Citing Community Concerns About Care Disruption, Cardinal Innovations Expresses Disappointment in Commissioners’ Vote

Cardinal Innovations Healthcare — May 20, 2021
Winston-Salem, NC, May 20, 2021 – Citing concerns raised by members, providers, and the community, Cardinal Innovations expressed disappointment in a vote by the Forsyth County Board of Commissioners to formally request to break from the organization. Comments expressed through the recent 60-day public comment period showed the public’s concern about changes in care coordinators, lack of community input into the decision, and added confusion due to statewide Medicaid transformation.
The official disengagement decision will ultimately be determined by the Secretary of the North Carolina Department of Health and Human Services.
“Members of the community, including some who are the most vulnerable among us, made clear through the public comment process that they want to remain with Cardinal and appreciate the care they get through Cardinal’s network of providers. We are disappointed in this vote because we know our members and their families are concerned about the disruption that would be caused by disengagement. We hope these community voices are heard and carefully considered by the Department of Health and Human Services during the final decision process,” said Trey Sutten, CEO of Cardinal Innovations.
He continued: “Cardinal continues to strengthen our services in the county, including how we care for children involved with the foster system and by expanding our network of providers. Cardinal Innovations is committed to serving our members in Forsyth County and will continue to work directly with county officials and local stakeholders to help our members be safe, and live full lives.”
All public comments can be viewed [here]. The selections of comments below expressing concern about disruption are taken directly from the page and have been condensed for length:
Scott W. Davis: “Cardinal has been serving our community for years, and their work and the relationships care coordinators have made with members and their families should not be disrupted at a time like this.” (Page 95)
Michael Tyree: “I think ‘Change’ is very difficult as it, for those of us who aren't disabled. So I can only imagine how devastating and disrupting this sort of change might be to someone who is disable or suffers with a mental disorder. We should do whatever it takes to create a sense of normalcy for these individuals. Anything else would be cruel and inhumane.” (Page 9)
Families Together Inc., CEO Dan Zorn: “Medicaid Transformation 2021 is in full play. … Moving to another LME/MCO during this dust storm may cause significant confusion for Consumers, and the Providers who serve them.” (Page 28)
National Alliance on Mental Illness NW Piedmont Chapter, President Louise B Whealton: “I celebrate Forsyth County’s involvement in the mental health care of its citizens. The proposal to implement TWO major changes at almost the same time, however, concerns me greatly, especially now while mental health needs are increasing due to the pandemic.” (Page 3)
Debra M Rhodes: “The potential fallout to individuals, their families, & the staff of Cardinal Innovations, is immeasurable. Why? Why wasn't the community asked for their input prior to this decision?” (Page 16)
Forsyth County

Read all the public comments from Forsyth County.

In November 2021, Cardinal Innovations announced a County Action Plan to strengthen support for individuals in Forsyth County with mental and behavioral health needs. The Plan of Action was created at the request of and with feedback from Forsyth County staff.
Cardinal Innovations’ Plan of Action progress to date for Forsyth County includes:

Service Expansion and Enhancement

  • Faster decisions on all treatment authorization requests, with 94 percent of requests for children involved in foster care processed within 72 hours as of May 15
  • New agreements with three major behavioral health providers to serve more youth who represent the most complex and challenging cases.
  • Added five new therapeutic foster care agreements in December to support the needs of children and families in Forsyth County.
  • Added 48 new services for its members since April 2020.
    • 28 of the services were added from November 2020 through March 2021 and include 4 new providers, 11 providers with new sites and 4 providers with additional services added to their contract.
    • In March 2021, five new services were added in Forsyth County in Enhanced Crisis Response, Family-Centered Treatment, In-Home Therapy Services, and Residential Supports.

Caring for Children and Families

  • Cardinal Innovations has aligned licensed, clinical staff with county DSS offices across all 20 counties it serves.
  • Cardinal Innovations is now assisting in-home teams to support pre-custody efforts in Forsyth and Mecklenburg Counties. This focus on early intervention and prevention is critical to helping families remain intact and stable.
  • Expanded the Youth Villages Intercept program to all of the counties Cardinal Innovations serves, including Forsyth. The program teaches in-home parenting skills to safely prevent children from entering out-of-home care or to reunify them with family as quickly as possible.
  • Beginning in November, Cardinal Innovations no longer requires Therapeutic Foster Care (TFC) providers to contract at the site level for homes (Cardinal Innovations contracts with 13 of 14 TFC providers in the county).

Emergency Department Strategy

  • Collaborating with Wake Forest Baptist and Forsyth Medical Center (Novant) to develop an ED Peer Support Specialist program (Cardinal Innovations’ goal is to identify providers who can have a response time in less than 90 minutes for a face-to-face encounter).
  • Convening meeting with SPARC and Wake Forest Baptist to introduce the Enhanced Crisis Response program.
  • Collaborating with local Behavioral Health Urgent Care (BHUC) on serving low-acuity, non-emergent Members.
  • Discussing engagement strategies to support members in attending 7-day follow-up appointments post-ED discharge.
  • Participating in clinical rounds at Wake Forest Baptist and Novant; staff has been assigned to these facilities to support discharge planning for ED and inpatient care.

Community Engagement

  • New Regional Affairs Director.
  • Assigned a Cardinal Department of Social Services liaison to Forsyth County’s Department of Social Services. This individual participates in consultations regarding children who are involved with Child Protective Services or in-home services.
  • Developing Involuntary Commitment initiatives, inclusive of law enforcement, hospital, provider, and peer support organizations.
  • Partnering with local health departments to provide Narcan to counties in support of law-enforcement efforts to combat opioid overdose.
  • Conducting Medicaid Transformation trainings to help stakeholders prepare for upcoming changes to the Medicaid program.

About Cardinal Innovations Healthcare: Cardinal Innovations Healthcare is a specialized health plan and care coordinator for Medicaid recipients and the under- and uninsured in North Carolina with complex behavioral and special needs. Cardinal Innovations connects people with treatment and support for mental health, intellectual and developmental disabilities, and substance use disorders through a network of providers in their communities. The organization serves this important role in 20 counties. In 2020, Cardinal Innovations administered nearly $850 million for the care of 825,000 people in the region and invested more than $50 million to improve support systems and to respond to the pandemic. Cardinal Innovations also works with local governments to address public health concerns such as homelessness, suicide prevention, child welfare and domestic violence through education, engagement and outreach.

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