Dealing with federal Affordable Care Act, new state rules require more staff
An expected increase in Washington County health care cases due to the Affordable Care Act and a new state assessment process will require more personnel to handle the work load, the Board of Commissioners learned during another round of 2014 budget workshops Tuesday.
Community Services Department officials said the growth of health care cases since the recession has stabilized at about 9,400 from 6,700 at the start of the economic downturn. However, CSD officials expect another 2,600 cases will be added by implementation of Obamacare and converting current cases to follow the new system rules.
The department added nine staff positions this year to handle ACA cases, according to CSD officials.
Because the state legislature mandated a new assessment process — MnCHOICES — to determine how disabled and older county residents receive services, CSD officials expect increased hours required to do 3,500 annual assessments. CSD will add 10.5 staff positions to comply with the new MnCHOICES rules, officials added.
CSD has a $39.2 million proposed 2014 budget, with half the revenue from the tax levy, a third from federal sources, 15 percent from the state and the remainder from other revenue sources. Major department expenditures are:
- $15.7 million in social services that include child care assistance, child support, food support, medical assistance, Minnesota Family Investment Program and housing.
- $10.8 million in economic assistance.
- $7.49 million for mental and chemical health including assessment, therapy, psychiatry, case management, medication management, housing and crisis services.
- $2.8 million to the WorkForce Center for unemployment counseling, resource rooms, senior and youth programs, job search workshops and unemployment insurance.
- $2 million in administrative costs.
- $186,000 for veterans services.
The Department of Public Health and Environment also expects to see services affected by implementation of ACA. DPHE already sees increases in family health home visits and County Jail medical services and costs.
On the environmental side, DPHE expects more residential septic systems will need inspections or replacing as the housing market improves.
Other 2014 projects DPHE plans are adoption of community health improvement and groundwater plans, implementing a county solid waste master plan and evaluation of the county’s Environmental Charge.
The DPHE’s proposed $13.4 million 2014 budget is 4 percent higher than in 2013. About 10 percent of the DPHE budget comes from the tax levy, 47 percent is from the county environmental charge assessed on trash collection bills and other funds from federal and state grants and fees for services and licensing.
Environmental programs receive 60 percent of DPHE expenditures, health community programs getting 17 percent and health services getting 9 percent. The remaining budget goes to programs fighting infectious disease, infrastructure and emergency preparedness.
The 2014 Washington County Extension budget of $286,509 is a 1.5 percent increase from this year. The Extension offices asks the county to contribute $159,200 of the budget, with the remaining funds from grants, fundraising and dues.
The Extension service budget includes money for a 4-H coordinator and Youth Teaching Youth program coordinator.