RALEIGH Mecklenburg County lawmakers are trying to stop an attempt to transfer the county’s network of managing mental health care to an area authority with an independent board.
A House panel this week added language to a Senate bill that would remove MeckLINK Behavioral Healthcare – and its millions of dollars in Medicaid funding – from the control of county commissioners and assign it to an authority.
The state’s other managed-care organizations are controlled by authorities. MeckLINK is the only one under county control.
County commissioners learned of the authority provision on Tuesday and unanimously voted their opposition. They instructed Brian Francis, the county’s legislative liaison, to convey their opposition in Raleigh.
Francis told commissioners that the bill with the substitute provision appeared to be on a fast track.
But a Wednesday floor vote was postponed and pushed to next week.
Meck delegation speaks up
Until then, Mecklenburg lawmakers are working to remove the MeckLINK language.
“It doesn’t make sense in my opinion to create another layer of bureaucracy for something that the Board of County Commissioners is statutorily responsible for overseeing anyway,” said Republican Rep. Charles Jeter of Huntersville.
Jeter and other members of the delegation that includes House Speaker Thom Tillis of Cornelius are talking to other House members in an effort to remove the authority provision.
The provision was inserted into the Senate-passed bill by Republican Rep. Nelson Dollar of Wake County, who is considered the architect of the state’s managed-care structure.
Dollar said he wants all the MCOs governed the same.
“All we are providing for is that everyone in the state will operate under the same set of uniform provisions,” Dollar said.
State vs. county
The move appears to be another example of state officials attempting to take control away from municipal and county governments.
Legislation would remove Charlotte’s busy airport from its control and transfer it to a regional authority. A bill filed in March would put Asheville’s water system under control of a Metropolitan Sewerage District, without compensating the city. The Senate canceled Raleigh’s lease of the former Dorothea Dix Hospital property the city wanted for a park. Instead, the bill required the state to get fair market value for the property.
“The General Assembly seems to have an insatiable appetite to attack local government,” Democratic commissioner Trevor Fuller said after Francis briefed commissioners on the MeckLINK provision Tuesday.
“It is yet another incidence in which the leadership of the General Assembly seems to have lost sight of the principles of local government – that local government is the best government,” Fuller said.. “With this legislature, that doesn’t appear to be the case.”
Under the MeckLINK provision, the authority board members would be chosen by commissioners, but the agency would be a level removed from the county’s oversight, Francis said.
He said he’s puzzled why the state would want to remove Mecklenburg from overseeing MeckLINK when state health officials are giving the agency and its oversight good reviews.
“We’ve gotten great feedback from (state health officials) on how we’re running MeckLINK right now,” he said. “In an environment where MCOs across the state are struggling, we don’t understand why you would take one that is succeeding and change it into a structure that is similar to those that are not.”
If MeckLINK wasn’t under county control, Francis said, the authority would have to create its own human resources, accounting and technology departments. Or it could contract those services with the county, which would likely increase MeckLINK’s expenses.
Dollar’s effort is the third attempt to remove MeckLINK from county control. Last year, Dollar made a similar move but pulled it at Mecklenburg’s urging, Francis said.
In January, the acting N.C Health and Human Services secretary tried to transfer control of MeckLINK to an out-of-county agency. Mecklenburg hired former commissioner and Charlotte lawyer Dan Bishop, who successfully warded off the attempt.
Mecklenburg has rehired Bishop to represent the county in the latest effort.
The provision drew outrage from commissioners and other Mecklenburg officials.
Republican commissioner Bill James said that if the state wants to remove MeckLINK from county control it needs to reimburse Mecklenburg for all the money the county spent to get it up and running.
“They ought to be paying out the costs we have in it,” James said. “I’m not inclined to spend taxpayer money if they want it.”
Commissioner Fuller said the move – done so quietly – is dangerous.
It “threatens the very foundation that the governance of our state is built on,” he said. “It’s the wrong way to govern. The folks in Raleigh don’t have on-the-ground understanding of how these issues affect people’s lives … It’s wrong and it’s got to stop.”
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