Major Changes to Medicaid Will Test DHS After Years-Long Disinvestment

DHS’s intent to hire 450 eligibility staff and increase salaries by $2,000 are positive steps. However, these measures don’t go far enough to address years of disinvestment by lawmakers in the state government’s workforce, which has contributed to the current staffing crisis. In FY 2022, DHS’s 30.3 percent turnover rate was higher than the state government’s. In DFCS, the workforce dropped by 16 percent between FY 2017 and FY 2022. Furthermore, the number of DFCS frontline staff processing Medicaid, SNAP and TANF cases declined over the past two years. As of March 2023, the staffing level for these workers was below 1,400, its lowest point since the start of the pandemic. Many vacant positions are still unfunded and thus unable to be filled, even with stronger hiring.

DFCS Has Lost about 16 Percent of Its Total Workforce Since FY 2017

Note: Total active count.

Source: Department of Administrative Services’ Workforce Reports from FY 2017 to FY 2022.

DFCS will not only redetermine 3 million Medicaid cases this year but will also launch Pathways to Coverage, the governor’s narrow Medicaid expansion that includes include work requirements. Because of persistent turnover, these two major initiatives impacting millions of Georgians will be implemented by mostly inexperienced staff. It will take several months for the state to hire 450 new caseworkers and fully train them to manage these enormous tasks. Yet even with training, it may be another few months to a year before new staff fully understand their role. Case managers’ workloads will remain high despite automatic renewals for many clients. High workloads combined with inexperienced staff will inevitably result in mistakes. These errors could mean an unnecessary loss of coverage for potentially thousands of children or seniors. Furthermore, news reports of delayed SNAP payments, which help people afford the cost of food, signal the workforce issues impact more than just Medicaid.

These growing pains may be worthwhile if DHS builds a more competent workforce that can effectively and efficiently get Georgians the benefits and services they need to be economically secure and protected from abuse and neglect over time. However, state leaders must be willing to take actionable steps now not just to hire but to retain staff. Such measures should include professional development, benefits like paid family medical leave, competitive starting salaries and a system of merit-based raises. Next year’s budget is another opportunity to consider some of these options.