Vaya Health has pledged additional operational funds as part of new plans for spending $1.4 million from the state to enlarge and renovate a county-owned building on Peace Street, North Wilkesboro, for expanded behavioral health care services.

Under a proposal officially announced this week, Synergy Recovery Services’ existing facility-based crisis (FBC) center will be expanded by two beds and Daymark Recovery Services will occupy part of the building to offer additional services to an area that includes Wilkes, Ashe, Alleghany and Watauga counties.

Shirley Randleman of Wilkesboro, credited with securing a bill appropriating the $1.4 million in her last term in the Senate in 2018, said the latest proposal complies with legislative requirements for the funds because it and the legislation both call for spending the $1.4 million on construction for facility-based crisis services.

The legislation awarded the $1.4 million to Asheville-based Vaya, which oversees mental health care in Wilkes and the 22 other westernmost counties as one of the state’s seven local management entity-managed care organizations (LME-MCOs).

Christine Dupuch, Vaya chief community operations officer, said Vaya is asking the Wilkes County commissioners to approve a resolution supporting the new proposal Tuesday night. This resolution would be submitted with the new plans for approval by the N.C. Department of Health and Human Services. Under legislation appropriating the $1.4 million, the plan must be submitted to the DHHS by April 1 and then to the Joint Legislative Oversight Committee for approval.

Dupuch said the commissioners will also be asked to approve naming the Peace Street facility the Shirley Randleman Recovery Center.

Vaya originally planned to use the $1.4 million to construct a 16-bed FBC center as an addition to the Daymark building at West Park, North Wilkesboro, but later in 2018 said it lacked funds for this due to a $47 million cut in state financing of Vaya services to patients without Medicaid or private insurance since 2015, on top of a $31 million cut from 2009 to 2015.

A report released this fall, identified as being from Wilkes County government, Vaya and Daymark, proposed to instead use the $1.4 million to expand Daymark’s current walk-in clinic at West Park to 24/7. Randleman and Rep. Jeffrey Elmore of North Wilkesboro both objected, saying this would result in loss of the $1.4 million because the money must be spent on construction and on a facility-based crisis center.

Vaya, Daymark, Synergy and county officials then came up with plans shared in a meeting Tuesday in the commissioners’ room of the County Office Building. They were explained by Dupuch, and Brian Shuping, county relations representative for Vaya’s northern region.

Shuping said in an interview that expanding Synergy’s FBC center by two beds to make it a 16-bed facility would require less of an increase in recurring operational funding from Vaya than adding a 16-bed FBC center to the Daymark building. He said Vaya officials also believe that with existing or planned FBC center beds in the area, the number of these beds is already reaching the point of saturation.

The plan calls for Vaya to dedicate an additional $225,000 for operating the center in its first two years, an additional $400,000 annually in recurring Medicaid and non-Medicaid for the center’s operations and to maintain Synergy’s existing annual funding of $855,000.

Although Synergy has inpatient beds, it doesn’t offer the array of services at FBC centers in Lenoir, Asheville and elsewhere. Synergy’s existing 14-bed operation focuses on detoxification and primarily uses the building’s ground floor, leaving most of the second floor available for other uses. Under state law, FBC centers can have up to 16 beds.

Part of the increased appropriation from Vaya will fund employment of additional medical staff needed for the center to be certified as a drop-off site for people with involuntary commitment orders. These people are transported by law enforcement officers, usually Wilkes Sheriff’s Office deputies, after a magistrate signs an order having them committed to a facility for psychiatric care.

Law enforcement officers now take them to Wilkes Medical Center and stay with them at the hospital, sometimes for several days, until a bed in a licensed psychiatric care facility is available. Officers will be able to instead leave them at the Peace Street facility for evaluation when it’s certified by the state as an IVC drop-off site.

Also, planned at the Peace Street building as part of the latest proposal are services provided Daymark, including a substance use disorder treatment program for pregnant and postpartum women.

This is a pilot three-year program funded with about $1.4 million awarded to Vaya by the state to expand and enhance services for pregnant and postpartum women in under-served rural communities with opioid and other substance use disorders and those needing medication assisted treatment. Goals include reducing abuse of alcohol and other drugs among pregnant and postpartum women and it has an emphasis on new promising and evidence-based services.

Daymark would also oversee a drop-in center on the second floor for people who want to connect with peers as part of their recovery. There also would be meeting space for peer support specialist training and other recovery-oriented groups and classes such as Wellness Recovery Action Planning (WRAP), Whole Health Resiliency Model, Healthy Boundaries and Mental Health First Aid.

Vaya said the new proposal calls for the Peace Street facility to “offer secure, residential stays for people with both mental health and substance use disorders, as well as people in need of non-hospital detox and/or involuntary commitment. The short-term, medically supervised program will provide services and support to individuals in crisis who need a secure environment, with the goal of alleviating acute crisis situations through stabilization, treatment and crisis planning.”

The people at the meeting Tuesday included members of the steering committee that Dupuch said will meet monthly through December at least to work out details of the new plans. The members include Randleman, County Manager John Yates, County Attorney Tony Triplett, Commissioner Chairman Keith Elmore, Commissioner Brian Minton, Wilkes Department of Social Services Director John Blevins, Wilkes Health Department Director Rachel Willard, Daymark Director Billy West, Synergy Director Carl Spake, Tina Nuger from Home Instead, Wilkes Medical Center Chief of Nursing Susan Bachmeier, Project Lazarus Director Fred Brason and others from Daymark and Synergy. Dupuch said a recovery addict also should be a member.

County officials are working with Vaya to develop a detailed project timeline and final construction costs.

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