Category Archives: Al Delia

Big Win for 13 Medicaid Recipients Who Had Lost Access to PCS

Big legal win for 13 Medicaid PCS recipients Tuesday, April 2, 2013!

Background:

13 North Carolina Medicaid recipients brought suit against the Department of Health and Human Services (DHHS) when they lost access to in-home PCS due to the General Assembly passing stricter PCS eligibility requirements in 2010.

PCS is a Medicaid service that assists disabled adults with daily tasks such as eating, toileting, and bathing.

The 13 Medicaid recipients argued that the new PCS program violated the Social Security Act, the Americans with Disabilities Act (ADA), and the Rehabilitation Act, among other claims.

The District Court agreed.  Judge Boyle held that the new PCS program treats people with similar needs differently and puts North Carolinians “who have been successfully living in their own homes…at risk of segregation, in the form of institutionalization.”

On March 5, 2013, the 4th Circuit Court of Appeals upheld the District Court’s 2011 decision to stop the State of North Carolina from implementing a 2010 policy concerning Medicaid personal care services (PCS).

For the March 5, 2013,  4th Circuit Court decision in Pashby v. Delia, click here.

After the 4th Circuit held in favor of the recipients, the State requested a rehearing.

Tuesday, the 4th Circuit said, “Nope.” The rehearing request was denied.

This means that the case will now return to District Court Judge Terrence Boyle for further proceedings and final determination.

To say that bringing a lawsuit enjoining the government from implementing policy is like David and Goliath is a mischaracterization of bringing a lawsuit against the government.

Bringing a lawsuit enjoining the government from implementing Medicaid policy is like the ant on the bottom of David’s shoe fighting Goliath.

Well, in this case, the ant is winning.

Health care providers who are being harassed by Managed Care Organizations and DHHS, take this as a lesson:

The ant can win.

Aldona Wos: New Head of DHHS

December 13, 2012, Governor-elect Pat McCrory appointed Aldona Wos as the new head of the Department of Health and Human Services (DHHS).

But who is she? Will she proceed differently than former head of DHHS Albert Delia?

Wos (pronounced Vosh) is a native of Poland.  She is a retired physician and, in 1997,   moved to Greensboro when her husband, Louis DeJoy,  set up a business there.  Wos” husband, Louis DeJoy, is Chief Executive Officer of New Breed Logistics, Inc., a privately held third-party logistics company founded in 1968 and headquartered in High Point, North Carolina.

Once Wos moved to NC, she became an avid Republican Party fund-raiser. She was appointed North Carolina State Chair of Women for Senator Elizabeth Dole.  For the 2004 Bush/Cheney presidential campaign, Wos served as the Carolina Finance Co-Chair.  President George W. Bush appointed her to two terms on the U.S. Holocaust Memorial Council, which was apropos, since Wos’ father was a Holocaust survivor.

From 2004-2006, Wos served as the Ambassador to Estonia.

According to http://www.CampaignMoney.com, in 2008, Wos donated $73,120 to the Republican party.

Does the fact that Wos contributed to the Republican Party for years and was appointed by a Republican governor mean that Wos is not qualified for the job?

I think not. Obviously, Wos is a retired-phyician.  She has the health care knowledge from the perspective of a physician. This could be a great thing! Hopefully she will have first-hand knowledge of the need for physicians to receive higher Medicaid reimbursements

Also, Wos is no Newby to politics. Her past political contributions and public service shows a great love for this country, which is not her native country.

I could not find much about Wos between 2006 and 2012 (her appointment as head of DHHS). There has been a lot of criticism of Wos due to her contributions to political campaigns.  But, I say, let’s see what she does. She is obviously educated in health care and savvy in politics…which makes her qualified without question as head of DHHS.

Look at former head of DHHS Albert Delia.  He was not a physician. Before he served at head of DHHS he was Gov. Purdue’s chief policy advisor and Senior Advisor. I was unable to find any positions Delia held prior to head of DHHS that would have made him uniquely qualified to head DHHS at all.  (Which is better? Being appointed because you were involved in the governor’s politics as a career? Or being appointed because you contributed to campaigns, but held your own medical degree?)

I’m not saying Wos is qualified merely because she is a physician.  I’m just saying let’s give her a chance because she does seem qualified, regardless of her campaign contributions. Plus, having someone who worked at a physician may have its benefits.  We will see…

Perdue: Takes $20 Million From Medicaid, Gives to Pre-K Programs

In one last hurrah, Perdue took $20 million from DHHS, or the Medicaid budget, and redistributed it to the Pre-K Program, formerly known as More at Four. The Medicaid budget is extremely tight as it is; the budget cannot even cover all the Medicaid services, much less fund another program.

At the end of the last fiscal year, the General Assembly needed to appropriate an additional $212 million to Medicaid to cover a budget shortfall that had grown over the previous year.

NC Secretary of DHHS, Al Delia, stated that the $20 million came from the AIDS Drug Assistance Program, foster-care services, funding reversions and unspent salaries.  Which begs the question, if there were unspent monies in the Medicaid budget, why did DHHS ask the General Assembly a few months ago for $212 million to finish the fiscal year?

Although it is important to note that Perdue was acting via a Court Order. Personally, I’d like to see the Court Order. I’d like to see whether the Order ordered the funds to come from DHHS. Because Medicaid funding is the one of last budgets I would dip into.