Rowan County’s Department of Social Services is proposing a stop-gap sustainability plan to help deal with a significant increase in the department’s Medicaid workload.

Created in part by a new software system and a turnover in staff, Rowan County’s DSS is expected to present a sustainability plan Monday to the board of commissioners to deal with a large increase in the overall workload for employees. The plan proposes an increase in DSS income maintenance staff pay; paying overtime to caseworkers and supervisors; and hiring former DSS employees and DSS employees of neighboring counties.

The plan already passed the DSS board during a meeting on Saturday.

The plan states that the increase was specifically intended to manage the increased workload association with the implementation of NCFAST — a software system that processes food and nutrition assistance and medicaid applications — and the Affordable Care Act.

As an example of the increased workload, DSS Director Donna Fayko said her department has seen a 2.3 percent increase in Medicaid cases since 2013 and a 7.9 percent increase in Food and Nutrition Assistance in the same time period. Rowan County isn’t alone in its workload increase. A statement from North Carolina’s Department of Health and Human Services said the statewide increase for Food and Nutrition Services over a five year period ending June 30, 2013 was 75 percent. Medicaid cases increased 24 percent over the same time period.

“Cases must be converted from the legacy system to NC FAST prior to processing re-certification. This process takes up to 2.5 hours per case,” Fayko said about Medicaid cases. “This is a short term plan being implemented to address the high volume of Medicaid re-certifications that need to be completed.”

DSS board chairman Jim Sides said the department’s current, or legacy system, is using paper copies of documents.

In the plan, DSS would specifically be asking for a minimum of a 5 percent increase for its income maintenance staff’s salaries in the form of  a stipend, which would have to be approved by commissioners.

The county currently doesn’t pay overtime to caseworkers and supervisors; instead, workers receive compensation time for extra hours worked. Paying overtime would be a part of the plan.

“What good does it do us to take an employee and give them comp time,” Sides said. “If they
take off the next week, there’s still work to be done and we’re no further ahead.”

Any former employees of Rowan’s DSS and employees from neighboring counties, already trained in NCFAST, would work after 5 p.m. and on weekends to assist in processing cases. The plan also proposes to include additional employees in DSS’ fiscal year 2016 budget.

Costs associated with the plan would be paid for through a 25 percent increase — from 50 percent to 75 percent — in an administrative Medicaid reimbursement, which became effective statewide in March. Though, initially the county would have to pay a small sum of money.

A statement from North Carolina’s Department of Health and Human Services says the NC FAST system may initially require an added amount of work, but eventually would make multiple processes simpler and faster.

“County DSS directors have been advocating for many years to replace the state’s 40-year-old patchwork of IT systems,” the statement said.

Another factor that compounds the extra workload is the DSS’ turnover in staff.

“Rowan County has historically been a training ground for caseworkers who go to larger counties for higher pay,” Fayko said.

Sides added that pay is only a part of the reason some employees leave, with job stress being another factor.

In the previous six months, 20 percent — 15 — of Rowan DSS’ income maintenance caseworker staff left the department, with seven going to neighboring counties who pay a higher salary for the same work, the sustainability plan states.

“Turnover is a critical factor in that newly hired staff must learn to navigate the automated system and learn policy and programmatic operations,” the plan states. “This process takes a minimum of three months to bring a new staff to a level of proficient performance. Thus, turnover has a direct negative impact on the ability to process cases and on service delivery to our customers.”

The Rowan DSS has nine job openings in economic services, which is the specific division the plan is intended for. The plan states 14 staff are not fully trained and proficient in job duties. Lead workers and supervisors taking on cases is one of the measures DSS plans to take to address the vacancies and employees being trained.

Fayko said DSS initially considered asking for a 5 percent across-the-board increase for its income maintenance staff, but changed its request because county manager Aaron Church wants to conduct a county-wide compensation study before actually increasing salaries.

Contact reporter Josh Bergeron at 704-797-4246