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State health officials, local governments must approve plan

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The Western Highlands Network governing board unanimously approved a resolution of intent Thursday to begin work with Smoky Mountain Center on a plan to transition the management of the state contract for Medicaid waivers and other functions.

“If all goes well, 23 counties will be under one managed care organization,” Western Highlands board chairman Charles Vines said.

For more than a year, Western Highlands has been the managed care organization for mental health, substance abuse and development disability services in Buncombe, Henderson, Madison, Mitchell, Polk, Rutherford, Transylvania and Yancey counties.

Smoky Mountain Center manages services for Alleghany, Alexander, Ashe, Avery, Caldwell, Cherokee, Clay, Graham, Haywood, Jackson, Macon, McDowell, Swain, Watauga and Wilkes counties.

The resolution of intent was announced after a nearly one-hour closed session Thursday morning followed by a motion from board member Artie Wilson to seal the minutes of that meeting. The Western Highlands and Smoky Mountain Center boards also met late Thursday afternoon at the Renaissance Hotel in Asheville to further discuss the transition plan.

Board member Steve Wyatt read the prepared resolution which recommends to the N.C. Department of Health and Human Services that Smoky Mountain Center begin management of the state contract after a reasonable transition time. Wyatt stressed several times that the action is a resolution of intent, which is not a binding agreement at this point. The plan must be approved by DHHS and local governments.

Western Highlands was notified April 5 that the state would terminate its contract effective July 31. The following week, the board met to discuss options for what to do next. Leaders then said that one of options included exploring the management agreement with Smoky Mountain Center, while the other option was to develop a a pilot project based on the integrated care model the state plans to roll out in 2015. That approach involves coordination of primary care and behavioral health care.

Vines told Carolina Public Press that the pilot program was rejected by DHHS and the Division of Medical Assistance during a conference call April 17, due to the timing of the termination and the length of time it would take to develop such a program.

Board member Mandy Stone said in a prepared statement that after the Western Highlands and Smoky Mountain boards met recently, “we felt that our mutual commitment to a seamless continuity of care for consumers receiving services and the stability of providers in the Western Highlands Network could be the underpinning for a strong collaboration.”

Western Highlands interim CEO Charles Schoenheit added that one of the primary reasons that exploring a relationship with Smoky Mountain Center is advantageous is that the leadership of that managed care organization views Western Highlands’ employees as a valuable resource that is critical to the success of Smoky Mountain’s ability to fulfill the state Medicaid waivers contract and other functions.

Prior to the board going into the closed session, local consultant Dan Zorn, encouraged the board not only to immediately transition to Smoky Mountain Center, but also to expand that partnership, if finalized, with Community Care of North Carolina.

Community Care is a private-sector initiative involving 14 regional networks of physicians, nurses, pharmacists, hospitals, health departments, social service agencies and other community organizations. It is sponsored by DHHS and the Division of Medical Assistance.

“I have had a chance to work with Smoky Mountain Center and have found that their system is gelling, they have smart leadership and are provider friendly,” said Zorn, who is a former provider of behavioral health services through Families Together.

If a management plan with Smoky Mountain Center does not work and behavioral health services are privatized, Zorn said he believes private companies will reinvest their dollars elsewhere and the menu of services will evaporate in Western North Carolina.

“Our primary goal is to establish a collaborative process with the board and staff of Western Highlands Network that will promote open communication and active engagement with consumers, providers and community stakeholders in the transition,” Smoky Mountain Center CEO Brian Ingraham said in a prepared statement.

Rick French, chairman of the Smoky Mountain board, said the board is pleased that the Western Highlands board chose to partner with their board.

“We both are committed to maintaining a strong local presence in the communities we serve, as well as being responsive to the unique needs of each county in our respective catchment areas,” French said in a news release.

Schoenheit said staff of both organizations will begin meeting to plan for a smooth transition, and plan to do so in a manner that will focus on providing information and regular communications with consumers, providers and all the community agencies and local governments in the combined service area.

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Peggy Manning

Peggy Manning is a contributing reporter for Carolina Public Press. Contact her at

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