Proposed last week, the rejected draft outlined specific cuts that could save the organization a projected $667,000 per month. However, these cuts also included rate cuts to services — cuts that came at too high of a price, said providers, families and patients who attended the board’s most recent Aug. 10 meeting.
“Please don’t jeopardize my sons’ lives and the lives of so many others for these budget cuts. It’s easy to forget that these are living, breathing people that we’re talking about here, and not just numbers and dollar signs,” Rebecca Demmer told the board. The mother of two autistic children, she added, “My sons can be valuable assets to the community if they have the right resources in place, and we can’t do this alone.”
Western Highlands provides mental-health, substance-abuse and developmental-disability services to residents of Buncombe, Henderson, Madison, Mitchell, Polk, Rutherford, Transylvania and Yancey counties. At the request of its board of directors, Western Highlands posted the proposed plan online for public comment. By the morning of Aug. 9, a total of 35 comments were received. All but 10 of the comments were from providers or agencies in the Western Highlands provider 350-member network.
On Jan. 3, Western Highlands changed the way it operates, becoming just the second managed-care organization in North Carolina (the first one, Piedmont Behavioral Health, launched in 2005). Under the General Assembly’s 2011 statewide Medicaid expansion, all local management entities must make the same switch by next year. However, with the discovery of an almost $3 million shortfall, Western Highlands has had a difficult time becoming an MCO. After its first six months of operation, the board fired its CEO Arthur Carder Jr.
Now, the board must face the numbers and balance the budget while adhering to the state’s 10-page plan of correction. One aspect of the plan involves hiring a consultant to analyze claims data and assist in business management practices — a process that board members began at the last meeting by listening to four presentations from potential consulting groups.
On Friday, the board narrowed it down to two different groups and created an ad-hoc committee to come back with a formal recommendation. And the board must move quickly with a hiring decision, since the plan of correction dictates a consultant must be contracted by Sept. 3.
But balancing the budget with the concerns of the people affected by Western Highlands services remain the biggest concern, said board chair Steve Smith. "We have to be accountable to a lot of people, our communities, our providers, our consumers, and we’re going to do our very best to balance those needs and interests,” Smith said after the meeting. “We're going to be accountable to the people that we serve, period.”
But Henderson County City Manager Steve Wyatt also said the board needs to be accountable to the people that Western Highlands hires while the organization tries to satisfy the plan of correction.
“I would hate to think that we would hire somebody in the next week and then 45 days from now say, ‘Sorry,’” he told the board.
After brief discussion, the board approved a temporary hiring freeze. The freeze, however, will not affect the claims or IT department that the interim CEO Charles Schoenheit told the board is understaffed.
In other business, board members reluctantly adopted state fund budget cut recommendations that total about $1.5 million toward the end of the 5-hour meeting. Putting forward the official motion, Wyatt said, “I would offer a motion that we reluctantly and begrudgingly —”
“Makes us want to throw up,” interjected Mandy Stone, Buncombe County assistant county manager and director of social services.
“— Implement and accept the recommendation,” Wyatt concluded.
These budget cuts came from the state and affect those who do not have Medicaid coverage. “Some of the things that do happen are not under our control, and we just have to deal with it the best we can,” Smith said.
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