Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the County Finance topic
No spam. Unsubscribe anytime.
Caswell County health director says recent Medicaid reimbursements are pass-through funds, not available for general use
Summary
County health director told the Board of Commissioners that a recent large Medicaid reimbursement and new state funds are restricted and cannot be used to replenish county fund balance; department and county finance are still reconciling records ahead of overdue audits.
Jennifer Eastwood, Caswell County health director, told the Board of Commissioners on Oct. 20 that a roughly $616,000 Medicaid payment tied to 22 clients is a pass-through reimbursement for specific services and cannot be treated as general county revenue.
Eastwood said the funds are for the Community Alternatives Program, which supports people with disabilities and medically fragile children to remain at home. "It's a pass through money. It's not actually revenue that's gonna sit in our coffers, so to speak," she said.
The health director told the board the department's internal books (QuickBooks) show a surplus for several programs even while the county finance system (Munis) shows a shortfall for the same period. She said staff and finance are working to reconcile the differences, and that 2024 has been reconciled while 2025 reconciliation remains in progress.
Eastwood also warned of program risks tied to larger state and federal actions. She said October 1 brought a 3–8% reduction in Medicaid payments for the county's Medicaid services and that a federal shutdown was disrupting the WIC program. The state, she said, is covering WIC temporarily but county appropriation is not available to backstop the program long term.
County Manager Scott Whitaker and board members asked for follow-up from the finance office. Whitaker said savings from current vacancies could cover some near-term needs, and Finance staff were providing regular reports. Board members pressed for a clearer explanation of a line item labeled "fund balance appropriation" (about $336,412) in the September financial packet and asked that Chief Finance staff provide a reconciliation update.
Board members and health staff said the discrepancy partly arises because the health department maintains multiple program-level budgets and uses QuickBooks for detailed program tracking while Munis is the county's official accounting system. Eastwood said the department had provided QuickBooks reports to Finance to support reconciliation.
Why it matters: Commissioners said they want clarity before committing any one-time funds to balance budgets. Eastwood asked the board to note that state and federal restrictions and anti-supplanting rules limit how state or Medicaid funds can be used.
The board did not take formal action on the matter; members directed staff to continue reconciliation and to report back.
