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Medicaid savings exceed #036;4 million locally

It’s not a permanent solution, but Roanoke-Chowan area counties will ride the financial wave of Medicaid relief in excess of $4 million if state lawmakers approve the 2007 Appropriations Act.

Late last week, the North Carolina House of Representatives, in a show of bipartisan support, unanimously approved $100 million in one-time Medicaid relief for counties for 2007-08. The original relief package, part of House’s overall budget proposal, was $60 million. However, Rep. Bill Owens of Pasquotank County made an amendment on the floor to boost the proposed relief package from $60 million to $100 million. The amendment was approved.

The proposal calls for $50 million that would be shared by all counties based on their proportion of actual 2006-07 Medicaid expenses to the statewide county total.

$40 million would be shared by those counties whose Medicaid eligible population is 25 percent or greater of their total population. The remaining $10 million would be targeted to those counties with between 20-25 percent of their citizens listed as Medicaid eligible.

Each county’s Medicaid relief would be provided in 12 equal payments credited monthly against the county’s Medicaid costs.

Local county officials are anxiously waiting for the Appropriations Act to gain approval on the Senate side of the General Assembly. With the Senate’s approval and based upon the aforementioned criteria, Bertie, Gates, Hertford and Northampton counties stand to save a combined $4.32 million.

Three of the four – Bertie, Hertford and Northampton – each exceed the 25 percent Medicaid eligibility rate. Thus they will share in the additional $40 million pot of state relief.

According to the proposed numbers, Hertford County, with 30.78 percent of its population eligible for Medicaid, would benefit from $1.558 million worth of relief. The lion’s share ($1.282 million) of that money would come from the $40 million pot of targeted relief.

Hertford County’s projected Medicaid costs for 2007-08 is $2.850 million.

“We are thankful and grateful for this relief,” Hertford County Manager Loria Williams said. “But what frightens us the most is what if the General Assembly doesn’t fund this the following year. Then that becomes six-to-seven cents on the tax dollar to make up and we don’t have a choice in this, we have to fund our share of Medicaid.”

As far as preparing the county’s budget for 2007-08, Williams said she was thinking about setting the Medicaid funding at $2 million, basically in-between what is projected as needed and the proposed relief.

“We’re hopeful this will pass (the Senate), but we need to err on the side of caution,” she stressed.

Bertie County (32.89 percent) has the fifth highest Medicaid eligible population in the state. From the targeted relief, Bertie stands to gain $1.209 million. Coupled with the $260,011 they will receive in general relief funds, Bertie’s proposed total comes to $1.469 million, a figure that will more than slice in-half their projected $2.689 million in Medicaid costs for 2007-08.

Bertie County Manager Zee Lamb has long been a proponent of Medicaid relief. He, better than anyone, knows that promises often fall short of expectations.

“We can’t count our chickens before they hatch,” Lamb said. “We can see the egg cracking on this and inside we can see help from state. If that egg fully hatches, we will very much appreciate the help we are receiving. It’s a great first step, but a long-term solution is needed and that’s a phase out of the county contribution to Medicaid.”

Lamb said he was extremely pleased to see an additional pot of money for targeted relief for counties with high eligibility rates. He added that depending on how long the Senate tinkers with the bill would lead him to possibly delay sending a final budget for the Bertie Commissioners to approve.

Northampton’s share of the proposed pot of money totals $1.217 million. Of that amount, $1.002 million is linked to the county’s 31.78 percent of Medicaid eligible citizens. The county faces projected Medicaid costs of $2.228 million for the upcoming fiscal year.

“We appreciate the efforts of our legislators, especially Representative Michael Wray and Senator Ed Jones,” Wayne Jenkins, Northampton County Manager, said. “But what we don’t see in this is permanent relief. This is a stop gap measure; we need something permanent if small, rural counties such as Northampton are to survive. We can’t keep placing the burden on the shoulders of our already overburdened taxpayers.”

Jenkins said this measure, if approved by the Senate, will provide an opportunity for legislators to see what a positive impact relief funding can have on rural counties who are struggling to make ends meet.

Gates County’s eligibility rate is 19.07 percent, meaning it did not qualify for either of the two proposed pots of targeted relief money. However, the county will gain $76,174 in general relief, money it can apply to its projected Medicaid costs of $787,882.

All totaled, North Carolina counties are projected to spend over one-half billion dollars ($517,161,512) on Medicaid during 2007-08.

North Carolina is the only remaining state that requires its counties to pay a portion of Medicaid. There are measures being discussed to relieve the counties of that burden.