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At times like this, it can be hard to know if the information you hear is accurate. Read on to see how the facts stack up to what you may have heard.


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You May Have Heard:
At the April 9 meeting of the Rutherford County Commissioners Meeting, the commissioners voted to disengage from Vaya Health and align with Partners Behavioral Health Management, another managed care organization (MCO) headquartered in Gastonia, North Carolina.


You Should Know:
Prior to the decision, the commissioners apparently did not seek input from consumers, families or Rutherford County providers contracted with Vaya. Consumer and provider input is critical to understanding more about the potential impact on services.


The commissioners did not notify Vaya of the decision before or after the fact. No one on the Board of County Commissioners or in Rutherford County leadership let Vaya know that they were contemplating a move to another MCO. They did not voice any concerns about their relationship with Vaya Health or offer Vaya the opportunity to present information or discuss the potential impact on citizens, before the decision was made. In fact, Vaya management learned about the decision several days after the April 9 meeting. Vaya never received an official communication from the Board of County Commissioners about the decision, although a notification was sent to each of the County Managers in the Vaya Health catchment area.


To date, and despite multiple attempts to connect with a number of public officials in Rutherford County, Vaya has been unable to meet with or talk to the county commissioners about their decision. The Vaya Board Chair requested a meeting with county leadership in an April 23 letter, and again requested a meeting on May 7 in his public comment to the commissioners, but Vaya has heard nothing in response.


You May Have Heard:
Some community members have heard that Vaya Health initiated the change. Others have heard that county leadership are not pleased with the relationship they have with Vaya Health.


You Should Know:
Vaya Health was not involved in the county’s decision whatsoever. And at no point in the process has Rutherford County leadership cited dissatisfaction with Vaya Health, its management of services, network of providers, community engagement or any other area of involvement as a reason for the proposed disengagement. In an April 17 article from The Daily Courier, Rutherford County Manager Steve Garrison was quoted as saying, “We are not critical of the management of the mental health and substance addiction services provided by Vaya Health…”.


You May Have Heard:

At the May 7 Rutherford County Commissioners Meeting, Commissioner Bryan King stated, “This is a local process … We are the elected officials, this is Rutherford County. We are not part of Vaya; we are not part of Raleigh.”


You Should Know:
Rutherford County is one of 23 counties in western North Carolina that relies on Vaya Health to manage public funding for mental health, substance use disorder and intellectual/ developmental disabilities services. Vaya staff have served Rutherford County since 2004, when Rutherford-Polk LME joined forces with TREND and Blue Ridge Area Authority to form Western Highlands Network. Vaya has deep roots in Rutherford County, employs 20 staff who work directly in the county, and shares the commissioners’ vision for improving the quality of life of those who call Rutherford County home.


It is a local process, but it is not the decision of county commissioners alone. Rutherford County has the right to request to “disengage”, or end their relationship with Vaya Health. The process for doing so is included in a set of laws that focus on managed care organizations, or MCOs, like Vaya. As part of that process, county commissioners are required to ask for public input on their plan. (Read more about how to share your thoughts here)


The final decision on the county’s request is made by Mandy Cohen, M.D., Secretary of the N.C. Department of Health & Human Services, based in Raleigh. Secretary Cohen’s decision is based on many factors, including how the proposed change will affect the quality, variety and amount of services for county residents. She must also consider input from consumers, families, advocates and other stakeholders. (Read more about how to provide your input here)


You May Have Heard:
At the May 7 Rutherford County Commissioners Meeting, Commissioner Bryan King stated that Vaya Health sent a letter to “consumers of mental health services in Rutherford County”. Commissioner King went on to say that the tone of the letter was “intended to create fear and anxiety for the county’s most vulnerable families” and that it further demonstrated “clear disregard and disrespect to Rutherford County” and its “legislative protective [sic] right to realign to a different LME/MCO.”


You Should Know:
Just as a private health insurer must notify customers when changes are made to their coverage, MCOs are required to inform their members when something happens that may affect their services.


Vaya reached out by mail to individuals in Rutherford County who received mental health, substance use disorder and/or intellectual/developmental disabilities services through Vaya’s network over the past 12 months. The letter informed citizens of the commissioners’ decision, the potential impact on their care, and the process for providing feedback. Vaya believes that members and their families have a right to participate in decisions about their health care and to be informed when proposed changes could affect their health care.


(Read the letter to Rutherford County members)


You May Have Heard:
At the May 7 Rutherford County Commissioners Meeting, Commissioner Bryan King stated that members of Vaya Health’s leadership team “have never attempted to directly engage county officials or members of our administrative team since this Board of Commissioners has been in office.”


You Should Know:
As required by N.C.G.S. § 122C-118.2, Vaya Health has a County Commissioner Advisory Board (CCAB) that serves as the chief advisory board to the Vaya CEO and Vaya management regarding the delivery of services in its 23 counties. Each Board of County Commissioners is asked to designate a commissioner to serve on the CCAB, which meets quarterly. Rutherford County Board of Commissioners’ designee is Bryan King. Vaya’s meeting records indicate Commissioner King has attended one meeting on March 24, 2015. Vaya staff have routinely reached out to Commissioner King to encourage his participation in the CCAB.


You May Have Heard:
In the rationale of their proposed disengagement plan, Rutherford County Commissioners maintained that “Leadership and staff throughout Partners are engaged in relationships within their communities, actively collaborating with stakeholders, providers, consumers and others to meet the challenges faced.”

At the May 7 Rutherford County Commissioners Meeting, Commissioner Bryan King stated that Vaya leadership “disengaged from Rutherford long ago.”


You Should Know:
Vaya Health values its collaborative relationships in Rutherford County. Vaya staff routinely participate in an array of meetings with other county partners and stakeholders, including:


Rutherford County Community Health Council – CHC brings together the county manager and department directors, Vaya Health, DSS and health directors, law enforcement, community leaders in health care and education, the Chamber of Commerce, Council of Government and non-profits to address the county’s key health concerns. Meetings are held monthly.


Rutherford County DSS High Risk Staffing –Vaya staff attend and provide both case consultation and coordination for children and family involved in Rutherford DSS. Meetings are held monthly. Prior to 2016, meetings were held weekly, with Vaya staff attending. Rutherford County Juvenile Justice Treatment Continuum Children and adolescents often struggle with mental health, substance use and environmental stressors while navigating the juvenile justice system. Vaya staff attend a bi-weekly meeting with Rutherford County providers and juvenile justice authorities to ensure children receive the right interventions and supports.


Rutherford County Community Child Protection Team/ Child Fatality Prevention Team – This combined team reviews active cases in which abuse, neglect or dependency is found and where resources may be lacking or gaps and deficiencies in resources affect the outcome of the case. The team also reviews child deaths that are suspected to have resulted from abuse, neglect or dependency. Vaya Health has been part of the team since 2013, with staff regularly attending the quarterly meetings.


Rutherford Regional Hospital High Utilization Meeting– Vaya Health staff attend this quarterly meeting that focuses on frequent readmissions at Rutherford Regional Hospital. Care models that focus on better outcomes, improved patient experience, improved clinician experience and lower costs—known as the Quadruple Aim—have been effective in lowering readmission rates. Vaya Health’s model, Vaya Total Care, uses technology to more effectively identify and match an individual’s whole person care needs to behavioral and physical health treatment as well as social support resources.


Rutherford Regional Hospital Treatment Team – Vaya’s Acute Response Care Coordinator, who is located on site at Rutherford Regional Hospital to help members who need assistance in the coordination of care across MH/SUD/IDD and other healthcare networks, attends this weekly meeting.


Rutherford County Behavioral Health Coalition – Vaya staff have attended the bi-monthly meetings of this community-based coalition since 2013.


Rutherford County Healthy Children’s Collaborative – Community leaders, providers, county residents and Vaya staff meet each month to discuss and assess childhood obesity in Rutherford County.


Likewise, Rutherford County residents are members of Vaya Health committees and stakeholder groups, serving as influential voices in the community and advocates for the best interests of those individuals and families who receive services through Vaya’s network of providers. Rutherford County residents serve on Vaya’s Consumer and Family Advisory Committee (CFAC), Human Rights Committee and Innovations Stakeholders group.


You May Have Heard:
At the May 7 Rutherford County Commissioners Meeting, Commissioner Bryan King stated that the county was “27th in the state for highest counties with an opioid death in 2015”. Other commissioners have claimed that Vaya does not provide naloxone to the county.


You Should Know:
Vaya was the first LME/MCO in the state to purchase/provide NARCAN®, the first and only FDA-approved naloxone nasal spray. In fact, because of Vaya’s leadership on this issue, DHHS asked Vaya to purchase NARCAN® for distribution statewide. Vaya has partnered with the North Carolina Harm Reduction Coalition (NCHRC) to distribute 157 NARCAN® and Naloxone kits in Rutherford County since 2014 (64 in 2017 alone). Over the past 10 months, Rutherford County law enforcement has requested and been supplied an additional 75 NARCAN® kits by Vaya. Six opioid overdose reversals were reported in Rutherford County in 2017 (more than the previous three years combined).


The opioid epidemic is hitting Rutherford County hard, but Vaya Health is committed to working with local and state partners to address it. Vaya staff serve on the Opioid Leadership Action Team and Substance Use Prevention subcommittee of the Community Health Council of Rutherford County. Vaya staff helped plan the Rutherford County Opioid Leadership Forum in October 2017. The event was sponsored by North Carolina Association of County Commissioners (NCACC). Vaya’s Chief Medical Officer and a representative from the Provider Network team presented at the forum. In their report out to NCACC, Rutherford County identified Vaya Health as a key partner to help champion legislation, funding and programming, as well as an asset in expanding education initiatives. And in their Strategic Goal Planning and Setting for FY 2018-2019, Rutherford County Commissioners identified Vaya Health as a partner in continued efforts to address “substance addiction and mental health service needs in the county”.


Vaya is currently working with the Rutherford County Detention Center on a grant-funded pilot project. The program offers a year-long continuum of care that includes Medication Assisted Treatment (MAT) with Vivitrol, a prescription injectable medicine used to treat opioid dependence, and individual or group therapy during incarceration. When participants re-enter the community, they receive MAT, outpatient treatment and/or peer support services. Participants are also linked to medical care and other community supports. (Read more about the program in a report by WLOS-TV)


You May Have Heard:
In their resolution to end the county’s partnership with Vaya Health, Rutherford County Commissioners stated, “Partners’ priorities and projects align well with the county’s responsibilities to citizens with Behavioral Health and Intellectual/Developmental Disability needs.” And in the rationale of their proposed disengagement plan, Rutherford County Commissioners maintained that “As the state reports on numbers of individuals who access care compared to the population as a whole, Partners consistently is at or near the top, indicating good accessibility of services to residents in the counties served.”


You Should Know:
Managed Care Organizations, or MCOs, like Vaya Health and Partners must report regularly to the N.C. Department of Health and Human Services about how many individuals look for services, how many receive services and what kinds of services they receive. The penetration rate, or proportion of individuals who sought and received services, is the best indicator for how easily residents can find and receive the care they need. Since 2012, Vaya Health has consistently had the highest penetration rate in the state, and it is always higher than Partners.


From July 2017 to March 2018, Vaya Health’s penetration rate for Medicaid was 8.1%, which is the highest in the State. That means 12,063 individuals who have Medicaid received mental health, substance use disorder and/or intellectual or developmental disabilities services. Partners’ penetration rate for the same period was only 7.9%.


From July 2017 to March 2018, Vaya Health’s penetration rate for non-Medicaid was 3.9%. That means 3,030 individuals who do not qualify for Medicaid received mental health, substance use disorder and/or intellectual or developmental disabilities services. Partners’ penetration rate for the same period was only 2.4%.


Using cost savings to pay for services for individuals in need is a priority for Vaya Health. In North Carolina, the Medicaid Innovations Waiver allows individuals with intellectual or developmental disabilities to live more independently while receiving long-term services and supports. Federal and state funding for the Innovations Waiver is limited, and there is a wait list for eligible consumers to receive Innovations services. This wait list is also known as the Registry of Unmet Needs. When an MCO manages care effectively, the savings can be used to pay for services for individuals on the Registry of Unmet Needs. From July 2017 to March 2018, 430 individuals on the Registry of Unmet Needs received services through Vaya Health. During the same period, only 209 individuals on the Registry of Unmet Needs received services through Partners Behavioral Health Management.


Vaya also reimburses providers of Innovations Waiver services at a higher rate than Partners, resulting in approximately $417,550 additional reimbursement annually.


You May Have Heard:
In the rationale of their proposed disengagement plan, Rutherford County Commissioners stated that “Rutherford County has always desired more local services and a choice for county residents”.


You Should Know:
Vaya’s current service array is more robust than Partners’. In fact, there are services contracted by Vaya and utilized by Rutherford County consumers that are currently not contracted by Partners or available to consumers in the eight counties Partners serves.


Since 2013, Vaya has been actively working with area providers to add these specialized services to respond to urgent county needs and offer evidence-based, person-centered solutions that go above and beyond State requirements. Loss of these services in Rutherford County could pose significant risk and disruption of services.


Partners promises that they will add these services to their benefit plan in the future, but there is no guarantee they will be able to follow through on this commitment. Vaya has a proven track record of leading the way in offering these services now, because it is the right thing to do for consumers, not because they are trying to convince a county to join their catchment area.


Single Point Assessments

For many families, trying to find the “right door” for assessments and services can be challenging. With single point assessments, the referring agency (DSS or DJJ, for example) has access to a calendar of appointments for the assessing agency. An assessment appointment can be scheduled while the family is still there, and the assessor meets the family back at the referring agency’s office for the appointment.



Intercept uses family-centered, strength-based interventions to divert youth from out-of-home placements, such as residential treatment facilities, foster homes, psychiatric residential treatment centers, hospitals or group homes, and successfully reunite children with their families in the community. Specialists provide services to the whole family, instead of just the child, meeting with families at least three times weekly and remaining on-call 24/7. Treatment plans are collaborative and specially tailored to each family.



YVLifeSet helps young people aging out of state custody successfully transition to independence. Specialists work with participants to meet their goals, such as finishing high school or earning a GED, seeking physical and mental health services, accessing community resources and building and maintaining healthy relationships. What sets YVLifeSet apart is that the family is considered a key part of the young person’s path to success.


Long-Term Community Supports (LTCS)

Long-Term Community Supports is a community-based comprehensive service for adults with intellectual and/or developmental disabilities (IDD) who would otherwise be institutionalized in an intermediate care facility. LTCS provides individualized residential and day programs that teach skills to help consumers live as independently as possible in the community.


You May Have Heard:

In the rationale of their proposed disengagement plan, Rutherford County Commissioners stated, “From a commuting pattern and ‘citizen flow’ perspective, Rutherford County aligns well with Cleveland County and shares much in the way of normal flow of local residents. There is a greater sense of connection to Cleveland County for most local citizens than traversing the mountain to reach Asheville for goods and services, including healthcare.”


You Should Know:

Vaya Health understands the connection between Rutherford and Cleveland Counties, which is why it has always contracted with Cleveland County providers to ensure that Rutherford County residents have access to providers in Cleveland County.