The 'dead moose' in the room

by Patrick Gannon, The Insider, September 22, 2014.

In a few years covering the Legislature, I don't recall hearing the words "dead" and "moose" uttered together in any legislative meeting.

It happened last week.

Embattled Health and Human Services Secretary Aldona Wos told state lawmakers during a committee meeting that her department is on the mend after changes she's made in DHHS leadership and the ongoing restructuring of the Division of Medical Assistance, which administers the state's $13 billion Medicaid program.

Wos, an appointee of Gov. Pat McCrory, pleaded with lawmakers not to remove Medicaid from her watch, a move threatened in the wake of DHHS struggles.

Wos has been in crisis mode since she took over in early 2013, responding to problem after problem and leading legislators from both sides of the aisle to question her ability to lead the 17,000-employee department.

Wos said she's now running the agency more like a private-sector company. She hired experienced people as chief information officer, chief financial officer, human resources director and Medicaid director, she said. And the Medicaid division – where many of the problems reside – is undergoing a major restructuring, its first in decades. (Critics have equated the restructuring the rearranging deck chairs on the Titanic).

Progress also is being made, Wos said, on a system that will enable the department to get more reliable financial data about Medicaid to legislators as they work on the state budget. That has been a sore spot for budget writers in recent years, as large Medicaid shortfalls have left the General Assembly with less money to spend elsewhere.

"We are actually very close to the finish line with the improvements that we are making," Wos said. Stopping that momentum now would be a waste of taxpayer money and a disruption to those the department serves, she added.

Then came Sen. Jeff Tarte, a Mecklenburg County Republican, who mentioned the "dead moose on the table." "We all know it's in the room," he said. "We've recognized it for a long time, and nobody wants to talk about it."

That "dead moose" that Tarte referenced is that elected officials and others have "very low confidence" (those are Tarte's words) in the financial numbers, budget forecasts and performance of Wos' department. "Without that changing dramatically … there will be actions taken in some way, shape or form," Tarte said. "So how do we gain confidence in the information you provide us?"

In other words, he was asking Wos, "Why should we trust you?"

Wos responded that Tarte's feelings were based on his past experiences with the Medicaid division. "The relationship has to continue to develop as we are making fundamental, structural changes and targeted specifically at the finance arm of the equation," Wos said. She added that "it will take time for you to trust us."

If given more time, she said, the department would provide legislators with a more reliable, more timely and more accurate product. So will legislators give her more time or remove Medicaid from her department?

That will depend on whether they come to trust her.