Minnesota's health insurance marketplace MNsure has presented numerous challenges for Crow Wing County Community Services, the county board heard Tuesday.
A presentation on the county's response to the rollout of the marketplace preceded a request for county board approval for hiring an additional financial worker to work in that area.
Sheila Skogen, community services supervisor, told the board adding a financial worker would allow more phone coverage to answer customer questions and allow the department to continue evaluating staffing patterns and work processes.
Between Sept. 2013 and Oct. 2015, health insurance cases handled by community services increased by 59 percent, from 6,175 to almost 10,000. During this time, Skogen said the county also took on several unexpected tasks handed off by the Minnesota Department of Human Services, including the processing of a backlog of paper applications, processing of changes in circumstances and medical assistance renewals.
Skogen said she understands why some in the community are frustrated by the new health insurance processes and that community services is frustrated as well.
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"I've heard smatterings of 'dysfunctional' and 'unhappy,'" Skogen said. "The angst we're hearing from folks out in the community that don't understand what this process is is really out of our control. But I can certainly understand why the community would be frustrated with this process. We learn something new every day, and the system of the state has not helped it. But we continue to manage the work."
Skogen said other counties-even those with smaller caseloads-hired additional workers to accomplish the work associated with MNsure. The added workload coupled with software issues led Crow Wing County to do some "creative work" to make internal changes to staff. Skogen gave an example of an update to a case file that once took just a few minutes-the birth of a new baby-now requires two to three hours of work.
Skogen said part of this restructuring was due to contracting out the Minnesota Family Investment Program Tier 3 clients to the Employment Resource Center earlier this year. This move freed up about 8 hours of staff time, she said. A case aide was reclassified as a financial worker and a supervisor was replaced with one as well, reducing the number of program coordinators to two.
"They are only successful because of the rest of the financial workers. Those are the ones working the other systems-the long-term care, adults, families-and our support staff, who are front and center," Skogen said. "All these folks work together so the MNsure team could be pulled out of the old system and working solely on MNsure."
Skogen said hiring an additional worker is anticipation of yet another set of tasks DHS is handing off to counties, which is mixed household case reviews.
"For the past two years, we've taken a very conservative, thoughtful and creative approach to managing the work and the unknowns," Skogen said. "What we're saying is, you've entrusted us to thoroughly evaluate our processes and our practices and to provide you with an accurate and honest picture of where we were at and where we are today."
Commissioner Rachel Reabe Nystrom made the motion to approve the hiring request, and Commissioner Paul Thiede seconded the motion. Commissioner Doug Houge asked Skogen how the department's workload would be affected, should some of the software incompatibility issues be resolved in state systems.
"We do expect that at some point in the future, if it works like we dream and hope it will, our workloads will decrease," Skogen said. "The increase of the cases will not go away."
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The request was unanimously approved by commissioners.
CHELSEY PERKINS may be reached at 218-855-5874 or chelsey.perkins@brainerddispatch.com . Follow on Twitter at www.twitter.com/DispatchChelsey .
