The Vance County Board of Commissioners will confront the Medicaid crunch during their monthly meeting this evening.
County Manager Jerry Ayscue, in his report to the board, said Medicaid spending through the county’s Department of Social Services is on pace to exceed its $2.74 million budget by $301,000 — about the amount that the commissioners cut from the proposed budget a year ago to help prevent a property tax increase.
Ayscue proposes to spend $250,000 from the county’s contingency fund and transfer $51,000 in surplus public assistance money in the department’s budget to cover the county’s share of Medicaid.
Medicaid is the federal-state health program for the poor and fills some gaps in Medicare for the elderly. With a pending law change in New York, North Carolina will be the only state that requires counties to pay a share of the program’s expenses in reimbursing health care providers and pharmacies.
The top legislative priority of the North Carolina Association of County Commissioners is a plan to shift the counties’ Medicaid costs to the state. Medicaid’s explosive growth has been a budget buster at all levels of government, but because it is a program for the poor, the expenses disproportionately hit low-wealth counties such as Vance.
A legislative study committee issued a report during the winter that called for a five-year phaseout of county Medicaid costs, with an accelerated schedule for the poorest counties. But that proposal has gone nowhere in the General Assembly as lawmakers have dealt with a $1.2 billion projected shortfall in the upcoming budget, as well as revenue measures such as the lottery and a higher cigarette tax.
Ayscue has budgeted for a 15 percent increase in the county Medicaid budget for the fiscal year that starts July 1, but that’s only 3.6 percent ($109,000) more than the amount Vance now expects to spend this year.
Also on the agenda for the meeting, whose highlight could be the public hearing on the proposed budget that will run throughout the session:
* Dera Adair from the Kerr-Tar Regional Council of Governments is due to bring two Community Development Block Grant matters and an update of Vance’s fair housing plan before the commissioners.
Adair is asking the board to let Ayscue award the final bids for the Julia Avenue concentrated-needs CDBG project. Under state guidelines, she reported, contracts must be signed by next Sunday for water and sewer hookups from the right of way to the houses in the project, but because only one bid came in after the first advertisement, the project was rebid, with a deadline of Saturday.
In a separate, scattered-site project, Adair is seeking board approval of an ordinance authorizing the use of $400,000 in CDBG money from the state. Of that total, $129,000 will go toward housing rehabilitation, and $204,000 will be spent on relocation assistance.
As for the fair housing plan, the only new activity is a repeat of the first activity when the plan was implemented in March 2003: the distribution of fair housing posters in English and Spanish to Realtors, banks and other locations. The plan says, “There are no instances nor reports of discrimination as far as is known by County Officials. None have been filed at County Offices.”
* County Emergency Operations Director Brian Short will make a PowerPoint presentation on the county’s plans to use federal funds to upgrade the emergency communications system, including the local implementation of the statewide digital VIPER system.
* Ruth Jones plans to address the problem of unreliable private cellphone service in northeastern Vance. Jones says in a faxed letter that U.S. Cellular is the only service that works at all in the area, and “they are not the best.” Jones adds: “We are trying to promote some residence and homeland security in our area. We may be able to assist our law enforcement one day.”
* Kim Butler is scheduled to present the proposed 2005-06 budget for the operations of the Juvenile Crime Prevention Council. The total proposal for such efforts as Friends of Youth, Project Youth Outreach and community service is $283,751. That includes $73,441 in county cash, $9,450 in additional local money and $9,790 in local in-kind contributions.
* Sam Watkins of Rose Oil, the chairman of the county Economic Development Commission, will present an update on the private Henderson-Vance Economic Partnership. He wants the commissioners to approve the group’s bylaws and officially appoint Commissioners Tommy Hester, Danny Wright and Terry Garrison as members. Those three have participated in the group’s organizational meetings.
* In another economic development matter, Economic Development Director Benny Finch is seeking approval to apply for a no-local-match state grant of $35,000 for water and sewer hookups to businesses.
* Ayscue recommends that the commissioners authorize the filling of two vacancies — a fire captain and a Department of Social Services human resource aide.
* Ayscue wants the board to approve participation agreements for the North Carolina Association of County Commissioners’ insurance pools for health, workers’ compensation, and property and liability. Because of the high quote for workers’ comp insurance, the county is shopping for a better deal.
* Finance Director Jerry Tucker’s report covers eight budget amendments, none of which appear to involve locally raised money. They include spending a $250,000 state grant for the regional industrial hub. Tucker also has $351.13 in tax refunds and $2,427.55 in ambulance charge-offs.
The meeting starts at 6 p.m. at the county Administration Building on Young Street.