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MeckLINK Saga Ends, Cardinal Takes Over County Mental Health

Ben Bradford

As of today, the Mecklenburg County government no longer oversees mental health, substance abuse, or disability services for the county. MeckLINK—the organization it built to handle those services—closed today, as the larger, outside agency Cardinal Innovations takes over. MeckLINK operated for little over a year, but that tenure spurred fights with state lawmakers for control, cost the county millions of dollars, and contributed to the fall of two top county officials.

In December 2012, then-county manager Harry Jones announced to shocked commissioners at a public meeting that the state had pulled MeckLINK’s contract, about a month before the agency was scheduled to begin managing more than 200 million state and federal Medicaid dollars for mental health.

Accusations flew against state officials, including from commissioner George Dunlap.

“I can’t help but believe there’s something that smells funny about this whole thing,” Dunlap said at the meeting.

The state planned for Cardinal Innovations to take over instead. Based in Concord, it was the original, and largest, of the new organizations designed to manage mental health care in North Carolina. But, the county had at that point hired 131 workers and spent $3 million to convert MeckLINK for the job. Jones urged commissioners to fight.

“We’ve invested, I believe, far, far too much to walk away at this particular point. I think we need to continue on course,” he said.

Commissioners threatened to sue, the state relented, and the county received an extension.

It turned out MeckLINK had received multiple negative reports from a consultant vetting the new organizations. The financial and IT systems were not ready, and many positions remained vacant, according to the consultant’s reports.

The county fixed those problems, passed its next report, and began operating in March 2013. But, the whole saga, along with problems at the Department of Social Services and a botched property revaluation, helped end a two-decade county career.

County chairwoman Pat Cotham publicly fired Jones as county manager in May, and cut off his last words.

Board members ultimately voted Cotham out of her position as chair in December, although she remains a commissioner. Shortly after Jones’ firing, state lawmakers moved a bill to strip the county of its control of MeckLINK.

The bill left commissioners with a choice: create an authority to run MeckLINK, or hand control to Cardinal. By this time, the county had poured $8 million into the agency and staffed it with more than 200 employees. But, state health officials want to consolidate the number of mental health organizations down from 11 to just 4. It did not make sense to spend more money on an agency obviously on the chopping block, commissioners said. In November, the board voted to work out an agreement with Cardinal, cutting the county out of oversight.

“We are not responsible for decisions that Cardinal Innovations makes about what services they will fund, what providers they will fund, and how much they fund them for,” says commissioner Dumont Clarke.

Two commissioners will be appointed to Cardinal’s board, along with another two professionals from Mecklenburg.

For those giving and receiving mental and behavioral health services, it is the latest in a series of changes to how mental health is administered that extends back years.

“We’ve been on such a rollercoaster, emotional rollercoaster, information changing from month-to-month and week-to-week,” says Stephaney Gaddey. “And it’s just been really nerve-wracking.”

Gaddy works with adults and children with special needs, and, she is a parent of a 14-year-old born with a variety of developmental disabilities which have left him in a wheelchair.

When the state canceled MeckLINK’s contract in favor of Cardinal, Gaddy opposed it. She worries about services being cut to save money. That has also been a criticism of every one of the new mental health organizations, including MeckLINK.

Cardinal CEO Pam Shipmann says there should be little change for those receiving services, because Cardinal is taking over for another, similar agency.

“Our goal is for this to be pretty seamless for consumers,” Shipmann says. “Mecklenburg has operated for a year, so it’s not like it’s just starting up. Basically we want to pick up where they’re leaving off.”

Cardinal has hired about 100 employees from MeckLINK. The county reports it reassigned 47, and eight retired. That means about 40 lost their jobs. Cardinal also hired a former Mecklenburg county mental health supervisor to manage them, and says some services may be easier to access. Gaddy says that information has quelled some of her fears.

“At this point, I feel better,” she says. “I don’t have a whole lot of choice, because they’re it. If I go in running scared, then I’m just going to be miserable.”

For its part, the county gets back about $4 million. And, it is out of what has been a troublesome mental health business.