HomeMy WebLinkAboutAgenda - 05-18-2021; 6-b - Approval of a Resolution Authorizing the Submittal of a Request to the Secretary of the DHHS to Disengage from Cardinal Innovations and Realign with Alliance Health 1
ORANGE COUNTY
BOARD OF COMMISSIONERS
ACTION AGENDA ITEM ABSTRACT
Meeting Date: May 18, 2021
Action Agenda
Item No. 6-b
SUBJECT: Approval of a Resolution Authorizing the Submittal of a Request to the
Secretary of the Department of Health and Human Services to Disengage from
Cardinal Innovations Healthcare and Realign with Alliance Health
DEPARTMENT: County Manager's Office
ATTACHMENT(S): INFORMATION CONTACT:
Travis Myren, Deputy County Manager,
1. Resolution 919-245-2308
UNDER SEPARATE COVER
2. Plan Documents and Resources
Only Available Electronically at:
http://orangecountVnc.gov/2634/LM
EMCO-Disengagement
PURPOSE: To approve a resolution authorizing submittal of the request to the Secretary of the
Department of Health and Human Services to disengage from Cardinal Innovations Healthcare
and realign with Alliance Health to administer Medicaid and uninsured behavioral health and
intellectual/developmental disability services for Orange County residents.
BACKGROUND: North Carolina General Statutes and the North Carolina Administrative Code
authorize and prescribe the process through which a County may seek permission to disengage
from one Local Management Entity/Managed Care Organization (LME/MCO) and realign with
another. The final decision making authority rests with the Secretary of the North Carolina
Department of Health and Human Services (DHHS).
The Board of Commissioners and County staff have completed all of the formal measures that
will be included as supporting documentation in the request to the Secretary of DHHS:
• The Board approved the County's Intent to Disengage on November 5, 2020.
• Formal notice of the Intent to Disengage was transmitted to the Secretary of the North
Carolina Department of Health and Human Services, the Co-Chairs of the Joint Legislative
Oversight Committee on Health and Human Services, and the affected counties on
November 16, 2020.
• The Board of Commissioners approved a Disengagement Plan on February 16, 2021. This
Plan created a Realignment Committee consisting of County officials and agencies,
Alliance Health and Cardinal Innovations Healthcare representatives, and other
appropriate stakeholders.
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• The County also opened a sixty (60) calendar day public comment period and posted those
comments for an additional thirty days following the public comment period. Public
comments can be reviewed at http://orangecountync.gov/2684/LMEMCO-Public-
Comments In addition to the comments posted, the County received a letter of support
from the Orange County National Alliance on Mental Illness.
• The Alliance Health Board of Directors approved a resolution for Orange County to realign
with Alliance Health on March 4, 2021.
• The Board of Commissioners approved a Continuity of Services Plan on April 6, 2021. This
Plan outlines how the management of Medicaid and uninsured behavioral health and
intellectual/developmental disability services will transition from Cardinal Innovations
Healthcare to Alliance Health.
• A formal notice to providers was distributed to the forty-one (41) providers that serve
Orange County on May 4, 2021 to insure each provider is aware of the realignment
process. This notice also invited comments and questions.
In addition to these formal efforts, the County and Alliance Health have conducted informal
information and outreach activities:
• Frequently Asked Questions (FAQ) documents for members and providers were created
and distributed. The FAA's are posted on the County's website
http://orangecountync.gov/2634/LMEMCO-Disengagement
• Alliance Health has made attempts to contact all Orange County providers that currently
contract with Cardinal Innovations Healthcare directly. Alliance was able to successfully
connect with 19 of these providers to date and Alliance has engaged in conversations to
learn more about the services and arrangements that these providers have with Cardinal.
Alliance provided information on the realignment process to these providers and agreed to
further engagement as the realignment process moves forward into the implementation
phase.
• The Alliance Provider Network leadership specifically reached out directly to Freedom
House Recovery Center, Club Nova, and OE Enterprises based on their longstanding
history of providing services within Orange County, their unique service array, and their
experienced understanding of local systems and community need.
• Alliance Health coordinated a meeting with the local parent advocacy group, Parent
Advocates for Adult Children with Intellectual and/or Developmental Disabilities, on April
26.
• The County and Alliance Health has communicated with the State and Local Consumer
and Family Advisory Committee (CFAC) and has begun drafting a charter for an Alliance
Health CFAC.
• The County hosted a Virtual Town Hall meeting on May 12, 2021. Approximately sixty
individuals attended the event to ask questions and submit comments. The attendees
represented providers, members, parents, and advocates as well as staff from the County,
Alliance Health, the Department of Health and Human Services, and Cardinal Innovations.
A summary of those questions and comments will be distributed to the Board prior to the
meeting.
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Timeline
The remaining timeline for realignment process is expected to proceed as follows:
• May 18, 2021 — Board of Commissioner consideration of a Resolution Authorizing
Submittal of the Request to Disengage to the Secretary of the Department of Health and
Human Services.
• May 20, 2021 — Pending Board approval, submittal of the formal Request to Disengage to
the Secretary with the required documentation. A decision by the Secretary is required
within 90 days.
• August 17, 2021 — Anticipated approval by the Secretary
• Following Secretary Approval — Transition and implementation phase
• January 1, 2022 — Proposed effective date of transition
FINANCIAL IMPACT: There is no financial impact associated with this item.
SOCIAL JUSTICE IMPACT: The following Orange County Social Justice Goals are applicable
to this item:
• GOAL: FOSTER A COMMUNITY CULTURE THAT REJECTS OPPRESSION AND
INEQUITY
The fair treatment and meaningful involvement of all people regardless of race or color;
religious or philosophical beliefs; sex, gender or sexual orientation; national origin or ethnic
background; age; military service; disability; and familial, residential or economic status.
• GOAL: ENSURE ECONOMIC SELF-SUFFICIENCY
The creation and preservation of infrastructure, policies, programs and funding necessary
for residents to provide shelter, food, clothing and medical care for themselves and their
dependents.
ENVIRONMENTAL IMPACT: There is no Orange County Environmental Responsibility Goal
impact associated with this item.
RECOMMENDATION(S): The Manager recommends the Board approve the Resolution
Authorizing the Submittal of a Request to the Secretary of the Department of Health and Human
Services to Disengage from Cardinal Innovations Healthcare and Realign with Alliance Health
(Attachment 1). The resolution also authorizes the County Manager to take all necessary steps
to submit supporting documentation as required by North Carolina General Statutes and North
Carolina Administrative Code.
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RES-2021-034 Attachment 1
RESOLUTION AUTHORIZING SUBMITTAL OF THE LME/MCO DISENGAGEMENT AND
REALIGNMENT REQUEST TO THE SECRETARY OF THE DEPARMENT OF HEALTH AND
HUMAN SERVICES
WHEREAS,North Carolina General Statute§122C-115 (0) empowers a county to choose its Local
Management Entity/Managed Care Organization(LME/MCO)subject to the approval of the Secretary
of the North Carolina Department of Health and Human Services; and
WHEREAS, On November 5, 2020, the Board of Orange County Commissioners voted to initiate the
disengagement process from its current LME/MCO, Cardinal Innovations Healthcare, to realign with
Alliance Health and authorized, directed and empowered the CountyManager and others to begin that
process; and
WHEREAS, the Board of Orange County Commissioners approved the Disengagement Plan on
February 16, 2021, posted and received all comments thereto and received further public comments
over the past three(3)months; and
WHEREAS,the Board of Directors for Alliance Health unanimously approved a Resolution in support of
this realignment on March 4,2021; and
WHEREAS, the Board of Orange County Commissioners also approved a Continuity of Services Plan
on April 16,2021,reviewed by a Realignment Committee made up of key stakeholders headed by the
County Manager's designee; and
WHEREAS, Orange County held a virtual public Town Hall on May 12, 2021 6pm, with
representatives of Orange County, Alliance Health and Cardinal Innovations to solicit and receive
additional comment and questions from the public, at which approximately sixty(60) members of the
public attended; and
WHEREAS, the Board of Orange County Commissioners have received and reviewed a recommended
Distribution of Real PropertyPlan attached to this resolution, reflecting no known realty needed to be
distributed for this LME/MCO disengagement and realignment; and
WHEREAS, the Board of Orange County Commissioners have received, reviewed and agrees with a
financial liability statement, also attached tothis resolution.
NOW, THEREFORE, BE IT RESOLVED
1. The Board of Orange County Commissioners approves disengagement from Cardinal
Innovations Healthcare to join Alliance Health, effective January 1, 2022, or on such other date
mutually agreed upon with the State and Alliance, subject to approval by the Secretary of the NC
Department of Health and Human Services.
2. The Board of Orange County Commissioners approves the Distribution of Real
Property Plan reflecting no known realty needed to be distributed for this LME/MCO disengagement
and realignment, saidplan is attached to this Resolution.
3. The Board of Orange County Commissioners approves the Disengagement Financial
Liabilities Statement, of which there are none, said statement is attached to this Resolution.
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4. The Board of Orange County Commissioners directs and empowers the County
Manager to completeall necessary steps to effect the change in accordance with guiding statutes and
rules in the most expeditious manner possible.
5. The Board of Commissioners hereby authorizes the County Manager and staff to
prepare and issue any appropriate documentation and request to the Secretary,to affect this Resolution,
the disengagement and realignment.
Adopted this the 18th day of May, 2021
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Distribution of Real Property Plan
In accordance with State law, a written plan which provides for the distribution of property,
where appropriate, must be approved by Orange County during an LME/MCO realignment
process. This disengagement involves no real property (land, buildings, etc.) to be distributed,
and therefore no such distribution of property will occur.
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Disengagement Financial Liabilities Statement
There are no outstanding financial liabilities to Cardinal Innovations Healthcare, nor will the
County have any within 30 calendar days of the request to disengage. Should Cardinal
reasonably disagree, the County will work amicably and promptly with Cardinal to resolve
equitably and if unable to do so, defer the matter to the NCDHHS Secretary for resolution.