Another fight is likely brewing over the county’s agency that oversees mental health services for thousands of Mecklenburg residents.
Mecklenburg County commissioners on Tuesday will get a recommendation that they ignore the preference of a top state health official and create a one-county authority to govern MeckLINK Behavioral Healthcare and its millions of dollars in federal Medicaid funds.
Such a move would be at odds with N.C. Health and Human Services Aldona Wos. Several commissioners said that last week Wos told Mecklenburg she wouldn’t approve MeckLINK – currently governed by commissioners – moving under a single-county authority. DHHS spokesman Ricky Diaz said Wos discussed the department’s preference but did not issue a directive.
That is acknowledged in a report from a committee that’s been studying how to deal with the agency after state legislators passed a law requiring that MeckLINK be turned over to an authority.
The report said the secretary has told the county she’d only approve MeckLINK merging with an existing contiguous managed-care organization.
There are two: Gastonia-based Partners Behavioral Health Management and Kannapolis-based Cardinal Innovations.
The transition is necessary after legislation during the recent session forced Mecklenburg to give up control of MeckLINK and turn it over to an authority.
The committee charges that Wos’ preference for merging with an existing organization is not consistent with the newly passed law, contending Senate Bill 208 allows for single-county authorities and multi-county authorities, contiguous or not.
Commissioner Trevor Fuller, a Charlotte lawyer, said the committee is right. “The statute does allow for it,” Fuller said. “I think if we follow the statute despite what the secretary says, we’re on solid ground.”
The three committee members – a retired county attorney, a provider and a local mental health advocate – recommend commissioners create a Mecklenburg authority and appoint its board.
They say that arrangement would:
• Allow commissioners to influence policy by approving the authority’s budget and members of its board.
• Cause the least disruption to Mecklenburg’s current system.
• Provide the best assurance that current programs would be preserved and that local collaborations would be maintained.
• Give consumers and providers access to a mental health governing board.
• Provide Mecklenburg with “the ability to meet the intent of the law” and give MeckLINK time to figure out its future.
MeckLINK is the only one-county MCO in the state. Diaz, the DHHS spokesman, said MeckLINK leaders have been invited to Raleigh later this month to discuss finances and options. “Our goal is a longterm, sustainable model,” he said.
Some commissioners seem to be tiring of the ongoing saga between the county and state over what do with MeckLINK, and seem resigned to turning it over to one of the multiple-county MCOs.
Fuller said the board is faced with “bad options.”
The single-county authority would include expensive transition costs. And merging with another MCO would mean “our citizens may not receive the quality of attention they have been receiving.
“Our citizens are stuck in the middle.”
Then there’d be the question of what to do with about $18 million the county spends for services that are outside Medicaid’s requirements.
“What do we do about that?” Fuller asked. “We can’t say we’re not going provide (those services) anymore. Or we can and watch our jails and emergency rooms fill up.”
He said if the board chooses to merge with another MCO, he’d be interested in hearing more from Partners.
“They seem to really want to do business with Mecklenburg – and give the county a voice,” he said.
Commissioner Bill James, a Republican, wants the county to get “out of the mental health care business.”
The committee’s recommendation, he emailed to other commissioners and county officials on Monday, “just continues a fight that is unwinnable, unwise and financially disastrous to the county.”
Board Chair Pat Cotham, a Democrat, wants to turn MeckLINK over to Cardinal – which Wos and her predecessor tried to force last year before the county sued to prevent it from happening.
Mecklenburg spent millions to get MeckLINK operating.
A single-county authority “is what the state said not to do,” Cotham said. “We’ve already fought this battle and spent a lot of money. We tried in January to go it alone. We can’t keep spending taxpayer dollars on something we don’t have a shot at.”
She said she prefers turning the agency over to Cardinal because it is more established. Partners, she said, has only been operating since February.
Cotham said Cardinal officials have told her they want as little disruption for MeckLINK clients as possible. They would keep the MeckLINK name and hire many of MeckLINK’s employees.
“I’m not comfortable, as big as we are, with merging with a group that just started in February,” she said. “We need the security of a bigger, more established group.
“Since the state is planning on reducing the numbers of these authorities, then going with a bigger group reduces the chances of having to go through this again.”
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