Trillium outlines Medicaid changes, provider pressures and local services to Wayne County commissioners

Victoria Jackson, regional vice president for Trillium Health Resources, told the Wayne County Board of Commissioners on Aug. 19 that the behavioral-health managed-care landscape is changing and that those changes are affecting local provider capacity and funding.

"We are considered the largest geographically because we have 46 counties that we're covering," Jackson said, describing Trillium's coverage area and its role as one of North Carolina's LME-MCOs (local management entity–managed care organizations). She said Trillium manages multiple plans and that membership numbers fluctuate: roughly 51,000 in the Tailored Plan, about 163,000 in the Medicaid direct behavioral-health plan, and about 287,000 under the state health plan, figures she said are fluid.

Jackson said Trillium is preparing for reductions announced at the federal and state level. "The department had put out a message that providers are going to take a cut," she said, estimating that the reductions could average about 3 percent, with steeper cuts (8–10 percent) for inpatient and residential providers and some therapy providers.

Why it matters: Commissioners pressed Trillium on whether local vendors and facilities will continue to serve Wayne County residents and on whether transportation and out-of-county placement costs will fall to the county. Several commissioners warned that reduced provider capacity or funding could force children and adults to travel out of state for placement, increasing county staff travel and overtime costs.

Jackson said Trillium is working closely with the North Carolina Department of Health and Human Services and with providers to manage services within the new funding constraints. She acknowledged difficulties placing children in residential treatment and said residential capacity and crisis services are statewide issues. "Residential treatment, especially for our children, is a challenge," she said, adding that Trillium collaborates with the Department and with neighboring counties to identify openings.

Commissioners asked for specific lists and local data. Jackson said Wayne County has representation on Trillium's regional advisory board and that she will provide the county with more specific information and local contact points. "On our online provider-choice database, it lists by county all the providers that's within your county," she said when asked about local provider listings. She also agreed to follow up with an email to County staff with a provider list and a breakdown of the budget she described.

Jackson described local programs Trillium supports, including school-based substance-use prevention, distribution of naloxone kits and test strips, peer-support access through a recovery app (CHES), small-business funding programs for people with intellectual/developmental disabilities, and technology supports for individuals with IDD (Tula).

Jackson also briefed the board on Medicaid program phases and upcoming transitions: she said the Tailored Plan launched July 1 of the prior year and that Phase 3 (the children and family specialty foster-care plan, to be operated statewide by Blue Cross Blue Shield’s Healthy Blue Care Together) will transfer an estimated share of membership to that plan as it takes effect. "We're looking at about transitioning, a little approximately 11% of our membership over to Blue Cross Blue Shield," she said.

Jackson invited commissioners and county staff to contact her directly for follow-up and provided business cards and local liaison contacts. Commissioners pressed for continued communication and expressed concern about workforce and sustainability of providers if funding cuts continue.

Ending: Jackson said Trillium will continue outreach and follow up to the county with provider lists, budget breakdowns and local contact information. Commissioners asked staff to coordinate receipt of that information so the board can assess local impacts.