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Over the summer I did TV ads and Internet videos for the Association for Hospice and Home Care and, in the process, got a close up look at the inner-workings of the Department of Health and Human Services – which has to be the looniest department in state government.
I guess the best example is Secretary Lanier Cansler – back in the middle of the state budget crisis – buying $38,000 in crab pots to put a disabled man in the fishing business on the theory it was vocational rehabilitation.
And there are a lot of other things going on at DHHS that are just plain odd – and most go back to Governor Perdue’s budget.
It’s an odd thing for a liberal Democrat to do but Beverly Perdue decided to cut Home Care for elderly Medicaid patients $160 million (or 40%). But, right off, the Governor encountered a big problem. Because Medicaid Home Care is an entitlement program the state’s legally bound to provide care to every patient who’s eligible. So to cut 40% – or the equivalent of 15,000 patients – she needed to change the eligibility requirements. And make them tougher.
But the Governor didn’t do that. Because the Obama Administration told DHHS (the Department of Health and Human Services) No – and added if the Governor went ahead anyway it could cost North Carolina $2 billion the next time President Obama passed out ‘Stimulus Money.’
Now you’d have thought at that point the Governor – unless she wanted to risk $2 billion – would have left well enough alone and cut the new $25 million fishing pier in Nags Head and the other pork from the budget and left home care alone.
But she didn’t. Instead she made the $160 million cut – but didn’t change the eligibility requirements. That meant she had balanced the budget on paper – but, in reality, she had no way to cut 15,000 patients who are legally eligible.
It gets sillier.
For years, DHHS – the Department of Health and Human Services – has assessed and reassessed North Carolina’s 35,000 Medicaid home care patients and confirmed they are eligible. But now, suddenly, the Department has discovered it was dead wrong. The patients aren’t qualified. And DHHS has hired an old client of Secretary Cansler’s – CCME – for $8 million to ‘review’ each patient.
And here’s what’s strangest of all.
Before the first reviews been done DHHS has projected exactly how much money is going to be saved when CCME finishes cutting patients: Exactly $138 million.
Now, does that sound like an even handed review or does it sound like DHHS told CCME, Here’s the deal: We pay you $8 million and your job is simple: Come back with $138 in cuts.
And that leads the Governor into an even bigger problem.
Because every patient CCME cuts has a right to appeal. Do the math. CCME and DHHS cut 15,000 patients who’re legally eligible – and there’ll be thousands of appeals. It’s a lawyer’s dream. There’ll be enough appeals to clog state agencies and courts for years and cost millions of dollars and while the appeals are being heard every patient has the right to continues to receive care. And when the appeals are done every legally eligible patient will be reinstated.
So instead of saving millions Governor Perdue’s creating another boondoggle, not unlike the mental health meltdown the same DHHS bureaucrats created a couple of years ago that cost taxpayers $400 million.
So let’s sum up: The Governor passed a budget that wasn’t balanced, now has to end run the law to cut $138 million, is about to clog the courts with appeals and when all’s said and done it will cost the state millions.
And, right now, that’s the plan the looniest Department in state government is working day and night to implement.


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