Commissioners approve moving Alliance Health expansion proposal to consent agenda after presentation on service and funding options

Alliance Health presented a multi-part proposal to expand behavioral-health, substance-use and jail reentry services in Cumberland County and the Board of Commissioners voted to place Option 1 of the proposal on the April 21 consent agenda for final approval.

The presentation, led by Rob Robinson, chief executive officer of Alliance Health, with Kelly Gabela (chief financial officer) and county staff in the room, summarized services already added in the region and proposed three new county-funded programs: an integrated specialized primary-care clinic with Cape Fear Valley Health, a post-overdose response team, and a jail liaison/post-release care coordination team.

The proposal arises from several years of planning and an accumulation of restricted fund balance on Alliance’s books. Gabela said Alliance’s restricted fund balance for Cumberland County stood at “a little less than $9,000,000” as of June 30, 2024. She described two funding options: Option 1 would draw on the existing fund balance to cover some ongoing costs in fiscal 2026, while Option 2 would budget roughly $4.8 million from county appropriations instead of using the fund balance; Alliance projected that without new funding the expanded programs would require additional county dollars by fiscal 2028.

Robinson described services already in place or expanded during the pandemic and since Medicaid expansion, including added providers, peer-support and outreach teams, CityBlock as a community provider, residential and bridge-housing capacity, mobile crisis work and youth-focused mobile crisis (Morris) care. Robinson said the new funding would support an integrated primary-care partnership, a post-overdose response outreach team (an initial one-time gap payment and an ongoing annual amount), and a three-person jail liaison team (two master’s-level care managers and a certified peer support specialist) to coordinate reentry and continuity of care.

County public-health staff said the proposal aligns with sequential-intercept mapping and opioid-settlement strategies already under way and emphasized overlap with existing county-funded services to avoid duplication. Commissioners asked for clarification about budget timing and long-term sustainability, use of the fund balance, and what would happen if Medicaid funding levels changed; Alliance staff said a reduction in federal Medicaid match would pressure state and local funding and could require program reductions.

After questions from multiple commissioners about budget impacts and program details, the board voted to move Alliance Health Service Expansion Proposal Option 1 to the consent agenda for the April 21, 2025 meeting. The motion was made, seconded and approved by voice/show-of-hands vote.

The proposal as presented included estimated one-time and recurring costs: a not-to-exceed $750,000 one-time contribution toward the specialized primary-care partnership, a one-time stop-gap amount of about $179,462 for the post-overdose response team and ongoing annual costs for that team (presented as roughly $693,000), and an annual estimate of about $292,000 for the jail liaison/post-release program. Alliance estimated the cumulative expansion would total roughly $2,000,000 in initial expansion funding and indicated the need for county discussions about whether to use fund balance (Option 1) or annual budget appropriations (Option 2) to sustain programs into the late 2020s.

County staff will include the item on the commissioners’ April 21 consent agenda for final action. The board’s vote to place the item on the consent agenda was recorded as an affirmative voice/show-of-hands vote.