Mecklenburg County commissioners met with the leadership team of Cardinal Innovations on Monday afternoon, in one of the final steps as the county prepares to surrender oversight of its mental health patients and millions of dollars in Medicaid funds. Commissioners had three requests for Cardinal, but little leverage to negotiate.
The state is forcing Mecklenburg County to surrender control of MeckLINK, the 8-month-old county agency that controls Medicaid funds for mental health, substance abuse, and disability services. The state ultimately just wants a handful of these organizations, so Cardinal Innovations, MeckLINK’s largest counterpart, is preparing to move in.
On Monday, commission’s Ad-Hoc MeckLINK Transition Committee met with Cardinal’s top people to discuss how a takeover would work. Commissioners want three things from Cardinal: a larger say in the agency’s operations, assurances that MeckLINK employees will have jobs at Cardinal, and reimbursement for start-up costs.
Commissioner Trevor Fuller led the meeting by asking for a larger say. Cardinal has a governing board, but has offered the commission just one slot on it, of about a dozen.
“Meckelnburg really is different,” Fuller said. “We have a million people here, and we are urban. The notion that Mecklenburg County would only have one representative is a difficult proposition to accept.”
Cardinal CEO Pam Shipmann argued that commissioners would control appointments to a local board, which could make recommendations but have no voting power.
“The board is firm about the structure,” said Shipmann.
Next, Fuller asked about MeckLINK’s staff.
“You know we have around 200 employees in MeckLINK,” he said. “Is it your expectation that you would hire the 200?”
Shipmann said MeckLINK employees would have to reapply for jobs at Cardinal, but would be given preference.
“We do nothing but gain by employing people that already know, are already trained, already understand the system,” said Shipmann.
And, third, the county is trying to recoup MeckLINK’s start-up costs.
“The county expended approximately $8.4 million of county money, not Medicaid money—Mecklenburg citizens’ taxpayer money—to create MeckLINK,” said Fuller. “I wonder if you’d talk to us about how we might recoup some of those dollars?”
“I’m not aware of the state making provisions for that in the past,” Shipmann replied. “You know, we used our own money for start-up, and they haven’t paid us back for that. So, I’m not sure there’s a way that could be done.”
Commissioners pushed back by identifying a $25 million investment fund they suggested Cardinal could use. But, all three requests received three less-than-inspiring answers for the commission. And that is because Cardinal has the upper-hand in the negotiations. The county has to give up MeckLINK next April and Cardinal has emerged as the only taker.
The commissioners voted for county staff to finish negotiations. Tonight, the full commission will vote on that proposal.