Dr. Devdutta “Dev” Sangvai was sworn in as the new Secretary of the North Carolina Department of Health and Human Services (NC DHHS) on Sunday, Jan. 12, and – given one particular large looming problem emanating from Guilford County and many other counties in the state – he will have some work to do from day one.

Leaders of Guilford County and other counties were greatly angered recently when a last-minute move by the outgoing secretary of the Department of Health and Human Services Kody Kinsley stripped those leaders and their counties of any oversight capacity over billions of dollars in federal mental health money.

Dr. Sangvai was chosen by North Carolina’s new governor Josh Stein to lead the department that oversees health and many other important state services.

Sangvai (pictured above)  will be the state’s 19th Secretary of Health and Human Services.

The Sunday swearing-in ceremony was held at Dorothea Dix Park where the department is currently headquartered.

While most new officials get a honeymoon period before they really have to get down to work, Sangvai takes office with at least one huge problem on his plate:  On the way out the door – on December 31, 2024, Kinsley’s last day in that position, just before Kinsley turned out the lights of his old office for the last time – the former NC Department of Health and Human Services secretary committed what many say was a highly underhanded act that stole the ability of 46 counties, including Guilford County, to have any say over how billions of dollars in federal money is spent in their counties on things such as addiction treatment, mental health services and behavioral health issues.

In other words, Kinsley left Sangvai a huge mess that involves nearly half the counties in the state.

Even though Kinsley is the person being sued by Guilford County, the consequences of his 11th-hour move will need to be dealt with by Sangvai because NC DHHS will have to manage the ongoing war between some county leaders and Trillium, the management entity that’s now overseeing how those mental health dollars are being spent in almost half of the state’s counties.

About two decades ago, Guilford County had a county department that administered mental health services and the federal funds that paid for those services.  Over the years, in the name of “efficiency,” state officials forced the counties into larger groups – however, the counties did have some choice as to which group they joined.

Guilford County ended up choosing Sandhills Center, Inc., where Guilford was one of nine counties. Guilford County had seats on the Sandhills board, which allowed the county to vote on matters pertaining to Guilford County as well as how money was spent in the nine-county area.  However, then Sandhills and another administrative entity, Eastpointe, were forced to merge, and then forced under Trillium, which is when the problems started.

In addition to suing Kinsley, Guilford County is also suing Trillium, in a legal action that began earlier in 2024 in an attempt to allow counties to maintain some control of those federal dollars.

Chairman of the Guilford County Board of Commissioners Skip Alston said this week that since Kinsley dissolved the old Trillium board on December 31, 2024, and named a new board with practically no county representation, all 46 counties are now at the whim of essentially one person.

Alston and Commissioner Carlvena Foster were Guilford County’s representatives on the old board but are not on the new one, which has not met yet.

Alston said that Trillium CEO/Area Director Joy Futrell wanted him off the board because he was asking too many questions.  During 2024, Alston said, Trillium controlled 11 of the seats on the 22-member board and so any time the original Trillium group didn’t like something, the Trillium board had the votes to call the shots.

Alston said he was alarmed after the merger to find out that CEO Joy Futrell was signing contracts on behalf of the board without Trillium board members ever even seeing those contracts.  Alston said one huge purpose of a board such as this one is to oversee the contracts and other financial dealings of the staff.  For instance, Alston said, Guilford County Manager Mike Halford can sign some smaller contracts under a certain dollar threshold on behalf of Guilford County; however, when it comes to any major contracts or large financial moves, the board, in that case, the Guilford County Board of Commissioners, must vote to approve the expenditure or the action.

In 2024, Alston began to openly question if Futrell had the authority to sign any contract on behalf of Trillium.  He said at board meetings he asked repeatedly for the legal paperwork that gave her the authority but he said Trillium could not produce any such justification.  He said that the old Trillium board had been letting Futrell just sign any contract she wanted to sign.  He said since she didn’t have authority under the old board and the new board hasn’t met yet, she is still signing contracts on behalf of Trillium with no justification.

“She does not have the authority to sign those contracts,” Alston said.

He said that, since there had been no oversight of previous contracts that Trillium had signed with providers and others, all previous contracts should be audited.

That was another move in 2024 by Alston that the Trillium board shot down.

Alston said it causes him a great deal of alarm that, every time he has sought financial transparency from Trillium, Trillium has put up roadblocks.

He said some former original Trillium board members who Alston butted heads with in 2024 are upset right now because their board seats got snatched out from under them as well when Kinsley dissolved the prior board at the very end of 2024.

Alston said he’s confident that Futrell handpicked the new board – which is 18 members as opposed to 22.  That, he added, means she will have near total control of the billions of dollars that flow through Trillium.

“Don’t you think Mike Halford would like to pick his own board,” Alston said of the Guilford County manager, “But that’s not how it works.”

Robeson County Commissioner Wixie Stephens, a former Eastpoint and Trillium Board Member, echoed the concerns of how this was done – as part of a huge bill with no debate or disclosure.

 This week, she said, “The addition of these revisions via a conference report without disclosure to legislators or affected counties was a blatant disregard for transparency and due process. The people we serve deserve better. I am so disappointed in how this transpired without open debate or discussion.”

Alston said he plans to speak very soon with Sangvai, the new secretary of NC DHHS, in addition to pursuing the matter in the court and with elected state officials.

Guilford County’s lawsuit against Kinsley and Trillium has been seeking a permanent injunction to the changes and restoration of local control of public mental health funds.

While the matter will no doubt be a headache for Sangvai from the start of his tenure as secretary, he at least got to enjoy his swearing-in ceremony this weekend.

“I am honored to lead the Department of Health and Human Services and build on the already strong foundation toward creating a healthier North Carolina for all,” Sangvai said upon being sworn in. “I look forward to working with the incredible team at NCDHHS and Governor Stein to ensure every North Carolinian has access to the right services to support their health, safety and well-being — no matter where they live or how much money they make.”

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