Staton v. Union Cnty. Dep't of Soc. Serv.s

CourtCourt of Appeals of North Carolina
DecidedMay 5, 2015
Docket14-1014
StatusUnpublished

This text of Staton v. Union Cnty. Dep't of Soc. Serv.s (Staton v. Union Cnty. Dep't of Soc. Serv.s) is published on Counsel Stack Legal Research, covering Court of Appeals of North Carolina primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Staton v. Union Cnty. Dep't of Soc. Serv.s, (N.C. Ct. App. 2015).

Opinion

An unpublished opinion of the North Carolina Court of Appeals does not constitute controlling legal authority. Citation is disfavored, but may be permitted in accordance with the provisions of Rule 30(e)(3) of the North Carolina Rules of Appellate Procedure.

IN THE COURT OF APPEALS OF NORTH CAROLINA

No. COA14-1014

Filed: 5 May 2015

Union County, No. 13-CVS-00273

JERINDA D. STATON, Petitioner,

v.

UNION COUNTY DEPARTMENT OF SOCIAL SERVICES, Respondent.

Appeal by Petitioner from order entered 9 July 2014 by Judge Tonya M.

Wallace in Union County Superior Court and order entered 22 May 2014 by Judge

W. David Lee in Union County Superior Court. Heard in the Court of Appeals 18

February 2015.

Meagan I. Kiser, Cranfill Sumner & Hartzog LLP, for the respondent-appellee.

John S. Arrowood, James McElroy & Diehl, P.A., for the petitioner-appellant.

HUNTER, JR., Robert N., Judge.

Jerinda D. Staton (“Petitioner”) appeals from the order denying her Motion to

Present Additional Evidence entered on 9 July 2014 and the order affirming her

termination from Union County Department of Social Services (“DSS”) entered on 22

May 2014. STATON V. UNION CNTY. DEP’T OF SOCIAL SERVICES

Opinion of the Court

I. Factual and Procedural History

In April 2011, Petitioner was terminated from her position as an income

maintenance worker within the Children and Family Medicaid section of DSS. Prior

to her termination, Petitioner had been employed by DSS for over seventeen years in

various positions. As an income maintenance worker, her job responsibilities

included “processing, determining and/or re-determining applicant/client eligibility

for Medicaid, including interviewing clients, completing initial applications, [and]

verifying the information obtained.”

For the majority of her time as a DSS employee, Petitioner received positive

reviews and even won an “Outstanding Caseworker Award” from the North Carolina

Chapter of National Eligibility Workers Association. In 2007, however, Petitioner

began receiving negative reviews from her new supervisor, Mary Beth Gaddy

(“Gaddy”). As a result, Petitioner was placed on a “Performance Improvement Plan.”

Petitioner believed Gaddy was targeting her, and she both verbally complained and

filed official complaints to this effect.

Petitioner’s work performance continued to decline, and in June 2010, she

received a five-day suspension for “unacceptable personal conduct” when she signed

on to another employee’s computer to reopen a client’s benefits for food and nutrition.

Petitioner’s unacceptable conduct constituted both unauthorized access and a breach

-2- STATON V. UNION CNTY. DEP’T OF SOCIAL SERVICES

of client confidentiality. Petitioner was warned that this violation in itself could be

grounds for dismissal, and that further disciplinary actions could result in dismissal.

On 11 August 2010, Chris Bisbee, a caseworker for DSS, received a Medicaid

benefits application from C.B.1 Bisbee questioned C.B.’s eligibility for Medicaid

benefits based on C.B.’s private insurance plan and his suspicion that C.B. was

married. On 10 September 2010, Bisbee referred C.B.’s application for benefits to

Iola Crook (“Crook”), a program integrity investigator, who initiated an investigation.

On 30 September 2010, Crook made a notation to the statewide online verification

system (“OLV”) under the Enterprise Program Integrity Control System (“EPICS”)

tab indicating an investigation of C.B.’s file was ongoing. The OLV system alerts any

caseworks who check it of alerts or issues in place for a particular client. After

conducting an investigation, Crook found C.B. was ineligible for Medicaid benefits,

and relayed this information to Bisbee on 30 September 2010. C.B. received notice

that she was denied Medicaid benefits “because [she] ha[d] not provided the

information needed to establish eligibility.” On 1 October 2010, Crook opened an

integrity claim against C.B. and updated C.B.’s OLV file to reflect that there was an

investigation referral in place.

DSS has several policies in place to prevent improper approval. As dictated in

the employee manual, all caseworkers are expected to view the files of each applicant.

1 We use the pseudonym “C.B.” to protect the applicant’s identity.

-3- STATON V. UNION CNTY. DEP’T OF SOCIAL SERVICES

If the physical file cannot be located, intra-agency communication and prevention

mandates of the Medicaid Manual require caseworkers to send out an agency e-mail

or contact a supervisor. DSS reiterates these policies to its workers in unit meetings

and by email; it also recommends that caseworkers ask processing assistants for aid

in finding missing files. Further, all employees are required to complete a full OLV

inquiry, which includes examining the EPICS tab. The EPICS tab lights up to

indicate if there are any red flags for the applicant or client.

On 28 December 2010, C.B. filed an application for Medicaid with Petitioner.

DSS policy dictated that Petitioner process this claim within forty-five calendar days.

Because of the prior investigation, Crook had possession of C.B.’s file during the

entire duration of the approval process. On 11 February 2011, Petitioner approved

C.B. for Medicaid benefits without ever viewing her physical file or requesting it.

Although Petitioner contends she did check the EPICS tab in OLV and saw no

indication her case was undergoing an integrity investigation, the integrity referral

had been in place since September 2010. Therefore, if Petitioner had checked the

EPICS tab, she would have been aware of the ongoing investigation.

On 10 March 2011, a caseworker brought Crook paperwork which indicated

Petitioner had approved C.B.’s application for Medicaid. Crook wrote a memorandum

explaining the incident and sent it to Petitioner and the caseworker who brought the

file to her. On 11 March 2011, Crook determined C.B. was not eligible for benefits

-4- STATON V. UNION CNTY. DEP’T OF SOCIAL SERVICES

and instructed a caseworker to terminate any further Medicaid benefits to C.B.

Subsequently, both Stephanie Leach, Crook’s supervisor, and Gaddy, Petitioner’s

supervisor, were notified of the improper approval, but not told at the time of

Petitioner’s involvement. Rae Alepa (“Alepa”), Gaddy’s supervisor, was also notified.

On 11 March 2011, Alepa and Crook filed a memorandum detailing ten violations

Petitioner made during the approval process of C.B.’s application. Alepa notified

Director Dontae Latson (“Latson”) and HR Manager Suzanne Moose (“Moose) of the

information contained in the memorandum. The 11 March 2011 memorandum was

also provided to Gaddy.

After receiving the aforementioned information, Latson scheduled Petitioner

to appear at a pre-disciplinary conference. On 15 March 2011, Petitioner received a

letter notifying her of the pre-disciplinary conference and the allegations against her.

During the pre-disciplinary conference, which took place later that day, Petitioner

claimed she believed the manual gave her authority to approve C.B.’s application. On

16 March 2011, in a letter to Latson, Petitioner explained she believed she was in

possession of C.B.’s file, but at some point without her knowledge, the file had

disappeared from her office.

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