Item:
Title
Approval of Budget Ordinance Amendment No. 27BCC012 for the Department of Social Services to Recognize $850,290 in Additional State Funding and Authorize Nine New Full-time Equivalent Positions to Support the Implementation of Federally Mandated Medicaid Changes Resulting from H.R. 1
Body
Date of BOCC Meeting: August 10, 2026
Request for Board Action:
Agenda Text
The Board is requested to approve Budget Ordinance Amendment No. 27BCC012 for the Department of Social Services to recognize $850,290 in additional State funding and authorize nine new full-time equivalent positions to support the implementation of federally mandated Medicaid changes resulting from H.R. 1.
H.R. 1 introduces several significant eligibility changes that will substantially increase the workload of county Medicaid staff, including but not limited to:
• Requiring eligibility redeterminations for the Medicaid Expansion population every six months instead of annually, effectively doubling the number of required reviews.
• Implementing work and community engagement requirements for certain adults ages 19-64. Staff will be responsible for reviewing participation in qualifying activities, verifying exemptions, requesting additional documentation, and taking appropriate action on eligibility.
• Revising Medicaid eligibility requirements for certain non-citizens, which will require staff to review immigration classifications and reassess eligibility for affected recipients.
Durham County DSS does not currently have sufficient staffing capacity to absorb this additional workload while maintaining timely and accurate processing of existing Medicaid applications, renewals, and case changes. The nine additional FTEs are necessary to support implementation, maintain compliance with State and federal requirements, and protect continued Medicaid access for eligible Durham County residents.
Alignment with Strategic Plan: Healthy and Inclusive Community supporting equitable and inclusive health and well-being for all.
Resource Persons: Maggie Clapp, Director, Department of Social Services, Margaret Faircloth, Assistant Director, and Cynthia Cason, Assistant Director.
County Manager’s Recommendation: The County Manager recommends that the Board approve Budget Ordinance Amendment No. 27BCC012 for the Department of Social Services to recognize $850,290 in additional State funding and authorize nine new full-time equivalent positions to support the implementation of federally mandated Medicaid changes resulting from H.R. 1.
Signature
County Manager: ____________________________