BC 2009 05 20 Recessed - Budget Meeting

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May 20, 2009 (Recessed Meeting) Page 1401 eliminate time spent looking for records and filing papers. We are looking forward to implementation of this application agency wide. Position requests: • Foreign Language Interpreter - 1 position • Income Maintenance Caseworker - 9 positions Income Maintenance Casework Position Requests The Department has included in the FY10 budget a request for four (4) Income Maintenance Caseworker II positions to manage cases involving Medicaid and Food and Nutrition Services (formerly known as Food Stamps). The chart below represents the cases active each December from 2000 through 2008 along with the caseload as of April 2009. The staff available to manage these cases and the average caseload are also shown for 2002 through April 2009. Dec-00 Dec-O1 Dec-02 Dec-03 Dec-09 Dec-OS Dec-06 Dec-07 Dec-08 Apr- 09 Total Cases (Medicaid and Food Stam s) 10,929 12,561 15,055 18,103 19,982 21,751 22,913 29,038 26,728 27,717 Income Maintenance Staff w/ caseloads 33.75 35.75 39 90 93.25 93.25 48.75 98.75 Average caseload per Worker 996 506 500 599 518 556 598 569 Annual growth in cases 158 208 208 88 128 38 78 11.198 13.09& Unemployment rate 3.68 5.8$ 5.38 8.18 4.78 4.08 3.88 4.98 8.5$ 11.38* *3/09 - The most recent unemployment figure available Summary • Cases in Economic Services (Medicaid and Food Stamps) have grown an average of 12o annually since 2000. • While the growth rate may increase during periods of high unemployment, no corresponding reduction in cases during low unemployment has been observed. • Caseworker staff increases have not keep pace with growth in cases. The average caseload in December 2002 was 946 while the average caseload in December 2008 was 548 cases. The average caseload per caseworker increased even with the addition of 15 caseworkers. • As of April 2009, using a caseload standard of 500 cases per worker, 55.9 caseworkers would be necessary to manage existing cases - an increase of 6.65 workers. Conclusions • While utilizing untrained staff loaned from other departments has helped in the agency's ability to accept applications for assistance and gather the required documentation, the need for trained staff familiar with the program policy to apply policy to determine the eligibility for each case (application or review) has not been addressed. • Failure to determine eligibility properly or within the established time frame increases the County's liability. With the State assuming the total cost of non-Federal share of Medicaid in FY10, we have been advised to expect an increase in monitoring activity by the State and closer scrutiny of our actions and documentations with the County charged for the cost of services received in error. While the State has not offered any dollar amount, the general consensus is to expect some County payback for errors. Mr. Young and staff responded to a variety of questions from the Board. Recess