Forsyth faces another behavioral health oversight shift with Vaya Health takeover of Partners

Forsyth County and four other Triad counties will have a new behavioral health managed care organization beginning Oct. 1 with Vaya Health taking over Partners Health Management.

Devdutta Sangvai, the state's health secretary, approved Friday the consolidation that combines Vaya's 32 counties and Partners' 15 counties. The combined MCO will be branded as Vaya Partners.

Vaya is based in Asheville, while Partners is in Gastonia.

Behavioral health MCOs oversee providers of mental health, substance abuse, intellectual and development disabilities, and traumatic brain injuries. The agencies manage Medicaid, federal, state and local funding.

"NCDHHS supports this transition and remains focused on ensuring people - including those with mental health and substance use needs, intellectual and developmental disabilities, and brain injury - continue to receive the care and services they need without disruption," according to a news release.

"As the process moves forward, NCDHHS will work closely with all partners to prioritize continuity of care, support providers and communities, and keep the health and well-being of North Carolinians at the center of this effort."

Partners began providing behavioral health oversight duties in Davie and Forsyth counties in November 2021, when their respective commissioners gained permission from then-state health secretary Dr. Mandy Cohen to leave an embattled Cardinal Innovations.

Vaya Partners, to be based in Gastonia, will serve more than 222,000 individuals, including more than 18,000 in Forsyth - by far its largest county by population.

Vaya and Partners said in a joint news release their combination will "create a balanced and sustainable regional model that supports the long-term viability of North Carolina's public behavioral health system."

"The consolidation also establishes a more connected and cohesive region that better reflects how care is delivered and how communities function, positioning the public system to more effectively meet the needs of those it serves."

Don Martin, Forsyth's commission chairman, played a key role in Forsyth's decision to leave Cardinal for Partners.

Martin said in response to the Vaya-Partners news that "a key issue for me is how the governance structure will change - will they regionalize the organization with area directors?"

Martin said that Forsyth, as the largest - and only urban - county in a combined Vaya-Partners, must have a board of directors representative as it does with Partners.

Martin said commissioner Gray Wilson, who serves on the Partners board, voted against joining Vaya "partly because such questions were not answered."

"I suspect that there could be some savings in back-office expenses, but one has to question whether something was broken and needed to be fixed."

Martin said the commissioners' focus with the consolidation "is that our citizens who currently rely on Partners to connect them with physical and mental health providers continue to receive the service they need, and be able to navigate the new bureaucracy to solve problems."

Vaya Health chief executive Tracy Hayes will serve in that role for the combined agency.

Partners chief executive Libby McCraw would become senior deputy chief executive, while Partners deputy chief executive Rachel Porter will remain in that role.

The agencies said individuals who receive services through Partners will not experience changes to their benefits or providers. Contracted providers will experience no immediate changes to participation, billing or administrative processes.

"This consolidation brings together the strength, experience and shared commitment of both organizations to better serve members and communities across North Carolina," McCraw said.

"We will build on that foundation, broaden our reach and deliver even greater impact for members, families, providers and communities."

Jackie Copeland, Partners' regional director of Community Operation, wrote in a memo to Forsyth officials and behavioral health advocates and providers that "we want to stress our commitment to local relationships, local responsiveness and strong county partnerships remains unchanged."

"You will continue working with the same regional director, community staff and leadership contacts you know today.

"We remain committed to maintaining local connection, community engagement and accessible support for the counties and communities we serve. Our goal is for this transition to feel stable, thoughtful and minimally disruptive."

Sangvai's order represents the last phase of the consolidation effort, which started with 41 local management organization entities in 2003.

The dramatic reduction over the past 23 years comes from the preference for larger oversight groups by the N.C. Department of Health and Human Services and state legislators.

When the Vaya takeover of Partners is completed, there will be just three behavioral health MCOs in the state.

Trillium Health Resources has 46 counties, mostly in eastern N.C., but including Guilford and Randolph, and Alliance Health with seven.

Other counties in the Partners network are Burke, Cabarrus, Catawba, Cleveland, Davidson, Gaston, Iredell, Lincoln, Rutherford, Stanly, Surry, Union and Wilkes.

Among Vaya's 34 counties are Alamance, Alleghany, Ashe, Rockingham, Stokes, Watauga and Wilkes.

The others are Alexander, Avery, Buncombe, Caldwell, Caswell, Cherokee, Clay, Franklin, Graham, Granville, Haywood, Henderson, Jackson, Macon, Madison, McDowell, Mitchell, Person, Polk, Rowan, Swain, Transylvania, Vance and Yancey counties.

The Republican-controlled legislature included in the 2023-24 state budget language that directed DHHS to reduce the number of MCOs to either four or five in what was called an "effort to improve delivery of care, stabilize the system, and launch tailored plans."

In October 2014, officials with the four-county CenterPoint Human Services of Davie, Forsyth, Rockingham and Stokes expressed their interest in joining Partners rather than Cardinal.

However, CenterPoint and Partners shelved their merger discussions in February 2016, in part because no decision could be reached on who would run the combined agency between CenterPoint chief executive Betty Taylor and then Partners chief executive Rhett Melton.

Davie and Forsyth joined Cardinal in July 2016.

However, Forsyth switched from Cardinal to Partners in November 2021 after years of complaints about service gaps and other problems that people have brought to the board of commissioners.

Forsyth commissioners unanimously authorized a resolution in November 2020 that said the county "has repeatedly addressed concerns directly with Cardinal over the years with little to no resolution."

Those include: gaps and delays in service authorization; authorization of lower levels of care than what is clinically recommended; limited local providers, and a lack of seamless transition during hospital emergency-room discharge planning and transitions to higher levels of care.

There also had been concerns about Cardinal's lack of assistance in placing youth in foster care, particularly those released from juvenile detention centers, along with slow reimbursement rates when counties take the initiative to place the youths.

Laurie Coker, a former CenterPoint board member and founder of GreenTree Peer Support Program in Winston-Salem, was a vocal critic of how CenterPoint and Cardinal handled their oversight duties.

She said she is hopeful that a combined Vaya-Partners will be overall beneficial for individuals and their families.

"Through the years, I have noted that Vaya has been more informed by service users, families and system survivors than any other MCO," Coker said.

"I think Partners had an early start with establishing good data-mining approaches to help inform system improvements.

"What they learn from each other will I think make it an optimally responsive system."

Copyright 2026 Tribune Content Agency. All Rights Reserved.