Thread: The Hispanic impact Medicaid

The Hispanic impact ... DSS requests more staff for foster care, Medicaid

By J.D. Walker -- Staff Writer, The Courier-Tribune

ASHEBORO — Despite an improving economy, with falling jobless claims and low unemployment, Martha Sheriff is seeing the workload for her staff continue to grow.
Sheriff is the director of the Randolph County Department of Social Services (DSS).
Two areas of concern are in foster care for children and in Medicaid assistance.
At a June 6 budget hearing, Sheriff asked the Randolph County commissioners to fund four new positions in the 2006-2007 budget — an additional attorney, a computer technician, a foster care worker and a family and children Medicaid worker to help reduce that workload.
Commissioners asked Sheriff several questions, including the Hispanic impact on those programs. She told them she did not have exact figures on the ethnic breakdown of participants.
“We have just started tracking those numbers this month,” she said. “Not because we are required to, but because so many people keep asking about it.”
Sheriff told commissioners that illegal immigrants are not eligible to receive Medicaid, food stamps or any other government program in her department unless they are in a “life or death” situation.
“And pregnancy is considered life or death by the federal government,” she said.
Sheriff said that, when taking applications for DSS programs, staff members take the word of the applicant about residency and eligibility unless they have reason to suspect the applicant is not telling the truth.
If questions arise, the applicant is asked to provide a birth certificate or one of eight other types of documentation to prove eligibility. Staff members can check the information at a secure website set up by the Department of Homeland Security.
Sheriff said, effective July 1, everyone who applies for DSS programs will be required to show a birth certificate. The change was mandated by the federal government.
Medicaid growth
A major area of concern is the growth in Medicaid assistance to families and children, said Sheriff. If they meet certain criteria, DSS assigns eligibility for Medicaid benefits to indigent residents, pregnant women, the disabled, children and the elderly.
Normally, Sheriff said, the number of people served on Medicaid is equal to 10 percent of the population per month — but that is not the case for Randolph County.
The county has an estimated population of 138,367, according to information on the Piedmont Triad Council of Government website. Ten percent of 138,367 would be 13,836.7.
Sheriff estimates her department assisted roughly 15,000 per month in Medicaid in 2005-06, using $9.5 million.
Food stamps
In the food stamp or EBT program, she told commissioners the average number of food stamp households in the county is at 4,000. The number of children in the Child Care program is 1,400. The Work First program has an estimated 500 clients.
She did not have concrete numbers on how those clients break down by ethnic group.
She stressed that children born in the U.S. to illegal immigrants are considered American citizens. Benefits such as food stamps can be distributed to the family. However, those benefits are pro-rated — adjusted to the number of legal American citizens in the household, she said.
In this example provided by Sheriff’s office, consider a mother and father, both of whom are illegal immigrants, with two children who were born in the U.S. and considered American citizens. The family applies for food stamps.
Dad works, making $800 in total income for the month. The total $800 is divided by the number of family members, in this case four. The result is $200.
Then this figure is multiplied by the number of eligible household members. Since Mom and Dad are illegal, they do not receive benefits. The two children in this example are legal. The result is $400 ($200 x 2 = $400). The family would receive $400 in food stamp benefits.
Foster care
Sheriff said in an interview that DSS has 130-140 children under foster care in Randolph County. She estimated that 90 percent of those children come to the program because of substance abuse problems in their families.
Not many children in foster care are Hispanic, she noted, so they are not having an impact on that program.
Part of the problem of providing foster care services is the amount of time and paperwork involved. Sheriff said the state mandates that each foster care case be reviewed in court at least twice per year. Foster care workers must visit each child at least monthly and arrange for parental visits, where eligible.
Each of her eight foster care workers should only be handling 12 cases, according to state guidelines. They are currently handling over 17 cases each, said Sheriff. Each supervisor is supposed to oversee five foster care workers. Sheriff has one foster care supervisor to oversee the entire staff.
Sheriff said the attorney position is necessary to help with the overflow of legal paper work. Her department is contracting for those services now.
In addition to the requirement of reviewing foster care cases in court at least twice yearly, Sheriff said changes to laws have resulted in more appeals when parental rights are revoked.
“It seems that almost every case in which parental rights are revoked, there is an appeal,” she said. “We used to not see that.”
That change came about in 2000 when the state established the North Carolina Indigent Defense Service, said Sheriff. Among other rights, it gives parents free attorney services to appeal termination of parental rights cases.
The extra attorney requested in this year’s DSS budget, if approved, would also help with other legal matters in the department. Sheriff reasoned that her department spent roughly $48,000 to contract for legal services in the previous year. For that amount, she told commissioners, DSS could hire a second attorney full time, giving the department greater control over that person’s time.
The new positions
The additional positions would add $139,108 to Sheriff’s proposed $21,936,894 budget. The county’s share of that budget is $11,964,925, according to information in the proposed budget. The difference is made up from state and federal resources.
In 2005-06, the DSS budget was $21,787,853. The budget increase over the previous year amounts to 3.2 percent. Sheriff’s request for personnel, if granted, would represent a 6.8 percent increase in salaries over the previous year. Declines in other programs would offset the increase in personnel, to a degree.
Sheriff’s request does not represent the total number of people she would like to have to fully staff the local DSS office. Sheriff originally asked for 16 new positions.
Sheriff has found federal funds to pay for a fifth new social worker position to work with foster children, ages 13-21, to prepare them for independent living after they age out of foster care.
She has been approved to convert two (out of 10) unfunded positions to county-funded positions. The positions were formerly paid from money for lapsed (unfilled positions) salaries.
Why the increase?
Sheriff is at a loss to explain why programs continue to grow in an economy that is supposed to be improving.
Some of the people seen in the local office have lost their jobs and have not been able to find a new one, she said. Others are working short time or in jobs that don’t provide healthcare benefits.
Commissioners speculated in budget hearings that the stigma formerly attached to receiving government aid has diminished in recent times.
“I don’t know what the answer is,” said Sheriff. “We thought it would have leveled off by now. I do know, in speaking with DSS offices in other counties, it’s not just Randolph County. Every county is experiencing the same thing.”
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Contact staff writer J.D. Walker at 626-6118 or email her at .
http://www.courier-tribune.com/articles ... ws/gn2.txt

Every county is experiencing the same thing.”

IMO, I believe that EVERY county, city, state should be required to keep statistics on the TRUE cost of illegal immigration....i.e. social services, crime, health care, schools, loss of jobs by Americans and LEGAL immigrants, etc.

I believe that American citizens and LEGAL immigrants would be shocked if the TRUE information was given out.