Becketts warns of more social-service bottlenecks

Dec. 04, 2013 @ 06:41 PM

Come spring, people in Durham who rely on Medicaid and food stamps likely are in for more trouble in securing access to those subsidies thanks to a still-new state computer system, said Social Services Director Michael Becketts.

“It has been a rather turbulent year for social services,” Becketts told County Commissioners this week. “The picture for next year doesn’t look any better.”

Slowdowns in the flow of aid are likely because the department faces a doubling of its application-processing workload from March to June, when it’ll have to recertify the eligibility of many of its Medicaid recipients.

Any problems there can affect food stamps too because the state now handles both programs through a single database called NC FAST.

The state opted to combine the processing of paperwork for the two programs as both an efficiency and customer-service measure.

But the switchover to the new database has been rocky, contributing this past summer to a slowdown in the flow of food stamps that in turn sparked a run on the services of local food banks.

Becketts said the problems with NC FAST continue, and have been exacerbated by issues involved in interfacing with new health-insurance programs set up in response to the federal Affordable Care Act.

The system as of Monday morning had been down for nearly four of the past 10 workdays, Becketts said.

Compounding matters, county social service departments around the state have received conflicting advice from different arms of the N.C. Department of Health and Human Services, he said.

Some opinions from that quarter clearly matter more than others, but “what we want from the state is accurate information with a single point person who would actually be responsible for telling us what it is we need to be doing,” he said.

Becketts added that state officials of late have hinted that county-level agencies like his should hire more staff if they face backlogs in processing applications.

That was the approach the Durham department took last year during the first wave of problems, at the cost of some friction with County Manager Mike Ruffin, who was at first dubious of its staffing requests.

This time around, Becketts fears problems will hit hardest on the Medicaid front, affecting particularly the ability of his clients to purchase medicine.

To counter that possibility, he’s been talking with Duke University Health System officials, warning them that they could face a run on emergency room services.

His worries are finding a receptive ear in the Duke administration. Health System President Victor Dzau attended Monday’s commissioners meeting to present DSS with a $25,000 donation for emergency food and medicine.

“When Michael came to talk about the predicament he found himself in with Social Services and the issue, shall we say, with NC FAST, I said something needs to be done,” Dzau said. “And we’re very happy to do something for the citizens of Durham.”

Monday’s donation might not be the last, as Becketts said Duke Health officials are trying to determine “how much money they could put behind an ‘insurance policy’ in case people lose access to their benefits.”

But he made it clear that his purpose in briefing commissioners Monday was first to get them to meet with the Social Services board, and more importantly to enlist them in prodding the state to lend a hand.

Commissioners agreed to try, but said they would likely do so through the N.C. Association of County Commissioners. The organization is a lobbying arm for county governments across the state.

It is also, by its nature, bipartisan, which could matter given that the Durham commissioners are all Democrats and state government is in the hand of Republicans.

Becketts in requesting “political advocacy” by county officials was adopting an approach favored by critics of his predecessor, former Social Services Director Gerri Robinson.

Before Robinson’s ouster in 2011, a former subordinate, Sharon Hirsch, faulted her for providing “no advocacy for low-income people [or] progressive policies” at the statewide level.

The NC FAST problem, however, touches on some of the more polarizing political debates in both the state and the U.S.

Health and Human Services Secretary Aldona Wos has been easily the most controversial member of Gov. Pat McCrory’s administration. She came to the post with a background as a physician and as a political fundraiser, but had little in the way of large-enterprise management experience.

The Affordable Care Act – more colloquially known as “Obamacare” – is the focus of bitter partisan debate nationally, and as such was a factor in the fall’s federal-government shutdown.