AGENDA DATE: 8/1/2018
TITLE:
Title
Social Services Request for New Positions for the UVA Medicaid Unit
BODY
SUBJECT/PROPOSAL/REQUEST: Authorize Social Services (DSS) to hire an Eligibility Supervisor, Eligibility Worker and DSS Specialist to meet demands of Medicaid Expansion in the hospital setting
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. At the Hospital, where DSS staff assist with applications from all over the state, it has been estimated that between 17,000 and 20,000 indigent patients this past year would qualify for the Medicaid expansion.
STRATEGIC PLAN: Quality Government Operations. Ensure County government’s capacity to provide high quality service that achieves community priorities
DISCUSSION: The collaboration between DSS and UVA Hospital for rapid application and case processing of Medicaid applications is unusual and highly successful, with many beneficiaries. The total amount for Medicaid Unit collections for FY17 is $29,053,810.24, which paid for medical services for low-income customers. UVA Patient Financial Services is very interested in seeing a smooth transition from funding for indigent customers to funding from Medicaid Expansion for those eligible. UVA administration has expressed support for the expansion of Medicaid Unit staffing.
It is the opinion of Social Services administration and eligibility supervisors that additional staffing of three additional positions should be provided: one eligibility supervisor at paygrade 17, one eligibility worker at paygrade 12, and one administrative professional (DSS Specialist III) at paygrade 9 (See Attachment A).
BUDGET IMPACT: Total cost for the three recommended positions in the first year including one-time start-up costs is approximately $221,155. Positions at UVA Medicaid are paid for through state funds coming to the hospital (25%) and federal funding (75%). The Federal match is higher because it is a Medicaid-only program. No local money is required for these positions.
RECOMMENDATION:
Recommendation
Staff recommends Board approval for the hiring of three additional positions for the UVA Medicaid unit in FY19 to meet the demands of Medicaid Expansion, which is beginning January 1, 2019. Positions will be advertised in early September, with anticipation of having staff hired and beginning orientation and training by November 1, 2018.
ATTACHMENTS: Attachment A UVA Positional Costs