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22 <br /> 1 <br /> 2 b. Letter to North Carolina Association of County Commissioners Expressing a <br /> 3 Regional Preference for Medicaid Tailored Plans <br /> 4 The Board considered voting to authorize the Chair to sign a letter to the North Carolina <br /> 5 Association of County Commissioners expressing Orange County's preference to align its <br /> 6 Medicaid Tailored Plan Region with Durham and Wake counties. <br /> 7 Travis Myren presented this item: <br /> 8 <br /> 9 BACKGROUND: <br /> 10 In February 2019, the North Carolina Association of County Commissioners was asked by the <br /> 11 North Carolina Department of Health and Human Services to assist with phase two of Medicaid <br /> 12 transformation by coordinating and facilitating a process to develop recommended regions for <br /> 13 Tailored Plans. <br /> 14 <br /> 15 The Association has organized a committee to coordinate recommendations. The Committee <br /> 16 consists of county commissioner representatives from each Managed Care Organization (MCO) <br /> 17 region. This Committee has invited stakeholder input on the composition of Tailored Plan <br /> 18 regions. The deadline to provide input is April 17, 2019. <br /> 19 <br /> 20 At the April 2, 2019 regular Board meeting, a petition was made requesting that the County <br /> 21 communicate Orange County's preference to be part of a Tailored Plan region that also <br /> 22 includes Durham and Wake counties. Staff has attached draft language for a proposed letter <br /> 23 addressing that interest. It is proposed that the Board formally authorize the Chair, on behalf of <br /> 24 the Board, to sign a letter expressing the County's preference, and requested that the Clerk to <br /> 25 the Board submit the letter before the April 17 deadline. <br /> 26 <br /> 27 Chair Rich said Commissioner Bedford brought this petition forward. <br /> 28 Commissioner Dorosin asked if Orange County is grouped with particular counties <br /> 29 currently. <br /> 30 Travis Myren said for behavioral health purposes, Orange County is grouped in the <br /> 31 Cardinal Innovations MCO region, which does not include Durham and Wake counties, which <br /> 32 are with Alliance. He said it does include Mecklenburg County. <br /> 33 Chair Rich said the Board received a letter from Cardinal earlier today, detailing some of <br /> 34 the actions that Cardinal Innovations takes, which supply support for Orange County locally. <br /> 35 Commissioner Dorosin asked if this change is made, would Orange County be with <br /> 36 Alliance, instead of Cardinal Innovations. <br /> 37 Chair Rich said yes. <br /> 38 <br /> 39 PUBLIC COMMENT: <br /> 40 Trey Sutton, CEO Cardinal Innovations (CI), asked if the BOCC would consider the <br /> 41 potential disruptions of this proposed change to members. He said he also questions the <br /> 42 issues with the geography, as the Cl provider network includes UNC, Duke, Wake Med, etc. <br /> 43 He said historically Cl has had a strong relationship with Orange County, and last year Cl <br /> 44 received capitation with care costs associated with members of$26 million, but spent $35.4 <br /> 45 million. He said this is a loss, but CI is not a business, it is a mission-focused organization that <br /> 46 has a commitment to this County. He said Cl also made several investments in community <br /> 47 organizations, including Compass Center, El Futuro, YMCA, Special Olympics, etc. He said IC <br /> 48 has as many employees in Orange County as it does in other counties, as well as an office. He <br /> 49 said the stakes are of this decision are high for the organization and the County. <br />