Budget-related issues again topped the agenda at this month's Social Services Board meeting on Monday night. Virtually every issue addressed focused on state and local funding problems that are filtering down in one form or another.

Social Services Director Marvin Rouse told the board that the department is presently using internal transfers to fill critical positions and deal with the constraints the county's hiring freeze has placed on backfilling positions from outside the department.

"We have used in-house hiring to fill critical vacancies," said Rouse. "Sometimes it has caused some problems in other areas, but so far we've been able to deal with it fairly well."

He added that staff members are also being used to help out wherever possible in departments with heavy workloads and personnel shortages.

Board member Dr. Delilah Blanks asked Rouse if the transfers are not creating pockets of vacancies in some areas of the department.

Rouse replied, "As long as we can't go outside (the department to hire), we're going to have pockets of vacancies. But so far, it has not been something we couldn't deal with."

Board Chairman Sam Brown asked Rouse if he believed the department would be able to make to the end of the year without additional personnel.

"We'll make it unless there's a big explosion (of personnel losses or increased business)," Rouse said.

"How's morale?" asked board member Gloria Smith.

"It's holding up so far," replied Rouse. "They (the employees) understand that the county's in dire straits (with its budget) and that everyone is going to have to pick up the slack wherever they can."

On another budget related issue, Rouse said the department has been judicious in developing next fiscal year's budget.

"We recognized the financial issues the county is dealing with and have not asked for additional staff," said Rouse. "We did ask for a little increase in funds for supplies and equipment. This area has been cut each of the past few years and the cost of paper and other supplies is increasing. We also asked for funding for the security doors that the county Safety Committee recommended we have.

"The committee concluded that the security risks for the agency are high because of easy access and recommended that the security doors be installed," Rouse explained.

"We also asked for a few dollars more for funding the foster parenting program because of the expected caseload," Rouse added.

Brown cautioned Rouse about not asking for needed funding, even if the request is not granted.

"Ask for what you need and let the (county) commissioners cut if they choose to do so. Otherwise, they can say you never asked. You've let them off the hook so far as funding you adequately is concerned," said Brown.

Rouse again explained the impact of the projected increase in Medicaid costs for next year. Rouse pointed out that the state has estimated that the overall cost of Medicaid in Bladen County will increase by around $16 million next year and that the county's share will increase more than $600,000.

He added that so far this fiscal year, Medicaid costs have run a little under what was budgeted so far, but cautioned that the amount may increase as the year comes to a close.

Rouse pointed that the state's computer model has projected that the county appropriation to the Department of Social Services next fiscal year will need to be $5,314,764, most of it to fund mandated and entitlement services.

On another issue, the board members discussed the impact on nursing home vacancies on Medicaid costs.

Rouse explained that nursing homes use the percentage of vacancies in establishing charges for their services. He said this impacts the amount Medicaid must pay for beds in nursing homes.

Several board members pointed out that increasing the cost of beds to make up for expected vacancies amounts to paying for vacant beds.

"Why should we pay for vacant beds? asked Blanks. "If there are too many nursing home beds in the state, that's something the industry should have to address. They should not be charging based on the number of expected vacancies. We need to look into this and see what can be done."

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