NC DHHS comes up short on answers after meeting with legislators

by Lynn Bonner, News and Observer, October 9, 2013.

After grilling leaders at the state Department of Health and Human Services for about nine hours on Tuesday about flawed programs and high salaries, lawmakers on both sides of the aisle expressed frustration.

Legislators didn’t get a firm date for when a Medicaid claims payment system that’s frustrating hospitals, doctors and medical equipment companies will work as advertised.

Nor were some happy with DHHS Secretary Dr. Aldona Wos’ explanation that she followed state rules when paying two 24-year-olds $85,000 and $87,500 respectively.

It’s hard to respond to constituents who read that someone with an English degree and one year out of college is making more than twice what a teacher with five years experience earns, Sen. Tommy Tucker, a Union County Republican, said. “I’m disappointed,” he said. “We get blamed for your actions.”

Problems and controversies have beset the large state agency in the last few months. The only area where legislators seemed satisfied was with the improved performance of the computer system that provides needy residents with food stamps. But even as the day progressed, the agency was buffeted by more problems and questions.

Wos was asked about a new report from North Carolina Health News that DHHS changed its responses to a critical state audit of Medicaid, including editing out an explanation for a misleading audit finding that administrative costs were higher in North Carolina than in comparable states. Gov. Pat McCrory’s administration has used the audit to push the narrative that the state Medicaid system is “broken.”

“It concerns me tremendously when I see us fiddling with the facts,” said Senate Minority Leader Martin Nesbitt, an Asheville Democrat. “We need accurate information.”

Short on answers

State Rep. Beverly Earle questioned a contract that pays former state Auditor Les Merritt, a Wake Republican, up to $312,000 a year and the $40,000 payment to a Wos former chief of staff after he left his job. Earle became frustrated when Wos told the DHHS human resources director to respond rather than answer the question herself.

“I feel like we have a right to ask the secretary direct questions and get a direct answer,” said Earle, a Charlotte Democrat. “She made these decisions. I think someone needs to be held accountable.”

Answering questions later about the two former aides to Gov. Pat McCrory’s campaign who landed high paying jobs at DHHS, Wos said she hired the best people for the positions. One of the 24-year-olds, DHHS spokesman Ricky Diaz, pulled Wos away from reporters when she was asked if she considered any other candidates for those jobs. She did not answer.

Medical billing problems

Legislators heard horror stories from medical providers who said they have tried without success to get payments for Medicaid services from the new system built by Computer Sciences Corp. that the state calls NC Tracks.

Sandra Williams, CFO of Cape Fear Valley Health Systems, said hospitals and doctors have had problems getting paid even though Cape Fear participated in testing the system and trained 100 people to use it.

“NC Tracks has made billing go from complex to borderline impossible,” she said.

Mike Gaffney, a vice president at CSC, told legislators the system has a “mix of defects” that would take three to six months to resolve.

“CSC will be doing all the heavy lifting,” he said.

Sen. Jeff Tarte, a Mecklenburg Republican, was not satisfied with the answer and threatened to subpoena reports that a former company official had refused to hand over voluntarily.

Tarte demanded payments to health care providers and fixes to the computer system, but said the criticism of personal services contracts was overblown. The $125 an hour that Wos adviser Joe Hauck makes is less than an inexperienced consultant would earn, Tarte said. Hauck is a vice president in Wos’ husband’s company and is working on a contract that will pay him up to $310,000 for about 10 months of work.

Wos credited Hauck with a plan to save more than $5 million a year by hiring permanent nurses to replace contract nurses in state facilities, though the plan has not been put into action.

“If we can hire 100 people at this rate, it’s worthwhile,” Tarte said. “You need to come out and communicate the results.”

Dr. Aldona Wos has made controversial hiring decisions since becoming secretary of the Department of Health and Human Services this year. Here is a list some of those people and their salaries.