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5 NC Counties Look To Break With Cardinal Innovations Healthcare As Company Releases Improvement Plan

Alex Olgin

Cardinal Innovations Healthcare coordinates behavioral health care for Medicaid recipients in 20 North Carolina counties. On Tuesday, at least five of those counties — Mecklenburg, Union, Cabarrus, Stanly and Orange — were planning to or were in the process of cutting ties with the company.

“We’ve moved past the time to try to remedy this issue,” said Stanly County Manager Andy Lucas. Stanly County commissioners unanimously voted Monday night to start the process of dropping Cardinal.

“It just seems like we’re told time and time again that they’re ‘working on it.’ At some point it just becomes lip service versus action,” Lucas said.

Stanly County leaders found the process of working with Cardinal “frustrating” and “disheartening,” according to Lucas, particularly when he said the company failed to conduct behavioral health assessments of children in foster care in a timely manner.

“We don’t need an assessment in, you know, three, five, eight days. We need an assessment now,” Lucas said.

Leaders in Mecklenburg County have leveled similar accusations for months.

At a commissioners meeting last week, Assistant County Manager Anthony Trotman said Cardinal was delaying care for Mecklenburg residents, including children, and that the company has a limited network of health care providers. According to Trotman, in 2019, Mecklenburg County spent $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 responsibility.

On Monday afternoon, Cardinal released a “county action plan” that it said would improve its services and address county concerns, including those raised by Mecklenburg County and Forsyth County leaders in an Oct. 23 letter to the company and North Carolina’s Department of Health and Human Services.

In its improvement plan, which it said was effective immediately, Cardinal said it would issue treatment authorization decisions within 72 hours for foster children and individuals who visit the emergency department two or more times within two months. The company also said it would remove authorization requirements for a “broad category of outpatient and community-based services.”

Health and Human Services must approve counties’ decisions to disengage from local management entity-managed care organizations like Cardinal.

At a press conference Tuesday afternoon, Health and Human Services Secretary Mandy Cohen said the agency takes the concerns raised about Cardinal “very seriously.”

“We have asked Cardinal for corrective action which they have outlined in a plan,” Cohen said. “Our role as regulators is to make sure that that plan turns into action and that they follow through with that and if they don’t, that we hold them financially accountable for that.”

Leaders in Union, Cabarrus and Stanly counties have said that if the state approves their disengagement plans, they plan to switch to using Partners Behavioral Health Management.

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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.