The Lycoming-Clinton Joinder Board Wednesday ratified a new five-year agreement with Health Choices, the program that manages mental health and drug and alcohol services for Medical Assistance recipients.
The agreement runs from July 1 of this year to June 30, 2017, according to Joinder Administrator Debra Duffy.
The board, which is comprised of Lycoming County Commissioners Jeff C. Wheeland, Tony R. Mussare and Ernie Larson, and Clinton County Commissioners Robert "Pete" Smeltz, Jeffrey Snyder and Joel Long, unanimously supported the agreement.
Prior to the vote, Duffy presented an overview of the program, which is nearing the end of its initial five-year run.
The local Joinder was given the option by the state to manage its own Medical Assistance funding and services beginning in 2007, Duffy said.
At the time, sitting board members reasoned that locally managing the program would provide flexibility on how to best use Medical Assistance funding.
The Joinder hired Harrisburg-based Community Behavioral Health Network of Pennsylvania as the local Health Choices manager.
According to Duffy, the program and arrangement has worked well.
The Joinder is responsible for financial reporting, rate negotiations, care coordination and ensuring consumer satisfaction, while CBHNP is responsible for provider claims payments, care management and the handling of grievances and denials.
Money flows from the state Department of Public Welfare to several accounts, including those for claims and administration costs by both the Joinder and CBHNP.
About 36 percent of services through the program are for substance abuse services, 16 percent for inpatient psychiatric care and 11 percent for residential treatment.
The Joinder has been able to save money while expanding services and increasing the number of people served through the program, Duffy said.
Health Choices allows unspent funds to be placed in a contingency account or reinvested, she said. Prior to the implementation of the program, those funds had to be returned to the state.
The contingency fund can cover up to 30 days of medical claims and reinvestment funds can be used to fill gaps in services, develop new programs or strengthen the overall provider network.
About $1.6 million has been placed in the contingency fund, while about $500,000 has been reinvested, Duffy said. Another $300,000 is going to be used for children's mental health services.
In other business, board members discussed proposed cuts to services administered by the Joinder, including mental health services, intellectual disabilities,behavioral health services and homeless assistance.
The proposed cut could be as high as $1.3 million, or 20 percent, of the Joinder budget.
Gov. Tom Corbett proposed the cuts but also proposed rolling the remaining funding into a block grant that counties will have flexibility in using.
Although the idea is for counties to save money by reducing administrative costs, it is unlikely the Joinder will be able to save enough to make up for the proposed cuts, Duffy said.
The Joinder's administrative costs already are low, so there are few areas where cost savings can be realized, she said.
The board also received a report on an audit performed by representatives of the accounting firm Zelenkofske Axelrod LLC.
The representatives said the report was "unqualified," which is the highest rating an audit can receive. No issues were found in the agency's financial reporting, they said.
