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State won’t return Medicaid program to county

New official says supervision of Meck Medicaid funds stays with outside agency

MCCRORY12.NE.121312.CCS
Chris Seward - cseward@newsobserver.com
Dr. Aldona Wos (both cq), Governor-elect Pat McCrory's selection to head the Department of Health and Human Services, listens at a news conference held to introduce some cabinet selections in downtown Raleigh, NC on Dec. 13, 2012.

N.C. Health and Human Services Secretary Aldona Wos told Mecklenburg leaders Monday that she stands by a decision to reassign supervision of the county’s federal Medicaid funds for mental health services to an outside agency.

Meanwhile, County Manager Harry Jones said Monday that county-hired attorneys don’t believe the decision by Wos’ predecessor, acting Secretary Albert Delia, complied with state law.

Last week, Delia ruled to redirect about $200 million in Medicaid money from the county’s MeckLINK Behavioral Healthcare and let Kannapolis-based Cardinal Innovations Health Solutions administer the money.

“We believe that the outgoing secretary didn’t fully comply with the law as written,” said Jones, who hired Charlotte attorney Dan Bishop, a former Mecklenburg commissioner, to explore what legal remedies, if any, the county might have. “I concur, when you look at some of the language of the law.”

Jones declined to elaborate, saying he wanted to discuss the findings with county commissioners at a meeting called for Tuesday by board Chairwoman Pat Cotham to find a resolution to the MeckLINK reassignment.

Wos held a brief teleconference early Monday with Cotham, Jones and several commissioners about her decision to uphold Delia’s ruling.

“She said she wants to follow the law,” Cotham said. “She said she was very sorry that had to happen, that she knew we worked on this aggressively.

“But she said … she needed to ‘close the circle.’ ”

Wos and Delia say they had no other choice than to make the decision they did. State law, they say, required that Delia decide by Jan. 1 if MeckLINK was ready to start the program by a soft launch date of Feb. 1, already extended a month for Mecklenburg.

The official launch date is July 1. Last week, MeckLINK chief Phil Endress told the Observer that his agency would be ready by Feb. 1. But the state’s consultant, Mercer Government Human Services, concluded that MeckLINK had too many unmet requirements to overcome.

Mercer did conclude that MeckLINK could be ready by April 1 – or three months ahead of the official launch.

Yet Delia on his last day in office on Dec. 31 gave the program to Cardinal, a managed care organization formerly known as Piedmont Behavioral Healthcare that oversees Medicaid programs in 15 N.C. counties.

If Mecklenburg loses the program, it would have to lay off at least 200 people hired to implement the services through MeckLINK. It would also waste about $3 million already spent preparing for implementation.

Cotham said she’ll go to Tuesday’s meeting with “an open mind” about which approach to take to resolve the matter.

“There are many things we need to think about: the people we’ve hired. The money we’ve spent. What are the possible remedies? And what did we learn from this?” she said. “I want to have a good rapport with the state. I don’t want us to be perceived in Raleigh as the crazy people in Mecklenburg County.”

Cotham said she wants to know why Endress was hired as late as August.

“Mr. Endress, it appears, got on too late. Did he even have a fair shot of getting this thing up and running before the deadline we knew that we had?” said Cotham, who has worked as a recruiter for corporations. “The common theme here is that we didn’t hire people fast enough.

“ … We knew going into this what the rules were. (The state has) been giving us reports all along and we haven’t measured up. They gave us continual feedback about what we need to do. We didn’t get it done.”

She said that the county’s only likely remedy would be to pursue new legislation to reverse Delia’s decision and extend the deadline.

Mecklenburg legislators, she said, are already pursuing special legislation related to the 2011 revaluation that has stirred controversy the last year.

“We’ve already saddled our legislators with revaluation,” Cotham said. “How many anchors are we going to put on them before we go back to work?”

She said she hopes the board at Tuesday’s meeting will decide on a “definitive” plan of action.

“All this vagueness is not doing anybody any good,” she said. “It’s not fair to the people we’ve hired. To consumers of the services. To the providers.”

Commissioner Bill James emailed commissioner that he’d also like to see some decisions come out of the meeting.

Initially the meeting was to discuss policy or budget issues. Jones had cancelled that meeting last week, but Cotham reset it to discuss MeckLINK. Yet the board rarely takes actions at those meetings.

James wants some decisions. He said the board could decide to sue to reverse Delia’s decision, though he doesn’t support that idea.

If Mecklenburg doesn’t sue, he said, it should request the state and Cardinal take over existing leases, computer systems, hire MeckLINK employees and pay back the $3 million the county has invested.

“These are weighty issues involving 200 employees,” James wrote. “I see a lot of issues floating around this, but to me this is about either challenging the decision or working with it.”

Perlmutt: 704-358-5061

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