In an apparent victory for Mecklenburg County, state health officials gave the countys MeckLINK Behavioral Healthcare a month longer to prove it can go live by March 1 and effectively oversee millions of dollars in Medicaid money for mental health services.
If it cant, MeckLINK will lose the program to an outside agency.
The agreement was reached Wednesday by Mecklenburg officials and N.C. Health and Human Services Secretary Aldona Wos. The secretary, in the job for less than a month, reversed an earlier decision by her predecessor to reassign the Medicaid program to Kannapolis-based Cardinal Innovations Health Solutions.
Yet if MeckLINK cant demonstrate its ready for a March 1 startup, Wos will reassign the Medicaid oversight to another agency and, under the agreement, Mecklenburg cant appeal.
The agreement bolstered contentions by County Manager Harry Jones and General Manager Michelle Lancaster that MeckLINK was on track to start by a Feb. 1 soft launch. The county already had spent $3 million and hired more than 140 employees to get the agency off the ground.
In late December, they were caught off guard by a decision from former acting DHHS Secretary Albert Delia to transfer the Medicaid program to Cardinal. A state consultant found MeckLINK wouldnt be ready by the deadline.
Days later, Wos upheld Delias decision.
The matter elevated tensions between Jones and some Mecklenburg commissioners, who have complained that the county manager hadnt kept them fully informed on several important issues.
Jones reiterated Wednesday that MeckLINK would be able to start up sooner than other agencies and the agreement avoids the delay, expense and distraction of litigation.
He said he was confident that MeckLINK would be ready by March 1.
The agreement was cheered by many of the more than 150,000 Medicaid recipients and their families in Mecklenburg County.
They rely on more than $200 million in federal and state money for mental health, substance abuse and developmental disability services, said Doug Sea, an attorney who represents Medicaid cases for Legal Services of Southern Piedmont.
I know that families are relieved and pleased, and that its really encouraging to see the state look at this more carefully and make a smart decision for North Carolina, Sea said. Its not final yet, but its a step in the right direction.
Not without conditions
The monthlong reprieve comes with conditions.
Under the agreement, the state will send its consultant, Mercer Government Human Services Consulting, to MeckLINK on Jan. 30 to determine whether it is highly probable that MeckLINK will be ready to conduct business as a managed care organization by March 1, said Charlotte lawyer Dan Bishop, a former commissioner hired to represent the county in the matter.
Mercer will file its findings with the state by Feb. 1, Bishop said. If the agency passes that review, it will continue preparing and undergo a second review of its readiness during the week of Feb. 11. Mercer will report by Feb. 14 on MeckLINKs progress and whether it can begin implementing the program on March 1.
If MeckLINK fails either review, DHHS will summarily reassign MeckLINKs responsibilities, including both federal and state funding, Bishop wrote in a summary to commissioners. If MeckLINK fails the first review, there will be no second review.
Director: On track
Through all the negotiating between the state and Mecklenburg, MeckLINK continued to prepare for a Feb. 1 startup.
When the matter blew up in early January, Phil Endress, the agencys director, was adamant MeckLINK could be ready by then.
In a bulletin to families on Wednesday, MeckLINK stated it is on track to begin Feb. 1.
The state has ordered its 11 local management entities, which will administer managed care using Medicaid and state money, to be operating with few kinks by July 1, the hard launch deadline.
Mecklenburg is the only county running its own agency. The other 99 counties belong to one of the other 10 agencies.
Cardinal manages Medicaid care for 15 counties.
Wos reversal came after meeting with Bishop and county staff, including Jones and Lancaster, who told the secretary they were confident MeckLINK would be ready and argued that Delia improperly interpreted state law.
Earlier this month, the county had threatened to fight Wos reassignment by filing an appeal with the N.C. Office of Administrative Hearings.
Nothing had been filed when the agreement was reached in part because Wos believed it was a better alternative to prolonged litigation.
Wos, she said, backed Delias decision without reviewing all the information, said DHHS spokeswoman Julie Henry.
When she issued her statement in early January, shed just come on board and was basing her decision on the previous administration, Henry said. She has since reviewed additional information and felt that this was the best option to keep things moving forward.