Local agencies gearing up for new Medicaid recipients

Local social services agencies continue to prepare for the registration of new Medicaid-eligible residents in the New Year.

It could mean adding new staff to handle the influx as well as a reduction in state funding expected to be covered with the new federal dollars, officials said.

Effective Jan. 1, an estimated 1,900 Culpeper County residents could become eligible for health coverage through Medicaid per the Affordable Care Act expansion approved earlier this year by the Virginia General Assembly.

Rappahannock Rapidan Community Services Board Director Jim LeGraffe gave a presentation on the topic last week at the Culpeper County Board of Supervisors meeting. The agency provides services as well in the surrounding counties, where residents will also be newly eligible to get Medicaid – 1,600 in Fauquier, 700 in Madison, 1,200 in Orange and 300 in Rappahannock, according to LeGraffe.

Supervisor Sue Hansohn asked how his agency was gearing up to handle the new caseloads.

“How many more employees will you need and will the state pay for that?” she asked.

LeGraffe responded by saying community services board statewide would experience a reduction in state allocations to cover the estimated $200 million cost to Virginia to expand the program. He noted his agency “accepts patients regardless of their inability to pay.”

Providing expanded Medicaid access to these same patients will “fill up that void,” LeGraffe said, of the federal government’s pledge to pay at least 90 percent of the expansion cost.

“That is the big hope,” he said, adding, “Hope is not a strategy.”

LeGraffe said his agency would work closely with Culpeper County Department of Social Services to get newly eligible residents enrolled in the health coverage program as quickly as possible “so we are able to maintain a funding stream.” The Medicaid expansion will allow the local community services boards to bill the federal program for the additional patients not previously covered.

Hansohn reiterated her worry that staff would be inadequate to handle the new caseload.

“With the same number of people serving additional folks, it’s going to be rough,” she said.

LeGraffe said his agency would continue to recruit for any needed positions.

Of Rappahannock Rapidan Community Services Fiscal 2019 budget of $26.4 million, 36 percent or $9.5 million comes from Medicaid fees paid on behalf of clients already covered by the program, he said.

Per Virginia’s plan to expand Medicaid, hospitals will be taxed to generate revenue for the state’s 10 percent share of the roughly $2 billion annual cost. Under the Affordable Care Act, newly eligible for Medicaid are people with incomes up to 138 percent of the federal poverty level—$16,750 a year for an individual and $28,700 for a family of three.

Culpeper Human Services Director Lisa Peacock said her agency is preparing for its role in the Medicaid expansion.

“We will be ready when enrollment begins,” she said.

Eligibility Supervisor Teresa Jenkins said enrollment would be done at different levels beginning Jan. 1. People already enrolled in mental health coverage through the Governor’s Access Plan who meet the new income guidelines will automatically be enrolled for Medicaid directly at the state level, she said.

Additional enrollments will take place at the central processing unit in Richmond based on identified targeted groups, Jenkins said, while other applications will be processed through the Marketplace when someone applies for their services.

Other populations will be part of a mass mailing in October to food stamp recipients not on Medicaid and will be able to respond to the local agency or state central processing unit to sign up, she said.

In addition, starting in November citizens may make application online, at the call center or at the local agency and those applications will be processed by the local DSS office, according to Jenkins.

It will likely result in new employees needing to be hired.

“We are gearing up for the additional potential Medicaid recipients in our local office and the man power to be able to process the applications,” Jenkins said. “DSS is currently advertising to hire additional staff that will needed and educating the community on what the new guidelines are. We have received some phone calls on the new category and I am sure that will increase closer to the release date of the program.”

Madison County DSS is currently advertising online to hire a benefit program specialist I with a job title to include the processing of Medicaid applications “within strict timeframes.” The annual salary advertised for the position is $27,366.

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