County gears up for Affordable Care Act impact

Anoka County continues to gear up to handle changes that will come with implementation of the federal Affordable Care Act later this year.

Anticipating a significant increase in the number of applicants for health care coverage through the Medical Assistance program starting Oct. 1, the Anoka County Board in March approved hiring ahead 14 financial assistance specialist positions in the economic assistance department.

On the recommendation of its management committee, the board last month authorized the hiring ahead of seven more.

According to Jerry Vitzthum, the county’s economic assistance department and job training center director, 13 of the 14 positions approved by the board in March have been filled.

But the county has lost nine financial assistance specialists since then, Vitzthum said.

“So we are only ahead by four,” he said.

The department employs about 100 financial assistance specialists, according to Vitzthum.

There is also a long training period for the new hires, which is exacerbated by the caseload growth and the need for staff to work in multiple systems, Vitzthum said.

For new hires, there is a three-month classroom training process before they are ready to take on even a small caseload with staff working with them and it is usually a year before they are fully up to speed, according to Vitzthum.

All the training takes place in-house, Vitzthum said.

“The expansion of eligibility for the Medical Assistance program is estimated to increase Anoka County’s Medical Assistance workload by 20-30 percent,” he said.

“This is on top of the significant caseload growth of 40 percent over the past five years.”

In fact, Vitzthum said he expects the growth spike to continue for some 18 months to April 2015.

Those that apply for coverage and are eligible will be managed by the counties under the federal legislation, he said.

Besides the jump in caseload, all current cases have to be converted to a new web-based eligibility platform starting in October, according to Vitzthum.

This will take place in stages with cash and food programs to be done last in a time frame that is not known at this time, but completion is expected by 2016, Vitzthum said.

“This will require staff to work in multiple systems until the conversion is completed,” he told the county board.

This means double entry into systems of data for households on Medical Assistance, food stamps or cash programs, which will increase the time to process applications and changes, Vitzthum said.

While receiving authorization to hire ahead the seven new positions, Vitzthum anticipated some of them will be left vacant if the workload decreases, he said.

“This will be evaluated on an ongoing basis,” Vitzthum said.

According to Vitzthum, an increase in federal dollars for Medical Assistance is expected to pay most of the cost of the new hires.

But that is by no means certain, Vitzthum said. “The devil lies in the details,” he said.

However, there is also one-time funding available in the department’s budget through temporary salary dollars, he said.

Commissioner Scott Schulte said he read in a recent StarTribune story about other counties, notably Hennepin County, hiring ahead to deal with the Affordable Care Act impacts.

“The pool appears to be small and getting smaller,” he said.

In his presentation to the county board in March, Vitzthum said that a preliminary analysis of additional staff and overtime needs associated with the Affordable Care Act implementation shows the potential for unfunded costs between $1.2 million and $1.4 million over a three-year period.

Peter Bodley is at
[email protected]