Thursday, August 02, 2012

Medicaid Waiver: WHN LME Budget for July, 2012

Baby, if you can decipher this mess, you're an actuarial genius. This is associated with finances for this LME in their 5th month of the Medicaid Waiver. These numbers are associated with May, 2012 finances.

This is what this non-actuarial person has noted as being of interest:


2. Adult mental health expenditures are greater than for any other category.

3. "Contracts" and "Grants" consumed the greatest amount of money, specifically, approximatl6 $2.7 million ; what is a 'contract' and a 'grant' please?

4. The Medicaid 'approved budget' for the year is approx $56 million; what has been used, year to date is approx $47 million.  So, how are they going to continue services when they have spent over two-thirds of the allocated budget?

5."Innovation Services' is by far ($17 million year to date) is consuming the most money.  What is
'Innovation Services'?: These are the people with developmental disabilities: see:  For instance, I have a client w/ cerebral palsy in Waynesville, NC, under SMC LME, who is trying to work at the sheltered workshop, HVO, and SMC LME has allocated a set amount to HVO which can be used however they desire.  I don't know of any sheltered workshops within the WHN LME catchment area so it is not clear to me how this money is being used.

6. (the pdf will not allow you to cut and paste so here is summary): RHA, a private company billing WHN LME is problematic. They have "several problems w/ their billing." How much of the services paid for by WHN LME is associated w/ RHA? Who is RHA?: "RHA Health Services, Inc. is one of North Carolina’s leading non-profit providers of services and supports for people with developmental and intellectual disabilities.":

7. When the Director of Buncombe County DHHS asked about the 'cash flow' problems, it is stated in the pdf that it is 'very difficult' to anticipate these.

Boy, what a mess.


Blogger dog-inheaven said...

I was hoping I would see something on your blog... "Marsha Ring, WHN’s director of clinical operations, outlined three factors that contributed to the financial shortfall: an encumbrance with contractual obligations inherited from former managed-care agencies Value Options and Crossroads; increases in the cost for some services; and the lengthy duration of some services meant to be short-term in conjunction with service stacking (adding more than one service to a treatment)." Do you know what Marcia Ring is referring to by Crossroads? I'm familiar with Value Options but haven't' heard of Crossroads with the exception of a defunct provider in Hendersonville by the name of Crossroads that RHA bought and then shut down.

1:11 AM  

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