County to bring in 24 new hires for health system reform



As the state of California has dropped the ball with leading local governments toward implementation of the federal Affordable Care Act—or “Obamacare,” as it’s popularly called—the county’s Department of Social Services is preparing for a massive overhaul of the local health-care system, according to the county’s head of social services.

On Aug. 13, Social Services Director Lee Collins told the Board of Supervisors that the county will hire 24 new full-time employees and spend some $2.2 million in grant funding per year for two years to help the county deal with the anticipated influx of residents seeking eligibility for Medi-Cal.

The board unanimously approved the acceptance of the grant funding, which came from both state and federal sources to help local governments deal with the changes.

Under the Affordable Care Act, which was signed into law in March 2010 and implemented statewide in June, millions of previously uninsured state residents will become eligible for coverage under either Medi-Cal or a new low-cost, subsidized program offered by Covered California, the state’s version of the federally required insurance exchange.

“The Affordable Care Act has been the subject of a great deal of discussion in Washington and elsewhere,” Collins said. “At the Department of Social Services, we don’t have the luxury of having an opinion on it; we’re only charged with implementing it.”

A majority of the new hires will staff a call center that will be open 12 hours a day, six days a week, Monday through Saturday. They will help residents determine whether they’re eligible for the new coverage.

Based on current estimates, Collins said he expects 9,179 county residents to apply for Medi-Cal when the state begins accepting applications. Of those, Collins said, approximately 73 percent are expected to be eligible. An additional 1,000 residents are also expected to sign up for the exchanges under Covered California.

The Department of Social Services currently has 427 staff members spread over five regional offices to handle approximately 25,530 cases. Through natural attrition, Collins said, the county loses between 18 and 24 staffers every year, and should the impacts of the Affordable Care Act be less than expected a few years down the line; the staffing levels will level out by themselves. Should the impacts be greater than expected, the state may provide additional allocations in 2015-16, Collins said.

Collins said the county needs to have the staffing in place to be prepared to begin accepting applications by October, and the programs go into effect in January.

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