The Alamance County Behavioral Health Center served 723 individuals last month, Donald Reuss, vice president of behavioral health and intellectual/developmental disability network operations at Vaya Health, said at a Nov. 18 Alamance County Board of Commissioners meeting.
The center officially opened June 19 after a two-year-long collaboration between Vaya Health, the North Carolina Department of Health and Human Services, RHA Health Services and other community partners, according to Reuss.
He said conversations revealed a need to support the crisis system in Alamance County to divert people with mental health and substance abuse issues from jail.
“Previously in the county, they had pieces of these services, but they were kind of fragmented,” Reuss said. “It really made it a little more challenging for citizens to access, as well as for law enforcement to really develop good, strong relationships and coordinated efforts.”
Vaya Health is designated as a local management entity/managed care organization, or LME/MCO, by the NCDHHS. According to NCDHHS' website and Reuss, these companies manage North Carolina’s tailored Medicaid plans, coordinate and facilitate the provision of services and work with licensed practitioners and provider agencies.
The crisis diversion center aims to treat behavioral health issues, such as substance abuse, mental health disorders and intellectual and developmental disabilities, according to Reuss.
“It's primarily for people that have a mental health or substance abuse issue that they're working on, but it's also fully operational for anybody that has an intellectual/developmental disability,” Reuss said.
The 28,000 square-foot center was announced in September 2022 and is located at 963 Kirkpatrick Rd.
According to Reuss, the center features a 16-bed residential facility which will function as a crisis center for individuals who need inpatient care. This facility will open pending state acute care facility licensure by the North Carolina Department of Health and Human Services. Reuss said he does not yet have an idea of when this will be; he said some facilities have been licensed within a few months, while other providers have waited for up to a year.
In his presentation to the board of commissioners, he said an application to NCDHHS was submitted a month ago and he is waiting to hear back, though he said he requested an expedited process from his contacts there.
NCDHHS declined Elon News Network’s request for an interview.
However, the center does already have operating facilities. Its behavioral health urgent care facility is open for 16 hours a day, seven days a week, and eight beds are available for patients to stay up to 23 hours. Ideally, Reuss said, this part of the center will be open 24/7, but he said the facility will need around-the-clock officers on-site for this to happen.
“It's really just finding the officers that are willing to work those shifts,” Reuss said. “We hope it's soon.”
In his presentation to the board of commissioners, Reuss said he reached out to county municipalities to ask for officers or financial support.
“I met with every municipality in the county and asked for their support,” Reuss said. “And I’m sad to say, I did not get any takers in my request at that time.”
At the meeting, vice chair Steve Carter said there is around $450,000 in the board’s budget that can be allocated to provide funding for officers
“I really want to see this being able to run 24 hours a day and provide the service, because obviously, the numbers you just indicated, there's a need,” Carter said.
At the meeting, Alamance County Sheriff Terry Johnson said there is one officer paid for by RHA Health Services with money from the board, who is on shift from 8 a.m. to 5 p.m. He said he met with county police departments earlier this year to ask for support.
“Burlington, in fact, they said no. Graham said no. Elon Campus, Mebane and Haw River and Gibsonville has interest in coming on board to help,” Johnson said.
Licensure code doesn’t require security, according to Reuss, but it’s best practice to have — so acquiring 24-hour security is the last step in keeping the urgent care open at all times.
Drew Elliot, vice president of public affairs at Vaya Health, said the walk-in facility is open to the community and provides a centralized emergency treatment facility for individuals in need of behavioral health care.
“The way we like to describe it is just as you would go to an urgent care if you sprained your ankle — you didn't know if it was broken, sprained or just twisted — you're going to go to the urgent care,” Elliot said. “They're going to triage you and make sure that you get the right sort of support for you. Just like that, but for behavioral health.”
Additionally, the center offers a peer bridger program, designed to reintegrate patients who have been in the hospital for a period of time.
“If somebody goes on to their inpatient psychiatric unit, those peers will actually go to the hospital and help bridge people coming out of the hospital back to the community,” Reuss said. “A lot of individuals coming out of psychiatric inpatient care are asked the highest risk for committing suicide across our communities in North Carolina, so it's one of our most vulnerable populations.”
Reuss said the center also houses a peer living room, where anyone can come in to receive support, use computers and be with a community. He also said the facility has recently been licensed for a substance abuse intensive outpatient program and offers medication management services, individual and group therapy and an intensive in-home care, where licensed clinicians administer mental health treatment for children and their families.
He said the center hopes to create a community calendar, inviting outside organizations — such as the National Alliance on Mental Illness — to offer services within the center.
“We really want to start working on bringing those individuals, those organizations, to the table, and really building out what we call a community calendar, so people know that every Monday and Wednesday, National Alliance [on Mental Illness] will be in that facility, and every Tuesday and Thursday vocational rehab may be there,” he said. “So people know that if they need to get access from those supports, they can get them in at one place.
Reuss said when Vaya Health began to work with Alamance County in late 2020, it was told planning and opening the center was a number one priority.
“We sat down with community leaders,” Reuss said. “We looked at available land across the county. We looked for different resources, different partners, to go in this venture, and we worked with the county to identify a location and funding and support in order to move forward.”
According to Reuss, the center is funded through a $4.6 million NCDHHS grant secured by Vaya Health, $1.5 million from Cardinal Innovations — the LME/MCO with which Alamance County previously worked — and $500,000 from the North Carolina General Assembly.
Elliot said this center has been the result of a community effort.
“Vaya and the county commissioners have been the driving force behind this, but it's required a whole lot of other coordination from different parts of state government,” Elliot said. “It's been a lot of different groups coming together to make this happen. And it will also require ongoing support from a lot of those same groups.”
He said the center has been designed to be a sustainable project for the Alamance County community.
“You've got expenses,” Elliot said. “Who owns the building and how is it financed, and leases to the providers and then, and how is the revenue coming in? Is it through Medicaid? Is it through other support and ongoing county support?”
Reuss said Vaya Health can only pay for certain patients — not all.
“We only can pay for the members that the state has assigned to our health plan that walk into that facility, but anybody can walk into that facility,” Reuss said.
He said Vaya has been working to ensure that the center will be accessible.
“We can adjust our rates to make it sustainable, but if other health plans are not configured in a right way to where other health plans help also cover that cost in the plan, then we don't have a long-term sustainable program,” he said. “We’ve really been working hard to make sure that the rates that the health plans are paying really contributes to what we provide.”
He said there is more to come as the center obtains licenses — once it does, Vaya Health will begin a marketing campaign to raise awareness in the community.
“The journey is not over,” Reuss said. “There’s still a lot of work to do there, but we got the physical plant infrastructure in place that we're building that foundation around.”