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16 <br /> BACKGROUND: <br /> Local Management Entities— Managed Care Organizations (LME-MCOs) are public managed <br /> care organizations that administer behavioral health services for residents in need of mental <br /> health, developmental disability, or substance use services. The State of North Carolina is <br /> currently served by seven different LME-MCOs divided into regions. Cardinal Innovations <br /> Healthcare currently serves Alamance, Cabarrus, Caswell, Chatham, Davidson, Davie, Forsyth, <br /> Franklin, Granville, Halifax, Mecklenburg, Orange, Rockingham, Person, Rowan, Stanly, <br /> Stokes, Union, Vance and Warren counties. Alliance Health currently serves Cumberland, <br /> Durham, Johnston, and Wake counties. <br /> North Carolina General Statutes and the North Carolina Administrative Code authorize and <br /> prescribe the process through which a County may seek permission to disengage from one <br /> LME-MCO and realign with another. The final decision making authority rests with the Secretary <br /> of the Department of Health and Human Services. The applicable administrative code is <br /> attached as Attachment 1. <br /> The first step in initiating disengagement is providing written notice of the County's intent to <br /> disengage to the Secretary of Health and Human Services, the Co-Chairs of the Joint <br /> Legislative Oversight Committee on Health and Human Services, and the affected counties a <br /> minimum of nine months prior to the proposed effective date of disengagement. This abstract <br /> would authorize the County Manager to send the disengagement notice letter and begin the <br /> formal disengagement process. <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 /> In April of 2019, the Board of Commissioners approved a letter to the North Carolina <br /> Association of County Commissioners expressing its preference to become part of a Tailored <br /> Plan region that included Durham and Wake County. The Tailored Plan letter is attached as <br /> Attachment 2. While that action did not initiate the formal disengagement process, the same <br /> justifications for realigning with other counties in the Triangle Region are applicable. This prior <br /> action was also similar in terms of timing. The County was asked to express its preference for <br /> Tailored Plan regions prior to the implementation of Medicaid Transformation. At that time, <br /> Medicaid Transformation was scheduled to be implemented in February 2020. Implementation <br /> has since been delayed until July 2021. <br /> Travis Myren presented the following PowerPoint presentation: <br /> Slide #1 <br /> ORANGE COUNTY <br /> NOR1 H CAROLINA <br /> LME-MCO Disengagement <br /> and Realignment <br /> November 5,2020 <br /> Virtual Meeting <br /> ■ <br />