I-Team: Babies not getting care due to backlog

The ABC11 I-Team has uncovered a new problem with an issue we've been reporting on for months.
April 24, 2014 2:58:32 PM PDT
The ABC11 I-Team has uncovered a new problem with an issue we've been reporting on for months - the delays associated with North Carolina's NC Fast computer system, which is supposed to help counties process Medicaid and Food Stamp applications.

Earlier this month, officials with the state Department of Health and Human Services told reporters the agency met a federal deadline to clear a backlog of food stamp applications or face the loss of $88 million in funding from the US Department of Agriculture.

But the rush to clear the food stamp backlog has meant the state and counties are far behind on Medicaid requests, and that's affecting the care for pregnant women and their babies.

Jessica Wilson filed for Medicaid last summer as soon as she learned she was pregnant.  What's supposed to take 45 days to get processed, turned into months - all the way up to her due date.

"I'm telling the supervisor, 'Look I'm 3 centimeters. I can go in tonight or tomorrow. I need Medicaid.'  She said 'Well, since you're pregnant, we'll push your Medicaid.' But I'm like 'Well, I'm about to go into labor now.'  She's like 'Well, I'll let your case worker know. But as I'm calling her at the delivery, still don't answer.  Her voicemail box is full. The supervisor still won't answer or call me back," said Wilson.

She delivered with no Medicaid and her baby girl still isn't covered.

"I'm stressed, worried. I haven't slept in like what? Since I've been home from the hospital, I haven't slept," she said.

Mary Harris said she feels that same stress.

"I need to go have my prenatal care for my baby. I need to make sure that the baby is okay," she explained. 

But without Medicaid, she said she can't afford to have many tests done - not even an ultrasound.

"I don't even know how far along I am. I don't even know if I'm having twins," she said. "I mean the baby could have health problems that I would love to know about."

Harris filed for Medicaid in February but said her many trips to Cumberland County social services haven't been positive.

"She just through her hands up at me pretty much, and told me to be prepared to have the child without insurance," said Harris.

"She said that they were in November and December applications," said Harris. "She said it would be at least 3 or 4 months before they even start processing mine."

Harris paid for a few basic doctor appointments by herself and thinks she's about 31 weeks pregnant.  But she worries about the rest of her pregnancy and beyond.

"How am I gonna have its vaccinations? It's gonna have to go to a one-week appointment, a two-week appointment, month, two months, 3 month, and I can't take em up there without insurance," she said.

Wilson and Harris are not alone. In Wake County, officials say they don't expect to get its backlog cleared until October.

That's too late for new mom Wilson and a very pregnant Harris.

"I just know going into labor and knowing that I don't have insurance is most likely going to put more stress on me into the labor and delivery," she said.

Since the I-Team starting investigating this story, we brought Harris's case to the attention of the director of Cumberland County social services, and she was quickly approved.  The director said Mary's case was not overdue or part of the backlog, it was processed timely.  Mary has since gotten the prenatal tests she needed and found out she's carrying a healthy baby girl.

As for Wilson, she's still waiting and wondering how she's going to pay the big delivery bill she just got. 

When it comes to the backlog, the state claims it's primarily a county workforce issue and they have implemented several measures to resolve the problem.  The state also blames a huge influx of applications from healthcare.gov.  They add the Medicaid backlog is not just a NC issue, it's being seen across the country.

Statewide, there are currently more than 85,000 pending Medicaid applications in NC Fast beyond the standard 45 days processing time.


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