Two will become one.

A pair of public agencies overseeing access and management of services for mental health, substance use and intellectual/developmental disabilities have entered into a formal agreement to consolidate. The Boards of Directors for Wilmington-based CoastalCare and Greenville-based East Carolina Behavioral Health (ECBH) signed a letter of intent to form one new agency by July 1, 2015. The new public agency will manage state funds and Medicaid dollars for behavioral health services across 24 counties in eastern North Carolina.

Currently, ECBH serves all four counties in the Roanoke-Chowan area (Bertie, Gates, Hertford and Northampton) as well as 15 others – Beaufort, Camden, Chowan, Craven, Currituck, Dare, Hyde, Jones, Martin, Pamlico, Pasquotank, Perquimans, Pitt, Tyrrell, and Washington.

CoastalCare now covers Brunswick, Carteret, New Hanover, Onslow, and Pender counties.

The new entity will maintain about 400 employees and keep current office locations across the 24-county area.

A state Medicaid Waiver in 2011 allowed public mental health agencies to move from a fee-for-service system to a managed care system. To meet population and operational requirements to manage Medicaid dollars, agencies across the state began to consolidate to form Managed Care Organizations. All 100 counties have been operating under the Medicaid Waiver model since March 2013.

Consolidation of CoastalCare and ECBH is in line with the plan proposed by the current nine public agencies in response to Governor Pat McCrory’s initiative, “Partnership for a Healthy North Carolina,” and NC Department of Health and Human Services (DHHS) expectations. The plan is to continue operating regionally based organizations while consolidating the existing nine organizations into approximately four. This is designed to maintain goals of improving quality of care, improving access to care and increasing cost efficiencies. During the first year of the Medicaid Waiver, these nine entities saved North Carolina over $150 million.

ECBH CEO, Leza Wainwright, said the consolidation would increase the efficiency of the current system, and make it easier to navigate for consumers and providers alike.

“Under current operations, providers who serve several different counties could be working with CoastalCare and ECBH, which means using two different processes for service authorizations and claims. Some people receiving services may need to travel to another county to see a certain provider in order for their regional network to match their Medicaid assignment,” Wainwright explained. “Consolidating will streamline these issues and will assist in making services easier to provide and receive.”

Speaking earlier this month to the Gates County Board of Commissioners at their regularly scheduled meeting, Wainwright boasted that ECBH has maintained a strong track record over the past two years in regards to the Medicaid Waiver.

“One of the things the Waiver was supposed to do was control costs and we have demonstrated that has happened, but not at the risk of reducing services,” she said. “The number of people we serve has slightly increased, to now about 28,000 people a year. We have saved about $8.5 million in state money, money that we can re-invest into the counties we serve, to include upgrading technology, specifically our Tele-Health Program.”

Wainwright stressed to the Gates County leaders that consolidation will not lead to a reduction in services.

“We will try to increase our presence into our local communities; you will see us,” she said.

“ECBH and CoastalCare have stayed true to our consumer-focused missions through these recent transitions and have met every expectation set by DHHS,” said CoastalCare CEO, Foster Norman. “As a new entity, this organization will continue the dedicated service offered by its predecessors. We are looking forward to continuing to serve the communities of eastern North Carolina.”

Maintaining a local presence and taking the least disruptive approach for consumers, families, providers, the community, and employees of the current agencies is paramount for the new organization. With a total population of 1,259,757 – and an estimated 165,000 of those people eligible for Medicaid – the combined agency would have an approximate budget of $400 million annually.

Norman stated, “It’s important to remain visible and ensure our community understands available resources and where to call for access to care.”