Q. What will MeckLINK be doing to work toward improvement in crisis care and assuring well-qualified providers?

Susan Marchetti

Department of Social Work UNC Charlotte

MeckLINK, which launched March 1, is not geared specifically toward crisis care – the agency directs those experiencing an emergency to call 9-1-1, to CriSyS (the county’s emergency mobile response team) or to the nearest emergency room.

But maintaining the quality of treatment for Mecklenburg’s low-income or disabled residents lies at the core of the agency’s mission. Continuing behavioral care can take pressure off emergency rooms, which can struggle to handle mental health patients.

MeckLINK is one of 11 agencies that this year will take over the behavioral needs for millions of North Carolinians. The groups will work much like managed-care insurance companies, with significant leeway to put together a network of providers and control costs.

Up to now, providers would file for reimbursement after treating a patient. But MeckLINK, which has been given a set amount of money per client, sets what it thinks is a fair price for various forms of care. For example, CriSyS, the county’s crisis-response team, signed a contact with MeckLINK for a set amount of money based on an estimated number of calls for help.

Executive Director Phil Endress, who was hired in August, calls MeckLINK’s approach the “Five Rights”:

“The right service to the right person at the right time for the right result at the right cost,” he says.

MeckLINK intends to monitor a patient’s care and progress, not just the cost of treatment. The agency has been handling 2,500 calls for care a week, but Endress expects that to grow as residents learn more about the agency.

This year, MeckLINK will control about $280 million from the state and Medicaid – the government insurance program for low-income and disabled residents. About 155,000 county residents qualify for Medicaid. MeckLINK pays for mental health programs that served 55,000 people in 2011.

Not only is MeckLINK supposed to stick within its budget, it is also required to put aside savings until it builds reserves of $42 million.

Will it work? To save money, the new state system went up years early, and a major glitch has already surfaced. Families who live in one of the coverage areas but get treatment in another have run into problems getting their claims covered.

Meanwhile, some psychiatrists and psychologists have stopped seeing Medicaid patients, citing the paperwork the new regional groups require.