Restructuring DHHS in North Carolina

This year North Carolina’s Department of Health and Human Services has remained under the spotlight of the General Assembly, as well as the residents of the state. DHHS has faced many issues over the last year; ranging from potential sanctions from the federal government due to backlogs with the food stamp program to legislators questioning the ability of the leadership of the agency. Now DHHS Secretary Dr. Aldona Wos is preparing to face the joint oversight committee to discuss multiple issues regarding the status of the agency. The most serious topics of discussion are things such as: updates on restructuring of DHHS, costly contracts for consultants, ongoing issues with the NC Fast (food stamp program), reviewing fiscal performance for 2013-2014, and reviewing the overall budget for Medicaid.

Both Democrats and Republicans share some of the same concerns when it comes to DHHS. While other concerns are split between the two parties. Democrats seem to have their sights set on obtaining answers to the inability of DHHS to completely resolve the backlog with the NC Fast and NC Tracks applications and their ongoing software issues. The Republican leaders are more concerned with the lack of predictability regarding Medicaid costs for the state and they are also proposing privatizing Medicaid. The oversight committee will also be looking into the accuracy of fiscal data that has been presented previously and recently regarding whether or not DHHS ended fiscal year 2013-2014 with a surplus or not. Secretary Wos recently informed legislators with reports stating that the Medicaid program had a surplus of $63 million. However in April, the CFO of DHHS projected a shortfall in the ballpark of $120-140 million for the same fiscal year. Which leaves many legislators questioning how Secretary Wos obtained her figures and whether or not the data they are provided is accurate or not. http://goo.gl/ZELxw7

Some Republicans have suggested that the state’s Medicaid program no longer remain under the control of DHHS. In addition to removing Medicaid from DHHS’ control, there have also been suggestions that a new state governed agency be created to provide oversight for Medicaid. Secretary Wos disagrees with the suggestion to remove Medicaid from DHHS. Her rationale is that removing the Medicaid program from DHHS would undermine plans to restructure the entire agency, which would be the first major overhaul of DHHS since the late 70’s. Under the Secretary’s restructuring plans, DHHS would create five separate divisions that would create an agency that can better serve the residents of North Carolina. http://goo.gl/bSr318

There seems to be concerns across the board regarding many aspects of what is going on with DHHS. Hopefully in the upcoming hearings and meetings held by the joint oversight committee there will be some clarification on many of the issues that surround DHHS. Whatever happens Secretary Wos should be prepared to not only answer the many questions and concerns of the committee members, but also be prepared to provide data/evidence to support what she is reporting. Otherwise concerns about DHHS will continue to linger in the minds of committee members and the residents of North Carolina.

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Will NC Allow Agencies to Add or Obtain a New License to Provide In-Home Aide Services in the Near Future?

The Journey Begins Sign

Since July 1, 2011 North Carolina’s Division of Health Regulation Service (DHRS) Acute and Home Care Licensure and Certification Section (a division of North Carolina Department of Health and Human Services) has placed a 3-year moratorium on issuing new Home Care Agency licenses for in-home aide services. This July marks the end of the 3-year moratorium and many aspiring Home Care Agencies and current Home Care Agencies that are looking to expand the services they offer. Many are wondering if DHRS will lift the ban. As of May 2014 according to data published by DHRS, there are currently 1,000’s of Home Care Agencies across the state of NC offering different services that range from Private Duty Nursing, Infusion Services, Hospice Services, Medical Social Work, and in-home aides.

There is some speculation that there are hundreds of applications that have already been filed with DHRS in an effort to be one of the first agencies in line to be issued a license to offer or add in-home aide services to their agencies. However many are still question whether or not the moratorium will actually end in July. So far there has been no indication from the DHRS that they intend to begin to accept applications again on a specific date or that they will be extending the moratorium until further notice (or another specified date.) It seems that there are so many unanswered questions at this point as far as in-home aide services are concerned at this point. Which leaves many to begin exploring alternative options with so much uncertainty and July 11th quickly approaching.

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What some people fail to understand is, everyone that is sick or who might have a minor injury, or may undergo a minor surgical procedure does not belong in the hospital or a nursing home or rehabilitation facility. Many times procedures can be provided in an outpatient setting, which would allow patients to recover in the comforts of their own home. In some cases those who have had minor injuries and/or procedures just need a little assistance and that’s where in-home aides play such a valuable role. In-home aids are able to assist with things like meal preparation, medication reminders, and can assist with allowing other healthcare providers to gain access to the patient/client so that they can receive additional medical treatment in their home. Aides often times make being at home a safer and a more comfortable environment for some and provide an additional support system in other situations while loved ones go to work.

With proper monitoring and management of in-home aides and protocols in place to follow-up with the satisfaction of the patient/client, quality service can be provided without wasting tax dollars or other insurance benefits (which ultimately drives up the cost of care for other patients.) When the announcement was made and the moratorium was put into effect in 2011, no reason or rationale was ever given, and to this day there is still no known reason. Until July, those of us in the healthcare industry will wait and see what DHRS decides to do.

Make this short week a great week!

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