To: jjennings@alexandercountync.gov, rmayberry@alexandercountync.gov, jmoose@alexandercountync.gov, drobertson@alexandercountync.gov, lyoder@alexandercountync.gov
Cc: MaryKShort@aol.com
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Dear Commissioners: I have appeared before you and I have tried to tell you about my concerns regarding this change from a statewide CAP-MR/DD waiver to an LME/MCO run NC Innovations waiver. I have expressed my concerns about this change to an "at-risk insurance company." I am hopeful you will take the time to read this series of newspaper articles regarding ECBH (East Carolina Behavioral Health).
I am asking that you contact me by email to tell me that this is NOT also true of what is happening at SMC (Smoky Mountain Center) which is due to "go live" with the change on July 1st.
Mary K. Short
828-632-5888 or 704-451-4144 (cell)
In a message dated 6/25/2012 10:31:57 A.M. Eastern Daylight Time,
Begin forwarded message:
From: "Crystal J. De la Cruz "
Date: June 25, 2012 10:14:44 EDT
To: undisclosed-recipients:;
Subject: NC Medicaid Waiver - financial mysteries with ECBH
Dear US Government Officials, members of the NC General Assembly, DHHS representatives, and fellow concerned parents and NC Citizens,
Please find attached 3 news articles from The Daily Advantage, a small paper in the eastern part of the state which highlights some very frightening issues surrounding the Medicaid Waiver and budgetary concerns expressed by Camden Co. Commissioner Mike McClain, also an accountant and ECBH board member.
Also attached, my recent open letter and outline (with supporting documents) addressing related concerns, in the event you have not had an opportunity to review.
Kind regards,
--
Crystal J. De la Cruz - Hopper
Mother, Advocate & Concerned Citizen
When we allow the value of human life to be determined by capital gain, when we sacrifice the well-being of the most innocent among us to compensate our own shortcomings, and when we judge the worth of our most fragile, not by their character nor intention, but rather their abilities – We Are in Crisis.
"The moral test of government is how it treats those who are in the dawn of life . . . the children; those who are in the twilight of life . . . the elderly; and those who are in the shadow of life . . . the sick . . . the needy . . . and the disabled."
--Hubert H. Humphrey
The Daily Advance ECBH 'lost' $11.4 Million - East Carolina Behavior
Posted by:
Date: Sun Jun 24, 2012 1:05 pm ((PDT))
_Click here: The Daily Advance_
(http://www.dailyadvance.com/news/mclain-ecbh-8216lost8217-114m-1113601)
NC Advocacy: As you have to subscribe to see the article - I've pasted it
below.
The Daily Advance
June 24, 2012
McLain: ECBH ‘lost’ $11.4M
“This is basically Albemarle Mental Health on steroids.”
-quote by Mike McLain Camden commissioner
By Reggie Ponder
East Carolina Behavioral Health — the Greenville-based agency that
oversees mental health services in the region — has lost $11.4 million in the
current fiscal year and is losing about $1 million a month, an ECBH board
member charged last week.
Camden County Commissioner Mike McLain, who sits on ECBH’s Area Board of
Commissioners, said the current management at ECBH is 10 times worse than
Albemarle Mental Health Center’s ever was.
“This is basically Albemarle Mental Health on steroids,” McLain said,
referring to the now-defunct organization that was shuttered in 2009-10 in the
wake of a state audit that uncovered glaring mismanagement.
But ECBH Director Leza Wainwright categorically denies that ECBH is losing
money. “We are not losing money,” Wainwright said Friday when asked
about McLain’s concerns.
McLain, an accountant and an instructor in accounting at Hampton
University in Virginia, said he noticed while reviewing financial statements
recently that revenues do not match expenses.
McLain said when he asked about the discrepancy, which ECBH records show
amounted to some $11.4 million for the 2011-12 fiscal year as of May 31, he
was told not to worry about the figures.
McLain said he was told that ECBH expected to lose $6 million when it
launched its Medicaid waiver program but the actual loss has been more than $11
million. ECBH has managed Medicaid funding for programs serving people
with developmental disabilities under a waiver system since April.
Wainwright and ECBH Assistant Director Joy Futrell insist the loss exists
only on paper and is the result of board-approved fund balance transfers
coupled with an especially conservative way of accounting for potential
liabilities. They say the accounting method was recommended by a consultant as
the safest way to begin ECBH’s foray into the Medicaid waiver field.
A financial report for May presented to ECBH’s Finance Committee shows
expenses of $87 million as of May 31 but revenues of only $75.6 million — a
shortfall of $11.4 million.
While Wainwright acknowledged that while the report shows a net loss of
$11.4 million, those figures reflect one-time transfers from fund balance
that were authorized by the board, she said.
ECBH transferred $6.7 million out of fund balance into a retiree health
insurance trust account and $4.5 million for the Medicaid waiver start-up.
She said the reality is that ECBH is not losing money but is between $1
million and $1.5 million to the good.
Futrell explained that once ECBH gets further along with the Medicard
waiver program, staff will be able to estimate Medicaid service liability more
precisely.
“Typically and in the future, ECBH will estimate outstanding Medicaid
service liability utilizing data which considers providers’ billing history,
specifically considering the average number of days it takes for providers to
bill and get paid,”
Futrell said in an e-mail response to The Daily Advance. “Due to the
waiver starting up in April, there was no history to estimate the outstanding
Medicaid liability and there was no authorization data to utilize, so the
recommendation was made to use the most conservative approach in estimating
the Medicaid liability to be 100 percent of what was not spent for Medicaid
services based on the budget.”
As an example, and noting she was using “completely made-up numbers” for
the purpose of the explanation, Futrell said that if ECBH had budgeted $500
per month for Medicaid outpatient services but spent only $200 in a given
month, ECBH still considered the entire $500 a liability.
This accounting method was chosen because it is the most conservative,
assuming that all Medicaid service funds will be spent, she said. ECBH plans
to use the conservative approach until the agency has enough history with
providers to be able to make accurate estimations, Futrell said.
But McLain said ECBH is making light of very real risk. The new ECBH model
is essentially that of an insurance company, he said.
“There’s a lot of risk in being an insurance company,” McLain said. “You’
re on the hook for potential liabilities.”
Although the ECBH board has been assured there are risk management
procedures in place, board members have not been informed of what those procedures
are, he said.
“That scares the heck out of me,” McLain said.
The ECBH Area Board of Commissioners will meet Tuesday at 7 p.m. in the
EMS building at 205 E. Main Street in Williamston. The meeting will include a
public hearing on ECBH’s 2012-13 budget.
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