FAQs: Potential County Disengagement

Cardinal Innovations Healthcare — October 26, 2020
Cardinal Innovations has a long history of helping individuals by connecting them to treatment for mental health conditions, intellectual and developmental disabilities, and substance use disorders. We have been deeply rooted in our counties for decades and were both disappointed and surprised by the actions of elected leaders in some of our counties to begin the process of disengagement from Cardinal Innovations. We have and continue to be very active in each community to address ongoing concerns and have been making progress. We will continue our efforts to serve our members and partner with providers in these counties.

What are the concerns the counties are raising?

Some of the concerns voiced by these counties include issues that are systemic in nature, including child welfare, availability of services and providers, and emergency room utilization.

What is Cardinal Innovations doing about the concerns the counties are raising?

We have been extremely active in these and other counties to address some of these universal issues. We listened to counties’ concerns, specifically the DSS agencies as it relates to kids in custody. We want to ensure that children in the custody of the child welfare system get the services they need to achieve safety, stability, and a permanent home. In order to achieve this, we are changing how we work with our DSS partners across our region.

Through this new program, our goal is that children entering foster care receive timely screenings, assessments, and connection to a consistent Care Coordinator. To make this happen, we are expanding our network, and added 199 contracted providers this year. This helps us ensure a wide selection of community-based care to meet every child’s needs.

Under this new model, we will work more closely with the Departments of Social Services (DSS) to improve how quickly children in need are identified. This will allow us to provide trauma-informed screenings and assessments to get them the right care more quickly. The improved processes will ensure that we know immediately when a child in need of extra attention enters the custody of the child welfare system.

We are also working on a number of pilots and programs throughout our counties aimed at emergency room utilization, inpatient length of stays, and overall network development and expansion.

Do the counties have the authority to disengage?

The vote by both boards of county commissioners is essentially asking for permission to begin the process of disengagement, which is defined by statute. Once the process plays out, the final decision rests solely with the Secretary of Health and Human Services.

What does this mean for Cardinal Innovations members in our counties?

As mentioned, the process of disengagement, if successful, is a thoughtful and lengthy one. Our members and providers will experience no change at this time. We will continue to ensure access and continuity of care for members, and partner with our providers who deliver services and support to our members.

What does this mean for Cardinal Innovations providers in our counties?

We remain committed to putting our members at the center of all that we do, and we know that our providers share this same commitment. Cardinal Innovations members residing in our counties are still Cardinal Innovations members. There are no changes to the services you provide, who you interact with, or how you submit claims at this time. Please continue to provide services in the same way until further notice.

What is the response from DHHS and what is their position?

We have been in close contact with DHHS, and we understand that they are committed to a thoughtful process and will issue further guidance as the process moves forward. An important step in the process is the public comment. We encourage all of you to provide thoughtful and honest feedback.

The counties’ request is inconsistent with the North Carolina Association of County Commissioners’ (NCACC) recommendations regarding Tailored Plan regions, which were accepted by DHHS.

When will we know the result of their disengagement request?

The disengagement process is mandated by statute and lengthy. It will be months before a decision is made or a plan is put in place.

If I am a member on the Innovations Waiver, will my care coordinator and services transfer to Partners if disengagement happens?

If and when the counties transfer to Partners, everyone’s goal will be to ensure continuity of care for members. If you receive Innovations Waiver services today through Cardinal Innovations, they will be available through Partners. Partners has indicated a commitment to ensuring our providers are included in their network, and we will cooperate fully to help our providers understand if they are affected and what steps they can take. Care coordinators are the employees of Cardinal Innovations and would not be part of the transfer of services.

Why weren’t members and providers consulted about this change and how do I share my feedback?

We can’t speak to the process that the counties took to reach their decision. We do know that the process includes a 60 day listening period, and it is very important for all stakeholders to make their voices heard. Details on how to do this are posted on both county websites and Cardinal Innovations will publish an update on our own website and collect feedback to share directly with DHHS. We encourage all to share.

Who can members contact for more information?

At Cardinal Innovations, if they have any type of clinical or care concern, they should contact the Access Call Center at 800-939-5911. For general questions regarding potential disengagement, please visit our online feedback form.

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