Trillium updates commissioners on Medicaid transition, local services; panel urges youth prevention

Trillium Health Resources told the Brunswick County Board of Commissioners on April 21 that a statewide Medicaid transition and the launch of "tailored plans" have increased spending and call volume but that the local network is expanding crisis and prevention services.

The update, given by Cecilia Pierce, southern regional vice president with Trillium, covered membership and spending changes since February's consolidation, local programs supported by county contributions and a timeline for remaining Medicaid transformations. Pierce said Trillium now covers roughly 46 counties and that the organization's half-year expenditures after tailored-plan launch were about $802 million, with an expected annual budget near $2 billion. "We had around 80,000 members who were eligible, for those services," Pierce said, adding Trillium served roughly 3,200 people in Brunswick County from July through December in the tailored-plan period and that the value of services there was about $30,000,000.

The presentation described operational changes after the tailored-plan launch: call volume initially surged and has since fallen to "around over 13,000 calls per month," with average answer times near 12 seconds. Pierce said Trillium funds local naloxone kits, distributes xylazine and fentanyl test strips, supported opening a local Oxford House recovery residence, and helped bring mobile behavioral health units and an app-based recovery tool (CHESS Health) to the county. She noted the behavioral health crisis line is answered regardless of insurer and that mobile crisis can deploy with a goal of response "no more than 2 hours."

Why it matters: the Medicaid transformation alters how behavioral and physical health benefits are administered and can change local service costs and access. Trillium framed its local work as a partnership with counties and community providers to maintain access during the change.

At the same meeting the county's Substance Use, Addiction and Mental Health Commission presented a prevention-focused report led by Laura Truman, with contextual remarks by Josh Torvitch of Christian Recovery Centers. The commission highlighted statewide declines in overdose deaths and more modest local declines in emergency-department overdose visits: "for 2024, it looks like for the state of North Carolina, we're down 27 percent in overdose deaths," Truman said, and for Brunswick County ED overdose visits she cited 98 visits in 2024 versus 110 the prior year, an roughly 11 percent decrease.

The commission emphasized prevention for vulnerable youth groups, noting local foster-care data: Truman said about 61.5 percent of children in Brunswick County foster care in 2023 had parental substance abuse as a contributing factor. Presenters urged actions including improved on-site clinical assessments for justice-involved youth, more local residential placements at higher levels of care, expansion of mentoring programs, a school-based working group to review the state's new health curriculum, and continued naloxone distribution and education.

Commission members and Trillium staff answered questions about the consumer and family advisory committee (Trillium said it seeks a mental-health representative), 988 and local 911 center routing, and how pilot services that address social determinants of health have reduced average monthly costs for participants. Trillium noted that some standard-plan enrollment in the county reflects a higher proportion of dual-eligible (Medicare/Medicaid) residents.

The presentations did not include formal votes. Staff and commissioners noted opportunities to help fill service gaps recommended by the commission and to recruit local people with lived experience to advisory roles.