N.C. Legislators Don't get Answers they Want About DHHS Problems

NC FAST’s inability to processes food-stamp applications re-emerged, and the erroneous mailing of nearly 49,000 children’s Medicaid identification cards over the New Year holiday period.


There were no fireworks or demands for the resignation of North Carolina’s health secretary during the opening of a joint legislative oversight committee meeting Jan. 14.

However, several legislators — including Sen. Earline Parmon, D-Forsyth, and Sen. Martin Nesbitt, D-Buncombe — asked Secretary Dr. Aldona Wos to tell them when the problems with the NC FAST and NCTracks programs would be resolved.

Wos was making her first public appearance since issues with NC FAST’s ability to processes food-stamp applications re-emerged, and the erroneous mailing of nearly 49,000 children’s Medicaid identification cards over the New Year holiday period.

Those topics, as well as concerns about the N.C. Department of Health and Human Services’ overall effectiveness, dominated the first 68 minutes of the meeting even though they were not on the agenda. The questions and Wos’ responses were civil.

Wos and the Department of Health and Human Services have been criticized by legislators and advocates for several financial and technological issues, including:

  • Struggling to get the NCTracks Medicaid payment-processing and NC FAST food-stamp application systems functioning properly;
  • Providing high-dollar state personal contracts to consultants with limited health-care qualifications, including one who works for Wos’ husband at New Breed Logistics;
  • Offering less-than-complete updates to the oversight committee.

Wos attempted to head off some of the more critical questions in her opening comments. She said she was “deeply apologetic” for the impact on recipients and their families caused by the Medicaid ID card problem, saying that the agency’s response to the crisis did not meet her expectations.

“I’m terribly disappointed,” Wos said.

Two Democratic committee members — Rep. Beverly Earle of Mecklenburg County and Rep. Michael Wray of Halifax County — as well as the state legislative Black Caucus have called on Gov. Pat McCrory to ask for Wos’ resignation.

Earle and Wray said the final straw for them was the erroneous mailing of the Medicaid ID cards. Officials said that problem affected 9,323 children in the Triad and Northwest N.C.

Earle and Wray also cited DHHS’ slow and incomplete response to the situation, which began Dec. 30 but wasn’t acknowledged publicly until Jan. 3.

The agency blamed human error in computer programming and ineffective quality assurance. Wos has requested two separate investigations. She said those investigations are about halfway complete, and that she expects to provide an update next week.

It is likely the N.C. DHHS could face significant fines from federal health agencies, potentially up to $1.5 million, for violating HIPAA policies.

Earle and Wray said that DHHS “intentionally released misleading information regarding the release of these private Medicaid records.” Parmon has made similar comments, individually and through the legislative Black Caucus.

Wos said it was “unacceptable that the issue was not elevated” to her office “as soon as the problem was identified.”

Most of the questions directed at Wos came from Democratic legislators.

Wos, as well as other DHHS officials, placed some blame for its information-technology mishaps on federal Affordable Care Act regulations that they say continue to change in unexpected ways.

Parmon asked Wos about the potential cost of the Medicaid ID card mistake. Wos said it would cost about $40,000 to reissue new Medicaid ID cards and mail them, an expense that would be absorbed by DHHS.

On the food-stamp recertification issue, Wos and DHHS officials said they have been exchanging information with the U.S. Agriculture Department since the federal agency sent a letter on Dec. 11 warning DHHS that it was prepared to sanction the agency for failing to show it was resolving widespread problems.

“These delays are completely unacceptable and a serious failure on the part of North Carolina. ... We have grave concern for the low-income people of North Carolina who are waiting for assistance,” the federal agency said.

DHHS officials said that part of the challenge is the significant number of recipients submitting multiple re-certification applications, online and in person. The multiple submissions were caused in part because of the program’s slow response to the submissions.

Sen. Floyd McKissick Jr., D-Durham, said he was “disturbed” that Wos and DHHS officials led the committee to have a “comfort zone” with NC FAST following their October presentation, including assurances that kinks in the system had been resolved.

He said the U.S. Agriculture Department letter has damaged DHHS’ credibility and integrity “if we can’t depend on information in meetings like these, and not getting information in a timely fashion.”

“I feel like we’ve been kept in the dark, especially when I’ve gotten calls in the past week from county officials saying things (with NC FAST) are not working well,” McKissick said.

Nesbitt said it is clear that NCTracks and NC FAST “continue to struggle” even when “victory was declared on NC FAST.” He recommended that Wos and DHHS reallocate resources and personnel to get more people involved in fixing the programs.

Nesbitt requested that DHHS submit data and trends on both programs in a quicker and more transparent way. He also wants Wos to submit “a written plan of action” that should include her estimate of when the problems with both programs will be resolved.

“People are getting crushed out here,” Nesbitt said.

Wos agreed to provide the updates, but demurred on a timeline for the completion of action. She said such a deadline would not be available given “there is no start and finish line with information technology.”

Sen. Shirley Robinson, D-Guilford, said she was not reassured by the answers she received from Wos and DHHS officials.

"They are talking about how complicated these programs are to run, but the people who are going without their food stamps don't care about that," Robinson said. "They just want it fixed so they can feed their families."

©2014 Winston-Salem Journal (Winston Salem, N.C.)