MECKLENBURG COUNTY, N.C. — County leaders are questioning Cardinal Innovation’s service as a managed care organization. Tuesday night at a county meeting, Assistant County Manager Anthony Trotman described Cardinal’s service as not adequate.
"This is really bad," Commissioner Trevor Fuller said after Trotman's presentation. "We are in a mess and I fear that people's lives are being put at risk because of this."
Cardinal Innovations has served as Mecklenburg County's managed care organization since 2014. Cardinal coordinates mental and behavioral health treatment for the county. Cardinal receives funding from the state and federal level.
At Tuesday's meeting, Trotman highlighted numerous problems the county is having with Cardinal.
The problems include 43 children in an emergency residential placement were delayed or denied access to Cardinal’s network of care. A spokesperson for Mecklenburg County said it is difficult to provide a cost estimate to taxpayers based on those denials, but the county paid $1 million in ongoing care related to those youth. The county said 127 children experienced county-funded emergency placements in 2019.
Trotman said changes in funding to Mecklenburg’s Mobile Crisis team resulted in 52 missed calls for service since December 2019. The cut in funding resulted in Mobile Crisis having to cut mobile clinicians from eight to three.
The county also said it has encountered issues with Cardinal in the Services for Adults Guardianship Unit, Criminal Justice Services and in juvenile court.
“I was stunned, I can say I am extremely concerned,” Commissioner Susan Harden said. “It’s unfair to the patients, it is unfair to the families and it is unfair to the taxpayers.”
Cardinal was not invited to or notified about Mecklenburg County's presentation in advance, CEO Trey Sutten said. The organization is planning to meet with commissioners to address concerns.
“Anytime somebody levels criticism at your organization you are going to be disappointed,” Sutten said. “We are never opposed to criticism. We would just like it to be done in a constructive fashion, and I think that is where frankly the assistant county manager fell down from our perspective.”
Responding to the county’s claims, Sutten said Cardinal is opposed to putting kids in psychiatric residential facilities. This resulted in youth being denied or delayed in receiving access to Cardinal’s care.
In response to the funding changes to Mobile Crisis, Cardinal is now requiring Mobile Crisis to provide more proof of services. Cardinal is no longer cutting checks on a quarterly basis.
“We had essentially given them $1.3 million last year, when we said show us what you are doing, they were only able to produce claims for $250,000 worth of services,” Sutten said. “It makes you wonder where is the rest of that money going.”
Despite the presentation, Sutten said Cardinal is committed to making the relationship with the county work.
“I am never going to give up on this relationship because what is at stake are the members we are caring for and our members are our No. 1 priority,” he said. “I don’t think the next step in this process is disengagement. I am hoping to meet with the county commissioners to provide additional facts and context.”
The county could require Cardinal to produce a formal improvement plan. If that’s not satisfactory, the county may look for a new managed care organization.
“I think we are at the beginning of an investigation,” Commissioner Harden said. " think we are going to get information from Mecklenburg County and Cardinal and then commissioners are going to make the best decision for Mecklenburg County."
Two counties have switched their managed care organizations; Nash and Rutherford. The process is long and complex. It requires DHHS approval and a 9-month notice of termination.
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