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1/25/-2023, <br /> Expected Challenges <br /> • Work Force shortages. <br /> • It takes the average Income Maintenance Caseworker a year to fully learn the job. <br /> • Potential for an entirely new Medicaid coverage group that will result in new policy <br /> and require training for staff. <br /> • It takes time to interview, select and train staff. The county not the state is <br /> responsible for training. Staff with the ability to train others are often those with <br /> heavy work volume such as program supervisors. <br /> • Automated transitions from Family Planning Program and Medicaid COVID coverage <br /> do not come without challenges. County staff expect to have cases that have to be <br /> manually corrected to transition from one program to another in NC FAST. <br /> Needs for Successful Implementation <br /> • Funding for increased county costs due to Medicaid expansion. <br /> • Advanced notice for counties to prepare for implementation. <br /> • Not an established caseload standard for Medicaid. Really need a study to establish <br /> caseload standards statewide. <br /> • Enact a hold harmless period for State and Federal penalties to counties during the <br /> implementation of Medicaid Expansion. <br /> • Combine audits to evaluate compliance with Medicaid eligibility determination to <br /> ease the burden on Local DSS Agencies. <br /> • Continue support of automation efforts in Medicaid to assist counties with staffing <br /> shortages. <br /> • Consideration of increased space needed for new positions. <br /> • Continued funding to counties for Medicaid Hold Harmless due to changes in <br /> Medicaid reimbursement. <br />