Updated April 13, 2021 at 12:09 p.m.
Cabarrus and Union counties have received state approval to cut ties with Cardinal Innovations Healthcare. Cardinal coordinates behavioral health care for Medicaid recipients in 20 North Carolina counties. At least four other counties — Mecklenburg, Forsyth, Stanly and Orange — have also taken steps to drop Cardinal.
Cabarrus and Union will switch to using a different agency, Partners Health Management, beginning Sept. 1, according to a joint press release issued by the counties and Partners on Friday.
Steve Morris, chair of the Cabarrus Board of Commissioners, said in the release that Partners will help advance what he called the county’s goal of "a safe, healthy community that provides appropriate mental health services.”
County leaders have complained about problems with Cardinal for more than a year. During a Mecklenburg County Commission meeting in February 2020, Assistant County Manager Anthony Trotman accused the company of denying or delaying care for 42 children in the county. Cardinal officials said they were not invited to the meeting.
Roughly nine months later, Mecklenburg commissioners unanimously voted to begin to sever ties with Cardinal, after many voiced concerns that Cardinal was still delaying care for residents, including children, and that the company had a limited network of health care providers.
Mecklenburg County is "still in conversations" with North Carolina's Department of Health and Human Services about its effort to break with Cardinal, a spokesperson for the state agency said in a statement, and the county has indicated it would like to create its own agency to replace Cardinal.
Leaders in Forsyth, Stanly and Orange counties have also voted to drop Cardinal. Stanly and Forsyth County leaders have said they would also switch to Partners Health Management if approved. Orange County would switch to Alliance Health.
“We’ve moved past the time to try to remedy this issue,” Stanly County Manager Andy Lucas told WFAE in November 2020. “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.”
Cardinal released a “county action plan” in November 2020 that it said would improve its services and address county concerns, including those raised by Mecklenburg and Forsyth County leaders in an Oct. 23 letter to the company and NCDHHS.
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. Dr. Mandy Cohen, the state’s Health and Human Services secretary, has said her agency takes the concerns raised about Cardinal “very seriously.”
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.
