SALISBURY POST

When the county’s Medicaid workers issued an urgent request for some staffing relief this week, they weren’t crying wolf.

While many departments make pitches for additional resources at budget-writing time, the scenario laid out by the workers and Department of Social Services Director Sandra Wilkes pointed to dire staffing problems in need of attention. The department currently has only eight employees to administer a file of approximately 5,000 Medicaid cases.

Each caseworker handles as many as 500 active cases at any time, in addition to processing new applications. That’s one of the highest caseloads in the state. It’s also a situation that invites errors and inefficiency. In addition to having such a high caseload, six of the eight caseworkers working under these conditions are relatively inexperienced.

The result, unsurprisingly, is an increase in errors that allow ineligible applicants to receive thousands of dollars in prescriptions and medical services to which they are not entitled. And when those errors are discovered weeks or months later, the county is financially liable for them. It also means that the particularly vulnerable segment of the community served by Medicaid — the impoverished, the aged and those with disabilities — are sometimes not receiving the attention they need.

In attempting to hold the line on spending in the 2001-2002 budget and avoid a tax increase, county officials rejected all requests for new employees, which in one sense was a fair way to spread in the pain. But in its plea for four additional workers, the Department of Social Services has made a strong case that Medicaid staffing shortages are wasting county tax dollars as well as further eroding the effectiveness of a division that has been chronically plagued by overwhelming workloads, high stress, mediocre salaries and, as a result, high turnover. Left unchecked, this is a situation that will deteriorate more as the county’s population increases.

The state’s mandated increase in county Medicaid payments has put a greater burden on local funding, and the county has good reason for its reluctance to approve staff increases in the current budget environment. In this particular case, however, it appears that holding the line on staffing may entail longterm costs that outweigh the short-term savings.