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Frequently Asked Questions for Members & Families 

County Realignment

 Cabarrus, Union and Stanly County Boards of County Commissioners have passed resolutions to disengage from Cardinal Innovations Healthcare and align with Partners. Each of the three counties have submitted their requests to realign to the Secretary of North Carolina Department of Health and Human Services. 

Forsyth County’s Board of County Commissioners voted on March 4 to begin the process for realignment. To review the plan, visit https://forsyth.cc/disengagementplan.aspx.

Davie County’s Board of County Commissioners voted on August 2 to pursue a relationship with Partners.

The North Carolina Deparment of Health and Human Services has approved each county’s request for realignment. Individuals in CabarrusUnion and Stanly counties who currently receive Medicaid or State-funded Services for intellectual or developmental disabilities, mental health or substance use disorders through Cardinal Innovations Healthcare were automatically enrolled with Partners on September 1, 2021. Individuals in Forsyth and Davie counties who currently receive Medicaid or State-funded Services for intellectual or developmental disabilities, mental health or substance use disorders through Cardinal Innovations Healthcare will be automatically enrolled with Partners beginning November 1, 2021.

 Citizens of realigning counties who have Medicaid or have no health insurance, and who receive Mental Health, Substance Use Disorder or Intellectual and Developmental Disabilities services will be impacted by this change. If realignments are approved, your services would be managed by Partners. 

Members currently served by Partners will not be impacted by this change. 

Yes. Partners will work with providers currently serving realigning counties to include them in Partners’ Provider Network. Partners will honor member service authorizations, annual plans and other documentation and decisions essential to ensure a smooth transition. 

Continuity of care is Partners’ top priority for individuals receiving services in realigning counties. It is critical to ensure that the transition process is as seamless as possible for members and their families. Partners will make every effort to employ current care managers who are supporting members in realigning counties; and, consistent with Partners’ philosophy and model of a broad and open provider network, we will contract with existing providers in those counties. We will also work to identify highest-risk members in care to provide them with additional support during the transition. 

Partners has reviewed the currently available “In Lieu Of” services offered to members in Forsyth County and are confident that there will remain the same or similar services after transition. Partners has many “in lieu of “services available to members, many the same as Cardinal. If during the ramp-up process any are discovered that are currently available and do not crosswalk to one of Partners such services, Partners will work with DHHS to have those approved as soon as possible, expecting to finalize before the transition date. Those that are currently offered by Partners and not by Cardinal will also become available to Forsyth residents at the time of transition. 

No. If you are currently receiving Mental Health, Substance Use Disorder or Intellectual/Developmental Disability services through Cardinal, and remain eligible for services, you will be automatically enrolled with Partners with the effective date of the realignment, should it be approved. 

Partners CFAC operates as an independent and self-governing group that provides valuable insight, feedback, suggestions and guidance to Partners’ Board of Directors and senior leadership. The CFAC membership consists of three members/family members from each of the current counties. There currently are no regional or county level CFAC groups. Partners supports the CFAC’s determination of the best structure to meet their needs and would support any additional regional or county level group if that was the will of the members. Partners has a very effective CFAC that collaborates closely with the governing board and leadership team. In addition, Partners’ Board has three CFAC representatives who are voting members of the Board. 

Partners does have bilingual staff to support our members and we are currently expanding our bilingual staff to meet the growing needs of members and families. Additionally, we offer immediate, simultaneous interpretation for members who call our Access to Care Call Center or other Partners’ staff who support members.

We routinely translate printed member information and education materials into Spanish and have the ability to quickly translate these materials for members who speak other languages.

If you have additional questions, please feel free to reach out to our Member Engagement Department at 704-884-2729. Our Member Engagement team is happy to help and can provide interpretation support if needed.

No, the state formula stays the same as long as the member transfers within the same state.

Members now receiving (b)(3) services through Cardinal will be able to continue receiving these services after transition to Partners. This includes the (b)(3) DI services (sometimes called Innovations look-alike services). 

Members who are self-directing their services through Innovations or the (b)(3) DI service array will also be able to continue doing so, regardless of whether using the Employer of Record model or the Agency with Choice model. 

Community guide is billed as a monthly unit so there is no minimum or maximum number of hours per quarter.

Community Living Supports, once implemented, is available for all LME/MCOs to add to their service array.

The minimum age for Day Support is 16 years old.

Community Living Supports is a State-funded service. It may be requested, when available, by members age 16 years old and over who are currently waiting for Innovations services, or members not currently waiting for Innovations.

Community Living and Supports and Day Supports services are funded with state dollars. Members do not need to be enrolled with Medicaid to access these services.

Once implemented, Community Living and Supports will be available for all LME/MCOs to include in their service array.

 

The NC General Assembly must allocate funding for additional NC Innovations slots before the NC Department of Health and Human Services would submit a request to CMS to approve additional slots.

When a member leaves the Innovations Waiver during the waiver year, the slot is “frozen” until the end of the waiver year.  The member can re-enter that same slot before the waiver year ends.  If the waiver slot is vacant at the end of the waiver year, it is then available as either a reserved capacity slot or a routine waiver slot that can be offered based on longest waiting per county

There are flexibilities due to Appendix K with the Innovations Waiver currently, but the normal requirements are outlined in Clinical Coverage Policy 8P, Attachment G: Relative as Provider.

This will not have any effect on member eligibility for the Registry of Unmet Needs when offered an Innovations Waiver slot. DSS determines if member income exceeds the allowable income amount for Medicaid.

Please see the link for detailed information on waiver programs in the 50 states i.e. eligibility requirements, number on the waiting list, etc. http://medicaidwaiver.org/  Waivers.

No, member enrollment dates can only transfer to counties within NC. Other states may have other waiver plans to support members qualifying for IDD services.

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