Faced with a backlog in the MNsure system, Dakota County is hiring six more workers to manage the cases of people covered by public health insurance.
The additional staff will work on ensuring that only those who qualify for coverage receive it from the state's Medicaid program, called Medical Assistance. Counties and the state jointly administer Medical Assistance, which provides health insurance to Minnesotans near or below the poverty line. In fall 2013, the state and counties started switching enrollment and eligibility for the program to the MNsure information technology system, but there have been a series of technical problems.
In Dakota County, the Medical Assistance caseload has increased 66 percent since the switch. Nine county workers have been handling the cases, and they are worn out from the overtime needed to deal with the growth and the inefficient, time-consuming new program, officials told the County Board last week.
Under the old system for handling Medical Assistance cases, staff would enter changes into the computer once and move on. Now they often have to enter those updates 40 times.
"There's 10,400 to-dos because the system can't do them," Community Services Director Kelly Harder said. "These tasks equate to time and labor."
County staff presented a long list of tasks that used to take five minutes to complete, such as adding a newborn to a family's policy. That has ballooned to a 40-minute ordeal. Someone got a new address? Count on 15 minutes of updating. Their income changed? Set aside a half-hour.
Until recently, employees could not even make most of those updates in the new MNsure system, said Tiffinie Miller, deputy director of employment and economic assistance.
Because workers were not able to update cases, some people retained coverage even if they had life changes that should have made them ineligible, Harder said.
The state said it would be rolling out products to speed up the process, but has not yet done so, said Marti Fischbach, director of employment and economic assistance.
"You don't see any light at the end of the tunnel right now?" Commissioner Tom Egan asked.
"I would say the light at the end of the tunnel is two, three years out," Fischbach replied. "There always seems to be hope out there and we see a lot of movement, but we haven't actually had any relief."
While the state is asking all counties to help with the MNsure backlog, Dakota County is unique in adding several more staff members now to tackle the job. That's because, with six financial workers and three support staff, the county has had a comparatively small team handling MNsure clients.
Financial workers help people apply for Medical Assistance and manage their cases. A Dakota County financial worker juggles 406 cases on average.
Anoka County financial workers average 339 cases, Ramsey County workers 368 and Washington County workers 334, according to county documents.
The addition of six financial workers is projected to cost $176,164 through the end of the year. That will be covered by savings from staff turnover, Fischbach said.
Commissioners unanimously approved the 2015 staff increase, though some noted their general opposition to MNsure.
"It's unfortunate the system has been … one of the most massively overpromised and underdelivered," Commissioner Chris Gerlach said.
Jessie Van Berkel • 952-746-3280