Undoing the Kink in MeckLINK

In the past few weeks, I came across numerous articles discussing mental health and access to healthcare for those with mental illness in the Charlotte Area. This prompted me to do more exploration on the issue.  I discovered that Mecklenburg County has a program, at the heart of the controversy, called MeckLINK.  MeckLINK is an organization which serves individuals suffering from mental health, substance abuse, or developmental issues, and provides a resource for evaluation and referrals to community mental health providers. Most everyone knows someone affected by a mental illness; many of those affected are impacted by the current dispute between the Department of Health and Human Services in Raleigh and Mecklenburg County regarding the oversight of millions of dollars of Medicaid funding.  As a community member, I found myself primarily concerned over the stability and effective provision of mental health services to those in need, thus prompting my interest in the issue.

What is the current state of Mental Health in Mecklenburg County and what is MeckLINK? 

Mental health is seventh on the Mecklenburg County’s top-ten list of current health priorities.  A national study revealed that 19.8% of North Carolina adults have suffered with a mental illness.  In Mecklenburg County, more than 150,000 individuals who suffer from mental illness, including substance abuse, rely on Medicaid funding for care.  One method of addressing community mental health needs was the County’s formation of “MeckLINK.”

MeckLINK Behavioral Healthcare is a component of the Mecklenburg County government with a mission “[t]o assist persons, families and communities affected by mental illness, substance abuse, or developmental disabilities to achieve their life goals.” According to their website, MeckLINK provides individual assessment of needs and then coordinates with community mental health providers to “link” the individual with the appropriate services.  Most relevant to the current unrest is the fact that MeckLINK also provides these services for individuals with “limited financial resources or no insurance,” including individuals who rely on Medicaid for healthcare.  Delivery of services and sufficient funding constitutes a major concern for any community attempting to prioritize mental health, as well as to those who suffer from illness.

So, what is currently happening in the News? 

At the end of 2012, the North Carolina Health and Human Services Secretary, Albert Delia, made the decision to remove oversight of Mecklenburg County’s federal and state Medicaid funding from MeckLINK. This decision came as a shock to the County, who had already taken drastic steps toward implementing the MeckLINK program as a managed care organization, including spending millions of dollars to initiate MeckLINK and hiring hundreds of employees. Mr. Delia ordered the Medicaid program’s reassignment to a private corporation, Cardinal Innovations Healthcare Solutions.

This decision received major pushback, from not just the Mecklenburg County government, but also, from providers and residents within the County. The County was frustrated with the decision, not only because of the time spent establishing the program, but also because of its belief that MeckLINK would work. Through MeckLINK, Mecklenburg would become the only county in the state to operate a managed care organization at the community level. By keeping Medicaid money and oversight within the community, the County’s goal is to reduce costs and to increase accountability and care.

One reason for the decision to move oversight to a private corporation was Mr. Delia’s belief that MeckLINK would not be operational by the deadline of February 1, 2013. Thus, on his last day of office, Mr. Delia reassigned the program to Cardinal Innovations Healthcare.

This January, Mecklenburg representatives and the new North Carolina Health and Human Services Secretary, Aldona Wos, reached an agreement giving MeckLINK another chance. Mecklenburg County has until March 1, 2013, to launch the program. If the county fails to demonstrate that MeckLINK will function as promised, then its services, including the millions of dollars in state and federal Medicaid money, will be permanently reassigned and the hundreds of employees hired by the County will be out of jobs.  Additionally, Mecklenburg County will be out the millions of dollars it spent to initiate the program.

Thankfully, in the first of two progress reports, required by the January agreement, MeckLINK received a favorable report. According to WFAE, on  January 30, 2013, a state consultant indicated that MeckLINK is “on track” for meeting the March 1st launch deadline.

What is at Stake if MeckLINK fails?

The goal of giving MeckLINK oversight of the Medicaid funding “is to . . . reduce costs by keeping people out of institutions and to be more accountable and consistent with services.” Apart from losing control of the supervision of Medicaid dollars within the County, what else is at stake if MeckLINK fails?

According to a statement from the Mecklenburg County Public Information Department, the state’s decision to give MeckLINK more time will avoid litigation. Given the number of people who rely on Medicaid funding for healthcare and the need for access to mental health services, it is doubtful that litigation would assist the county’s goal of prioritizing mental health.

Additionally, given the ever-present newsreel concerning the dangerous inadequacies in mental health care, instability in the provision of mental health services is an alarming prospect.  The outcomes of untreated illness include substance abuse, homelessness, and physical ailments. The fight to overturn the initial reassignment declaration began as a result of concerns raised by both consumers and community advocates that reassignment would reduce the quality of services provided.

Finally, should MeckLINK fail, the county will be forced to lay-off hundreds of employees, and the $3 Million dollars used to initiate the program will have been for naught.

 My Perspective   

I am not an expert in Medicaid or in Mental Health services in Mecklenburg County, however, I am an interested and concerned citizen. After conducting research, I can say that I am pleased that MeckLINK is making progress. For the sake of mental health care in Mecklenburg County and the highest quality mental health services for individuals on Medicaid, I hope that the program will remain on track through the deadline.

I fear the delay that would result from MeckLINK’s failure. Additionally, I fear that removing oversight of these critical funds will result in the disjointed provision of care in Mecklenburg County.  Mecklenburg is the only county in the state attempting to establish a managed care organization of its own. I fully believe that the state should support a county fighting for a way to increase accountability and stability in mental health care. The state should support a county whose mission is to prioritize mental health for its citizens. As a community member, I support the County’s fight and hope for the success of MeckLINK.

By: Emily Ray

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