State Medicaid director steps down after 8 months [Winston-Salem Journal, N.C.]
(Winston-Salem Journal (NC) Via Acquire Media NewsEdge) Sept. 24--The state's Medicaid director, Carol Steckel, said Monday she is stepping down from her duties after just eight months to take a job in the private sector in her home state of Florida.
Steckel's resignation as director of N.C. Division of Medical Assistance is effective Oct. 11. Steckel took over as Medicaid director Jan. 22. She has held similar Medicaid oversight roles in Alabama and Louisiana.
Steckel conveyed her resignation in a two-paragraph letter to DHHS Secretary Dr. Aldona Wos.
The N.C. Department of Health and Human Services said in a press statement that Steckel has accepted a position with WellCare Health Plans in Tampa, Fla. Steckel said in the statement she felt the agency had made good progress in controlling costs and improving care.
Steckel was touted by Wos as being the right person to guide the state through the massive restructuring of how Gov. Pat McCrory wants Medicaid to operate in the state.
Medicaid in North Carolina insures 1.8 million people, most of them poor children, older adults and people with disabilities. The goal of McCrory and Wos is converting the state's $13 billion Medicaid program to a managed care program. Parts of Medicaid could be managed by private companies, according to the scant details provided to date by McCrory and DHHS.
Wos, with Steckel by her side, said at a presentation at Forsyth Medical Center on May 16 that North Carolina is in "uncharted waters" in terms of reforming Medicaid and health care, and thus needed Steckel's expertise at the helm.
Steckel's salary was $210,000, more than the top salary set by the state for the position. Wos told legislators that Steckel's salary was warranted because of the expertise she brought to the agency.
Wos said Monday that Steckel made "invaluable contributions to the state and brought fresh ideas and deep knowledge and experience to the state's Medicaid program."
Health-care advocates critical of Wos' oversight of DHHS said they were surprised by the timing of Steckel's resignation, but not surprised that another top agency official was departing.
Steckel's resignation is the fourth DHHS leadership departure this year, perhaps the highest profile and most pivotal. Two of the other high-profile departures -- Dr. Laura Gerald as state health director and Dr. Rebecca King as the state's top dentist -- came as a result of disagreements with DHHS management.
"This is a huge blow to Gov. McCrory's stated intentions to make major changes to North Carolina's Medicaid program," said Adam Searing, an analyst with the left-leaning Progressive Pulse. "While I don't believe our award-winning N.C. Medicaid program needs major restructuring, if the governor really wants change, he needs people like Steckel who are professionals who actually understand Medicaid.
"It's hard to change a multibillion-dollar health program for the poor if the people in charge have very little idea how Medicaid works," Searing said. "And now, DHHS has lost one of the only top people who have extensive experience in Medicaid."
Many local and statewide health care providers and advocates are urging the McCrory administration to carve out a place for Community Care of North Carolina. It a homegrown, nonprofit series of Medicaid managed care networks that have shown success in lowering costs through preventive measures, such as monitoring patients with chronic diseases.
Martha Brock, a health care advocate based in Cary, said she was dismayed by Steckel's resignation decision.
"While personal reasons may have been a major factor, I also suspect that the management style of Wos was a factor, too," Brock said. "Unfortunately, the unqualified stick around and the highly qualified hit the road in this department."
In a separate development Monday, DHHS officials said they have launched training sessions for additional staff to supplement onsite and help-desk support for counties affected by slow benefit payments in the NC FAST program.
NC FAST is the state's new benefits distribution system, handling such services as the food stamp program, for more than 1 million North Carolinians and their families.
It has proven to be a major headache for Wos, cited by critics as an example of her lack of oversight abilities, as recipients, including many in the Triad and Northwest North Carolina, are going weeks and months without assistance benefits.
The agency said it has added more than 160 temporary employees and deployed them to counties being affected the most by the payment slowdown.
"With this additional staff, the state will offer at least one support staff in every county, with no additional cost to taxpayers as the cost will be absorbed within the existing project budget," DHHS said in its statement.
"In addition to the new staff, all counties have been given the option to send outstanding cases to Raleigh, where a specially trained DHHS team has begun processing and entering them into the NC FAST system."
Last week, two Democratic legislative leaders formally requested that the State Auditor's Office investigate what they call "apparent systemic mismanagement" at DHHS.
Senate Minority Leader Martin Nesbitt of Buncombe County and House Minority Leader Larry Hall of Durham sent a two-page letter to State Auditor Beth Wood. They requested that Wood complete an audit of the agency by Jan. 1. They said Wos has been unresponsive to their Aug. 29 letter asking her to address the agency's issues.
(c)2013 Winston-Salem Journal (Winston Salem, N.C.)
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