democratic leaders in the state House and Senate said this latest agency stumble showed that Wos doesn’t have the skills required to run the department. .
“There’s no question that the challenges faced by DHHS are significant and complex,” Democratic House Leader Larry Hall said in a statement. “That is all the more reason that the agency requires competent leadership with meaningful professional experience.”
DHHS’ problems in recent months have related to the roll out of new computer systems. The agency fielded numerous complaints from health care providers about a new Medicaid claims system called NC Tracks that failed to pay some of them for treating patients. And residents flooded soup kitchens or went hungry when problems surfaced with new public benefits software called NC FAST, which failed to properly issue food stamps.
“It’s just got to stop,” Nesbitt said. “This is a year and three major boo-boos, and it means people are not getting served, and it means people are not getting paid. Those are the major, fundamental functions of DHHS.”
McCrory said those computer programs were “inherited by his administration,” and that the contracts for them were in place when he took office.
Republicans defend Wos
Democrats have little influence over the Republican administration. Republicans, who have majorities in the House and Senate, were quick to defend Wos.
Sen. Andrew Brock, a Mocksville Republican and a chairman of the legislative information technology oversight committee, said Democrats neglected computer systems for years. Brock spoke to McCrory’s legislative liaison Saturday and came away confident that DHHS responded to the problem properly.
“They identified the problem; they’re taking steps to correct it,” Brock said. “They’re doing everything they need to do.”
Rachel Seeger, a spokeswoman for the Office for Civil Rights at the U.S. Department of Health and Human Services, said she could not talk specifically about the North Carolina incident, but when the medical privacy of more than 500 people is violated, the violator must notify the federal government within 60 days. State DHHS said Monday afternoon it had called the federal office.
At the federal Centers for Medicare & Medicaid Services, the office that oversees the government insurance program for poor, elderly and disabled, a spokesman said it had not, however, received a call from state DHHS by Monday morning, but instead had called the agency to find out what happened.
Sen. Tommy Tucker, a Union County Republican and member of a legislative health and human services oversight committee, called the situation “a mess,” but said Wos was not to blame.
“I think the mistake was made well below leadership,” Tucker said, and after the turnover in the DHHS head office in recent years, it would be good to have some consistency. Wos is the third person in five years to lead the agency.