Services to continue through WHN transition

Apr. 15, 2013 @ 10:49 AM

After the announcement that the North Carolina Division of Medical Assistance (DMA) will terminate its contract with the Western Highlands Network for providing 1915 (b)/(c) Medicaid waivers, state and local officials are ensuring that services provided by Western Highlands will continue without interruption.

The question still remains however regarding just how that will be accomplished.

On Thursday county managers from the eight counties represented by the Western Highlands Network met with DHHS officials and DHHS Secretary Aldona Wos in Raleigh to discuss the contract termination.

In a letter to county officials as well as state lawmakers issued Friday, Wos said that "consumers receiving necessary services will continue to be served by their current providers while the Western Highlands Network and DHHS work together to achieve a smooth transition … "

Also on Friday, the Western Highlands Network board met to discuss the termination. Through emails obtained by The Daily Courier, Henderson County Manager Steve Wyatt recommended an extension of the July 31 termination date to Dec. 31, 2013.

"Without this action I have strong doubts regarding our [WHN and State of NC] ability to reasonably transition the program," Wyatt said in the email.

Classen said that one potential transition can be to use the Western Highlands Network as a test program under Gov. Pat McCrory's "Healthy North Carolina" vision of integrated care.

"We are very hopeful that, between the DMA staff and the Western Highlands staff, there can be a pilot program that will offer comprehensive care in our area," said Carl Classen, Rutherford County manager and treasurer of the Western Highlands Network board.

Last week, DMA issued a press release indicating it was terminating the provider contract before sending an email to Western Highlands officials of the same intent.

According to Julie Henry, acting director of public affairs for the Department of Health and Human Serivces (DHHS), and department with direct oversight of DMA, the contract with Western Highlands is being terminated "without cause" which is permissible under the terms of the provider contract.

However, developments between late 2012 and January 2013 showed that Western Highlands was in financial troubles to the tune of a $4 million deficit. The findings of the financial issues did not escape state officials.

"We've been monitoring Western Highlands through the process and having regular reports and reviews of the operations," Henry said. "The department was very much aware of what was happening with Western Highlands and even how they had addressed some of the issues that had come up."

Western Highlands was the first of 10 programs known as Managed Care Organizations (MCO) implemented through legislation in 2011. Piedmont Behavioral Health was a pilot program prior to the legislation being enacted. The Western Highlands Network serves eight counties in western North Carolina, including Madison, Mitchell, Yancy, Buncombe, Henderson, Transylvania, Polk, and Rutherford counties.

Henry said that Western Highlands is the only MCO that is having its contract terminated.