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Minutes 05-10-2011
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Minutes 05-10-2011
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BOCC
Date
5/10/2011
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Work Session
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Minutes
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Agenda - 05-10-2011
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2. OPC Area Proqram Update on Medicaid Waiver Expansion — Partnership <br /> Proposed with Piedmont Behavioral Health LME <br /> Assistant County Manager Gwen Harvey gave some background information. She said <br /> that the OPC Board has unanimously agreed that this should go forward and the other <br /> counties have also approved it. <br /> Judy Truitt, OPC/LME Director, summarized the information. <br /> SUBJECT: OPC Area Program Update- April 2011 <br /> PURPOSE: To receive a report on the expansion of the 1915(b)(c) Medicaid waiver & the <br /> expected impact on the mental health, developmental disabilities & substance abuse service <br /> system in Orange, Person & Chatham Counties. <br /> BACKGROUND: On March 31, 2011 the Department of Health & Human Services (DHHS) <br /> released an RFA for the expansion of the 1915(b)(c) Medicaid waiver, which will have <br /> significant impact on the organizational structure and governance of the existing system. <br /> HISTORICAL INFORMATION: House Bill 381, passed in October 2001, outlined a major <br /> transformation of the public mental health system. Guiding principles included: <br /> • Greater choice for consumers — choice was never intended to be open-ended <br /> • No wrong door for admission to services <br /> • Services provided in the local communities <br /> • Greater involvement by both consumers and the provider community <br /> • State wide standardization and accountability <br /> • Focused shift to best practice and evidence-based treatment <br /> • Separation of management oversight from the provision of service <br /> In response to the new legislation OPC initiated divestiture of service programs in December <br /> 2003 and began its transition to a Local Management Entity (LME) with responsibility for: <br /> • screening, triage & referral for consumers entering the service system; <br /> • authorization of all state and/or locally funded services; <br /> • endorsement and monitoring of a comprehensive provider network; <br /> • customer service and community planning for our three county region. <br /> In 2007 the North Carolina General Assembly passed legislation that required that LMEs have <br /> a total population of 200,000+ or cover a geographic region of six or more counties. With a <br /> total population of 227,963 OPC is the fourth smallest LME in the state. <br /> As noted above LMEs were given responsibility for management of state and locally funded <br /> services, while management of Medicaid funded services was given to Value Options, a <br /> private for-profit vendor. This remained true until April 2005 when DHHS began operating a <br /> pilot project which allowed Medicaid funded services for mental health, developmental <br /> disabilities and substance abuse treatment to be provided on a capitation basis through a <br /> 1915(b)(c) combination waiver at PBH, the LME which covers Cabarrus, Davidson, Rowan, <br /> Stanly & Union counties. This pilot project has been successful and DHHS has made the <br /> decision to move forward with statewide expansion of the 1915(b)(c) waiver. <br /> What is a 1915(b)(c) Medicaid waiver? In 1965 amendments to the Social Security Act (SSA) <br /> established the Medicaid program. Under the Medicaid program each state establishes its own <br />
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