Billy West had a problem.
The CEO of Servicios de recuperación Daymark was sitting in Lexington, hours away from the flooding and wind from Hurricane Helene that had toppled trees into power lines and washed out roads and bridges. He was fielding calls and texts from Daymark staff across North Carolina’s mountains.
“We assumed this would be a mild to moderate weather event,” West said. “But calls quickly started coming in about the flooding, impassable roads, no power—communication started to get very spotty and even ended in some places.”
In Asheville, the center director had to walk a mile just so she could make phone calls.
“We’re running out of supplies,” she told West. “We have a house full of kids and we’re running out of supplies. Some staff can’t get in—some we can’t get in touch with.”
West knew they needed to get the kids off the mountain and to safety. But evacuating a facility-based crisis center is easier said than done. Daymark operates over 40 facilities in 28 North Carolina counties, but only two are suitable for children, the Caiyalynn Burrell Child Crisis Center (CBCCC) in Asheville being one of them.
“Between the Asheville facility and another, I’ve got 30 minors in care with 14 at the CBCCC. I’ve got the space at our Richmond County FBC, I’ve got the staff,” West remembers, referring to Daymark’s Child Facility Based Crisis center in Rockingham. “But I need a way out of Asheville. I also need a waiver to place 14 additional children in an FBC only licensed for 16 and that already has 15 children. This isn’t as easy as just taking your normal route from Asheville to Charlotte down to Richmond County, where these kids were going.”
West worked with Vaya Health, the N.C. Department of Health and Human Services, and the Highway Patrol to transport kids and staff out of the storm zone. A trip that would normally take four hours took almost 20.
“I have to give both staff and the kids credit. It was an adventure. It was a scary time.”
Enough to Worry About
Daymark had six facilities with major impacts from the storm. Staff from those facilities were all eventually accounted for, but some lost homes or loved ones due to the storm. Making sure those staff knew they would be paid was a priority.
“Vaya was great. Vaya helped us make sure everybody got paid. While dealing with a personal crisis, or helping a patient, or both—folks didn’t have to worry about their paycheck. They had enough to worry about.”
Eventually, Vaya would issue more than $6.8 million in provider stabilization payments to Helene-affected providers in the 22 counties Vaya serves that would be declared disaster areas in the weeks and months following the late-September storm.
West is grateful for his longstanding connections with Vaya. He has known Tracy Hayes, Vaya’s Area Director and CEO, for more than a decade. He was in near-constant communication with her and other Vaya staff in the days after the storm.
“We were able to communicate. We were able to work together to get people to safety. We were able to pay staff to keep them on board. And we were able to identify people with needs and find a way to serve them. Sometimes it was telehealth. Sometimes it was allowing someone to ride out on an ATV to deliver medicine even though we didn’t have the treatment plan paperwork done. Those things were just imperative.”
A Public System for the Public Good
West says that even beyond the one-on-one relationships he and other providers have with Vaya, having a public, community-led behavioral health system in North Carolina was a boon in a crisis like Helene. Instead of out-of-state or national payers, providers work with local management entities that are created for the benefit of North Carolina communities.
“The way I look at it, these are public systems are for the public good. Our managed care organizations like Vaya, they are public managers for a reason. I’m not saying we don’t have a payer-payee relationship over some things—but in cases like this, the focus was: what was the community need?”
West cautions that the effects of the storm are far from over. West’s experience following Hurricane Fran is that it can take 3-5 years for some effects to surface. Many people who have had significant loss from the storm will be coping during the extensive process of getting things back in order in their lives. It’s often several years after the crisis is over that people are able to take stock of their losses and behavioral health issues may surface.
“Our behavioral health system must stand ready to increase awareness of depression risks, advertise where to get help, and be ready to provide care when it is needed,” West said. “This is the reason you have a public payer and providers that are part of the fabric of the community.”
It will take all of us, West says.
“There are great stories of recovery to tell from this terrible event,” West said. “We need to celebrate them. But we also must realize—recovery doesn’t stop when the water recedes, and a building is repaired. It’s going to be a lifelong process for many of us. We all need to be part of the process.”
