As an addendum to today's story, Cardinal Innovations spokeswoman Rachel Porter confirmed after deadline Tuesday that her agency—known in official lingo as a managed care organization—does indeed receive federal funding from the U.S. Department of Health and Human Services (HHS).
That information is key because it confirms the state-funded Cardinal Innovations, formerly known as Piedmont Behavioral Health, is subject to the findings of a federal investigation into whether Cardinal has broken federal law by denying mental health care reimbursements for the treatment of undocumented immigrants in its 15-county service area, which includes Orange and Chatham counties.
As reported in today's INDY Week, HHS' Office for Civil Rights is probing the Kannapolis-based organization. Latino advocates say Cardinal's policy is effectively cutting off treatment for the undocumented community, a possible violation of federal discrimination laws.
Managed care organizations such as Cardinal Innovations are tasked with disbursing state mental health care dollars for the treatment of low-income residents. Undocumented immigrants do not qualify for Medicaid cash. But the state has deployed an alternate form of funding, known as integrated payment and reporting system (IPRS) dollars, to cover Medicaid gaps in the past.
Activists say Cardinal Innovations is declining the use of IPRS funds for that purpose today, and the impact has been felt in nonprofit organizations such as El Futuro that offer mental health care and substance abuse treatment for the undocumented community.
If the Office for Civil Rights inquiry finds Cardinal Innovations in the wrong, Cardinal can be forced to alter its policy or risk losing federal funding. Porter could not specify how much HHS funding the agency receives as of Tuesday night.
Addendum: It seems that Cardinal Innovation's approach on mental health care for the undocumented community is not unique.
N.C. Department of Health and Human Services spokeswoman Julie Henry notified INDY Week after its print deadline Tuesday that undocumented immigrants are only eligible for emergency service coverage under Medicaid rule, echoing the comments of Cardinal leaders in today's story. That indicates managed care organizations such as Cardinal—which is charged with dispensing public dollars for mental health treatment—are following the rule statewide to deny Medicaid reimbursements to providers treating mental illness among undocumented residents.
Today's story investigates the impacts of the policy on the undocumented community and general public health—in particular, the impacts on nonprofits such as El Futuro that provide mental health services for the undocumented and Latino population. An El Futuro board member argues that the rule is stressing nonprofit finances and may clash with federal laws that order healthcare providers to offer services regardless of citizenship.
It is unclear whether federal law requires a denial for undocumented reimbursements. Medicaid is a joint spending venture primarily paid for by the federal government, but many North Carolina lawmakers have been targeting Medicaid for cuts since state spending peaked at higher than $3 billion in 2009.
Cardinal Innovations serves a 15-county region in the state that includes Orange and Chatham counties.
The private water company Aqua North Carolina has asked to buy water from Chatham County that could be used for the 751 South project.
Chatham County Commissioners voted 4-1 to direct staff to draft a contract that would allow Aqua North Carolina to buy 850,000 gallons per day from the county. Sally Kost was the lone no vote at the Nov. 19 meeting—the Monday before Thanksgiving.
Kost told the Indy tonight that she specifically asked an Aqua representative if the the water allocation had anything to do with 751. Kost said the Aqua representative responded, "We've talked with them," adding that the company would take a "regional approach," including Durham, to reselling the water.
Here's another twist: Chatham County buys its water allocation from Durham. So in effect, Aqua would sell Durham water to not only Chatham customers, but it could also sell the water back to Durham customers, possibly to those in the proposed 751 development. The water allocation comes from Jordan Lake.
Durham has not finalized an agreement with Chatham County on water allocations.
Kost also blogged about the meeting on her website.
The controversial 751 South development would include 1,300 homes and as much as 600,000 square feet of retail development on 167 acres in the sensitive Jordan Lake watershed. In February, the City of Durham rejected a request from SDD to provide water to the development.
In June SDD and its lobbyist approached a state lawmaker, Tim Moore of Cleveland County, to sponsor a bill forbidding a city from denying water and sewer service to a project in its designated “urban growth area” outside municipal limits.
751 South lies in such an area in southern Durham County. The bill failed.
In July, Durham County Commissioners agreed to provide sewer to 751 South.
Kost told the Indy that she advised her fellow commissioners that "before we do anything we need to talk to Durham."
The Indy has confirmed with a Durham official that Chatham County contacted Durham's utilities department about the issue today.
It's notable that such a significant request was put on the agenda for a meeting just days before Thanksgiving. In addition, Kost noted, the title of the agenda item was vague: "A discussion and vote on Aqua North Carolina's request to purchase capacity in the county's water facility."
This post originally stated that Cal Cunningham, an attorney for SDD, approached Tim Moore. The story has been corrected.
Check back for updates.
The N.C. League of Conservation Voters just sent out an announcement about three upcoming meetings and public forums on the topic of hydraulic fracturing or "fracking," the process of mining for natural gas.
- March 14, 6 p.m., Cary (no address provided) — 'citizen activists' training by Environment NC and Public Interest Network; for info, contact email@example.com
- March 15, 7 p.m., Raleigh — talk on 'Facts About Fracking'; hosted by Capitol Group Sierra Club at the Unitarian Universalist Fellowship of Raleigh, 3313 Wade Avenue; click here for more info.
- March 23, 7:45 p.m., Buies Creek — “Exploration for Natural Gas and the Future of NC, a Scientific Perspective," a moderated forum; sponsored by Campbell University, 56 Main St., Buies Creek, at the Turner Auditorium in D. Rich Hall
The N.C. Department of Environment and Natural Resources will also hold two meetings this month to present its draft report on fracking and take public comments:
- March 20, 6:30 to 9:30 p.m. at the Dennis A. Wicker Civic Center, 1801 Nash St., Sanford
- March 27, 6:30 p.m. to 9:30 p.m. at East Chapel Hill High School, 500 Weaver Dairy Road, Chapel Hill
N.C. House Minority Leader Joe Hackney announced his retirement this morning, opting not to wage a re-election campaign against long-time colleague Rep. Verla Insko, D-Orange.
The two veteran legislators were drawn into the same district, the 56th, by the Republican-produced new maps last year.
Hackney has served 16 terms, 32 years, in the General Assembly representing the 54th district, which includes Orange, Chatham and Moore counties. He was elected Speaker of the House in 2007 following Jim Black’s removal. He severed as president of the National Conference of State Legislatures.
Visitors to Jordan Lake are finding the beaches littered with dead fish after the largest die-off of striped bass in the history of the reservoir.
More than 5,000 striped bass have died in Jordan Lake since Aug. 1; state wildlife officials counted 1,800 on Aug. 9 alone.
The affected area includes the Haw River near Robeson Creek to the main basin of the lake near the U.S. 64 bridge.
The fish kill is due to what biologists call a “dissolved oxygen/ temperature squeeze,” according to Brian McRae, Piedmont Region fishery supervisor with the N.C. Wildlife Resources Commission. In the deeper portions of the lake, the water is cooler, but there is less oxygen; meanwhile in the upper part of the water, the oxygen supply is more plentiful, but the water is hot.
“They get squeezed from both sides,” McRae says. “The record summer temperatures finally put them over the edge.”
The water temperature in Jordan Lake has hovered around 84 degrees since early July, chronically stressing the striped bass, which, more so than other fish in the reservoir, are susceptible to temperature extremes. They prefer water in the 80—81-degree range.
“The hot water increases their metabolism, which means they need to eat more, but they don’t want to eat,” McRae explains.
State wildlife officials have excluded other causes for the fish kill, such as excessive algae blooms, which can also deplete the water of oxygen, because so far only striped bass have been affected. Larger bass, those 18—30 inches, and a favorite of anglers, are dying in greater numbers than smaller fish, whose metabolisms are lower.
Although wildlife officials restock the lake every spring with about 70,000 striped bass, anglers could catch fewer of them this winter until the next crop of fish moves in.
Jordan Lake is a “pretty severe environment” for striped bass, McRae says, adding, “We never thought striped bass would do well in the system.” However, under normal conditions, the bass have thrived, likely because the food supply is adequate and the fish have enough reserves to endure the stress.
However, this year’s heat wave has stressed them beyond what they could withstand. More than 6,000 striped bass in the lake could die before temperatures return to normal.
And this summer has broken all semblance of normal.
Raleigh has hit 100 degrees or higher nine days since July 1, including five consecutive days from July 20—24, according to data from the National Weather Service.
The average temperature for July was 83.7 degrees, the warmest on record.
Seven days in July had record highs.
Record high minimums—meaning day’s low temperature—happened on seven occasions that month, including July 24 when the low “dipped” to only 79 degrees.
“The only thing that will turn it around is colder weather,” McRae says.
Eagles and other birds are gathering on the beaches to eat the dead
birds fish, McRae says. "They're having a field day."
After 53 years, the Chatham County Bookmobile is dead.
As part of departmental budget cuts, Chatham County commissioners have eliminated funding for the traveling library. For residents of northeast Chatham, the bookmobile was the easiest way to access library books. In 2001, a consultant hired by the county found that northeast Chatham, the fastest-growing part of the county, had the greatest need for a library.
However, the county's main library wound up in Pittsboro after Central Carolina Community College donated land for it. With no library in the northeastern part of the county, the bookmobile and its driver/ librarian, Edna Johnson, spent four days a week traveling to 19 stops in that area—some bimonthly, some weekly. In addition to the bookmobile's 5,000 volumes, patrons could request delivery of books from the three other Chatham County libraries.
Commissioners considered a 5 percent cut to the library budget last January. At the time, Chatham County Public Library Director Linda Clarke recommended the bookmobile be eliminated, in addition to temporary jobs from branch libraries. Clarke said it "was a tough decision," but the greatest financial motive was the savings in reassigning Johnson to other branch libraries.
Clarke says she's aware that the loss of the bookmobile could translate to a loss in readership. But, she says statistics showed that "a lot of people that used the bookmobile also used the other branches." Last year, the Sanford Herald cited a study showing that, 222 of the 536 people who used the bookmobile in the past 12 months had also visited a branch library. "In their case it was a duplication," says Clarke. "When you're cutting back, that's going to be the first thing to go."
The commissioners deferred the final decision until a June 6 budget meeting, when the recommended cuts were officially incorporated into the county manager's yearly budget.
"Nobody likes to see any services reduced," says Board of Commissioners Chairman Brian Bock. "The bigger question is, Is the county supporting the library system? You don't have unlimited funds, so you have to prioritize."
The bookmobile served about 600 people every month. Stops included day cares, schools, retirement communities, and several neighborhoods throughout northeast Chatham. Its patrons often had limited access to the other libraries for financial, logistical or personal reasons.
Sen. Ellie Kinnaird, D-Orange, Person, one of 10 state senators drawn into the same district as another sitting senator under the redistricting proposal Republicans released Tuesday, says she would seek to hold onto her seat, but running against a colleague would be “a very difficult situation.”Sen. Bob Atwater, D-Chatham, Durham, Lee, in his fourth term, would be forced to square off.
“Bob is a very good senator in Chatham County and running against a friend and fellow senator is very disappointing to me,” she said. “It’s a stressful situation and we certainly are not looking forward to it.”
The situation is not new for Kinnaird who defeated colleague Howard Lee in 2002 when their districts were merged. She won a hard-fought, but respectful primary campaign by just 119 votes.
Chatham County Commissioners on Monday plan to rescind a two-year-old resolution that critics say will hurt relations between undocumented immigrants and police.
In 2009, the previous board of commissioners, then dominated by Democrats, adopted a resolution acknowledging that undocumented immigrants live in and contribute to their communities:
"Chatham County is home to a diverse population — including people of color, documented and undocumented immigrants, citizens and noncitizens — whose contributions to the community are vital to its character and function; and whereas the Board of Commissioners is committed to upholding the civil rights of all persons in Chatham County and to protecting the enjoyment of any and all rights and privileges secured by the constitutions and laws of the United States.”
Commission Chairman Brian Bock, a Republican, said that the current board feels the language in the resolution discouraged local police and sheriff’s departments from entering into any future agreements with state or federal law enforcement.
"The original resolution was too broad," he said, "and we have this opinion sitting out there, that does not reflect the current board's opinions, and that is why we have decided to rescind it."
Activists fear that by abandoning this resolution, the commissioners will send not only a symbolic message that undocumented immigrants are unwelcome in Chatham, but they also will create a hostile climate for them.
Chatham Immigration Action Alert, a citizens’ group, is urging citizens and immigrants to speak out in disapproval of the commissioners’ plan to rescind the resolution.
“As a community, we worked hard to create and defend the original ICE Resolution,” writes Chatham Immigration Action Alert organizer Ilana Dubester, who is originally from Brazil and has lived in Chatham County for 20 years. “Is this in the best interest of our county’s inhabitants and businesses?”
At a May 16 commissioners meeting, Dubester, who also serves on the county’s Human Relations Commission, told the board that “all immigrants, including the undocumented, pay their share in taxes and contribute to the wealth of our state. Immigrants cannot be neatly divided into the so-called good immigrants with papers and bad immigrants without.
“Most families have mixed status—some members are documented while others are not,” she continued. “Resolutions that target the undocumented inevitably impact legal immigrants. Words matter. When Chatham leaders in the past voiced their hostility toward the undocumented, David Duke came marching into town. Collaboration with ICE is bad for public safety and bad for the economy.”
The deal to prevent Cary and Apex from annexing parts of Chatham County without approval from the Chatham County Board of County Commissioners is sailing through the General Assembly.
Commission Chairman Brian Bock announced the agreement Feb. 21 when the commissioners approved the Western Wake Partners’ plan to run 8.1-miles of wastewater treatment pipe underground through the county from the unincorporated Wake County town of New Hill to the Cape Fear River.
The partners, composed of Apex, Cary, Morrisville and RTP South, offered to take involuntary annexation off he table and to help push the legislation through this session in exchange for Chatham commissioners approving plan. Chatham commissioners voted 3-2 to allow the pipeline and also received $500,000 to spruce up a youth center and the option to tap-in to the pipeline in the future as needed.