Cardinal Innovations’ presence in the Triad appears to be winding down with the boards of commissioners from Davie, Rockingham and Stokes counties moving forward with their respective disengagement plans.
Cardinal, based in Charlotte, currently oversees providers for mental health, substance-abuse and developmental-disabilities services for more than 800,000 North Carolinians utilizing federal and state Medicaid funds.
As of Friday, 10 of Cardinal’s 20 counties have requested or are considering disengagement.
State law requires the state health secretary, Dr. Mandy Cohen, to approve of such a transition between behavioral health managed care organizations (MCO).
Cohen has approved disengagement for Cabarrus, Stanly and Union counties to join Partners by Sept. 1 and is reviewing requests from Mecklenburg and Orange counties. Partners already has Surry and Yadkin counties as members.
Davie commissioners voted 5-0 on June 29 to officially begin the process of shifting from Cardinal to Partners Health Management of Gastonia.
Stokes County manager Jake Oakley sent a letter on June 29 to Cohen to inform her of the county’s “probable disengagement from Cardinal. Partners made a presentation to the commissioners July 12, with the board likely to vote on its next step July 26.
Rockingham commissioners are expected to vote Monday on its disengagement plan from Cardinal to join Sandhills Center of West End.
The Davie, Rockingham and Stokes boards are following in the footsteps of Forsyth County, whose commissioners are seeking Cohen’s permission to join Partners, and Davidson County, which wants to rejoin Sandhills.
Forsyth is on a potential timeline of joining Partners by early 2022.
Oakley said in the letter to Cohen that “we feel that Partners ... would be a good fit” for Stokes.
He cited that residents “have had challenges in accessing” care through Cardinal, including “gaps and delays in services, authorization of lower levels of care that what is clinically recommended, a lack of quality in the services provided, limited local providers for various levels of care, and a lack of responsive care management for members.”
Oakley’s comments are similar to those expressed by Davidson and Forsyth county officials during disengagement talks with commissioners.
Suzanne Wright, director of Davie’s Department of Health and Human Services, told commissioners that the transition plans were under way before Cardinal announced plans June 1 to join with Vaya Health, which is based in Asheville.
“The decision was both thoughtful and deliberate,” Wright said, saying the county department met with a committee of stakeholders and several MCOs. “Partners serves several surrounding counties and has a solid reputation for outstanding customer service, community involvement and providing quality care.”
“The local stakeholders committee also looked for a MCO with a connection and commitment to Davie County, strong utilization management and care coordination practices and a robust provider network,” Wright said.
Davie manager David Bone said county staff plans to present the formal disengagement plan at the Aug. 2 commissioners meeting. If approved, the plan will undergo a 60-day public comment period. The disengagement proposal could be submitted to Cohen as early as early November.
Oakley said the pending Cardinal-Vaya merger could result “in little change in the management of operations, which would perpetuate the continued challenges that have been previously noted.”
Rockingham manager Lance Metzler said Friday that “we have the resolution, disengagement plan and timeline on the board’s agenda.”
Metzler said Rockingham county staff conducted a community outreach effort that also included the county district attorney and law-enforcement agencies, as well as interviewed officials from Partners, Sandhills and Vaya.
“There was some concern about the distance and the number of counties that were in the catchment area and the ability to represent Rockingham County on the MCO board,” Metzler said.
The combined Cardinal-Vaya potentially could cover up to 33 counties, primarily in western North Carolina with Alleghany, Ashe, Avery, Watauga and Wilkes, along with Alamance in the Triad.
Cardinal responded Friday to the potential departure of Davie, Rockingham and Stokes by saying it had no additional comment than what it provided when Davidson confirmed its plans to disengage.
Cardinal said in its Davidson statement that “our highest priority is the continuity of care for our members in Davidson County, and we are committed to working closely with Sandhills, DHHS and the county to help our members be safe and healthy.”
“We also understand the importance of relationships that members and their families have with care coordinators and providers, and we will strive to maintain those relationships wherever possible.”