North Carolina's Medicaid expansion could go into effect as early as Oct. 1. The Randolph County Department of Social Services is preparing for thousands of new applications.
Social Services Director Tracie Murphy says about 46,000 people in Randolph County currently qualify for Medicaid. She predicts they will add 12-14,000 more people.
"That tells us that in our county, a third of our citizens are living at or below the poverty level," Murphysaid. "I'd say about 25,000 citizens are receiving food nutrition services, and around 20 percent of children are living below the poverty level."
Murphy says many people were unable to return to their baseline after the fallout of the COVID-19 pandemic. "The reality is that the working poor, their incomes are not enough for a living wage, not enough for them to afford medical benefits and not require assistance to feed their families."
The date for the Medicaid expansion to take effect depends on the approval of a budget by state lawmakers. It will make eligible most adults with incomes up to 138 percent of the federal poverty level.
The county added five income maintenance caseworker positions to this year's budget. "It takes six to nine months to train a worker to independently process a Medicaid application," Murphy said. "So, we're hiring now and having time to train those staff so that we can be prepared, regardless of the date that we go live."
NC FAST, a tool from the NC Department of Health and Human Services, helps them with enrollment. Social Services has worked with the Division of Health Benefits to review strategies for quickly and efficiently setting up new applicants.
However, the majority of those strategies they've identified will not be ready by October. "Right now, the number of applications that are straight-through process are less than one percent," Murphy said.
In August, Randolph County Commissioners approved 22 additional staff for Social Services. "Those don't require you to have a four-year degree," Murphy said. "It requires you to have interviewing skills, have some affinity with numbers, be able to apply policy."
The state provided Randolph County $23,430 a month for every month Medicaid expansion is effective, and the county will contribute $219,928 for the fiscal year. Murphy says the county has been very supportive.
"We want to do all that we can to support our citizens," Murphy said.