News

Overhaul of North Carolina’s Medicaid program moves one step closer

If you’ve been reading about Medicaid reform for years, but not fully understanding how the state plans to reshape the program that currently serves 2.1 million North Carolinians, hop over to NC Health News this weekend and read the latest article by reporter Sarah Ovaska-Few.

This week the state Department of Health and Human Services (DHHS) released a Request for Proposal (RFP) for private insurance companies that wish to takeover the $14 billion state-managed health care system for low-income children, seniors and those with disabilities.

As Ovaska-Few and reporter Rose Hoban explain:

DHHS Sec. Mandy Cohen

All told, private companies or commercial managed care companies will earn about $6 billion of that annual total, tallying up to $30 billion over five years.

“It’s 2.1 million folks in the program, right now, and we think it’s about 1.6 million who will move into the program once it’s fully phased into managed care,” said Mandy Cohen, the N.C. Department of Health and Human Services secretary, in a call with reporters Thursday. Many of these are children and pregnant women, people for whom care is relatively cheap.

The remaining 500,000 – such as low-income seniors in nursing homes and people with mental health and intellectual or developmental disabilities – have more complex needs. Cohen said they will be phased into the managed care system in later years.

Medicaid recipients will have four statewide plans to choose from, as well as up to 12 smaller provider-led entities, which could be led by hospital systems or other localized health care groups.

Selected prepaid plans will come on for an initial three years, with the option to renew the contract, and renegotiate rates, for an additional two years, Cohen said.

Seeking budget stability

The major shift in Medicaid management comes at the behest of the N.C. General Assembly, which decided in 2015 to move Medicaid away from being managed by DHHS in favor of contracting the program out to commercial managed care companies or hospital-led health care systems to oversee patient care. Members of the Republican-led state legislature had voiced their displeasure for years about fluctuating Medicaid expenditures and said moving to a system where the state prepays an upfront price for each patient will lead to more budget stability and savings.

North Carolina is the largest state that does not currently have big swaths of its Medicaid program run by managed care companies.

Thursday’s RFPs make up the largest set of contracts the state’s health department has ever sought, with an estimated $6 billion a year in combined state and federal dollars expected to be contracted out, Cohen said.

But it’s not clear how much the move will save, if it even saves anything.

Read more

Higher Ed

Former UNC BOG members speak out on good governance, take current members to task

In a rare move, a group of ten former members of the UNC Board of Governors penned a letter this week taking current board members to task for what they describe as “clearly bad governance.”

The letter, posted Wednesday on the Higher Education Works website, criticized the board for disregarding the UNC President’s recommended candidate for the Chancellor’s post at Western Carolina University. Instead current board member Tom Fetzer, who had some interest in the WCU job for himself, sought out a third party to do a background check on the recommended candidate.

Former members also expressed their displeasure in ongoing efforts to micromanage and undermine the decisions of system President Margaret Spellings.

Here’s an excerpt:

A lot of very smart people have judged our University System to be the most valuable asset this state has. Our system of higher education is respected nationally as one of the best. It is what has set this state apart for decades. It has helped make us the forward-thinking state we have always been considered. Without it, we would not have the Research Triangle Park, one of the most successful research parks in the world, fostered by visionary leaders in business and academia.

Unfortunately, it appears our Board of Governors has become increasingly politicized, and some members are conflicted. Politics has no place in the selection of members, and any conflicts of interest must be avoided. Boards must have a high level of independence and professionalism to be effective.

What we saw last month was not good governance. Our state, our President, our faculty, our students, our entire University System deserve better. What we witnessed will negatively affect the quality of people willing to come to our Universities as Chancellors, faculty and staff.

Good governance has many positive aspects. Maybe the most important is to attract and retain great talent and leadership. We ask our legislators and our Board of Governors to remember that they serve the people of North Carolina. They can and should do better.

The letter is signed by the following former members of the UNC Board of Governors: Paul Fulton, Ann Goodnight, Fred Eshelman, Derick Close, Brad Wilson, Jim Deal, Peaches Gunter Blank, Leroy Lail, Phil Phillips and Jim Babb.

You can read the full letter here.

Current Board Chair Harry Smith tells the Raleigh News & Observer’s Jane Stancill that the assessment is unfair:

“I thought it was very unfortunate that they decided to take the attack route,” Smith said, adding, “I don’t think Paul Fulton and Higher Ed Works should chastise 28 members that are working hard, based on a handful that got into a tiff.”

For more on recent actions by the Board of Governors, follow reporter Joe Killian’s coverage here.

UNC System President Margaret Spellings

Higher Ed

Texas selects Milliken to lead university system

Editor’s note: This story has been updated from an earlier version to include comment from a UNC system spokesman.

James Milliken

On Saturday, the University of Texas System named James Milliken, the former chancellor for City University of New York, as the sole choice to lead their system.

“We are honored to announce Mr. Milliken as our sole finalist for this critical leadership role,” Regents’ Chairman Sara Martinez Tucker said. “His experiences in higher education leadership are deep and broad, and he has very effectively guided university systems that have many of the characteristics and strategic aspirations embedded throughout UT’s academic and health institutions. Moreover, he has enjoyed strong support from elected officials, students, and campus leaders in his previous posts, all of whom described him as someone they could count on in times of great opportunity and challenges.”

Under Texas state law, the university governing boards must name finalists for chancellor at least 21 days before making the appointment final.

The Austin American-Statesman reported last week that UNC System President Margaret Spellings’ name was floated for consideration.

On Sunday, Josh Ellis, Associate Vice President for Media Relations for the UNC system, denied reports that Spellings was ever a candidate for the position in Texas.

Rex Tillerson, the former CEO of Exxon Mobil and President Trump’s one-time Secretary of State, was another name on UT’s short list, according to published reports.

Spellings, became president of the UNC system in March of 2016, and has been focused in recent months on data modernization and talent retention among faculty and staff of the 17 campus UNC system.

Courts & the Law

Learn more about The Bail Trap

If you been wanting to learn more about the movement to end North Carolina’s broken cash bail system, head to Durham Friday evening for a free screening of “The Bail Trap: An American Ransom.”

Brave New Films has created a series of multimedia shorts that explain how money bail has become one of the main feeders of America’s mass incarceration system.

Friday’s screening will be followed by a panel discussion featuring:

  • State Senator Mike Woodard
  • Joe Killian, NC Policy Watch’s investigative reporter who has written extensively on the subject
  • Sarah Gillooly, director of political strategy and advocacy at the ACLU of North Carolina
  • David Hall, an “indigent defense attorney, representing people one at a time as they navigated the criminal legal system”
  • Lawrence Carpenter, a board member at Inmates to Entrepreneur

Can’t make it, but want to learn more about the state’s problematic money bail system?

Sarah Gillooly

Listen to Policy Watch’s recent radio interviews with two of Friday’s panelists:

Joe Killian

Friday’s screening of “The Bail Trap: An American Ransom” is hosted by Triangle People Power and runs from 6:00pm-9:00pm at Immaculate Conception Catholic Church, 810 W Chapel Hill Street, Durham, NC.

Defending Democracy, News, Voting

Sen. Burr: Russians continue use of social media to influence, divide Americans (video)

Three months before November’s mid-term elections, leaders of the Senate Intelligence Committee acknowledged that foreign operators are using social media to divide Americans, spread disinformation and undermine U.S. elections.

Republican Senator Richard Burr, who chairs the committee, said it was a complex problem that Congress must take every bit as seriously as terrorism:

“…it’s also the case that social media isn’t going anywhere. It’s part of how we exchange ideas and stay connected. It binds us as a community, and gives voice to the voiceless.

This was never about election, it is about the integrity of our society.

So how do you keep the good, while getting rid of the bad?”

Senators also on Wednesday rejected an amendment (50-47) that would have earmarked $250 million for election security.

North Carolina Senator Thom Tillis was among those voting against the appropriation, which needed 60 ‘Yea’ votes to advance.

Senator Burr was recorded as having not voted.

Click below to hear Burr’s opening remarks Wednesday morning before the Senate Intelligence Committee: