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Questions Remain As Mecklenburg Prepares To Cut Ties With Cardinal Innovations

Alex Olgin

Mecklenburg County is preparing to cut ties with Cardinal Innovations Healthcare. Union and Cabarrus counties ended their relationships with the company last month. Here's what happened.

What Does Cardinal Innovations Healthcare Do?

Cardinal is what’s called a Local Management Entity-Managed Care Organization. North Carolina's Department of Health and Human Services contracts with Cardinal and the company coordinates behavioral health care, like mental health treatment and substance use treatment, for Medicaid recipients in certain counties in the state. Cardinal receives a pot of money for each person with Medicaid who needs mental health services and can approve or deny treatment claims from recipients’ health care providers.

What’s The Problem With Cardinal?

Mecklenburg County leaders have complained about problems with Cardinal for months. In February, Assistant County Manager Anthony Trotman accused the company of denying or delaying care for 42 children in the county.

He raised similar concerns at a meeting last week. Trotman said Cardinal was still delaying care for residents, including children, and that the company has a limited network of health care providers. According to Trotman, in 2019, Mecklenburg County paid $2.3 million to place children in emergency care because services weren’t available, though he said not all of those costs were Cardinal’s fault.

In October, leaders in Mecklenburg and Forsyth counties wrote a letter to the state health department and to Cardinal’s Chief Executive Officer. They asked Cardinal to send an improvement plan by Nov. 9. But Trotman told commissioners he was not confident that the company would make the necessary changes.

Cardinal has a history of problems in North Carolina. In 2017, a state audit found the company’s CEO was using tax dollars on expensive trips for its board members. The state health department took over Cardinal briefly and fired its board of directors.

What About Other Counties That Use Cardinal?

In October, Union County leaders voted to cut ties with Cardinal over concerns similar to Mecklenburg leaders’. Cabarrus County followed suit — the county where Cardinal once built a multimillion-dollar headquarters. Davidson and Alamance counties are also considering ending their relationship with Cardinal, according to Mecklenburg County leaders.

What Does Cardinal Say?

At last Tuesday’s Mecklenburg County commissioners' meeting, Cardinal CEO Trey Sutten spoke for three minutes of public comment. He called the county’s plan to disengage “disappointing” and said the company does intend to submit a plan on Monday for how it will correct those problems. He said cutting ties with Cardinal could be confusing and lead to inconsistent health care for people in the county.

If Not Cardinal, What Company Will Mecklenburg Use?

It’s not clear. Last week, Mecklenburg County Manager Dena Diorio mentioned Partners Behavioral Health Managementas a viable option. Cabarrus and Union counties recently switched to Partners.

What Are The County’s Next Steps?

If Mecklenburg County leaders decide to move forward with the plan to sever ties with Cardinal, they will need to notify the state health department and state lawmakers. They will also have to publish the county’s disengagement plan on the county website and accept public comment on that plan for two months.

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Claire Donnelly is WFAE's health reporter. She previously worked at NPR member station KGOU in Oklahoma and also interned at WBEZ in Chicago and WAMU in Washington, D.C. She holds a master's degree in journalism from Northwestern University and attended college at the University of Virginia, where she majored in Comparative Literature and Spanish. Claire is originally from Richmond, Virginia. Reach her at cdonnelly@wfae.org or on Twitter @donnellyclairee.