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John K. Eller IV Director MEMORANDUM To: John Day From: John Eller Date: September 14, 2007 ', CABARRUS COUNTY Department of Social Services Re: Request for three (3) new IMC II positions Rita C. Williford Board Chair I am asking that you support my request for three additional Income Maintenance Caseworker II (IMC II) positions to ensure the Department's compliance with Federal regulations and meet community needs. These positions will be placed as follows: One at the Cabarrus Community Health Center on McGill Ave which is a Federally Qualified Health Center (FQHC) and our presence there is mandated. A second at the Cabarrus Health Alliance at their request and expense, and a third one in-house to work with Southern Piedmont Community Care Plan focused on enrolling Medicaid recipients in the managed care plan, Carolina Assess. McGill Medical Center Out-post In June, we learned that the new Community Health Center located on McGill Ave had been designated as a Federally Qualified Health Center (FQHC). DSS is mandated to place staff at FOHCs to take Medicaid applications. McGill staff has repojted that they see 35-38 individuals without health insurance per day -which would require us to fully staff the McGill Medical Center during normal business hours. This increase in workload was not anticipated during the regt}lar budget process. The number of income maintenance cases handled has increased 3.31 % since January 2Q07 (a rate greater than projected when preparing the FY08 budget). During the budget preparation, we projected a~ caseload (excluding CCP) of 22,808 for July 2007 with the actual caseload for this month at 23,232 (424 higher tljan projected). We do not have the capacity to place an existing IMC position at the McGill site. Therefore, I am requesting an additional Income Maintenance Caseworker II position for this site. The Family & Children's Medicaid manual clearly defines the requirements for an FOHC in Section 3200 tll B 8 as follows: 8. Mandatory Outstations l Staff must be available a(Disproportionate Share Hospitals (DSH) and Federally Qualified Health Centers (FQHC) located in the county to taake MPW and MIC applications. The county DSS must have a signed agreement with each DSH and FQHC onjhow to staff each outstation facility in the county with an Income Maintenance Caseworker (IMC). The agreement must be whiten and signed by the director of each involved agency and updated yearly. a. Hours of operation at the mandatory outstations must be the same as the local DSS agency unless the site is used infrequently. In/regGently is defined as serving less than 30 individuals not covered by Medicaid or North Carolina Health Choice (NCHC) in a week. Currently one staff person at DSS is assigned to the role of Carolina Access or Managed Care Coordinator to be available for recipients, providers, end caseworkers needing assistance with the Carolina Access program. This `" S