Mecklenburg County will abandon an idea to create its own authority to govern MeckLINK Behavioral Healthcare and the millions of dollars in federal Medicaid money it uses to provide mental health services.
Instead, a MeckLINK committee of four county commissioners is set to recommend to the full board next Tuesday that the county negotiate the best deal possible to turn over the program to Kannapolis-based Cardinal Innovations Healthcare Solutions. That would effectively dissolve MeckLINK and send Cardinal nearly $200 million in Medicaid funding that county uses each year for services to 120,000 patients.
It was clear from the committee’s Tuesday meeting that board members have all but given up the fight to keep MeckLINK and want to negotiate what is best for the consumers and providers – and MeckLINK’s 200 employees. Committee members were clear in what they want the county to get in the negotiations.
Those wishes include:
• A “proportionate” representation on the Cardinal board to give Mecklenburg a significant say in how its Medicaid money is used. The 15-county Cardinal oversees services for 187,000 consumers, compared with MeckLINK’s 120,000.
• Cardinal reimbursing at least some of the money Mecklenburg has sunk into MeckLINK. The county has spent $8.4 million to get the agency running and continues to pay $90,000 in monthly operating costs. Assistant County Manager Michelle Lancaster said in conversations with Cardinal CEO Pam Shipman that Shipman wasn’t against some level of payback.
Dena Diorio, also an assistant county manager, told the committee that MeckLINK’s reserve fund of as much as $4.5 million would be retained, possibly lowering the reimbursement request.
• Cardinal hiring MeckLINK employees who are “in good standing for positions they would want to hire” and MeckLINK consumers being able to keep the same providers if they choose.
In late December, the predecessor to N.C. Health and Human Services Secretary Aldona Wos tried to reassign MeckLINK to Cardinal. But after Mecklenburg threatened to sue, Wos allowed the county to continue operating – and governing – MeckLINK.
But in June, state legislators passed a law that forced the agency to operate under a single-county, independent authority or merge with an already existing multi-county authority by April 1.
For weeks, relatives of consumers and many providers have urged the county to pursue a single-county authority. In the end, commissioners said it would be too costly.
Commissioner Trevor Fuller, who chairs the committee, said he believes Mecklenburg has leverage to use in the negotiations. “We do have something they want,” Fuller said. “They want these people (the 120,000 consumers), and they want the ability to manage that amount of money.”
The new law requires county commissions in each of the authority’s counties to approve how Cardinal appoints its board. If Mecklenburg doesn’t approve the method, the authority wouldn’t comply with the law. “They would need our approval to do what they want to do,” Fuller said.
County Attorney Marvin Bethune told the committee that Mecklenburg could simply walk away from MeckLINK and tell the state “we’re terminating our contract on March 31. We’re not doing anything more – do what you want to do.”
That option didn’t seem to get much support from committee members. But “it is an option,” Fuller said. “We certainly can’t allow ourselves to be put in a position where get completely run over. So as a last resort, we can say, ‘fine, you want it, you manage all the issues, you pay for all the transition. Don’t ask us for anything.’
“But that gets messy.”
Still, he said, the county could use that threat to get state help with the negotiations. “If Cardinal is recalcitrant, we will need the state to control them a little,” Fuller said.
Lancaster said Shipman told her that Cardinal could transition MeckLINK within 120 days after a deal is sealed.
“The clock’s ticking,” said commissioner Bill James, a committee member.
Before the committee takes its recommendations to the full board on Tuesday, it wants to meet on Monday with Wos, Cardinal CEO Shipman and her board chair, and Rep. Nelson Dollar of Wake County, a key author of the law requiring MeckLINK to be governed by an authority.
“We want to hear from the secretary and Rep. Dollar what their vision is for what they’re trying to accomplish,” Fuller said. “And we want to have a conversation with (Cardinal officials) about how to get to where we need to be. We need some beginnings of commitment.
“We have looked at all the options, and are trying to do the best we can in a bad situation.”
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