Wos' worries

Editorial by Greensboro News-Record, September 28, 2013.

Gov. Pat McCrory promises big changes in the delivery of Medicaid services, but getting there won’t be easy.

The job took a setback this week when the woman hired to spearhead the effort, Carol Steckel, announced she’ll leave next month. Worse, she can’t make key decisions in the meantime because she’s going to work for a company that will bid for the state’s Medicaid business.

Steckel came with high-level experience in Medicaid management in other states. Until someone fills her post, the people in charge of devising a new Medicaid model are Joe Hauck, a consultant on leave from his job as vice president of sales, marketing and communications at New Breed Logistics in High Point, and Mardy Peal, who was hired earlier this month. Peal holds a master’s degree in health education but had not worked in health care since 1999. So Steckel’s departure leaves a huge gap.

Already, the Department of Health and Human Services has encountered operational troubles. Its NCTracks Medicaid computer payment system has drawn complaints from medical providers. That’s not a surprise. McCrory’s administration inherited a system that was behind schedule and over budget. But it insisted it could get it online by the target date of July 1. It did, but with plenty of glitches — although DHHS officials seemed reluctant to acknowledge them.

More media attention has been drawn to department hires, high salaries and big pay raises granted even after the governor’s office ordered a pay freeze across state government. DHHS seems to be an exception.

Former state Auditor Les Merritt was signed to a $312,000 one-year contract in May and given a title as chief financial officer for the Division of Mental Health, Developmental Disabilities and Substance Abuse Services. This week, when asked by a reporter whether working for the state while serving as a member of the State Ethics Commission — which can pass judgment on state employees — posed a potential conflict of interest, Merritt resigned the ethics seat. Someone should have seen the conflict before Merritt was hired. It’s just another example of the smoke clouding the work of this agency headed by Greensboro’s Aldona Wos. She hasn’t done enough to clear the air, offering few public explanations.

Is there a fire under that smoke? It’s too soon to say. Drawing rash conclusions — that the department is dysfunctional and Wos should go — isn’t helpful. DHHS is the most complex agency in state government. It administers a massive program that operates under federal rules and deals with a medical economy where costs always go up and opportunities for waste and fraud seem boundless. Past audits showed that North Carolina’s Medicaid program incurred higher administrative costs than most other states’.

Wos deserves time to show what she can do. But she must set realistic goals, achieve stability in key positions and be candid about progress and problems.