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<br />Once the disengagement notice is sent, the County is required to create a plan for <br />disengagement. This plan must be approved by the Board of Commissioners and must be <br />made available for public comment for a minimum of 60 calendar days. During the comment <br />period, the County is required to solicit comments from consumers, advocates, self- advocates, <br />and State and Local Consumer and Family Advisory Committees. These public comments must <br />be posted for a minimum of 30 calendar days. The Board of Commissioners must also approve <br />a written plan to ensure continuity of services during the transition and a plan which provides for <br />distribution of real property if applicable. <br /> <br />In April of 2019, the Board of Commissioners approved a letter to the North Carolina Association <br />of County Commissioners expressing its preference to become part of a Tailored Plan region <br />that included Durham and Wake County. The Tailored Plan letter is attached as Attachment 2. <br />While that action did not initiate the formal disengagement process, the same justifications for <br />realigning with other counties in the Triangle Region are applicable. This prior action was also <br />similar in terms of timing. The County was asked to express its preference for Tailored Plan <br />regions prior to the implementation of Medicaid Transformation. At that time, Medicaid <br />Transformation was scheduled to be implemented in February 2020. Implementation has since <br />been delayed until July 2021. <br /> <br />FINANCIAL IMPACT: No financial impact is associated with authorizing the County Manager to <br />initiate the LME-MCO disengagement process. <br /> <br />SOCIAL JUSTICE IMPACT: <br /> <br />• FOSTER A COMMUNITY CULTURE THAT REJECTS OPPRESSION AND INEQUITY <br />The fair treatment and meaningful involvement of all people regardless of race or color; religious <br />or philosophical beliefs; sex, gender or sexual orientation; national origin or ethnic background; <br />age; military service; disability; and familial, residential or economic status. <br /> <br />• ENSURE ECONOMIC SELF-SUFFICIENCY <br />The creation and preservation of infrastructure, policies, programs and funding necessary for <br />residents to provide shelter, food, clothing and medical care for themselves and their <br />dependents. <br /> <br />RECOMMENDATION(S): The Manager recommends the Board consider authorizing the <br />County Manager to initiate the formal disengagement process from the County’s current Local <br />Management Entity-Managed Care Organization, Cardinal Innovations Healthcare, and to seek <br />realignment with Alliance Health to administer mental and behavioral health services for Orange <br />County residents. <br />2