AGENDA DATE: 8/1/2018
TITLE:
Title
Social Services Request for New Positions for Medicaid Expansion
BODY
SUBJECT/PROPOSAL/REQUEST: Authorize Social Services (DSS) to hire two Eligibility Workers and DSS Specialist to meet demands of Medicaid Expansion
ITEM TYPE: Regular Action Item
STAFF CONTACT(S): Richardson, Walker, Savides
PRESENTER (S): Phyllis Savides
LEGAL REVIEW: Not Required
REVIEWED BY: Jeffrey B. Richardson
BACKGROUND: On May 30, 2018 the Virginia legislature voted to make government health insurance available to 400,000 low-income residents, and on June 7, 2018 Governor Northam signed the budget into law. Virginia joined 32 other states and the District of Columbia in expanding Medicaid coverage. The measure is expected to take effect January 1, 2019. Under the Affordable Care Act, the federal government allows states to open their Medicaid rolls to people with incomes up to 138 percent of the federal poverty level, which is $16,643 for an individual. The federal government pledged to pay at least 90 percent of the cost of expansion. According to one estimate, approximately 2900 individuals will become eligible in Albemarle County.
STRATEGIC PLAN: Quality Government Operations: Ensure County government’s capacity to provide high quality service that achieves community priorities
DISCUSSION: The Medicaid caseload has been growing substantially in recent years; workload measures generated by the Virginia Department of Social Services and used by DSS to assess capacity have demonstrated that the department is chronically short-handed in our eligibility units and will be exacerbated without additional positions for Medicaid Expansion (illustrated in Attachment A).
As many as 2900 new applicants and ongoing cases will be a daunting challenge. In order to avoid being swamped by Medicaid Expansion and to meet the demands of additional applications and renewals in a timely fashion, Social Services requires additional personnel. Along with Medicaid expansion, the Virginia legislature approved additional funds for eligibility worker positions for local departments of social services.
The allocation for Albemarle County which is included in the department’s base budget (for ongoing funding) is approximately $183,000. The money became available July 1, and so funds are ready for deployment. The state will provide the local match for FY19, but then the County will need to build the match (15.5%) into the budget from FY20 forward.
Upon review, it is the opinion of Social Services administration and eligibility supervisors that the money can provide and best be used for three additional positions: two eligibility workers at paygrade 12, and one administrative professional, a DSS Specialist III at paygrade 9 (see Attachment B). The three positions would be advertised in mid-August, with anticipation of having staff hired and beginning orientation and training by November 1, 2018.
BUDGET IMPACT: No or minimal budgetary impact in FY19, which include some one-time start-up costs including space provision. The locality will be responsible for the match of 15.5% of overall positional costs from FY20 forward. For example, 15.5% of $183,000 = $27,450.
RECOMMENDATION:
Recommendation
Staff recommends Board approval for the hiring of three additional positions in FY19 to meet the demands of Medicaid Expansion, which is beginning January 1, 2019. Positions will be advertised in mid-August, with anticipation of having staff hired and beginning orientation and training by November 1, 2018.
ATTACHMENTS:
Attachment A - Graphs: Positional shortfall and Applications
Attachment B - Positional Costs