The North Carolina Department of Health and Human Services, including the Division of Health Services regulation that monitors adult care homes, is housed on the campus of the former Dorthea Dix state mental hospital in Raleigh. Frank Taylor / Carolina Public Press

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North Carolina’s seven regional managed care agencies for behavioral health are receiving $30 million so they can keep a variety of programs running during the coronavirus crisis.

The money, which an N.C. Department of Health and Human Services spokesperson said represented unused Medicaid funds, has been shifted to state’s seven Local Management Entities/Managed Care Organizations, commonly called LME/MCOs. These are multicounty local government agencies governed by commissions that member counties appoint, which are then overseen by DHHS.

The LME/MCOS manage care for beneficiaries receiving mental health, developmental disabilities and substance abuse services, who are on Medicaid, uninsured or underinsured.

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In a March 20 letter to the seven LME/MCOs, DHHS said the primary objective of the $30 million transfer is to keep such services funded during the current epidemic. The letter also gave the LME/MCOs authority to use up to 15% of risk reserves to support contracted providers, but with a significant qualifier.

The agencies, DHHS said, would be able to use their reserves to support providers that are “maintaining consumers in their existing residential placements, utilizing telehealth capabilities to the maximum extent possible, providing services that keep consumers from needing access to emergency departments and inpatient services, and otherwise making efforts to deliver high-quality services during this crisis.”

The department’s caveat that local providers make every effort to keep their clients out of hospitals is part of a concerted campaign to maintain as much bed space and equipment as possible as the number of COVID-19 cases rises.

The state is also updating clinical coverage policies to waive “to the fullest extent possible” all face-to-face provider requirements and LME/MCO contract requirements that mandate face-to-face client care interventions.

The seven regional commissions covered by the department’s directive include Alliance Health, Cardinal Innovations Healthcare, Eastpointe, Partners Behavioral Health Management, Sandhills Center, Trillium Health Resources and Vaya Health.

Victoria Whitt, the CEO of Sandhills Center in Moore County, said her agency’s share of the $30 million, along with funds drawn down from Sandhills’ risk reserve and an increase in Medicaid reimbursement rates, will keep behavioral services intact during the coronavirus crisis.

“These state-funded increases were made possible only through the support of DHHS identifying and making available a significant increase in state funds to assist local communities,” Whitt told Carolina Public Press.

“Our hope is the announced funding increases will be used to stabilize the workforce of the provider agencies for these critical behavioral health services.”

In addition to releasing the $30 million, DHHS told the agencies that it was also moving up monthly payments appropriated by the General Assembly to support safety-net services for the uninsured.

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“To help support cash flow of the LME/MCOs, we are paying out the remaining single-stream monthly payments for state fiscal year 2020, which is $54 million,” said DHHS spokesperson Kelly Haight Connor.

“This is money they would have gotten already. They just get it sooner.”

Neil Cotiaux

Neil Cotiaux is a contributing writer for Carolina Public Press. He is based in Wilmington. Send an email to info@carolinapublicpress.org to contact him.

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