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Mecklenburg Will Sue State Over MeckLINK

Pat Cotham (left) and Trevor Fuller at a 2013 Mecklenburg County Commission meeting.
Todd Sumlin
Charlotte Observer

Mecklenburg County will continue its fight to reinstate its mental health service agency, MeckLINK, as the overseer of hundreds of millions of dollars in Medicaid funds. In a last ditch effort, county commissioners unanimously voted to take their case to court.

The state is changing how it disperses Medicaid funds for mental health, disability, and substance abuse services. The county decided to administer its share itself—over $200 million worth—through MeckLINK. But a little over a week ago, the outgoing Secretary of the Department of Health and Human Services stripped MeckLINK of that responsibility on his last day in office.

The county didn’t get any relief from the McCrory administration.

On Monday, new DHHS Secretary, Aldona Wos upheld the decision.

Yesterday at a meeting, the commissioners voted unanimously to bring the state of North Carolina in front of an administrative judge.

The state replaced MeckLINK with Cardinal Innovations, an established health management firm formerly known as PBH. Cardinal is managing the Medicaid funds for 15 other counties, which combined are smaller than Mecklenburg.

State consultants had found MeckLINK wouldn’t be ready to launch by a deadline of February 1st, citing delays with the organization’s implementation of its IT and financial systems. It is the only managed care organization—or MCO--out of eleven across North Carolina that the consultants found unprepared. At the commission meeting, MeckLINK director Phil Endress maintained the consultants are wrong.

“I am 100 percent confident that we will have a viable MCO ready to go live and provide the appropriate services to the residents of Mecklenburg County on February 1st,” Endress said.

The commission spent almost two hours in a closed session, consulting with a lawyer brought in by county manager Harry Jones. Commissioner Trevor Fuller says the lawyer convinced him MeckLINK has a case.

“I was, and am, very critical of the staff’s efforts,” Fuller said. “I believe we could have done better. Much better. But we are where we are, and we must take action.”

The lawsuit challenges the deadlines imposed by the state, arguing that the law itself only opposes one deadline for county health organizations—July 1, 2013, when the entire state system must be implemented. It also questions the process by which the secretary chose another organization to take control of county affairs.

At the commission meeting, officials argued management should stay within the county.

“Folks who struggle with mental health issues, with addiction, and with developmental disabilities are so used to being the most forgotten, the most disenfranchised groups in our community,” Loftis said. “If another county was proposing to take over our public education system—if they wanted to take over our schools—there would be no question about whether we would fight that.”

Whoever runs the Medicaid program stands to make around $20 million in administrative fees this year alone. Loftis and county officials argue Mecklenburg can reinvest that money to improve service, but if it goes to Cardinal it will basically be lost. MeckLINK would also lose its over 200 employees and waste the $3 million spent setting up.

Stephaney Gaddy is worried about how she will care for her developmentally disabled 13-year old son. She says Cardinal has a track record of cutting service in the other counties it manages.

“It takes anywhere from an hour and a half to two hours to get my son through feeding, toileting and bathing, and you’re going to cut him to two hours a day?” Gaddy said. “He only gets three now, but we’re making it. And PBH, Cardinal Innovations, has systematically been doing this since they came into existence.”

Mothers of developmentally disabled children and MeckLINK workers made up much of the audience. They cheered the commission’s decision to fight the state.  Chairwoman Pat Cotham says she’s not sure how the lawsuit will fair, but commissioners felt they needed to try.