Washington County will add nine full-time jobs to manage an increasing caseload expected to come with the Affordable Care Act.
All five county commissioners voted unanimously Tuesday to approve the new positions that will add about $500,000 in annual expenses.
Community Services Director Dan Papin called the move an "unusual" and "daunting" request, as he's never had to ask county officials to approve this many positions at once.
"Never in this capacity," said Papin, who's worked for the county since 1984.
Washington County acts as the "transaction" manager for these programs that are mandated by state and federal governments, he said, whether it's food stamps, cash assistance or health care.
In the past, positions have been frozen or cut and added in small doses, but with various parts of the Affordable Care Act kicking in this fall, the county will need additional staff to manage hundreds more cases who will qualify for health care coverage.
"There is a need for certain demographics to have additional insurance," Dist. 5 Commissioner and Board Chairwoman Lisa Weik said. "It really is our duty to implement what has been adopted."
The county needs to add seven eligibility specialists, one support staff and one economic support supervisor.
A few of the positions are contract or temporary appointments through 2015; however, it's still unknown how the law will affect staffing in the future.
The county expects Medicaid enrollment to go up by 4,454 individuals. Most of the increase will occur in 2014.
More than 9,500 existing cases will convert to a new computer system. That, along with new eligibility requirements will require additional staff training.
Economic Support Division Manager Linda Bixby said although new technology may streamline processes, it's not anticipated to have a positive impact on the tasks at hand.
Starting in October of this year, the county will begin to accept open enrollment cases through the health care exchange program that kicks off in January 2014.
New participants who aren't currently on MinnesotaCare (MA) are expected to qualify, adding about 2,127 individuals to the program, according to county figures.
Minnesota is expecting to see a total of 108,199 new participants during open enrollment.
"There is going to be a significant impact on county workload," Bixby said.
Anticipated growth will continue through 2014, with a 25 percent increase in the beginning of the year, and a 60 percent jump after the second half.
Although she was supportive of additional staff, Dist. 4 Commissioner Autumn Lehrke called the new health care law the "Unaffordable Care Act."
"This is just another expense of unfunded mandates that counties are required to fund," she said.
Washington County joins others across the state, including Anoka, which is expected to add 14 positions; Ramsey, 20; and St. Louis County, 31.
Because there are only so many qualified individuals for those positions, there was a sense of urgency to move forward with the approval in Washington County this week.
"The sooner we get in that market, the better," Dist. 2 Commissioner Ted Bearth said.