DHHS approves management agreement between Western Highlands and Smoky Mountain

Four days after the board of Western Highlands Network unanimously adopted a management agreement with Smoky Mountain Center, the state approved the transition, too.

Last summer, Western Highlands, the Asheville-based managed care organization provides mental health, substance abuse and developmental disability services in Buncombe, Henderson, Madison, Mitchell, Polk, Rutherford, Transylvania and Yancey, a report revealed the organization’s multi-million dollar deficit. At the time, it was unknown what would happen to Western Highlands. However, in the last few months, the Western Highlands board actively searched for a solution and unanimously voted to pursue a merger with Smoky Mountain.

After last week’s special meeting, county manager for Buncombe County and Western Highlands board member Mandy Stone told Xpress that the transition reflects the intention of both boards to keep services close to home.

“For consumers, it [the management agreement] really assures consistency for them in that the actual management of the state medicaid dollars and services move to Smoky, that the contracts with providers are honored and that consumers are automatically enrolled,” Stone said. “For them, it’s assuring consistency of services while we move through the merger processes.”

For Smoky Mountain, this is familiar territory. Two years ago, when New River Behavioral Healthcare board members realized that internal financial difficulties would mean closing the doors, Smoky Mountain absorbed its service area. Smoky Mountain currently provides mental health, substance abuse and developmental disability services to 15 counties. With the addition of Western Highland’s coverage area, Smoky Mountain’s coverage would expand to 23 counties.

The press release about the state’s approval of the management agreement can be found below.

Press release

From NC Department of Health and Human Services

May 23, 2013 – According to Charles Vines, Chair of Western Highlands Network (WHN), the North Carolina Department of Health and Human Services (DHHS) has “approved the request of WHN to enter into a Management Agreement with Smoky Mountain Center (SMC) that was requested in the Partnership for the Future Transition Plan which was jointly submitted by Western Highlands Network (WHN) and Smoky Mountain Center (SMC). While the Management Agreement is the first step in our partnership, DHHS has asked that we work to develop our consolidated organization by July 1, 2014.”

The Partnership for the Future Transition Plan, was also submitted to Division of Medical Assistance which manages Medicaid funds in North Carolina, and contracts with LME/MCOs for the management of Medicaid behavioral health and intellectual/developmental disability services as well as the Division of Mental Health, Developmental Disability and Substance Abuse Services, which contracts with LMEs for the management of state funds allocated by the NC General Assembly for behavioral health and intellectual/developmental disability services.

Mr. Vines stated that “DHHS has approved the transition of both of these contracts to SMC effective October 1, 2013 instead of the original date of August 1, 2013. “This extension is critical to the efficient and smooth transition of care for people in our communities and will ensure that we are able to work in an orderly process for enrolling all of the WHN providers into the SMC network”. We are very pleased that the Department saw the very real jeopardy that such an abrupt change for our most vulnerable citizens.

Mr. Rick French, Chair of the Smoky Mountain Center Board of Directors related “now that we the approval of DHHS to move forward, and have this key milestone set, we can really begin the work that will be needed amongst staff and the Boards to establish the structure for a new entity to serve the 23 western and foothills counties of North Carolina.

Mr. French continues by highlighting the “strength that will be gained by bringing the rich histories, highly motivated and qualified staff, an excellent network of providers, and a keen focus on high quality consumer care together into one 23 county, public managed care organization.

Mr. Brian Ingraham, CEO of Smoky Mountain Center agrees. “As we move through this year and develop into a single organization, our primary goal will be to evolve in a manner that will allow is to be successful in the Governor’s Initiative. This will include the need to identify and reach out to out to existing and new partners in the world of physical health. Many of our care coordinators and staff involved in community-based care spend a great deal of time with the Carolina Care of North Carolina (CCNC) staff to promote an integrated model of care for those we mutually serve.

As a way of supporting the Partnership for the Future Transition Plan, the Secretary of DHHS, will be working with the organizations to deal with key organizational needs and have appointed staff support from both the Divisions’ of Medical Assistance and Mental Health/Developmental Disabilities and Substance Abuse Services to be a part of the evolution of a new organization.