Orange County NC Website
19 <br /> 1 The Board considered voting to authorize the Chair to sign a letter to the North Carolina <br /> 2 Association of County Commissioners expressing Orange County's preference to align its <br /> 3 Medicaid Tailored Plan Region with Durham and Wake counties. <br /> 4 Travis Myren reviewed the information below: <br /> 5 <br /> 6 BACKGROUND: <br /> 7 In February 2019, the North Carolina Association of County Commissioners was asked by the <br /> 8 North Carolina Department of Health and Human Services to assist with phase two of Medicaid <br /> 9 transformation by coordinating and facilitating a process to develop recommended regions for <br /> 10 Tailored Plans. <br /> 11 <br /> 12 The Association has organized a committee to coordinate recommendations. The Committee <br /> 13 consists of county commissioner representatives from each Managed Care Organization (MCO) <br /> 14 region. This Committee has invited stakeholder input on the composition of Tailored Plan <br /> 15 regions. The deadline to provide input is April 17, 2019. <br /> 16 <br /> 17 At the April 2, 2019 regular Board meeting, a petition was made requesting that the County <br /> 18 communicate Orange County's preference to be part of a Tailored Plan region that also <br /> 19 includes Durham and Wake counties. Staff has attached draft language for a proposed letter <br /> 20 addressing that interest. <br /> 21 <br /> 22 The Board voted on April 16t" but it was a tied vote and thus failed. <br /> 23 Thus, Commissioner Dorosin requested that this be re-visited. <br /> 24 <br /> 25 It is proposed that the Board formally authorize the Chair, on behalf of the Board, to sign a letter <br /> 26 expressing the County's preference, and for the Clerk to the Board to submit the letter as soon <br /> 27 as possible. <br /> 28 <br /> 29 Commissioner Bedford apologized that she was unable to attend the April 16t" meeting <br /> 30 due to being with her sister who had open-heart surgery. She said she does have an adult <br /> 31 daughter with developmental disabilities, who is served by Cardinal Innovations (CI) and <br /> 32 currently resides in Harnett County. <br /> 33 Commissioner Bedford said counties have been asked to provide input about the <br /> 34 regrouping for tailored plans. She said tailored plans are in part 2 of the Medicaid expansion. <br /> 35 She said this decision will not be made by the MCO grouping, but rather the state DHHS will <br /> 36 make the final decision, and requested input from the NCACC and the counties. She said the <br /> 37 LME/MCOs will have representatives to this process as well. <br /> 38 Commissioner Bedford said as someone who is very familiar with the process, it would <br /> 39 be easier and more accessible for the residents in Orange County to access services in Orange <br /> 40 County and be aligned with Wake and Durham counties, as opposed to the 20 counties <br /> 41 heading west, with a headquarters in Charlotte. <br /> 42 Commissioner Bedford referred to the CI CEO's comment that more money was spent <br /> 43 than appropriated, and said this is expected from most of the counties in the state, because the <br /> 44 MCOs had been accumulating fund balance. She said in 2017, the General Assembly (GA) <br /> 45 appropriations limited and decreased their funding for those who are uninsured or <br /> 46 underinsured, and required maintenance of expenditures at the 2014-2015 level. She said the <br /> 47 GA wants the MCOs to spend more than they are appropriated in order to spend down the fund <br /> 48 balance. <br />