Mitchell County social services reports 98.8% Medicaid audit compliance; guardianship costs and foster caseloads discussed

Mitchell County Department of Social Services staff reported a 98.8% compliance rate in an ongoing state Medicaid audit and updated commissioners on foster care, guardianship and adult protective services caseloads during the March 3 Mitchell County Board of Commissioners meeting.

The updates came as county finance staff said overall spending is running below budget year-to-date but flagged several high-cost areas that will be managed through a planned budget amendment in May.

"As of today ... we are in a compliance rate of 98.8%," Miss Meade, director of the Department of Social Services, told the commission, citing the county's response to a multi-month state audit whose accuracy expectation the staff quoted as 98.7 percent. Meade said the audit has been pulling roughly 20 cases per month and that the county expects final results by mid-April or May.

Child welfare staff reported 31 children currently in custody and several cases moving toward reunification or adoption. "We have 31 kids in custody. And we have 5 kids that are close to their adoption," Mister Sharp, a social services staff member, said. Sharp said six children are on trial home placement after parents completed case plans and that two children had moved to higher-level (level 3) placements.

Sharp also provided intake and investigation figures: the department received 21 calls in March (up from 13 and 14 in January and February), 12 of which were accepted for investigation; at the end of the month the department had 15 open family assessments and six families receiving in-home services (up from three the prior month). For Adult Protective Services (APS), staff reported nine calls in March with four accepted for assessment and three handled as service intakes.

Guardianship caseloads and county fiscal exposure were raised as an ongoing concern. Sharp said the county currently has 15 individuals in guardianship (up one from the previous month) and anticipates two additional guardianships by May 1. He and board members noted that costs for guardianship and some APS services fall to the county and were amplified by recent storm-related needs.

County finance staff reported that, nine months into the fiscal year, expenses stood at about 71 percent of budget (the staff said the benchmark at this point is 75 percent). Reimbursements were reported at about 57 percent (staff said they would expect roughly 58 percent at this point). Finance staff said a $163,000 reimbursement that posted in April for February activity was not yet reflected in the monthly figures and that the county received state disaster funding described in the meeting as $32,004 specifically for APS-related costs. Finance staff said they will pursue recoding eligible disaster-related costs back to that funding and will present a budget amendment in May to move funds to cover high-cost areas such as overtime and facility maintenance tied to disaster response.

On complaints and facility oversight, social services staff described two facility complaints that remained open after being received in March and reviewed the county's process. "If a complaint comes in and it’s screened in, it gets relooked at," Sharp said, describing quarterly facility reviews and the county’s responsibility to submit findings to the state. Meeting discussion clarified that the county follows state guidance on complaint timelines: immediate response for safety issues (within 24 hours), a 14-day timeframe for less-urgent matters, and a 60-day window for completing investigations and reports to the state.

Commissioners and staff discussed onboarding and training for new social services hires. Meade and other staff described multi-week preservice training for child protective services and APS workers and state-required certifications for income-maintenance staff, plus ongoing on-the-job supervision and case transition practices.

The meeting also handled routine business: the board adopted the meeting agenda and approved the March 3 minutes by voice vote, and later moved to adjourn.

Looking ahead, staff said they will finalize the Medicaid audit results in mid-April to May, present a budget amendment in May to address disaster and overtime-driven costs, and continue monitoring guardianship and APS caseloads and associated county expenses.