Under the Dome

Legislators question hold on mental health mergers

Legislators questioned the state’s Medicaid director about a “pause” put on local mental health agency mergers.

Two of the state’s eight regional mental health offices, called Local Management Entity/Managed Care Organizations, or LME/MCOs, have agreed to merge. They are CenterPoint, which includes Forsyth, and Cardinal Innovations, which includes Mecklenburg.

Additionally, Nash County wants to leave the Eastpointe LME/MCO and join Cardinal.

The state Department of Health and Human Services, which includes the Medicaid office, formally told LMEs and county commissioners that the agency put a hold on approving mergers in late October. The regional agencies operate under contracts with the state.

But legislators want fewer LMEs. The former DHHS secretary said the target was getting down to four.

Medicaid director Dave Richard said the agency wants to make sure that any moves on the mental health front don’t conflict with bigger changes in store for Medicaid. The state is beginning the process of privatizing Medicaid, with the idea that “provider-led entities” and commercial insurers will offer health plans to Medicaid recipients. Eventually, public mental health services will be incorporated in some way.

“We want to make sure we’re in sync with you as a General Assembly,” he said.

Legislators said Wednesday at the Joint Legislative Commission on Governmental Operations that friendly mergers work better than those that are forced.

Lisa Barnes, a Nash County commissioner, said the county had researched leaving Eastpointe for Cardinal and wanted to switch on Feb. 1.

“We don’t see any reason to delay,” she said. “We would be better suited to be realigned with Cardinal so that we can prepare for the future.”

Richard tried to assure legislators that the merger requests would be considered, though he was reluctant to offer a deadline without consulting his boss, DHHS Secretary Rick Brajer.