Agenda - 05-17-2011- 5u - Laserfiche WebLink

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OPC and Waiver Expansion Frequently Asked Questions 1. Is OPC merging with another LME (Local Management Entity)? OPC is currently talking to PBH about the possibility of joining them. At their regularly scheduled meeting on April 14th the OPC Area Board reviewed the Request for Application (RFA) that was recently released by the Department of Health 8~ Human Services (DHHS) related to the expansion of the 1915(b) (c) waiver. After extensive discussion the OPC Board voted unanimously to move forward in negotiations with PBH and to seek authorization from the Boards of Commissioners in Orange, Person 8~ Chatham counties to do so. 2. Who is PBH and why is OPC in discussions with them? PBH is an LME (ike OPC. They currently operate a Medicaid waiver and have asked us to partner with them. PBH is a Local Management Entity (LME) like OPC which covers Cabarrus, Davidson, Rowan, Stanly 8~ Union counties. In 2005 PBH was chosen to operate a pilot project which allowed Medicaid funded services for mental health, developmental disabilities and substance abuse treatment to be provided on a capitation basis through a 1915(b)(c) combination waiver. This pilot project has been successful and DHHS has made the decision to move forward with statewide expansion of the 1915(b)(c) waiver based on the model created by PBH. In February 2010 OPC was approached by PBH about the possibility of forming an alliance. With approval of the OPC Area Board negotiations were initiated. In June 2010 legislation was passed which restricted PBH from expanding their geographic region and limited the number of sites for expansion of the Medicaid waiver. OPC's negotiations with PBH were put on hold. Legislative support now exists for removal of the restrictions on PBH, as well as expansion of the waiver. 3. Why would OPC want to merge? 5 Under proposed legislation, OPC is currently not large enough to operate as we currently exist.