“If people aren’t getting their mental health treatments and are displaced, they end up in our jail, calling our EMS, calling for social work services, the sheriff’s calls go up, it just impacts everything,” said Bryant Morehead, Haywood County’s manager. “It touches so many things we do. To my understanding, the formula that was used last year was about a 4 percent cut. The [impending] change now represents about a 21 percent cut in that revenue stream.”
Morehead’s talking about a $9 million funding cut proposed in the North Carolina General Assembly that would dramatically affect Vaya Health, a public Local Management Entity/Managed Care Organization that is responsible for managing and overseeing publicly funded mental health/substance abuse/IDD services for more than a quarter-million residents in the 22-county Western North Carolina region alone.
“Mental health treatment — we haven’t done a good job in this country, and here’s some more cuts coming down the line, and I worry at the local level that here’s a revenue source from the state or federal government that was paying for this,” he said. “If that cut happens, does it now become an issue we have to take care of with our property tax dollars?”
Haywood County Commissioners passed a resolution to that effect Sept. 16, calling on the General Assembly to stop cutting Vaya Health’s state single-stream funding “so that such funds can be utilized to strengthen access to healthcare services … of uninsured and underinsured Haywood County citizens.”
According to the resolution, state funding for behavioral health services such as those handled by Vaya “has been inconsistent and inadequate for more than 17 years, since mental health reform legislation was passed by the North Carolina General Assembly in 2001.”
Over the past four years alone, statewide cuts have added up to more than $458 million — $48 million of that to Vaya. That number will grow to $57 million if the proposed $9 million cut becomes law.
In 2015, Vaya developed a reinvestment plan designed to reduce needless emergency room visits, divert people from jails and combat the opioid crisis being felt across the nation and the state. Since then, Vaya has reinvested more than $18 million in programs that include things like opioid overdose reversal kits.
If the cuts — held up in the ongoing budget veto standoff — do come, that could prevent some in Haywood County from getting the mental health services they need and exacerbate the opioid crisis.
“People will self-medicate with opioids or alcohol or something like that, because they need … I know the clinical word isn’t relief, but they will probably look for some escape from whatever they are battling, and drugs and alcohol are the ones they turn to,” said Morehead.
In late August, Vaya CEO Brian Ingraham told The Smoky Mountain News that without the $9 million, there would have to be “some kind” of reduction in services.
Meanwhile, the state currently enjoys a $900 million budget surplus. Republican leadership in the General Assembly, including Senate Leader Phil Berger, R-Rockingham, and House Speaker Tim Moore, R-Cleveland, have proposed liquidating that largesse by giving refunds of up to $125 per taxpayer.