New Health and Human Services Secretary Aldona Wos came to the General Assembly Wednesday to lay out her departmental priories for the upcoming year.
By Rose Hoban
Medicaid and information technology – those were the two priorities laid out by the new Health and Human Services secretary for her department Wednesday at the General Assembly.
HHS Secretary Aldona Wos came to the state legislature for the second time since taking her position five weeks ago to tell lawmakers what she thinks DHHS needs to do.
Wos said she arrived to find an overstretched, underfinanced and, at times, unprofessional department.
For one division at HHS, Wos read off a list of responsibilities: “Human resources, contracting, construction, privacy, security, internal monitor, facilities controller, equal employment opportunities, information technology, MMIS, NC FAST. Now, what could tie these seemingly unrelated divisions together?” Wos asked. “They all reported to one person. And that one person actually just retired and there’s no succession plan for that position.”
Already, Wos has made some re-organizations, including implementing a new organizational structure. She has also hired a chief information officer to oversee the Medicaid Management Information System and the NC FAST computer system that will be used to determine eligibility for Medicaid recipients.
But she did hint that some of her agency’s problems could be due to the General Assembly.
“We actually have information requests daily for information and we are asked to provide 150 legislative reports per year. That is the equivalent to a report every Monday, Wednesday and almost every Friday,” Wos said, holding up a thick sheaf of papers she said was a legislative report requested on Jan. 30 and required to be returned seven days later with information on more than 1,000 contracts.
Wos said part of the problem at DHHS is the legislature’s lack of trust of the department.
“I firmly believe that the legislature was not receiving the data when it needed it,” Wos said. “So you required frequent reports to insure that you did have it on hand whenever it was necessary.”
Mixed messages
At times, Wos described a department that sounded more like the set for an episode of the Keystone Cops than an agency that manages health care and social services for close to 2 million North Carolinians annually.
“Our staff was bringing papers to my office, dropping them off – the papers had no name, no contact information – and asking me for signatures for something that needed to be done urgently,” Wos said. “One of my first days in the office, a high-level staffer ran into my office visibly flustered and distressed, saying I absolutely needed to sign this contract that moment.”
“Things are really broken, but we are in the process and on the path to fixing it,” she said.
Wos also cut the agency some slack, describing DHHS as having been chronically underfunded, lacking key staff and asked to perform tasks that divert staff time.
Later in the hearing, agency officials informed the committee that they were on target for several massive projects, namely the Medicaid Management Information System and NC FAST.
And as new Medicaid chief Carol Steckel introduced herself to lawmakers, she emphasized North Carolina Medicaid’s nationwide reputation for innovative programs, especially Community Care of North Carolina, the Medicaid medical-home program that assigns a primary-care physician to each Medicaid recipient.
“CCNC is something that many states are trying to build now,” said Steckel, who was the Medicaid chief in Alabama for 10 years. She described how that state has had two committees studying Medicaid reform. “Both committees said we need to look at the North Carolina model and go forward with that. There are states all across the country that are looking at [CCNC].”
Steckel and Wos both said they want to reform Medicaid to make it more efficient and accountable to taxpayers. To that end, they both talked about a recent public request for information.
“The excitement of hearing from across the state about this proposal is actually quite incredible,” Wos told the committee. “We’ve offered the people to come to the table with great ideas. And people are actually saying to the state, ‘What took you so long to ask us?’”
Mistakes were made
Wos herself has had some significant missteps since assuming her position at the head of DHHS; in particular, questions still remain about the appointment of Dianna Lightfoot to the head of the Division of Child Development and Early Education.
In the release announcing the appointment, Wos called LIghtfoot a “strategic and tactical top tier policy executive with extensive healthcare, child welfare and education expertise.” Lightfoot has no training in early-childhood education and had spent the last decade fronting an organization that disputed research on early-childhood development and education. LIghtfoot co-authored a statements on her website claiming publicly funded early-childhood education programs created government dependency and “more of an entitlement mentality.”
She was also found to have made inflammatory statements on Twitter and Facebook, and possibly committed voter fraud by registering to vote using a post office box as her address.
After a media firestorm, LIghtfoot resigned her position two days after being appointed.
Gov. Pat McCrory told News 14 Carolina that Wos was responsible for the hiring. He said “mistakes were made” in the vetting and hiring process.
Wos left the committee room quickly after the hearing, making the excuse that she had a meeting.
“The secretary has said that’s over and done with,” said DHHS spokeswoman Julie Henry. “She doesn’t like to dwell on that.”
Wos also had to backtrack on a dress code that was sent to DHHS employees and then later retracted.
“The version that was distributed was not approved; it was distributed prematurely,” Henry said. “And then once people started asking questions about specifics in it, it was discovered it was not approved. So that was taken back.”
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