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Forsyth health-care initiatives gain $93 million in state budget funding
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Forsyth health-care initiatives gain $93 million in state budget funding

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Forsyth County’s health-care sector will receive about $93 million in funding from the 2021-23 state budget, highlighted by $25 million for a crisis behavioral health program.

Much of the funding is being dedicated to infrastructure projects, such as $14.8 million for a planned Kernersville veterans nursing home facility, and $11 million to Triangle Residential Options for Substance Abusers toward at a new center at 1931 Union Cross Road.

Another major beneficiary is Second Harvest Food Bank of Northwest N.C., which gains $6.67 million toward a new headquarters on the Whitaker Park campus.

Sen. Joyce Krawiec, R-Forsyth, said the health-care projects are funded in part because of what she called “smart, restrained budgets” cobbled together by Republican budget writers.

“Because of that responsibility, we’ve seen multibillion-dollar surpluses,” Krawiec said. “This year’s budget builds on that with sweeping tax cuts, critical infrastructure improvements and funding for needed projects that will benefit Forsyth County for years to come.”

Crisis program

The state N.C. Division of Mental Health, Developmental Disabilities and Substance Abuse Services will provide $25 million to Forsyth and Mecklenburg counties for their respective crisis behavioral health program initiatives.

The counties will provide additional services through partnerships with local hospital systems, behavioral health crisis centers, emergency services providers and behavioral health managed care organizations.

For Forsyth, it will be among the first major projects county officials undertake with Partners Behavioral Health Management. Partners became the behavioral health MCO for Forsyth on Nov. 1.

The goal is directing individuals having a behavioral health crisis to the most appropriate health-care facility while reducing the number of those seeking care at a higher-cost hospital emergency department.

Although the bill cites easing the patient-volume pressures that hospitals are experiencing during the COVID-19 pandemic, efforts toward those goals have been slowly moving forward locally for much of the 20th century.

“Partners will be tracking closely distribution of the funds allocated to Forsyth and Mecklenburg counties and will work hand-in-hand with Forsyth County, providers and stakeholders to support county residents who need crisis care,” said Rachel Porter, Partners’ chief administrative officer.

The crisis programs “should bring about some relief to the health-care systems in these counties and improve care to everyone overall,” said Billy West, chief executive of DayMark Recovery Services, a provider of behavioral health services in the Triad and statewide.

DayMark operates a dedicated 24/7 crisis- and urgent-care center in east Winston-Salem.

However, West said there are “questions that remain unanswered” in terms of fleshing out the crisis programs.

“For example, our agency provided crisis walk-ins to over 28,000 people last year, facility-based crisis to over 6,000, and behavioral health urgent care to over 3,000,” West said.

“More than half of these people in crisis were uninsured. The proposed funding is non-reoccurring and earmarked for only crisis.

“So, there are questions still remaining how to sustain crisis services that are built from this money and how to assure uninsured persons receiving services in the crisis continuum can have adequate follow-up care post crisis.”

Laurie Coker, president of advocacy group NC CANSO and a former CenterPoint Human Services board member, said Forsyth “needs an array of options in our community.”

Coker said expanding options “will increase access to alternatives that might be more welcoming and appropriate to individuals earlier in their distress.”

“Hospitalization is not the best option for many, and indeed the rate of suicidality is actually highest shortly after discharge from psychiatric hospitalization.”

She cited as an example services provided by GreenTree, a community-based, peer-offered crisis support group that she helped organize and oversees.

“These models would also greatly reduce the costly and troubling overuse in our county of involuntary commitment orders, which are often sought in desperation because we do not have responsive upstream crisis components,” Coker said. “Such alternatives would reduce costs for high-intensity services and have better long-term outcomes in people’s lives, reducing recidivism.”

WS/FCS project

Winston-Salem/Forsyth County Schools will share in a $1 million grant with Anson County Schools in a virtual care pilot program involving elementary students.

The program is being run through Atrium Health and affiliate Atrium Health Wake Forest Baptist.

According to the state budget, funds will go to “support the development and implementation of a school-based telehealth care pilot program to address health disparities in historically underserved areas disproportionately impacted by the COVID-19 public health emergency.”

There will be six elementary schools in WS/FCS and four in Anson participating. Chosen schools will have at least 90% percent of its students eligible for free or reduced lunch.

Another state-funded program — without a designated amount disclosed — involves the divisions of Social Services and Division of Mental Health, Developmental Disabilities and Substance Abuse Services establishing a two-year child welfare and behavioral health pilot project.

Its goal is offering easier access to comprehensive health services for children in foster care by: creating better continuity of care; providing an alternative to therapeutic foster care; and ensuring care and services are available without disruption to a child’s foster care placement while accessing services needed to treat the child’s trauma.

Joining Forsyth in the pilot programs are Davie, Rockingham and Stokes counties — the four former members of behavioral health MCO CenterPoint Human Services.

“The purpose is “to establish a trauma-informed, integrated health foster-care model to facilitate partnerships” between county DSS and MCOs regarding children placed in foster care.”

VA nursing facility

The state budget includes $14.8 million for a planned Kernersville nursing home facility affiliated with the N.C. Department of Military and Veterans Affairs.

A groundbreaking ceremony was held in December 2019 for the $50 million, 120-bed facility at 495 Veterans Way.

The site is adjacent to the Veterans Administration hospital, which opened in February 2016, and across the street from Kernersville Medical Center, which debuted in March 2011.

The Council of State approved the project in July 2018, allowing the State Property Office to spend $3.42 million on behalf of the department. The VA department is providing more than $27 million in grant funding.

Each room will be private with access to skilled nursing care. There also will be a Memory Care unit for residents with dementia.

The facility is projected to have 200 employees.

Senior Services

Another $5 million will come to Forsyth to help pay to expand arts and wellness services at the Elizabeth and Tab Williams Adult Care Center.

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The budget includes language from House Bill 593, which provides Senior Services Inc. with $3 million in 2021-22 and $2 million in 2022-23.

The Williams center serves local residents who are living with Alzheimer’s and other forms of dementia.

The goal is building “a new and expanded” center that will “bring health, wellness, arts and intergenerational program partners under one roof.” The dedicated space would go from 10,000 to 15,000 square feet.

The current center is at 2895 Shorefair Drive in Winston-Salem. The new building would be on the same campus.

Lee Covington, Senior Services’ president and chief executive, said in April that the state funding could represent 25% to 30% of its necessary fund-raising amount. He described the planned campaign as the largest in the group’s history.

The goal would be to break ground in April and open the expanded center in summer 2023, Covington said.

Bill sponsors cited several Forsyth demographics as the emphasis for HB593 that include a potential doubling — from about 60,000 to about 120,000 — of those ages 65 and older living in Forsyth.

They also cited the projected federal Centers for Disease Control and Prevention estimates for increased cases of Alzheimer’s disease and other forms of dementia, and the number of Forsyth residents providing services to elderly relatives or friends.

“I believe this is an exceptional program combining the talents of many local health-care providers, researchers and local groups that will create a model for future services to those with Alzheimer’s and dementia and some relief for the caregivers,” Rep. Lee Zachary, R-Yadkin, whose district covers western Forsyth.

TROSA facility

Triangle Residential Options for Substance Abusers (TROSA) has received $11 million toward at a new center at 1931 Union Cross Road.

Meanwhile, the Addiction Recovery Care Association (ARCA) gained $2.2 million for its infrastructure needs at its new home at 5575 Shattalon Drive.

The new TROSA center is projected to open in early 2022, where it will have beds for 100 men with a staff of 20.

TROSA plans to eventually have beds for 200 people with opioid, alcohol and other substance use disorders by the time it completes its second phase, likely sometime in 2023, said Brian Buland, project lead for the Winston-Salem campus.

Based in Durham, TROSA uses an abstinence model to treat people with addictions. Clients stay for two years and receive vocational training in areas such as food and hospitality, lawn maintenance and construction.

In addition, TROSA plans to operate a thrift store off Peters Creek Parkway that will generate revenue for the facility while providing some retail training for the men in the program.

Treatment at TROSA is free. It also does not accept insurance.

TROSA previously secured a $6 million grant from the state legislature.

Second Harvest

Second Harvest Food Bank of Northwest N.C. gains $6.67 million toward a new headquarters on the Whitaker Park campus.

The facility will contain almost 140,000 square feet of space and is slated to be finished in the fall of 2022

The nonprofit has raised at least $10 million in a capital campaign conducted earlier this year.

“As we work and our programs have grown, we have found that the facilities we are in, which include three leased facilities and one that we own ... are just no longer adequate to do the work that needs to get done,” Second Harvest chief executive Eric Aft said in May.

“With the new tools that we envision for this campaign and this enhanced space, we know we can ... do even more for those we serve.”

Second Harvest said the new building will make food receiving and distribution more efficient and make it possible to lift limitations now in place on accepting fresh food because storage capacity for such items will double.

The nonprofit said the enhanced center would also support real-time data collection so that it is possible to target help where it is needed the most.

Operations, such as Providence Culinary Training, can expand and new job training programs that work in line with Second Harvest’s mission and goals can be started, officials said.

Hospital reimbursements

The N.C. Healthcare Association said it is “thankful that the state budget requires Medicaid and the local management entities to better reimburse hospitals for behavioral health patients.”

“But, our hospitals and health systems are severely disappointed in the General Assembly’s failure to expand Medicaid coverage to hundreds of thousands of hardworking North Carolinians and veterans.”

Steve Lawler, the NCHA’s president and chief executive, said that “improved behavioral health funding is sorely needed in our state, given that we remain in a behavioral health state of emergency.”

“It is past time for us to take a hard look at the broader issues behind North Carolina’s fragmented, insufficiently funded behavioral health systems to pursue true system reform,” Lawler said. “NCHA looks forward to continued partnership with our elected officials to improve whole-person, equitable care for patients living with a behavioral health diagnosis.”

The budget requires Medicaid and local management entities to reimburse hospitals beyond the first 30 hours of a behavioral health patient being admitted to a hospital emergency department.

Behavioral health patients often stay in EDs longer than 30 hours due to a lack of available community-based services and inpatient beds.

“This update is one of the most significant changes in the behavioral health space in years and is an important step toward aligning reimbursement policies to encourage insurers to develop accessible community-based provider networks while appropriately reimbursing hospitals for expenses they incur caring for these patients,” the NCHA said.

Lawler expressed disappointment that the Republican-controlled legislature and Democratic Gov. Roy Cooper agreed to approve a state budget that lacks Medicaid expansion to potentially 450,000 to 650,000 North Carolinians.

Cooper had vetoed the 2019-21 budget primarily because it did not contain Medicaid expansion and did not provide raises to public school teachers at the levels he felt was warranted.

“We have long said that closing the health-care coverage gap is essential to make high quality health-care and coverage accessible and equitable to fellow residents of our state, especially in our rural communities,” Lawler said.

“Doing so also would ease a portion of the burden of uncompensated care provided by North Carolina hospitals, which amounts to more than $2.8 billion a year.”

The limited Medicaid expansion for postpartum care “will hit hospitals with $250 million in additional taxes per year to cover the cost of 12 months of postpartum care for low-income mothers, and expanding home and community-based services,” the NCHA said.

“This is a 47% tax increase in the same budget that slashes taxes on non-health-care corporations. All told, hospitals will expect to pay an additional $1.7 billion in taxes over the next eight years.

“Coincidentally, this is the same amount North Carolina would have received from the federal government under a clean Medicaid expansion.”

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