Two state-funded companies that oversee low-income residents’ access to behavioral health services have announced plans to merge into a single entity that will cover 46 counties in eastern North Carolina.
The CEOs of both businesses signed the agreement on Saturday, which calls for Trillium Health Resources to assume management of Eastpointe Human Services. In order to provide care to Medicaid participants with mental health needs, substance use disorders, and intellectual or developmental disabilities, the agreement will alter the state’s managed care system.
Together, Eastpointe and Trillium make up a network of six LME-MCOs, or local management entities, that function as managed care organizations. The care of those patients is supervised by that network. With the consolidation, a third of these organizations, the Sandhills Center, will dissolve, leaving four LME-MCOs in North Carolina.
Eastpointe makes certain that people who are in need of assistance are connected to appropriate care. By providing screenings, they hope to identify co-occurring disorders and gauge the risk of suicide. Screenings are instruments that use questioning to find areas of concern. Co-existing refers to the co-occurrence of a mental health illness and substance abuse. Early identification of the problem areas ensures that the right treatment is provided and that screenings are typically quick. Research indicates that early detection of suicidal thoughts and behaviors, coupled with ongoing care and support, can prevent suicide.
The consolidation is the result of a directive that Sec. Leading the N.C. Kody Kinsley Health and Human Services Department. The General Assembly had given him instructions to lower the state’s current LME-MCO count in order to expedite the planned implementation of specialized plans for Medicaid recipients who need more extensive services than average recipients.
At the request of the LME-MCOs, DHHS has repeatedly postponed the implementation of these so-called tailored plans. Particularly, Sandhills Center had trouble negotiating provider contracts for customized plans.
In an interview with NC Health News on Monday, Kinsley stated, “Our objective is to get the tailored plan operators to a place where they can manage their patient population and the complex risks that they have in a smooth way.”
The provider community has made it very clear to us that, in terms of managed care organizations, “less is more.” Reducing the number of managed care organizations that these providers must enter into contracts with by bringing the LME-MCOs down to four is a fantastic opportunity.
According to him, DHHS will be collaborating closely with senior executives from the consolidated LME-MCOs in order to get ready for the July 1 launch of customized plans.
A yet-to-be-named company run by Trillium will oversee a region that will comprise almost all of the counties that Trillium, Eastpointe, and Sandhills Center serve. The organization needs to have a new name and branding in place by the beginning of 2025. The consolidation is set to take effect on January 1.
According to Kinsley, “this is really a consolidation of entities that have different strengths.” “And I believe they ought to rename this to reflect the fact that they’re uniting as a consolidation and to acknowledge this advancement.”
“All current employees who desire employment and are in good standing will retain their positions,” the companies pledged in a joint statement on Monday. “The consolidation agreement requires the companies to ensure that staff are offered compensation that is no less than employees’ current compensation.”
The new company will be led by Joy Futrell, the CEO of Trillium, and will have Sarah Stroud, the CEO of Eastpointe, as president. Anthony Ward, the CEO of Sandhills Center, will hold an executive position, according to the agreement.
“We’ll keep our members at the forefront of our priorities,” Futrell stated in a press release.
“We think the hard work that Trillium, Eastpointe, and Sandhills Center have already put forth will lead to a successful consolidation, even though we know the next few months will contain many new opportunities.”
The board of the new organization will consist of 22 people. Eleven members will be chosen from the Trillium board, and the remaining eleven will be chosen from the boards of Sandhills and Eastpointe.
According to Kinsley, “we’re still going to need to have more discussions about how we have a board that will be representative of all the regions that they currently share.”
Other LME-MCOs are now in charge of three counties that Sandhills Center and Eastpointe used to service. Rockingham County moved to Vaya Health, Harnett County to Alliance Health, and Davidson County to Partners Health Management as their new management entity.
Although Kinsley admitted that the process of consolidation “was not easy,” he commended the companies for their collaborative efforts to “better serve the people of North Carolina.”
Regarding the new organization, he remarked, “I think we all know that the behavioral health system desperately needs it.” “I appreciate their leadership because this is a big sea change moment for them to put us on that path structurally.”
