Alamance County’s commissioners have signed off on a plan that will allow the county’s department of social service to add 11 staff members to meet forthcoming federal requirements for the Medicaid program.
The commissioners voted 5-to-0 in favor of this staff level expansion on Monday on the assurance that the county won’t have to spend any of its own funds to foot the bill for these additional caseworkers.
According to Candice Gobble, the county’s social services director, the county has little choice but to upstaff in order to meet the federal government’s latest changes to Medicaid.
Gobble said that these mandates, which are scheduled to take effect at the beginning of 2027, include a new rule that requires adult recipients to work, volunteer, or hunt for a job in order to maintain their medical coverage.
In addition, DSS will have to implement federal policy changes for legal non-citizens who receive Medicaid and increase the frequency of its eligibility checks for beneficiaries who’ve been added to the Medicaid rolls since North Carolina expanded the program’s criteria in 2023.
“This is not one isolated policy change,” Gobble went on to inform the commissioners. “These changes are expected to add verification requirements, documentation, and follow-up, which means cases are going to take a little longer to complete, but the expectation for timely completion remains.”
In order to cope with the additional workload, Gobble told the commissioners she’ll need to add four Level I Income Maintenance Caseworkers to her Medicaid unit along with six Level II Income Maintenance Caseworkers and one supervisor – at a total annual cost of $712,660 in salaries and benefits.
The DSS director added that the county ordinarily picks up 25 percent of the bill for her agency’s staff members – which, in this case, would amount to an extra $178,165 a year for the 11 people she hopes to employ. Gobble added, however, that the General Assembly has foreseen the potential cost burden of the federal government’s rule changes and set aside $658,794 in “supplemental funding” to cover the county’s share of the new posts.
“So, there is no county requirement,” she went on to assure the commissioners.
The state’s pledge of supplemental funding ultimately gave Steve Carter, the vice chairman of Alamance County’s commissioners, some peace of mind about one factor that he said has been threatening to increase the county’s next budget. In the meantime, Gobble’s description of the new posts she plans to add left commissioner Sam Powell brainstorming about alternate ways to fill the demand.
“This is one of those examples,” he went on to speculate, “where AI could reduce the workload.”
The commissioners proceeded to approve the 11 requested positions in a 5-to-0 decision.
