North Carolina Department of Health and Human Services
State of North Carolina | |
Headquarters | Dorothea Dix Campus Adams Building 101 Blair Drive Raleigh, NC 27603[1][2] |
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Employees | 18,000 |
Annual budget | $38 billion |
Agency executives |
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Website | www |
The North Carolina Department of Health and Human Services (NCDHHS or DHHS) is a large state government agency in the U.S. state of North Carolina, analogous to the United States Department of Health and Human Services.[3] The NCDHHS has more than 18,000 employees. The NCDHHS has its origins in the former North Carolina Department of Human Resources (DHR). The head of NCDHHS (Secretary) is appointed by the Governor of North Carolina, confirmed by the North Carolina Senate, and is a member of the North Carolina Cabinet in the executive branch of the North Carolina government. The NCDHHS was created in 1971.
Divisions
Among its divisions are:[3]
- Division of Mental Health, Developmental Disabilities, & Substance Use Services
- Division of Health Services Regulation
- Division of State Operated Health Facilities
- Division of Public Health
- Division of Social Services
- Division of Child Development and Early Education
- Division of Child and Family Wellbeing
- Division of Aging
- Division of Deaf and Hard of Hearing
- Division of Health Benefits (most well known for the Medicaid program)
Secretaries
The following is a list of NCDHHS secretaries:
- Lenox D. Baker, 1972–73[4]
- David Flaherty, 1973–76
- Phillip J. Kirk, Jr., 1976–77
- Sarah T. Morrow, 1977–85
- Lucy H. Bode, 1985
- Phillip J. Kirk, Jr., 1985–87
- Paul Kayye, 1987
- David Flaherty, 1987–93
- Charles Robin Britt, 1993–97
- H. David Bruton, 1997–2000
- Carmen Hooker Odom, 2001–07
- Dempsey Benton, 2007–09
- Lanier Cansler, 2009–12
- Albert Delia, 2012–13 (acting)
- Aldona Wos, 2013–15
- Rick Brajer, 2015–16
- Mandy Cohen, 2017–21
- Kody H. Kinsley, 2022-present
Programs
History
Department of Human Resources (1971-97)
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The NCDHHS has its origins in the former North Carolina Department of Human Resources (DHR). The DHR was created in 1971 as an umbrella to consolidate what had been more than 300 free-standing state agencies. The first Secretary of Human Resources, Dr. Lenox Baker, was appointed by Governor Robert W. Scott.[4]
The Division of Public Health, an original part of the department, was taken out of the DHR in 1989. Most of its functions were transferred back to the DHR in 1997, when the agency was renamed the Department of Health and Human Services.[citation needed]
Medicaid system and abuse policy (2004-10)
In April 2004, NCDHHS awarded
An incident at NCDHHS psychiatric hospitals in 2009 attracted media attention, when a patient at
In 2009 and 2010, state regulators found that companies were billing for never performed care in the state Medicaid system, prompting the state
Vetoes and budget cuts (2011)
The state budget for the division overseeing Medicaid was around $3 billion by 2011.
As a result of the vetoes, Republican lawmakers passed a $19.7 billion state budget that dictated cutting $356 million
Budget shortfall and cuts (2011)
By October 2011, NCDHHS was facing a projected $139 million budget shortfall for Medicaid, partly because of "other agency liabilities that weren't paid for in the spending plan." NCDHHS argued that the legislature's dictated budget cuts hadn't taken into account a $300 million accounting error from 2008, and also hadn't noted that "the state also must repay $42 million after a federal audit found personal care services were either billed improperly or had inadequate documentation from providers."
After creating a list of potential NCDHHS budget cuts for the
Medicaid IT delays, shortfall patch (2011-12)
In late 2011, NCDHHS revealed ongoing problems with the state's contract to refurbish the Medicaid billing system.[15] In particular, the state's 2008 contract[15] with Affiliated Computer Services (ACS)[5] had faced two year delays, with the budget running from $287 million to $495 million. All but about 10% of the contract was paid with federal, not state, dollars.[15] Cansler stated the delays were due to constantly changing federal guidelines, requiring constant system redesign.[7] A performance audit of NCDHHS released on January 10, 2012, found problems with oversight of the Medicaid system's development. Among other budgetary missteps, the audit claimed that the computer system had been altered after final approval, leading to unexpected changes in the software.[5]
Despite the General Assembly's response to the Medicaid budget shortfall in October 2011, over the following months money was not indicated by lawmakers as available
On January 13, 2012,[6] Cansler resigned from his role as secretary of NCDHHS, giving a two-week warning.[7] Governor Perdue named Al Delia, her senior policy advisor, as acting secretary of the department in early February.[17] At the time, Cansler stated in interviews that he had grown frustrated with the "political contest" over funding in the state legislature.[6][18] Early in 2012, legislators passed a patch for the Medicaid shortfall. That year, the Medicaid program was estimated to have a $13 billion budget in state and federal funds.[19]
Personal care crisis (2012)
As of April 2012, North Carolina stood to "lose $414 million in federal funding" over conflicts with the federal government on the regulations for allocating funding for personal care services. The North Carolina Association of Long Term Care Facilities asserted that if the conflicts were not resolved, "30,000 people could be 'put out on the street'." A federal deadline to fix the problem was initially set for May 1. On April 4, federal regulators gave "tentative approval" to NCDHHS' proposal, giving the state until the end of 2012 to implement fixes to personal care services. The new plan, according to NCDHHS, made most applicants eligible for long-term care, though some "4,000 people who now receive services in long-term care facilities will have to find alternative arrangements."[8]
NCDHHS implemented the new computer system NC Fast in May 2012,
In October 2012, it was projected that "more than 11,000 disabled people in group or adult care homes will no longer qualify for the services through Medicaid as of Jan. 1 because the state considers them functional enough to live without them."[23] A special session on the group home funding was held in November 2012, called by house speaker Thom Tillis "to fix a budget gap that could cause about 2,000 people with mental illnesses and developmental disabilities to lose their homes." Wrote WRAL, "the crisis was triggered in July when the Republican-controlled legislature approved a one-word tweak to the state budget that excluded group homes from a nearly $40 million fund intended to cushion the effects of Medicaid eligibility changes for programs for the disabled."[24]
New cabinet hires and NC Fast (2013)
On January 4, 2013,[25] North Carolina Governor-elect Pat McCrory swore in Aldona Wos as Secretary of the North Carolina Department of Health and Human Services.[25] At the time, NCDHHS had around 18,000 employees and a budget of around $18 billion.[26] Wos declined her $128,000 salary and was instead paid a token $1.[27] A new performance audit of the Department of Health and Human Services for 2012 was released on January 31, 2013. The audit criticized NCDHHS for its lack of record keeping and management concerning various funds, among other budgetary problems. Wos released her responses to the audit, agreeing on all points with the auditor, including the conclusion that NCDHHS had consistently exceeded budgeted amounts for administrative costs due to lack of oversight.[28]
When speaking to the
Federal authorities began investigating NCDHHS for signs of wrongdoing in relation to work agreements in July 2013 from as early as 2006, with Wos and NCDHHS announcing their cooperation.
Backlog resolution (2014)
In early 2014, NCDHHS dealt with a backlog of duplicate food stamp applications in the NCFast system, with many people waiting over a month for benefits. The backlog reached about 24,000 cases by January 18.[37] On January 23, the USDA threatened to withhold $88 million in administrative funding for the state's food stamp program unless the backlog was promptly dealt with. The first deadline was set as February 10, and required the resolution of the "longest-delay cases." County agencies at NCDHHS met the deadline "by working nights and weekends, hiring temporary staff and diverting staff from other program areas." An end of March deadline was given for fixing the entire backlog.[31] Though NCDHHS initially gave assurances it could meet the March deadline as well,[37] on March 11, Wos told lawmakers that it would be difficult to resolve the outstanding 1,975 backlogged cases before March 31.[38]
On March 25, Wos announced that NCDHHS was on track to meet the March deadline, excluding that
Surplus, Brajer hired (2015-16)
Throughout 2013 and early 2014, NCDHHS worked to resolve glitches with the NCTracks Medicaid billing system. The department announced the system was working "effectively" by July 204.[30] The state's Medicaid program ended 2014 with a $130 million surplus, a contrast to the usual deficit held by the department.[39] Despite the surplus, Wos stated that she was "disappointed" that the state elected not to move forward with her proposal to reform the state's Medicaid program.[26] By 2015, NCDHHS had announced that the glitches from both NCTTracks and NC Fast were resolved, and Wos had "[convinced] the legislature of the need to invest in the state’s medical examiner system."[26]
Wos resigned on August 15, 2015,[39] stating in a press conference that it was "simply time to go home" and spend time with her family.[39] Asked by the press if she would "change any of the decisions that she made over a sometimes rocky tenure," she replied "not at all."[39] Wos was replaced by Rick Brajer, a former medical technology executive.[39] After being sworn in, Brajer asserted to the press that Wos' resignation had been unrelated to the ongoing federal investigation into NCDHHS.[40]
In October 2015, NCDHHS introduced their Medicaid 1115 waiver, which petitioned federal Medicaid authorities to change the state system to a "capitized" billing process, where doctors bill a set per-patient fee as compared to billing for specific medical items. At the time, the state was the "largest state that has not moved from a fee-for-service system to capitated payment."[41] Medicaid was running about $185 million below budget at the time of the proposal. Brajer was praised for the development from lawmakers such as Senator Tommy Tucker, who had previously been vocal in criticizing the department. Tucker also stated "I don’t want us to minimize the effort of these folks and the previous secretary in the reform of the department.... [that effort] has allowed us to look at $200 or $300 million in surplus."[41]
The Opioid epidemic, GenX in drinking water, and the COVID-19 pandemic (2017-22)
In January 2017 Mandy Cohen was appointed Health Secretary of the Department by Governor Roy Cooper.[42][43][44] [45][46] She dealt with multiple health crises in North Carolina including the Opioid epidemic, GenX in drinking water, and the COVID-19 pandemic.[43][47][48]
Cohen navigated the political divide over Medicaid in North Carolina, with
COVID-19 pandemic
Cohen stressed the need for North Carolinians to wear face masks, practice social distancing, and wash their hands in order to prevent the spread of COVID-19.[43][51][52] In March 2020 she sent a letter to the president of the 2020 Republican National Convention, asking for detailed plans on how the convention would operate during the COVID-19 pandemic after President Donald Trump published a series of tweets threatening to pull the convention out of North Carolina.[53][54] The Department announced the creation of up to 300 testing sites in North Carolina, active through July, and requested more supplies from the federal government.[55] On June 30, 2020, the Department announced that it would partner with Omnicare, a company owned by CVS Health, to administer tests to 36,000 nursing home residents and 25,000 nursing home employees in over 400 locations.[56]
In the beginning of July, Cohen warned of people becoming desensitized to the data being collected about COVID-19.[57] She said that she had concerns about teacher safety if schools were to re-open amidst the pandemic, but was confident in studies showing that the virus has minimal health consequences on younger children, saying that schools "have not played a significant role in the spreading of COVID-19."[58] She met with William L. Roper, president of the University of North Carolina, to discuss how to resume in-person instruction for students at North Carolina's public colleges and universities.[58] Earlier that month, during a press conference, she had called the virus a "serious threat".[59] She warned of the state possibly returning to a stay-at-home order.[60] She had also linked North Carolina's rise in cases with the reopening of the state.[61][62] Cohen indicated that there would be a test surge in areas with troubling metrics.[61]
References
- ^ North Carolina Department of Health & Human Services, Contact Information, Retrieved Jun. 27, 2022.
- ^ City of Raleigh, Dorothea Dix Campus Map, Retrieved Jul. 1, 2022.
- ^ a b "Official State DHHS Website". www.ncdhhs.gov. Retrieved March 10, 2020.
- ^ ISBN 0837902258.
- ^ a b c Wood, Beth A. (January 10, 2012). "Performance Audit" (PDF). Department of Health and Human Services - Office of Medicaid Management Information System Services. Retrieved April 11, 2016.
- ^ a b c "Outgoing DHHS chief: Politics led to frustration". WRAL. January 31, 2012. Retrieved April 11, 2016.
- ^ a b c Leslie, Laura (January 13, 2012). "Cansler departs DHHS". WRAL. Retrieved April 11, 2016.
- ^ a b Binker, Mark (April 4, 2012). "Legislators, DHHS plan ahead of Medicaid cutoff deadline". WRAL. Retrieved April 11, 2016.
- ^ Mildwurf, Bruce (November 4, 2010). "Critics: Delays in state Medicaid program 'unacceptable'". WRAL. Retrieved April 11, 2016.
- ^ a b c d e f Leslie, Laura (October 27, 2011). "NC Medicaid cuts lead to blame game". WRAL. Retrieved April 11, 2016.
- ^ a b c Leslie, Laura (July 25, 2011). "Override Hat Trick". WRAL. Retrieved April 11, 2016.
- ^ a b "State Medicaid cuts won't be easy, DHHS chief says". WRAL. August 4, 2011. Retrieved April 11, 2016.
- ^ a b Cansler, Lanier (October 27, 2011). "Letter to Beverly Eaves Perdue, Governor" (PDF). North Carolina Department of Health and Human Services. Retrieved April 11, 2016.
- ^ a b c d Midlwurf, Bruce (December 5, 2011). "Budget shortfall could mean catastrophic Medicaid cuts after all". WRAL. Retrieved April 11, 2016.
- ^ a b c d Leslie, Laura (December 13, 2011). "Fingerpointing, but no solutions for Medicaid shortfall". WRAL. Retrieved April 11, 2016.
- ^ Browder, Cullen (January 3, 2012). "Medicaid shortfall grows with no fix in sight". WRAL. Retrieved April 11, 2016.
- ^ Leslie, Laura (January 13, 2012). "DHHS secretary to step down". WRAL. Retrieved April 11, 2016.
- ^ "Interview With Outgoing NC DHHS Secretary Lanier Cansler". North Carolina Health News. February 1, 2012. Retrieved April 11, 2016.
- ^ a b Binker, Mark (June 19, 2012). "State fires Medicaid chief". WRAL. Retrieved April 11, 2016.
- ^ a b c d Poe, Kelly (July 12, 2014). "Report:DSS staff told to hide backlog". Greensboro.com. Retrieved April 11, 2016.
- ^ O'Connell, Brody (July 31, 2014). "Adult Medicaid program to transition to NC FAST system". WBTV. Retrieved April 11, 2016.
- ^ Leslie, Laura (October 18, 2012). "Perdue moves $20M to add 6,300 pre-K seats". WRAL. Retrieved April 11, 2016.
- ^ Leslie, Laura (October 25, 2012). "Looming group home crisis becoming political football". WRAL. Retrieved April 11, 2016.
- ^ "House leader calls for special session on group home funding". WRAL. November 30, 2012. Retrieved April 11, 2016.
- ^ a b
"McCrory begins naming administration members". News & Observer. Archived from the originalon October 24, 2013. Retrieved April 11, 2016.
- ^ a b c d e Hoban, Rose (August 14, 2015). "Exclusive: DHHS Secretary Aldona Wos". North Carolina Health News. Retrieved April 4, 2016.
- ^
Frank, John (January 10, 2013). "Gov. Pat McCrory gives his cabinet generous salary hikes". News & Observer. Retrieved April 11, 2016.
- ^ Wood, Beth (January 31, 2013). "Performance Audit" (PDF). Department of Health and Human Services - Office of Medicaid Management Information System Services. Retrieved April 11, 2016.
- ^ Hoban, Rose (February 14, 2013). "DHHS Secretary Wos Lays Out Priorities to Legislators". North Carolina Health News. Retrieved April 11, 2016.
- ^ a b "NCTracks still getting mixed reviews from medical providers". WRAL. July 1, 2014. Retrieved April 11, 2016.
- ^ a b c d e "Guilford backlog jeopardizes NC meeting food stamp deadline". NCCapital. March 26, 2014. Retrieved April 11, 2016.
- ^ a b c "DHHS still using NC Fast contractor with troubled past". WSAV-TV. September 26, 2013. Retrieved April 11, 2016.[permanent dead link]
- ^ "State health agency gave big contract to Wos acquaintance". WRAL. September 6, 2013. Retrieved April 11, 2016.
- ^
"North Carolina DHHS to expand audit team". Triangle Business Journal. August 7, 2013. Retrieved April 11, 2016.
- ^ "Secretary Aldona Zofia Wos Biography". NC Department of Health and Social Services. Retrieved April 11, 2016.
- ^ Searing, Adam (October 9, 2013). "A Reality Check for NC DHHS Secretary Aldona Wos". Progressive Pulse. Retrieved April 11, 2016.
- ^ a b "NC agency to fix food stamp problems before April". Associated Press. ABC Local. January 18, 2014. Retrieved January 19, 2014.[permanent dead link]
- ^ "Wos warns of next food stamp deadline". NCCapitol. March 12, 2014. Retrieved April 11, 2016.
- ^ a b c d e Binker, Mark (August 5, 2015). "Wos resigns as DHHS secretary, McCrory appoints former biotech executive to replace her". WRAL.com. Retrieved April 4, 2016.
- ^ Rodriguez, Jonathan (September 28, 2015). "Wos did not resign due to subpoenas, DHHS head says". WNCN. Retrieved April 11, 2016.
- ^ a b Gerlach, Kendra (October 27, 2015). "Wos took on Herculean tasks at DHHS". The Charlotte Observer. Retrieved April 4, 2016.
- ^ "Former NCDHHS Secretary Mandy Cohen is Biden's pick to lead CDC: Washington Post". ABC. June 1, 2023.
- ^ a b c Evans, Jon (July 7, 2020). "Dr. Mandy Cohen: She is a mom, a wife and the face of North Carolina's effort against COVID-19 ("1on1 with Jon Evans" podcast)". WECT.
- ^ "Mandy Cohen, MD, MPH". UNC Gillings School of Global Public Health. Retrieved July 18, 2020.
- ^ "Mandy Krauthamer Cohen, M.D. '05, M.P.H., named to key post in North Carolina". Yale School of Medicine. January 19, 2017.
- ^ Barry Smith (January 13, 2017). "Cooper makes two appointments; says he's working with GA leaders to ease confirmation". Carolina Journal.
- ^ a b c d e f g h i "10 Things To Know About DHHS Secretary Mandy Cohen". Raleigh Magazine. April 29, 2020.
- ^ ""Health Care in North Carolina" – Secretary Mandy Cohen, NC HHS 27607". HAR.com.
- ^ Bonner, Lynn (March 17, 2017). "New state health leader Mandy Cohen makes opioid treatment a priority". Charlotte Observer.
- ^ Carver, Richard (November 30, 2021). "Dr. Mandy Cohen, face of NC's pandemic response, to step down Jan. 1". Winston-Salem Journal. Retrieved November 30, 2021.
- ^ Laura Leslie (June 17, 2020). "DHHS chief says evidence shows masks, face coverings work to limit virus". WRAL.
- ^ Gary D. Robertson (June 23, 2020). "N.C. health chief laments virus trends as order soon expires". WLOS.
- ^ "NCDHHS Sec. Cohen asks RNC for plans on how Charlotte convention could operate amid COVID-19 pandemic". CBS. May 26, 2020.
- ^ Gary D. Robertson (May 29, 2020). "Trump, N.C. governor speak about GOP convention details". Detroit News.
- ^ Bryan Anderson (July 7, 2020). "N.C. residents won't need a doctor's order for a COVID test". AP News.
- ^ "North Carolina to test all nursing home residents, workers". Westport News. June 30, 2020.
- ^ "'We're almost getting numb to hearing these numbers:' Dr. Cohen on need to take COVID-19 seriously as NC hits record for new cases". WXII. July 2, 2020.
- ^ a b "As COVID cases hit new high, N.C. delays K-12 reopen plans". Alton Telegraph. July 1, 2020.
- ^ ""I've been ringing the warning bell" | Dr. Cohen says North Carolina's COVID-19 metrics are concerning". WCNC. June 10, 2020.
- ^ Christianna Silva (June 11, 2020). "N.C. Health Secretary Warns Of Surge In Cases, Possible Return Of Stay-At-Home Orders". NPR.
- ^ a b Dillon, A. P. (June 11, 2020). "Congressman reaffirms North Carolina metrics had issues prior to reopening". North State Journal.
- ^ Gary D. Robertson. "North Carolina health chief laments virus trends as order soon expires". The Dispatch.