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County considers outside groups for mental health program

A loose consensus emerged Tuesday among Mecklenburg County commissioners against the county creating its own authority to oversee mental health services.

Instead, commissioners want a questionnaire sent to three multicounty managed care organizations in an effort to decide which one should govern MeckLINK Behavioral Healthcare and its millions of dollars in yearly federal Medicaid money.

The board on Tuesday heard a three-member panel recommend that Mecklenburg create a one-county authority so commissioners would keep their involvement, ensure little disruption to clients and providers and preserve the jobs of more than 200 MeckLINK employees.

Their second choice would be to merge MeckLINK with an established group willing to give Mecklenburg say in how the county’s Medicaid money is spent.

“As mental health becomes Medicaid-ized, (it’s) no longer a local system,” said committee member Sandra Bisanar. “It’s the state’s money, the state’s rules and the state’s risk.”

A primary issue for the board to decide, she said, is “how involved do you want to be in the governance (of MeckLINK). All, some, or none?”

If not governed by a single-county authority, then the committee urged the board to choose a managed care organization willing to give Mecklenburg a voice so there is less disruption for clients.

On Friday, officials in Health and Human Services Secretary Aldona Wos’ office told Mecklenburg officials that Wos wouldn’t approve a single-county authority, or a managed organization that isn’t contiguous, Assistant County Manager Michelle Lancaster told commissioners.

But Tuesday, Wos spokesman Ricky Diaz said the secretary discussed the department’s preference but didn’t issue a directive.

Several commissioners spoke against Mecklenburg going it alone.

“You can look at single-county as least disruptive, but in the long run it could be the most disruptive” because the state continues to change mental health rules, commissioner Bill James said. “We could go to the expense of setting it up only to have it ripped away from us.

“It’s incredibly costly, and I’m not sure we’ll accomplish anything. Ultimately our mental health control is not really control at all.”

Yet James and other commissioners, including Karen Bentley, George Dunlap and Dumont Clarke, said they want a comparison of three MCOs that are interested in overseeing care for Mecklenburg’s 155,000 consumers and families.

The three are Kannapolis-based Cardinal Innovations, Gastonia-based Partners Behavioral Health Management and Durham-based Alliance Behavioral Healthcare.

Clarke wants to know from the MCOs how financially sustainable each would be after MeckLINK’s consumers and providers are added to their load.

After the meeting, he said a single-county authority “is not a dead issue,” but the board needs to look at a comparison of costs between creating one, or merging with an established one.

At the Sept. 17 meeting, commissioners will decide on a questionnaire to send each and then pick one at a later meeting.

“We need to know the financial piece, the cultural piece, the quality piece,” said commissioner Trevor Fuller. “Given the circumstances, we ought to try as best we can to compare apples to apples.”

Perlmutt: 704-358-5061
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