News, public health

Healthcare round-up: From Florence recovery to Medicaid expansion to combating NC’s opioid crisis (podcast)

By
23 days ago
In News, public health

Is 2019 the year for Medicaid expansion in the Tar Heel state? Will Medicaid reform save North Carolina money and deliver better service for millions of North Carolinians? And what do you need to know about open enrollment under the Affordable Care Act before December 15th?

We asked those questions and more to North Carolina’s Health and Human Services Secretary Mandy Cohen last week when she joined NC Policy Watch director Rob Schofield on News and Views.

Click below to hear our full interview where Sec. Cohen and Schofield also discuss Hurricane Florence recovery and the latest efforts to curb the state’s opioid crisis:

Environment, public health

Higher rates of birth defects found in four southeastern counties; link to PFAS uncertain

By
November 8, 2018
In Environment, public health
Illustration of human brain

Several factors can cause brain-related birth defects, including genetics and environmental exposures.

Rates of birth defects affecting the brain, heart and central nervous system were higher than the state average in areas of southeastern North Carolina from 2003 to 2014, the state Department of Health and Human Services announced today. The affected counties are Bladen, Brunswick, Cumberland and New Hanover, where GenX and other per- and poly- fluorinated compounds (PFAS) have been detected in drinking water.

However, DHHS said the study results can’t establish a link between the anomalies and PFAS. The number of cases was small and varied from year to year.

According to a DHHS report, the prevalence of brain reduction defects was higher in Bladen, Brunswick and Cumberland counties. While microcephaly —  an abnormally small brain — and hydrocephaly — an accumulation of spinal fluid around the brain — were more prevalent in New Hanover County. The higher prevalence of these birth defects, which included some related to heart development, was not confined to the lower Cape Fear region, DHHS said.

The prevalence of total brain defects varied substantially across the state, DHHS said. They can be caused by genetic, environmental exposure or even unknown factors.

There were 3,702 reported cases of all types of brain defects in North Carolina between 2003 and 2014. Bladen County reported 20; Pender, 32; Brunswick, 60; New Hanover, 130; and 220 Cumberland. When adjusted for population, these numbers were higher than the state average.

There are no national figures available to compare North Carolina’s rates with the rest of the US. Nor was data available for babies born at federal or military facilities, such as Womack Army Medical Center in Cumberland County. Infants born at military facilities are only included if transferred to a non-military hospital for care.

DHHS chose to analyze birth defects data because some animal studies have reported weak associations between PFAS exposure and birth defects; however, DHHS said these studies have important limitations. Animal studies, particularly using rodents, don’t necessarily reflect outcomes in humans.

News, public health

Six things to have on your radar this week

By
October 29, 2018
In News, public health

#1 – Anti-Semitism in the South, and where we go after the Pittsburgh synagogue attack

This evening at the Friday Center, the Carolina Center for Jewish Studies will present an important community lecture on anti-Semitism and the Jewish experience in the South. The program will feature author Jonathan Weisman and Ryan Thornburg, UNC School of Media and Journalism, focusing on Weisman’s book, (((Semitism))). The book is a rumination on the rise of anti-Semitism, racism and hate in this current political climate, and what should be done to confront it.

Tonight’s event is free and open to the public. It runs from 7:00pm-9:00pm at The Friday Center, 100 Friday Center Drive, Chapel Hill.

#2 – A new BTC Report on creating equitable health outcomes

On Tuesday the Budget & Tax Center releases a new report giving a breakdown of how state investments in the North Carolina Department of Health and Human Services have changed since 2008.
The report identifies the need to focus on equitable health outcomes to create a culture of health where every North Carolinian can reach their full potential.

We’ll feature more from that report this week on the Progressive Pulse blog.

#3 – Don’t Punish Pain™ Rallies

Don’t Punish Pain™ Rallies are being held in Raleigh and Charlotte on Tuesday.

In 2016, CDC guidelines that were made to address the illicit fentanyl/heroin crisis caused a drastic over-correction in the health care setting. An unintended consequence was that many physicians, hospitals, and even pharmacies stopped treating pain altogether.

This affects people with chronic pain, acute pain as well as post-operative pain.

Tomorrow in Raleigh there will be a rally starting at 11:00am at Halifax Mall. Learn more here: http://dontpunishpainrally.com/wp-content/Flyer-Files/Flyers/49%20NC%20Raleigh.PDF

In the Queen City , a similar event runs from 11:00 am until 1:00 pm at the U.S. Food & Drug Administration, 5701 Executive Center Dr, Charlotte.

#4 – Politics, polling and prognostications ahead of the November mid-terms

Also on Tuesday, NC Policy Watch will hold its latest Crucial Conversation: Trick or treat? A mid-term election preview Featuring Tom Jensen of Public Policy Polling. Tom was good enough to join Rob Schofield over their weekend on News & Views and offer a preview of how the polls are trending:

Join us tomorrow as we learn the details of where things stand and what the political world is likely to look like on November 7th after all the votes are tallied.

Tomorrow’s event begins at noon at the Center for Community Leadership Training Room at the Junior League of Raleigh Building, 711 Hillsborough Street.

Please be sure to register so we have a proper headcount.

#5 –  State Board of Education gets an update on Hurricane Florence recovery and the next charter-school takeover target

On Thursday, this month’s meeting of the State Board of Education will open with an update of Hurricane Florence recovery efforts. The board will also decide whether Carver Heights Elementary School in Wayne Country will be operated under the Innovative School District starting in the 2019/2020 school year.

An agenda for Thursday’s meeting at the Education Building can be found here: https://simbli.eboardsolutions.com/SB_Meetings/SB_MeetingListing.aspx?S=10399

#6 – Want to avoid the lines on Election Day? Early voting ends this Saturday!

Finally, one-stop early voting draws to a close on Saturday. You can look up early voting poll places, dates and times here: https://www.ncsbe.gov/Voting-Options/One-Stop-Early-Voting

News, public health

Medicaid overhaul clears a major hurdle

By
October 26, 2018
In News, public health

If this week’s $1.6 billion lottery jackpot had you daydreaming about big numbers, how does $6 billion sound?

That $6 billion figure is the annual amount North Carolina is expected to contract out to various managed-care groups as it overhauls the state’s Medicaid system.

Earlier this week the state crossed a major hurdle in receiving federal approval of its waiver to reform the system that covers more than two million people in our state.

NC Health News has a great summary of what this means:

Approval by the federal Centers for Medicare and Medicaid Services in what’s known as a Section 1115 Demonstration Waiver means the N.C. Department of Health and Human Services is on track with its Medicaid reform plan. The department will begin transitioning three-quarters of the state’s 2.1 million Medicaid patients next November to managed care and away from the current fee-for-service system.

The approval came after the state already collected applications from eight managed-care companies and provider-led groups who want to be involved. A decision on who wins those bids is expected to come in February. The first patients will migrate to the new system next November.

The approval (a copy can be read here) also gave a green light for pilot programs to look at alternative ways to improve health, making North Carolina the first state to receive permission to use Medicaid dollars for enhanced case management tools to target what are referred to as social determinants of health such as homelessness, family violence, toxic stress, transportation issues and food insecurity.

And for those still wondering if Medicaid expansion could be in the cards with this overhaul, reporter Sarah Ovaska-Few explains we may all be waiting a little longer:

Also getting a thumbs down from CMS was a proposed program, Carolina Cares, that would have been an alternate way of expanding the Medicaid program to cover the hundreds of thousands of North Carolina adults who are without health care and earn too little to qualify for a subsidy.

Carolina Cares was conceived as a backdoor of sorts to Medicaid expansion – it proposed to have low-income adults in the workforce pay into a health care plan without contributions from state coffers. But it couldn’t get enough support from the Republican-led state legislature, which has joined other Republican legislatures around the country in opposing the Medicaid expansion that became an optional piece of the Affordable Care Act after a Supreme Court ruling.

That’s why CMS didn’t give it the green light, advising that the state need the support of its own legislature before coming to CMS for permission.

Holding out hope for Carolina Cares is state Rep. Donny Lambeth, a Winston-Salem Republican and co-sponsor of the Carolina Cares bill.

Though it didn’t get backing last year, he’s planning on re-introducing it and hopes to persuade more of his colleagues this go-around.

“We’re not giving up on it,” he said about the proposal.

Neither is Cohen, who served in the Obama administration as CMS’ chief operating officer.

“I’ve been very clear that it’s a necessary part of building a healthier North Carolina,” Cohen said. “I want to bring those $4 billion waiting in DC to North Carolina.”

Currently one-in-five North Carolinian rely on Medicaid coverage.

Learn more about Medicaid reform and read today’s full story at NC Health News.

Environment, public health

At least 1.4 million people in North Carolina experiencing drinking water shortage, uncertainty after hurricane

By
September 18, 2018
In Environment, public health

 

More than 1.4 million people on public and community water systems don’t have reliable drinking water, as of Tuesday afternoon. The problems are plaguing 219 of the state’s 481 permitted systems. Source: Department of Public Safety

Low water pressure, no water, potentially contaminated water: More than 1.4 million people in North Carolina don’t have a reliable source of water from their public systems, according to the NC Department of Public Safety.

This figure doesn’t include people who are on private drinking water wells and whose systems could be polluted or shut off because of flooding. The safety of private wells is under the Department of Health and Human Services.

Forty-six percent of 481 public and community systems — such as those serving mobile home parks — are not fully functioning.

(Scroll to the bottom of the story for a comprehensive list, broken out by reason for the outage, name of the system and number of customers affected.)

Affected cities and towns include Rockingham, Oak Island and Grifton. Morgan Elementary School in Gold Hill, near Salisbury, has no water because the system has failed to operate

Of the affected people on public water, more than 38,000 are customers of public and/or community systems that can’t produce any water and are essentially closed.

Another 270,000 people are experiencing low water pressure; 19,000 are waiting for test results on their water to determine whether it is safe to drink. More than 1 million people are on water systems that are operating off emergency interconnections — borrowing water from other suppliers — are on backup power or are using only stored water. The McCain Correctional Hospital, in Raeford,  is among the systems using an emergency interconnect.

And a half-million people are under boil water orders or advisories, according to environmental officials.

CLOSED: SYSTEM NOT PRODUCING WATER 
NameTotal number of customers
ATLANTIC MHP113
ATLANTIC MHP II106
BIG RIDGE MHP50
BILLY K CAMPGROUND180
BLADEN BLUFFS WATER SYSTEM4589
BOLTON, TOWN OF750
CAMERON BOYS CAMP75
CAMP DON-LEE200
CASTLE CREEK MEMORY CARE86
CIRCLE D MHP91
COVIA CORPORATION43
DOWN EAST MHP107
GOOSE CREEK RESORT1600
GREEN ACRES MHP229
HUNTING ESTATES80
INTERNATIONAL PAPER ADMINISTATIVE SYSTEM30
INTERNATIONAL PAPER COMPANY750
INTERNATIONAL PAPER- NEW BERN MILL375
LAKE ROAD MHP40
LEA`S WATERFRONT MHP99
LIGHTHOUSE WAY MHP & APTS38
MAYSVILLE, TOWN OF1100
MCAS BT11-PINEY ISLAND25
MORGAN ELEMENTARY SCHOOL539
NATIONAL SPINNING COMPANY WHITEVILLE275
NEWPORT RIDGE MHP71
NORRIS MHP91
OCEAN SPRAY MH S/D368
PERDUE FOODS LLC2000
PORT OF MOREHEAD CITY174
PORT OF WILMINGTON280
RIVERSTONE99
SANDERSON FARMS1300
SEA SCAPE60
SMITHFIELD FRESH MEATS CORP - TAR HEEL4589
SURF CITY, TOWN OF5606
THE VILLAGE OF BALD HEAD ISLAND3254
TOPSAIL BEACH, TOWN OF3198
USMC LEJEUNE--ONSLOW BEACH320
WILLOW POINT MOBILE HOME PARK22
WRIGHTSVILLE BEACH WATER SYST5212
Total number of systems 41
Total number of customers 38214
Water pressure problems 
Name of systemNo. of customers
BELVEDERE PLANTATION3195
BRAGG ESTATES WATER SYSTEM363
BROOKWOOD COMM WTR SYSTEM15665
BRUNSWICK COUNTY WATER SYSTEM95739
CHANDA`S RIDGE70
CLARENDON GARDENS S/D276
GRAY`S CREEK MHP212
HARKERS VILLAGE S/D94
JONES COUNTY WATER SYSTEM8999
KINSTON, CITY OF27475
LAURINBURG, CITY OF17242
OAK ISLAND, TOWN OF23635
ROBESON COUNTY WATER SYSTEM64295
SAMPSON CO WTR DIST I-ROSEBORO148
SCOTLAN CO WATER-NORTH2566
SCOTLAND CO WATER-SOUTH3424
SEAGATE IV105
SOUTHPORT CITY OF6447
WRIGHTSBORO S/D100
Total no. of systems19
Total no. of customers
270050
Needs testing to clear advisory 
Name of systemNo. customers
ALBANY ACRES S/D81
ALTICE ESTATES S/D320
BELLA VISTA S/D25
CAMELOT S/D604
CREEKSTONE S/D498
FAIRFIELD HARBOUR4610
HARDSCRABBLE S/D640
HUNTER`S RIDGE S/D92
LEGEND HILLS S/D81
MAXTON, TOWN OF3125
NOTTINGHAM FOREST S/D543
OCEAN ISLE BEACH, TOWN OF7051
OLDE MILLS LAKE S/D96
PACEVILLE S/D58
RED MOUNTAIN S/D173
ROYAL ACRES S/D63
STANLEY STONE ESTATES52
STEPHANIE WOODS S/D245
SWEET BRIAR S/D143
THORNBURG S/D165
TIMBERLINE SHORES210
WEYERHAEUSER-SOUTHERN LUMBER185
Total no. of systems: 22
Total no. of customers: 19060
No Power 
NameNo. of customers
EAGLE`S NEST #124
EAGLE`S NEST #224
HARBOR HOUSE S/D142
JACKSON HEIGHTS MHP200
LEA ACRES WATER CO INC120
MELBILLE HEIGHTS96
MISSION PARK B&L TRAILER COURT65
OAKLEY MHP92
OSPREY COVE 1475
OYSTER POINT S/D99
RHA HOWELL CARE CENTER CLEAR CREEK302
ROBINFIELD ESTATES S/D124
SHADY HAVEN MHP46
SHERWOOD MHP353
SPERANZA`S MHP90
No. of systems affected 15
No. of customers2252
Operating off emergency interconnect 
NameNo. of customers
DOC-MCCAIN HOSPITAL850
DUBLIN, TOWN OF447
EAST ARCADIA, TOWN OF609
GREENFIELD HEIGHTS S/D145
GRIFTON, TOWN OF2800
JASON WATER CORPORATION331
PARKTON, TOWN OF487
RIEGELWOOD SANITARY DISTRICT460
ROCKINGHAM, CITY OF13159
SHINE WATER CORPORATION447
TAR HEEL WATER CORP250
TURKEY, TOWN OF300
Total No. of systems12
Total no. of customers20285
Operating backup power 
NameNo. of customers
ABERDEEN, TOWN OF9935
ATLANTIC BEACH, TOWN OF6380
AURORA WATER SYSTEM502
BALLOU MHP95
BEAUFORT CO SOUTHSIDE9203
BEAUFORT, TOWN OF4539
BEULAVILLE, TOWN OF1326
BISHOPS RIDGE S/D170
BLADEN CO WTR DIST-EAST BLADEN3853
BLADEN CO WTR DIST-WEST BLADEN11844
BOGUE BANKS WATER CORPORATION4995
BRANDYWINE BAY2189
BURGAW, TOWN OF4250
CABARRUS ACRES WATER SYSTEM46
CALYPSO, TOWN OF660
CAMERON, TOWN OF490
CAROLINA BEACH WATER SYSTEM10632
CFPUA/MONTEREY HEIGHTS8202
CFPUA/NHC29052
CFPUA-WILMINGTON137414
CHADWICK MHP90
CHINQUAPIN WATER ASSOCIATION4686
CHOCOWINITY WATER SYSTEM2550
CLARKTON, TOWN OF1500
CLINTON, CITY OF12410
CRAVEN COUNTY WATER SYSTEM32500
DOT-CEDAR ISLAND FERRY TERM200
DUPLIN COUNTY WATER SYSTEM17000
EASTMAN CREEK LANDING S/D335
ELIZABETHTOWN, TOWN OF5212
FIGURE 8 ISLAND999
FREMONT, TOWN OF1463
GLYNNWOOD MHP208
GREENEVERS, TOWN OF1390
GRIMESLAND, TOWN OF610
HARKERS ISLAND SANITARY DIST2358
HARNETT CO DEPT OF PUBLIC UTIL98905
HARRELLS WATER CORP1633
HAVELOCK WATER SYSTEM14246
JACKSONVILLE CITY OF45598
KENANSVILLE, TOWN OF876
KURE BEACH WATER SYSTEM5110
LAURADALE S/D2527
LUMBERTON, CITY OF25590
MANN`S MHP40
MARINE CORPS AIR STATION CHERRY POINT17144
MCAS ATLANTIC FIELD32
MERRIMON WATER SYSTEM71
MINTZ CHRISTIAN ACADEMY150
MOREHEAD CITY, TOWN OF9420
MOUNTAINBROOK S/D152
NEUSE REGIONAL WTR & SWR AUTH93238
NEW BERN, CITY OF30070
NEWPORT WATER SYSTEM4827
NORTH RIVER/MILL CREEK WATER SERVICE DIS2800
NORTHWEST ONSLOW WATER ASSOC1890
ONSLOW WTR AND SEWER AUTHORITY126761
ORIENTAL WATER SYSTEM903
PAMLICO COUNTY WATER15546
PEMBROKE, TOWN OF4111
PENDER COUNTY UTILITIES18000
PIKEVILLE, TOWN OF714
PINE KNOLL SHORES3861
POTTERS HILL WATER ASSOCIATION94
PRUITT HEALTH AT SEA LEVEL102
RED SPRINGS, TOWN OF4493
ROSE HILL, TOWN OF1862
ROWLAND, TOWN OF1341
SALEMBURG, TOWN OF850
SAMPSON CO WTR DIST II8670
SANDERSON`S MHP34
SEAGATE I345
SIDBURY`S MHP101
SNUG HARBOR ON NELSON BAY108
SOUTHERN PINES, TOWN OF17379
STERLINGSHIRE S/D147
THE CAPE MASTER SYSTEM9728
TOPSAIL GREENS S/D549
TOWN OF ATKINSON301
TREASURE COVE S/D760
USMC LEJEUNE-DEVIL DOG-VERONA LOOP800
USMC LEJEUNE--HADNOT POINT37500
USMC LEJEUNE--HOLCOMB BLVD17000
USMC LEJEUNE--NEW RIVER AIR ST11500
USMC LEJEUNE--RIFLE RANGE750
WADE, TOWN OF835
WAGRAM, TOWN OF801
WALLACE, TOWN OF5825
WALNUT CREEK VILLAGE990
WARSAW, TOWN OF3151
WAYNE WATER DISTRICTS32426
WAYNE WATER DISTRICTS PURCHASE16302
WEST CARTERET WATER CORP15311
WHITE LAKE, TOWN OF2500
WHITE STREET INDUSTRIAL PARK800
Total no. systems 95
Total no. customers 1046858
Using stored water only 
NameNo. of customers
BRUNSWICK REGIONAL WATER AND SEWER H2GO25583
CASTLE BAY S/D685
HOLDEN BEACH, TOWN OF6200
SIMMONS HEIGHTS APARTMENTS35
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