Mental health change will impact thousands

Apr. 10, 2013 @ 06:14 AM

Thousands of people in Rutherford County who receive mental health services — Medicaid patients —  through Western Highlands Network are facing another change on July 31, 2013. But no one knows what the changes will be.

Friday afternoon, Western Highlands Network was advised by the North Carolina Division of Medical Assistance (DMA) that the contract to administer the North Carolina Medicaid Behavioral Health Plan was being terminated. The plan is frequently referred to as the 1915b/c Waivers. 

The letter, signed by Carol Steckel, Director of DMA, stated the end of the contract with Western Highlands Network will occur on July 31. There were no reasons for the decision given by DMA.

The Western Highlands Network includes eight western North Carolina counties, including Rutherford, Yancey, Madison, Henderson, Buncombe, Transylvania and Mitchell counties.

The board of directors is comprised of two people from each county, usually the county manager and a private citizen.

Serving on the board from Rutherford is County Manager Carl Classen and Alan Carver of Rutherfordton. 

Classen, who serves as treasurer, said the way the news was delivered on Friday afternoon was very upsetting and frustrating.

The news was put on the state's website Friday afternoon before notification to anyone.

"It caught everyone off guard," he said. "An email was sent to the executive director at 4 p.m. Friday. That was the only notification made."

"The chairman of the board had been trying to reach people at the state for several days because there had been rumors, but no information.

"The press released was sent from the state office, before Western Highlands are ever notified." "There had been rumors the state was going to force something, but never had anyone been contacted," Classen continued. 

Western Highlands Network has contracted with the Division of Medical Assistance continuously since Jan.3, 2012 to operate the Medicaid 1915 b/c Waivers for the Division.

Classen said that Western Highlands had experienced financial losses of over $4 million during the first six months of Waiver operations, but those losses have been reversed.

"We are on schedule to recoup 100 percent by June 30 this year," Classen said.

The state had been advised on many occasions the finances had been turned around and Western Highlands was very strong financially, Classen said.  

The decision not to renew the contract could be due to the changes in the administration in Raleigh, he said.

But the ways the news was delivered was no way to treat people, he continued. "Those who had worked so hard to fix things. . .this was very frustrating and we do not know anything else at this time."

Classen said Steckel said she would talk with county managers regarding the change. "But the staff does not know anything yet."

He said there is a meeting of the Western Highlands board of directors Friday morning in Asheville.

According to a statement from Don Reuss, director of provider network operations, Western Highlands, "Western Highlands Network will continue to execute all of our obligations and operations under our 1915b/c Waiver Contract. Western Highlands Network will keep the communities we serve informed and will work to assure services to our enrollees/consumers are not interrupted due to this development."

Reuss said in the statement communities can be assured that Western Highlands Network will continue to refer enrollees/consumers to our provider network to receive mental health, developmental disability and substance abuse services. 

Western Highlands will continue our current authorization process for providers to deliver services to enrollees/consumers.

Western Highlands Network will continue to process and pay claims to members of our provider network.

Services for consumers and providers will not be interrupted by this development.

Western Highlands Network will continue all of its Managed Care operations according to our contract with DMA."