On Thursday, March 2, Republican state legislators announced they had reached an agreement that will mean the expansion of Medicaid services in North Carolina – and Guilford County officials are now gearing up to handle the added responsibilities.

At a Board of Commissioners work session just hours after the announcement from state officials, Guilford County Division of Social Services Director Sharon Barlow said a new division of Social Services will be needed along with the addition of 54 new county employees – 41 front line positions, six team managers, five supervisors, one program manager and a Medicaid Division director.

The county plans to set up the new division quickly.

“We anticipate moving as soon as practical but no later than December 1, 2023,”  Barlow told Guilford County Manager Mike Halford and the county commissioners at the work session in the Carolyn Coleman Conference Room in the Old Guilford County Court House.

Barlow said the expansion will “open the door to” – make eligible, that is – more than 600,000 people across North Carolina and about 33,000 in Guilford County.

“Medicaid will need our own division,” Barlow said, pointing to the complexity of the service and the amount of case processing the county will need to do.

Fortunately, the federal government is paying the lion’s share of those cost for now.

The county’s cost for the first full year of the expansion is expected to be between $1 million and $1.5 million, though it’s possible some help from the State of North Carolina will reduce that figure.

The cost to county taxpayers is expected to go up in future years since the percentage of salaries paid by the federal government will drop from 75 percent to 66 percent.  In the first year, the federal government is expected to pay about $4 million for the service in Guilford County.

Guilford County and other counties in North Carolina are appealing to state legislators to help out counties by having the state pay for needed new equipment, offering signing bonuses to the new workers and implementing cost share programs.