Liz Zeller tells Washtenaw County board Medicaid reconciliation and cash shortfalls are hampering services

Liz Zeller, identified in the record as an agency official, told the Washtenaw County Board of Commissioners that her agency is working to resolve a disputed Medicaid reconciliation that covers fiscal years 2023 and 2024 and has left the agency short on cash.

"You need transparency, and you need accountability," Zeller said, summarizing her priorities for rebuilding the agency’s financial and reporting systems. She described receiving Medicaid payments in lump sums and the year‑end reconciliation process that can require agencies to reimburse prepayments or, conversely, be repaid if expenditures exceed prepayments.

Zeller said the reconciliation dispute with the agency’s Medicaid partner remains unresolved and that staff have had to ask for early payroll disbursements while accounting systems are rebuilt. She said the situation has forced cost containment measures and reduced discretionary funding for flexible local services.

Why it matters: the funding mechanics Zeller described affect crisis response, case management and psychiatric care for residents who lack private insurance. Zeller said those uninsured patients rely on the county general fund for high‑cost inpatient services and that restoring stable cash flow is essential to avoid service interruptions.

In her remarks Zeller named two crisis‑system leaders, Joe Bartman and Eric from Longstreet, as managers of the county’s crisis response outside the city. She said the agency will provide quarterly updates on quality indicators and recommended the board work with the combined‑county dispute resolution group to revise performance measures in the enabling agreement.

Zeller gave one approximate figure on the record, saying "That is approximately $90,000,000," when discussing the scale of funds involved in the Medicaid program pool. She also described the county’s ability to create a special fund account to hold more flexible local dollars and said pursuing other funding streams is a priority for the next two to three years.

Board action: after Zeller’s presentation the board called for questions and moved on to other business; the transcript records no immediate formal board directive beyond requests for follow up and offers by Zeller to appear at work sessions.

The agency official said staff will continue working to reconcile the disputed years with the Medicaid partner and to rebuild accounting systems before restoring normal levels of discretionary spending.