Employees with little training or experience are making key decisions on spending millions of dollars in county tax money.

The Rowan County Board of Social Services listened to workers in the Medicaid program who described overwhelming caseloads, rapid turnover and increasing errors in deciding who is eligible for Medicaid. Medicaid is the federal-state program that provides medical care for the needy, aged, blind and disabled.

Nearly $5 million in county tax dollars will go for the Medicaid program next year as mandated by the state.

“This is a crisis,” said board member Lee Piper Pickthorne, speaking at Tuesday’s board meeting.

Social Services Director Sandra Wilkes and Medicaid staffers laid out the situation and asked the board to provide direction.

The board has asked for four new employees to help with the increasing cases of adults qualifying for Medicaid. County Manager Tim Russell has not recommended any new employees.

Zelma Alston, Adult Medicaid supervisor, and Susan Russell, a program leader, shared their frustration.

They said each caseworker has between 300 and 500 active cases. Only two of eight employees have experience. Four have been in their jobs for less than six months.

In addition to handling those cases, the staffers must also spend nine days a month handling new applications and must complete 30 to 50 reviews of cases each months.

Alston and Russell said that more errors are occurring because workers are overwhelmed.

She cited cases where ineligible people have been given Medicaid cards for months.

Under state and federal guidelines, the county is liable to pay back monies paid out for ineligible people.

Responding to a question from board member Leda Belk, officials said someone who is ineligible with a Medicaid card could run up thousands or hundreds of thousands of dollars in a very short time, and the county could have to pay the costs.

Belk, also a county commissioner, observed that hiring more staff could be a savings for the county.

“It’s scary,” said Belk, referring to the potential liability.

Board member Zell Setzer agreed. “The scary thing is what is out there we don’t know, stuff that will come back and bite us.”

“This is a real screw-up” said Pickthorne, referring to Russell’s recommendation against hiring.

With the county’s aging population, the numbers of Medicaid clients will continue to increase, she said.

In the past four years, the number of cases has increased by almost 1,000 while there has been no increase in staff.

Currently, 15,000 Rowan residents are eligible for adult Medicaid benefits.

Alston and Russell said workers continuously get calls from nursing homes with questions about individual cases. The staff doesn’t have time to handle the calls.

They also pointed out that the newly-trained employees are shedding tears of frustration and ready to flee to Cabarrus County where caseloads are less than half that of Rowan.

The Social Services Board agreed to meet with the Rowan County Board of Commissioners next week and appeal for additional personnel.

Contact Jessie Burchette at 704-797-4254 or jburchette@salisburypost.com .