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Mental health funding mixup irks county commission

Pat Cotham
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Pat Cotham

Some Mecklenburg commissioners were upset Thursday that they didn’t learn until the public did that a state official had reassigned oversight of millions in Medicaid money to Kannapolis-based Cardinal Innovations Healthcare Solutions.

On his last day in office on Monday, Albert Delia, the acting N.C. Health and Human Services secretary, ruled that the county’s MeckLINK Behavioral Healthcare agency would not be ready by Feb. 1 to manage $235 million in federal, state and county funding for mental health, developmental disability and substance abuse services. State statutes required him to reassign the management by Dec. 31 if he determined MeckLINK couldn’t meet the deadline.

Yet commissioners didn’t know about his decision until County Manager Harry Jones announced it at the start of their meeting Wednesday.

Board Chair Pat Cotham said the lack of information “blindsided” commissioners and fit a pattern in recent years in which important information “is kept from the board.”

“I was livid,” Cotham said. “I felt that we were hearing about this problem for the first time as the public was learning about it.

“They could have sent us an email on Monday. Or we had an hour in closed session and they could have let us know then so we weren’t blindsided.”

Before Wednesday’s meeting, Cotham said, she was told by an assistant county attorney and General Manager Michelle Lancaster that the state was only “encouraging” MeckLINK to work with Cardinal “if we needed help.”

The attorney and Lancaster “were very clear that this was not going to be a problem,” she said. “Now it seems to be a huge problem.”

Commissioner Bill James sent an email to commissioners saying that he, too, is upset that the board wasn’t told about Delia’s decision until the meeting.

“It is troubling that the commission didn’t know about the problem until we are sitting at the dais,” James wrote.

He said he understood that Jones and county staff were taken by surprise by Delia’s ruling, and that Tuesday was a holiday, but “the board should have been informed … before we got hit in the face.”

The county has spent $3 million preparing to run the programs. It hired Phil Endress to run MeckLINK in August and 131 staffers to implement the services.

On Thursday, Delia had already cleared out of his office and didn’t return calls to his home.

DHHS spokeswoman Julie Henry said Delia did what state law required.

She said he made the decision based on information from readiness reviews conducted by Mercer Government Human Services Consulting.

Lancaster has said the reviews found problems with MeckLINK’s “financial structure and IT structure.”

“The secretary had an obligation to act by Dec. 31, and that’s what he did,” she said. “Unless there’s a change in the statute, the secretary of DHHS has already acted on this matter.”

At Wednesday’s meeting, Jones said he’d pursue a reversal.

Jones wrote commissioners Thursday that he planned to keep them informed about MeckLINK. He also wrote that he’d searched Cardinal’s website and found job postings for Charlotte. Cardinal, a public health care organization with a $350 million operating budget, supervises similar Medicaid programs in 15 North Carolina counties.

“Unless Cardinal has some current presence in Charlotte that we are unaware of, the haste with which they have posted these positions leads me to conclude they were prepared for the ‘reassignment’ decision,” Jones wrote.

Cotham said she believes commissioners and staff should be meeting with state officials in Raleigh as early as possible.

MeckLINK, she said, would provide the county better control over money and services. “Cardinal will be making regional decisions about services and providers. I want MeckLINK to do that for us. …

“We’ve also got these 131 new employees with the county – 131 families – we’ve got to think about.”

County government has lost public trust over its 2011 revaluation and a troubled social services department. There’s also been tension between the board and top county staff, including Jones.

Cotham wrote in an email to Lancaster that the latest problem fits a pattern. “We have a theme of less than stellar communication,” she wrote. “… The board is not the enemy. We are here to help.”

Perlmutt: 704-358-5061

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