The needs of people in Wake County with behavioral health problems far outstrip the county’s ability to pay for their care, Wake County commissioners were told Monday.

A discussion arose as commissioners discussed and approved a $10.7 million funding agreement with Alliance Behavioral Healthcare for UNC Health Care to continue behavioral health services at the WakeBrook mental health facility. (Alliance is the local management area agency that pays out money it receives from Wake to behavioral health care providers.)

One section of the agreement caught commissioners’ eyes: “It is anticipated that there will not be enough funds to cover the costs of the programs; UNC Health Care will cover the budget shortfall.”

Wake County spends more than $26 million annually on behavioral health care. UNC Health Care committed $40 million when it entered into an agreement with Wake County to operate WakeBrook in 2013, but it has spent about half that amount.

“We are proud of the work we do at WakeBrook, but it’s not enough,” said Glenn George, senior vice president and general counsel of the UNC Health Care system.

If more than $10 million isn’t enough to cover WakeBrook’s crisis, assessment, addiction treatment, and inpatient functions, how much would it take, Commissioner Erv Portman wondered. “What is the full need?” Portman said.

Rob Robinson, CEO of Alliance Behavioral Healthcare, had an answer: $366 million for uninsured and underinsured people in the four counties Alliance covers*, including Wake, to get the same package of benefits they would get from Medicaid. Had the North Carolina legislature expanded Medicaid and not made cuts to mental health care, the cost would have been far less.

Michael Bollini, executive vice president and chief operating officer of Alliance Behavioral Health Care, said Wednesday that it would take approximately $197 million annually to meet the mental-health treatment needs referenced by Robinson.

“We need to make sure that the people understand that these kinds of problems are arising not from this building, but from three blocks down the street,” said
Commissioner John Burns, referring to the General Assembly.

Commissioners have planned an August 28 work session to look into the county’s mental health funding in detail.

*Clarification: Robinson told the county commission Monday that the $366 million was needed for Wake, but he called Wednesday morning to clarify that he had misspoken; that number includes the four counties that Alliance covers: Wake, Durham, Cumberland, and Johnston.