Agenda - 02-16-2021; 6-a - Approval of the Disengagement Plan to Disengage from Cardinal Innovations Health Care and Realign with Alliance Health

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5 On May 3, 2019, the BOCC sent a letter to the North Carolina Association of County Commissioners expressing our preference to become part of a Tailored Plan region that included Durham and Wake counties. While that action did not initiate the formal disengagement process, the same rationale for realigning with those counties within the Research Triangle remain applicable. On November 5, 2020, the BOCC voted to disengage from our current LME/MCO, Cardinal, to realign with Alliance Health. This Board action is attached and also available on our website at www.orangecountync.gov, where other information on this process (including this Disengagement Plan) is or will be posted. On November 16, 2020, Orange County's Letter of Intent to disengage was sent to the DHHS Secretary, the counties in the regional areas of both Cardinal and Alliance, and the Co-Chairs of the Joint Legislative Oversight Committee on Health and Human Services as required by law. II. RATIONALE As stated in our letter from May 3, 2019, Orange County is committed to ensuring that the best health systems, services and access to care are available to residents in our community. We believe that transitioning to Alliance will best accomplish that goal. From a service perspective, Orange County shares a regional transportation system, a regional workforce, and a network of providers with Durham and Wake counties. Orange County conducted a study of the provider network available to residents with behavioral health needs, and many providers used by County residents are located in Durham County. Other non-profit providers also serve residents from Orange, Durham, and Wake counties. A good example of that is CASA, which operates in Durham, Wake, and Orange counties to provide housing for people with mental illness. CASA's operations and client access would be more efficient if Orange County were grouped with Durham and Wake counties. Connecting these counties would provide greater access, more varied services, and better public transportation opportunities than any other alignment. Another example is Alliance's partnership with UNC Health Care to address the behavioral health and I/DD needs of patients who are uninsured or on Medicaid. UNC Health Care supports Alliance's efforts to manage a Tailored Plan and is exploring avenues to make a fuller array of its health care system's services accessible to Alliance's prospective Tailored Plan members. Orange County has always sought more local services and choices for County residents and Alliance's proximity allows greater access to quality services in the Triangle region. Orange County also agrees with Alliance's model of community priorities. Alliance utilizes its local networks of providers and community partners to effectively and efficiently serve individuals pursuant to the following priorities: • Investment in crisis service continuum, which services are available to anyone, to stabilize individuals experiencing behavioral health crises to reduce unnecessary trips to the emergency department (ED), hospitalizations, and incarcerations. For example, Alliance partnered with community stakeholders to create local crisis facilities in three of its four counties and opened two behavioral health urgent care centers across its service area to connect people with appropriate care and services before urgent situations become crises. Orange County LME/MCO Disengagement Plan 12