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PBH Local Business Plan 2007 Executive Summary: Expressions of Appreciation Through the development of our 2007 Local Business Plan, we have taken the time to conduct the self assessment delineated in this document. The improvements we have identified follow in our Goals for 2007- 2010. We are grateful to the members of our PBH Local Business Plan Oversight Committee for their time, insight, and support of our efforts. We appreciate the sincere feedback that we have received from our stakeholders and pledge to use it to improve ourselves as well as services to consumers and families. Our providers are our front line. Our achievements would be largely incomplete without the competence, commitment and perseverance that they have brought to our table. We also want to thank Carmen Hooker Odom, the Secretary of the Department of Health and Human Services for this opportunity and for believing we could be successful; without her support, we would not have had this chance. The Division of Medical Assistance and the Division of Mental Health, Developmental Disabilities and Substance Abuse Services have provided key resources to make this Demonstration possible. They have been wonderful collaborators and their support has played an essential role in our success to date. PBH has enjoyed the unfailing confidence of a Board of Directors that was willing to be on the'~cutting edge". No doubt, this endeavor was a calculated risk. The Leadership and Staff at PBH are grateful for and continually strengthened by this support. Our Local Elected Officials and Legislative Delegation have been hopeful, understanding when there were problems, and always there cheering us on. One of our goals was to demonstrate how public policy can be implemented on a local/regional level. As elected representatives of the citizens of our counties, their role is to set the direction, establish the public policy. Our part has been to carry it out. We are proud of the role that we have played in this continuum of government and we believe that we have been largely successful in achieving the vision that was established in the System Reform Legislation of 2001. The PBH Demonstration March 1, 2007 Multi-county Area Programs are political subdivisions of the State of North Carolina established and operating in accordance with NC General Statute 122C (G.S. 122C-116). The Secretary of the North Carolina Department of Health and Human Services is charged with the administration and enforcement of General Statute 122C (G.S.-112.1), which specifies the legal responsibilities, and authority of Area Programs regarding the provision of community services (G.S. 122C-117). General Statute 122C also specifies the role and responsibilities of county governments in determining the governance structure and developing Boards of Directors to manage Area Programs. The State Plan requires Area Programs to be certified as Local Management Entities through State approval of the Local Business Plan (G.S. 122C-115.2). Piedmont was certified by the Department of Health and Human Services as an LME, effective July 1, 2003. We subsequently divested of all directly operated services, with the exception of case management and focused our efforts on developing the requisite competencies of a public sector Managed Care Organization. These competencies include the capacity to manage financial risk for defined population(s), the management of defined benefit plans and all of the normal functions of a Managed Care Organization, i.e. network development, provider relations, rate setting, access to care, enrollee services, care coordination, authorization of services, utilization management, claims adjudication and payment, management of medical/loss ratio, quality improvement targets, and meeting established performance indicators. ~,