Medicaid program director resigns from Wos' staff
RALEIGH — The director of North Carolina's Medicaid program announced Monday that she is leaving, eight months after taking the job. Her departure calls into question the future of a proposal to shift operations of the government health care program for the poor toward the private sector.
Division of Medical Assistance Director Carol Steckel, who had previous medical positions in Alabama and Louisiana state government, is going to work for WellCare Health Plans in Tampa, Fla., which provides managed care services to government insurance programs.
"I appreciate the opportunity you provided me to work on behalf of the people of North Carolina," Steckel wrote to state Health and Human Services Secretary Aldona Wos in her resignation letter dated Monday. Steckel said she will resign no later than Oct. 11.
That's three days before the General Assembly planned an all-day health oversight committee, which was likely to address a series of challenges within Steckel's division and recent hirings within the Department of Health and Human Services.
Wos said in a prepared statement that Steckel "has made invaluable contributions to the state and the people we serve" and "brought fresh ideas and deep knowledge and experience to the state's Medicaid program." Wos pointed out that Steckel grew up in Florida.
"It was a difficult decision to leave DHHS, but this is a great opportunity I can't turn down," Steckel said in a written statement. Steckel was not available for interviews Monday, department spokesman Ricky Diaz said. Steckel and Wos announced the change together at an event with state Medicaid employees in Raleigh.
Still, her departure would seem a setback for efforts by Gov. Pat McCrory's administration and the department to create a long-tern plan to control expenses for Medicaid. It spends more than $13 billion in federal and state dollars annually covering as many as 1.6 million North Carolina residents — one of every six in the state.
"If the governor wants to make changes ... losing the top and most knowledgeable person in his administration is a real blow to the efforts to make changes," said Adam Searing with the North Carolina Health Access Coalition. "It's like you've lost your most valuable player."
Steckel, who made a $210,000 annual salary, was brought in as McCrory unveiled in April an initiative that would shift patient management and risk to a few managed-care organizations. The groups — private or public — would receive specific monthly allotments from the state for each patient they serve. Steckel helped lead a similar transition with Medicaid in Louisiana.
The legislature, smarting from another Medicaid shortfall this year that required lawmakers to allocate up to another $430 million, gave the department authority this summer to assemble a plan to rework how Medicaid is paid for by the state. A plan is expected to be unveiled before March, but the General Assembly told DHHS it couldn't carry out any plan without express legislative approval.
Several key legislators and the medical establishment in North Carolina have been cool to such wholesale changes, pointing out success within the nationally recognized Community Care of North Carolina, a series of nonprofit managed-care doctor networks. The proposed "Partnership for a Healthy North Carolina" also would dismantle recently consolidated public-sector organizations that help people receive treatment for mental illness, substance abuse and help with developmental disabilities.
There's been no official word from McCrory's administration about whether a shift to managed care remains the end goal.
Rep. Nelson Dollar, R-Wake and senior co-chairman of the House Appropriations Committee, called Medicaid reform a work in progress. Members of a new Medicaid advisory panel to help oversee changes are still being picked, Dollar said Monday.
While Steckel "seemed to favor commercial managed care," Dollar said, a number of legislators "were looking for other options for Medicaid reform" that built on the current system "in a more harmonious way," he added.
WellCare provides Medicare plans in more than a dozen states and Medicaid in a half-dozen states, including Florida and Georgia. Steckel will serve as a senior director for public policy, company spokesman Crystal Warwell Walker said. WellCare has about 21,000 members in its North Carolina Medicare prescription drug plan.
DHHS is working through problems with a pair of computer programs related to Medicaid. One is a billing system for Medicaid providers, while another determines eligibility for a host of services, including Medicaid, food stamps and financial assistance for living in adult care homes.