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Poverty, barriers to opportunity loom large for women as NC emerges from the pandemic

North Carolina receives a D+ grade on the Poverty and Opportunity Index

A new report on the status of women in North Carolina suggests that while modest progress has been made since 2016, far too many women are being held back economically.

The NC Department of Administration’s Council for Women and Youth Involvement recently released the report produced in partnership with the Institute for Women’s Policy Research.

While North Carolina ranks tenth in the nation when it comes to women-owned businesses, many more women are struggling to make ends meet.

According to the report, women have experienced a disproportionate number of job losses since the start of the pandemic. As of December 2020, 18 percent of women in North Carolina reported applying for unemployment benefits. Over 15 percent reported having a hard time paying their usual household expenses.

North Carolina ranks 44th nationally for its share of women with health insurance.

Lyric Thompson, policy director for the International Center for Research on Women, said even before the pandemic North Carolina was moving in the wrong direction in terms women’s workforce participation.

One policy change that would make a difference is paid leave, according to Thompson.

“The United States is one of the only countries in the world that does not mandate paid leave in some form, and North Carolina is one of a handful of states that does not have pregnancy protections, paid leave protections, you name it,” explained Thompson during Tuesday’s virtual panel discussion.

Lyric Thompson, International Center for Research on Women

While Gov. Roy Cooper provided paid parental leave for state government employees in 2019, that benefit is not widely available in the private sector.

Higher rents, fewer options

Adrienne Spinner with the NC Housing Coalition said the pandemic further exploited the ability to cover the most basic needs for some families.

“We saw this with the eviction crisis. There are folks that had to work in and out of the home, and even though wages didn’t go up for a lot of folks, housing costs did,” she explained. “We are severely lacking in quality affordable housing stock in this state and across the country. It is a crisis.”

Spinner said to reduce that inequity, North Carolina must increase its housing stock and reduce the instability families are facing.

“And then if we are going to see women going back to work, and returning to work full-time, that cannot be done without affordable childcare,” Spinner added. “Right now, childcare costs more for some folks than in-state college tuition.”

Universal Pre-k should be a priority, Spinner added.

Adrienne Spinner, NC Housing Coalition

For women of color the strain is greater

NCDOA Secretary Pam Cashwell said the 2022 Status of Women report highlights that poverty remains a persistent problem.

“North Carolina remains 38th in the country for the percentage of women living in poverty. That number is 13.6 percent overall, but again there is a great disparity between women of color and white women,” Cashwell said Tuesday.

“In North Carolina households headed by single women with children are more than five times as likely to live in poverty that households headed by married couples with children.”

Dr. Jada Brooks, an associate professor with the University of North Carolina School of Nursing, said domestic violence is yet another problem made worse by the prolonged pandemic.

“Often times this hasn’t been highlighted in North Carolina. The everyday lives of women, including the exposure to violence, all of those things can really compromise women’s health.”

Spinner told the online audience that North Carolina must have more equitable policies that help uplift the most marginalized.

“Just because you’re helping someone doesn’t mean that someone else gets less. If you uplift the most marginalized folks in society, we all rise.”

Lifting the most marginalized should also include a hike in the state’s minimum wage above $7.25 an hour, stressed Thompson.

“There’s zero statutory requirement on equal pay by race or gender. So, there’s really a lot of tools we could use,” Thompson said.

Higher education offers some protections

NCDOA Secretary Pam Cashwell

The report notes ‘higher levels of educational attainment are associated with higher earnings and increased job opportunities’ but educational attainment among women varies greatly across NC counties.

In 45 of the states 100 counties, the share of women aged 25 and older who have earned a bachelor’s degree or higher is less than 20 percent.

Hyde County has the lowest percentage with just 10% holding a bachelor’s or higher.

Greater representation could change the landscape

One way to change the current economic landscape is to get more women elected to public office.

“In North Carolina, women are slightly more likely to vote than women nationally, but we are not well represented in executive and legislative elected offices,” said Sec. Cashwell, noting North Carolina has only had one female governor.

In the NC Senate, 20 percent of the seats are held by women. In the NC House, women hold 28 percent of the seats.

“We clearly have more work to do.”

North Carolina Supreme Court Associate Justice Anita Earls said from her perspective the most important thing is to make it more financially affordable for women to run for office and then hold office once elected.

North Carolina Supreme Court Associate Justice Anita Earls

“We think of political participation as voting, but that’s just a one-time piece,” explained Earls. “’All the other element of political participation, including working on campaigns, running for office yourself, engaging in all the activities that hold your elected-officials accountable, when you have less financial resources, you have less ability to do all those things.”

Judicial public financing helped bring greater female representation to North Carolina’s courts until the legislature repealed the program in 2013.

But Earl said the state is fortunate to have some dedicated organizations that help train women how to run for elected office, something she said was ‘crucial’ to her own success in winning a seat on the state’s highest court.

Earl said another avenue to increasing female representation is by serving on the hundreds of boards and commissions across the state.

“Hopefully it will begin to create more of a pipeline for women to step up the plate and say ‘I have had a leadership role in this setting, and I am now ready to run for public office.'”

Bonus content: Before becoming the State Organizing Director for the NC Housing Coalition, Adrienne Spinner was a community volunteer who ran for public office in 2018. Even though she did not win that race, she has given a lot of thought to promoting equitable policies that uplift women and people of color. Spinner shared her thoughts this week on how to succeed in having more women serve in elected office.

“Great states can do great things.” Former Ohio Gov. John Kasich preaches Medicaid expansion to NC legislators

In an afternoon full of recitations of numbers and policy details on states’ experiences with Medicaid expansion, former Ohio governor John Kasich told North Carolina legislators that getting health insurance to more people was just the right thing to do.

“What I would say to the fine members of the legislature in North Carolina, to the people in North Carolina, there’s a lot of people that need a lot of help,” said Kasich, a Republican who championed Medicaid expansion in Ohio. That state expanded Medicaid in 2014, opening the government insurance program to low-income adults without dependent children.

“We have to open our hearts to those people,” Kasich said. “That doesn’t mean that when we do that that we put ourselves on the road to bankruptcy. It means that we have good management. And at the same time to able to expand this program.”

A legislative committee in North Carolina considering Medicaid expansion called on representatives from other states on Tuesday to talk about how they did it.

Expanding Medicaid would make about 600,000 people in North Carolina eligible for health insurance. Most low-income adults younger than 65 do not qualify for Medicaid. Those that make too little to qualify for subsidized health insurance available through Affordable Care Act marketplaces are said to fall into the health insurance gap.

Gov. Roy Cooper, a Democrat, has been trying for years to get Medicaid expansion in the state, with efforts that started even before he took office. Republicans in the legislature have rejected the idea since a U.S. Supreme Court ruling from 2012 declared Medicaid expansion under the ACA is optional.

North Carolina is one of 12 states that has not expanded Medicaid.

Rep. Donny Lambeth, a Republican who has authored bills that would set up an insurance plan for low-income adults, is co-chairman of the House and Senate committee considering Medicaid expansion. He has said hopes to present a package of proposals later this year.

The committee on Tuesday heard mostly positive experiences from the leaders and policy makers from four states that expanded Medicaid: Indiana, Montana, Michigan, and Ohio. All four had GOP-controlled legislatures when they expanded, and three had Republican governors. All incorporated work requirements into their Medicaid expansion plans that were never enacted or have been suspended.

In Ohio in 2014, the highest proportion of people using Medicaid who were diagnosed with cancer were the nearly 30,000 covered under expanded Medicaid in its first year.

Kasich asked North Carolina legislators to imagine not having health insurance and dealing with a cancer diagnosis.

“Can you imagine that? And if we have the chance to reach out and literally hand them a lifeline,” he said.

“Boy, if we can figure out how to do this, you’ll have people thanking you forever. That will be part of your personal legacy,” he said.

“Great states can do great things.”

Indiana adopted Medicaid expansion under Mike Pense when he was governor. About 500,000 people are covered under Indiana’s expanded Medicaid program. Indiana adopted a system that looks like private health insurance, where people get accounts similar to heath savings accounts, with incentives for preventive care and improved health, said Dr. Jennifer Sullivan, a former head of the Indiana social services agency that oversees Indiana Medicaid.

“This can expand without general fund costs,” she said. “The expansion helps hospitals and doctors. Expansion helps access in rural areas. And expansion decreases costs through better preventive care and disease management.”

Michigan also structured its Medicaid expansion program to look like commercial insurance, with health savings accounts and copays, said Dominick Pallone, executive director of the Michigan Association of Health Plans.

Only Montana officials offered a somewhat downbeat assessment of their experience with expansion. The Biden administration did not allow the state to require recipients to work, and the voluntary workforce program for Medicaid beneficiaries was never adequately funded and gets little use, said Montana’s Medicaid program leaders.

Nonetheless, Montanans enrolled in Medicaid through expansion work at least half of the year, said Adam Meier, the state’s Medicaid director. And the state saw 1600% increase in telehealth use, he said.

At a separate legislative committee meeting Tuesday also dealing with healthcare, lawmakers discussed why people in mental health crises get stuck in emergency departments for weeks and months waiting for space to open in hospitals where they can get psychiatric care.

Though people who are younger than 65 and are without insurance are 13% of the state population, they account for 35% of the visits to hospital emergency rooms for mental health care, according to state Department of Health and Human Services data.

Expanding Medicaid would free up state money now spent on mental health care for uninsured  people, said Dave Richard, North Carolina’s Medicaid director. That state money could then be redirected to meet other critical needs, he said.

As COVID numbers trend lower, NC legislators get an earful on the pandemic’s toll

NC Department of Health and Human Services Secretary Kody Kinsley

Stress, substance use, and a serious shortage of nurses are some of COVID’s lasting impact

NC Department of Health and Human Services Secretary Kody Kinsley wasted little time Tuesday in outlining for lawmakers the scars that the pandemic has left in its wake.

“We have lost a lot of ground. We know nearly 1 in 5 North Carolinians have a mental illness. During the pandemic, the number of people reporting symptoms of stress and anxiety tripled,” Kinsley told members of the Joint Legislative Oversight Committee on Health and Human Services.

Alcohol-related emergency department visits increased 13% from 2019 to 2020. Opioid overdose visits to the emergency room jumped 40%.

“After years of battling the opioid epidemic, we have lost considerable traction in that fight seeing the number of overdose deaths move beyond reality,” Kinsley continued.

The new DHHS Secretary said the state must refocus and redouble its efforts on behavioral health after the last two years.

Children experiencing food insecurity rose from 1 in 5 pre-pandemic to as high as 1 in 3 children in rural North Carolina.

“The number of children discharged from EDs (emergency departments) with no place to go, folks stuck between different systems without access to care has increased,” said Kinsley.

More than 3,500 children in North Carolina have lost a parent or caregiver because of COVID-19.

“Investing in our children is investing in the future and investing in children is not possible without investing in their families.”

Approximately 25% of North Carolina families missed seeking preventive care for their child due to the pandemic.

Earlier this month NCDHHS launched the Division of Child and Family Well-Being, bringing together multiple departments to better support the physical, behavioral and social needs of children.

Skilled nurses in short supply

Sec. Kinsley told lawmakers one of the greatest obstacles moving forward may be addressing a battered workforce.

The number of NC early childhood education staff decreased by about 10% between March 2020 and November of 2021.

Rep. Hugh Blackwell

“We have lost a considerable number of our healthcare workforce over the last several years, who frankly just cannot deal with the pressures of this pandemic after years of service,” he said.

Currently, there are over 15,000 nurse vacancies in North Carolina.

“What does your data tell you as to whether some portion of those vacancies are related to nurses who quit because of some vaccine or booster mandates by their employers?” Rep. Hugh Blackwell (R-Burke) asked.

“In our state operated healthcare facilities where we have around 10,000 staff, by the time we issued our mandate for individuals to be vaccinated, out of 10,000 we ended up having to separate 16 people. It was a very small negligible number,” Kinsley responded.

Sec. Kinsley said more common was nurses accepting traveling nurse roles where the pay is considerably more.

“They separated from nursing before they were terminated,” Rep. Mark Pless (R-Haywood Co.) responded. “Some of them left voluntarily and went to another line of work because they were not going to force the state or anyone else to terminate them. So when you are compiling data, I’d like to see that part about of how many left.”

“Specifically, to the state facilities, terminated or separated, it was 16 individuals total. We didn’t have other folks who left preemptively,” Kinsley said.

‘A daily mass casualty every day for two years’

Steve Lawler, president of the North Carolina Healthcare Association

Steve Lawler, president of the North Carolina Healthcare Association, said while COVID has stressed the system, the workforce crisis is not new.

“Where we are today, we’ve got a turnover rate of 18 percent. Prior to the pandemic it was somewhere between 8 and 12 percent,” Lawler told the committee. “What we are seeing today is a staff that has essentially been involved in a daily mass casualty every day for two years.”

Lawler said a best-case scenario forecast show by 2033 the state could experience a shortage of 12,000 nurses and 5,000 Licensed practical nurses.

Lawler believes the community college systems will play a critical role in filling that void.

Another key initiative: improving workplace safety.

Lawler said while the state has made it a felony to assault a healthcare worker, more must be done to ensure those laws are enforced.

“We’re caught up in family dynamics that you only see on the Jerry Springer show, but they are happening in our patient waiting rooms. They are happening throughout the hospital.”

The Joint Legislative Oversight Committee on Health and Human Services meets again March 15.

Op-ed: A prediction for North Carolina’s partisan gerrymandered maps

Punxsutawney Phil isn’t the only one making predictions today.

Veteran government and political watchdog Bob Hall has a must read op-ed in the Winston-Salem Journal with his own prognostication about how the state Supreme Court will handle the latest redistricting maps drawn by the Republican-controlled legislature. (The future of those maps will be back in court today.)

Hall writes:

Please don’t be surprised in the coming weeks when the state Supreme Court votes to throw out the Republican-drawn election maps for North Carolina’s congressional and General Assembly districts. It will likely be a 4-3 vote, with critics blasting the Democratic majority on the court for being biased.

But here’s the truth: A bipartisan panel of judges, with a Republican majority, has already unanimously ruled that Republican legislators intentionally drew the district maps to undermine the power of Democratic voters.

The judges said the legislators’ plan is an “extreme outlier” that “subordinates the Adopted Criteria and traditional redistricting criteria for partisan advantage.”

Translation: Instead of following its own rules, the legislature chose an extreme set of maps that divided (“cracked and packed”) you and your neighbors into districts to guarantee that more Republican candidates would win. Voters get valued differently; Black voters, who mostly register as Democrats, will be especially harmed.

Despite expressing their “disdain,” the judges didn’t take the big step of ruling the maps unconstitutional. The high court will soon take that step.

Anita Earls

Given the evidence of “systematic” and “extreme” gerrymandering, I expect the Supreme Court will rule the maps violate our state constitution’s protection against measures that subvert free elections, treat voters unequally and entrench one party in power.

To prevent my prediction from coming true, Republican legislators recently filed a motion calling for Democratic Justice Anita Earls to remove (“recuse”) herself from the case. They claim she has “an insurmountable conflict” because her election was heavily financed by a national political committee with a partisan interest in redistricting.

Paul Newby

Ironically, Republican Justice Paul Newby faced — and rejected — a nearly identical charge in a previous redistricting case. A motion filed by Democrats and others called for his recusal because his election was heavily financed by a national political committee with a partisan interest in the case. Rather than step aside, Newby wrote a decision upholding the challenged maps.

Republican Justice Phil Berger Jr. also refused to recuse himself recently in a dispute, like this one, where a chief defendant is his father, state Senate leader Phil Berger Sr. Phil Jr. dismissed the obvious conflict of a son judging a case involving his daddy. That’s strange enough, but there’s a major campaign financing conflict for Justice Berger, too.

Phil Berger, Jr.

Phil Berger Sr. is often a featured guest at his son’s campaign fundraisers. In fact, the vast majority of money Phil Jr. has raised for his judicial elections has come from the Republican Party and donors tied to political appointees and lobbyists who seek favorable treatment from Phil Sr., the Senate boss and most powerful Republican in North Carolina.

In response to a complaint I filed with the board of elections, Phil Jr. had to amend his campaign reports to reveal fundraising events paid for by political appointees and a fundraiser with Phil Sr. at a lobbyist’s home. How can the son impartially rule in a redistricting case involving the political fate of his major benefactor?

It seems hypocritical for Phil Sr. and others to tell Justice Anita Earls to recuse herself when Justices Newby and Phil Jr. have not. As a distinguished Black woman attorney with extensive expertise in racial and partisan gerrymandering, Justice Earls will likely play a key role in how the court rules in this case. That’s the real reason GOP legislators want her removed.

Partisan strife will continue, but please remember that Republican and Democratic judges agree that the district maps are extreme and unfair. They diminish your vote and disrespect your voice. Our state constitution’s protection of equal rights and fair elections means they must be declared illegal.

Read more in the Winston-Salem Journal.

Those wanting to watch the hearing in action today can do so starting at 9:30 a.m. on the Supreme Court’s YouTube channel. Policy Watch’s Lynn Bonner previews the case here.