Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Medicaid Staffing Hr1 topic
No spam. Unsubscribe anytime.
Rutherford County DSS says state 'HR 1' changes will increase caseloads and require more staff
Summary
Rutherford County Department of Social Services staff told the board Feb. 18 that changes under HR 1 — including more frequent Medicaid recertifications and new work requirements — could require roughly 9.5 additional family-and-children workers and add unfunded costs to the county budget.
Director Hunt and senior staff told the Rutherford County Department of Social Services board on Feb. 18 that a set of state changes they referred to as "HR 1" will shift some Medicaid recertifications from annual to twice a year and increase workload for intake and case maintenance.
"We have 5,424 Medicaid expanded cases in Rutherford County," Susan (staff) said, describing the county's case counts and processing history. "Out of those 5,424 cases, we only had to do the recertification for 3,471 because the others went through straight-through processing," she said, adding that straight-through processing previously handled roughly 36% of cases.
Why it matters: staff said HR 1's move to semiannual recertification and the addition of work-requirement checks will raise intake volume and churn — the repeated cycle of terminations and reapplications — increasing staff needs. "If you do the math, it looks like we are going to assume ... 7,377 additional recerts per year for family-and-children's Medicaid," Susan said, estimating the extra work would amount to about "9 and a half workers" when churn is included. Staff told the board this planning informs requests for additional positions in the county budget cycle that begins in July.
Staff also flagged state-level payment and administration changes that could affect county budgets. The county currently reports a 0% error rate for its own cases, but the state error rate was reported above the 6% threshold; staff said the legislature has not yet clarified how that state-level rate will translate into county-level obligations. A board member who attended a recent National Rural Health Association session called the likely result an "unfunded mandate for counties that will have to absorb the cost." Director Hunt said the directors association is advocating with lawmakers.
What happens next: staff said the effective date for many HR 1 provisions is Jan. 2027 and they will request new positions in the July budget to prepare; hiring and training timelines mean the unit could fall behind if positions are approved late. The board did not vote on new positions at the meeting; staff will bring budget requests and additional detail to the county budget process.
Sources: Projected case counts, straight-through processing rates and the 9.5-staff estimate were presented to the board by Susan and Director Hunt during the Feb. 18 meeting.
