Sep 242013


Published: September 23, 2013 Updated 13 hours ago

By Joseph Neff and Lynn Bonner —

RALEIGH — The state Medicaid director has resigned after only eight months on the job, raising more questions about troubles at the state’s program to provide health care to the poor.

Carol Steckel, who took on responsibility for holding state Medicaid costs in check and for reshaping it into a managed care program, submitted a resignation letter Monday to the state Department of Health and Human Services.

Legislative leaders from both parties expressed concern over Steckel’s decision. The leading House budget writer said he hoped the resignation would slow the momentum toward transferring Medicaid to commercial insurers. And the House minority leader said it was further proof that the General Assembly needs to investigate turmoil at the department and its management of the $14 billion Medicaid program.

DHHS Secretary Aldona Wos confirmed Steckel’s departure at a hastily called outdoor meeting with employees at the department’s headquarters on the Dorothea Dix campus in Raleigh. The meeting was so brief that scores of DHHS workers trailed into the meeting after it ended.

“I think it was a surprise for all of us,” Wos said of Steckel’s resignation. She called Steckel “a fireball of dynamism.”

Steckel is taking a job with Wellcare Health Plans in Tampa, Fla. Her last day at DHHS will be Oct. 11.

Wos had bragged about luring Steckel from her job in Louisiana, where she worked at the Louisiana Department of Health and Hospitals and took the lead in responding to the federal Affordable Care Act. She also served as Medicaid director in Alabama.

Recruiting Steckel from Louisiana was “the first big victory we had in HHS,” Wos told legislators earlier this year.

Steckel earned $210,000 a year, higher than the top state salary set for the Medicaid director. DHHS said the agency sought permission to pay Steckel more based on her experience.

Reached on the phone Monday, Steckel declined to comment. In a written statement released by DHHS, Steckel said the Wellcare job was “a great opportunity,” and called Wos a “strong and dynamic leader.”

She added: “In just a short time together, we have made good progress on reforming the state’s Medicaid program to control costs and improve care.”

High-profile departures

Steckel’s resignation is part of a string of high-profile departures at DHHS. Dr. Laura Gerald resigned her position as state health director, citing differences with the administration. Dr. Rebecca King, the state’s top dentist, was fired. Kelly Crosbie, who was Steckel’s chief operations officer, left that office and later left DHHS.

Steckel’s resignation comes as Gov. Pat McCrory has talked about impending reforms to the Medicaid system, which he has repeatedly called broken.

McCrory has made it clear that his administration would like to add several private insurers to manage the $14 billion Medicaid program. A proposal for opening up the system to commercial insurers and others is to be presented to the legislature by early next year.

Steckel helped make similar changes to Louisiana’s program, but the idea has met with resistance from some North Carolina lawmakers.

An opportunity

Rep. Nelson Dollar, the House’s chief budget writer, said Steckel’s departure was an opportunity for a fresh look at Medicaid reform.

“A number of us have been looking at a variety of models other than commercial managed care,” said Dollar, a Cary Republican. “We have many strengths in our Medicaid program that we would like to build on.”

Rep. Larry Hall, the House minority leader, said Steckel’s departure is more evidence of a troubled department. DHHS is still struggling with a new Medicaid payment system that started in July. Doctors and other health care providers have been complaining that they’ve had trouble getting paid and that their calls for help have been futile.

In addition to the Medicaid payment problems, Hall said he’s had dozens of complaints about the department’s computer program that administers the food stamp program.

“The fact that all these expert employees are leaving doesn’t create confidence,” said Hall, a Durham Democrat. “We have a department that appears to be in serious disarray.”

Hall said he looks forward to getting some answers Oct. 8 at a legislative oversight meeting that will focus on the department.

Neff: 919-829-4516

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via RALEIGH: NC Medicaid director resigns after eight months on job | State Politics |


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