Care provider in Randleman Center uncertain

Synergy Recovery Inc. has offered detox for people with substance use problems and other behavioral health care in the facility for 25 years while leasing it from the county. It has also operated as a facility-based crisis center since 2021, providing stabilization, treatment and planning for people in acute crisis needing a secure environment.

In recent years, Synergy has provided services at the Peace Street facility under contract with Asheville-based Vaya Health. Vaya manages Medicaid and other public funds for behavioral health care in Wilkes and 30 other western North Carolina counties.

The two-story Peace Street building was named the Shirley B. Randleman Center in 2021 in recognition of Randleman’s role in securing $1.4 million from the legislature for renovating the facility and enlarging its first floor while she was a state senator. Randleman is in the first year of her first four-year term as a Wilkes County commissioner and serves as chairman.

Synergy’s contract with Vaya to provide behavioral health services and the company’s lease contract with Wilkes County government for the Peace Street facility both expire June 30.

On March 4, the Wilkes commissioners unanimously approved a motion stating that the county will negotiate a new lease of the Peace Street facility with whoever Vaya selects as a service provider there. Commissioner Evan Handy made the motion after a closed session lasting over an hour.

Carl Spake, Synergy clinical director and president, said in an interview Wednesday that he received a letter from County Attorney Tony Triplett stating that the commissioners agreed to allow the county’s lease with Synergy to expire without a renewal during a close session of their Feb. 18 meeting.

Spake said Vaya officials told him Synergy accomplished everything the managed care organization wanted in place with its operation in the Peace Street facility. He added, “I think the county has a misunderstanding from the top,” referring to top Wilkes County government officials.

Wilkes County Manager John Yates said in an interview on Feb. 28 that county government will work with whoever Vaya selects as the service provider, “but we need to know from Vaya who that will be.” He added, “We are the landlord (of the Randleman Center) and it is Vaya’s responsibility to provide services.”

Vaya CEO Tracy J. Hayes said in a written statement released Feb. 26 that “Vaya staff are working with the current provider (Synergy) to ensure we have a comprehensive transition plan. Vaya’s decades of experience with provider transition, combined with our strong partnership with the county, make us confident that the needs of the community will continue to be met.” Hayes also said, “Vaya Health is working hand-in-hand with Wilkes County leaders to ensure that the crucial mental health and substance use services provided at the Shirley B. Randleman Center continue for those who need them.”

Shepherd told the Wilkes Journal-Patriot on Feb. 26 that the statement from Hayes was released after Randleman said she wanted “Vaya to put out a press release ASAP regarding services at the Randleman Center.” Shepherd also then that “the county is weighing its options about the lease of the Randleman Center. I wouldn’t be able to speak to the lease, but we want to make sure the community doesn’t worry that services could be lost at the facility.”

When contacted on Feb. 28 for a more complete explanation of the situation with the facility that bears her name and its lease to Synergy, Randleman referred the newspaper to Vaya. Despite the newspaper’s requests to AK Brinson, Vaya public relations manager, no more information beyond the brief written statement from Hayes has been released.

Synergy accepts clients from any of the counties served by Vaya, but it gets more from Wilkes than any other county. Many also come from Caldwell, Watauga, Ashe, McDowell and Buncombe counties. He said Synergy primarily serves people who are dually-diagnosed as both substance user and mentally ill, which can mean schizophrenia, delusional, psychotic, bipolar or other disorders

One key goal of the expansion and renovation of the Peace Street building was for Synergy to be able to accept people ordered involuntarily committed (IVC) by a magistrate for treatment of behavioral health and/or substance use issues. Designation as an IVC center comes from the N.C. Department of Health and Human Services.

Spake said Wednesday that Synergy’s operation in the Peace Street building now has the IVC designation, but that it had only received one IVC referral largely due to policies of Wilkes Regional Medical Center in North Wilkesboro. The first floor is a facility-based crisis center and detox is offered on the second floor.

Spake said in 2023 that Synergy averaged having nine of its 16 beds filled per day. He said then that with all clients being voluntary, they sign themselves in and can easily sign themselves out. Clients initially have a five- to seven-day stay. Accepting involuntary commitments would allow Vaya to keep clients longer if needed.

Concerns have been raised in recent years about local law enforcement officers having to spend days with people under IVC orders at Wilkes Medical Center until beds are available for them at designated IVC treatment facilities elsewhere in the state. Unlike some other community hospitals, Wilkes Medical Center doesn’t have this designation.

Spake told the commissioners in October 2023 that achieving designation “as an IVC center and being able to take people who are a danger to themselves or others related to behavioral health problems or substance abuse… has proven to really be more of a bear than we anticipated.” In October 2023, Synergy’s biggest remaining hurdle in receiving the designation was installing a new door lock system on its county-owned building.

Spake said Synergy received the accreditation it needed from the Council on Accreditation for being an IVC center. He noted that Synergy received IVC cases until the state made changes in the IVC process several years ago.