2023 Year in Review

Last year was a big year for North Carolina. After a decade of action and advocacy, as of this past December, Medicaid Expansion is finally in effect. This is no small accomplishment, even though it is just one step on the road toward truly healthy and equitable communities. Looking ahead, this policy victory will continue to play a major role as those of us at FHLI continue to act, change systems, and improve health.  

2023 was also a big year for FHLI. As we kick off the new year, we’re reflecting on everything we were able to accomplish alongside partner organizations and communities across our state. Read on for highlights from 2023 and look forward to what we have planned for 2024. 

Roadmap to Innovation 

This year FHLI took an important step to innovate our portfolio as an organization. We announced FHLI’s Roadmap to Innovation, which will help communities develop and implement their own paths to health equity. This line of work was built out of our Community Voice model, centering local, participatory decision-making to identify and act on community-driven solutions to health disparities and inequities.  

We are leveraging a $900,000 investment in ourselves to work deeply in three groups of contiguous counties across North Carolina to provide support and address social drivers of health. Stay tuned in 2024 as we begin the work to: 

  1. Facilitate community-driven identification of structural issues and systems change advocacy to impact those issues.  
  1. Increase community-based organization access to larger state, federal, and NGO sources of grant dollars.  
  1. Increase efficiency and integration of existing services through community-driven care networks that include traditional and non-traditional partners. 
  1. Increase overall community-based organization capacity to deliver services.  

Bertie County Integrated Behavioral Health Network 

Throughout this year, FHLI’s Community Voice and Center of Excellence for Integrated Care (COE) teams facilitated a network of local leaders in Bertie County to address their community’s behavioral health needs. The Network leverages FHLI’s Community Voice model, centering participatory engagement to allow communities themselves to identify needs and efficiently drive decision-making around desired outcomes, resource needs, and local and system-wide solutions.  

End-of-year update: The Bertie County Integrated Behavioral Health Network received a $300,000 grant from Merck to continue their work in 2024!  

Read more 

Bringing National Rural Health Day to Rural North Carolina 

In 2023, the National Rural Health Association co-hosted a National Rural Health Day celebration with the North Carolina Office of Rural Health (NC ORH). It was an extra special year for two reasons. First, 2023 also marked the NC ORH’s 50th anniversary. Founded by our nonprofit’s founding director, Jim Bernstein, the NC ORH is the oldest office of rural health in the country.  

The second reason this year’s celebration was special is because we brought the festivities to rural North Carolinians. Rather than having an event in Raleigh, we hosted the festivities at the Bertie County Aging Council – Senior Center, where the Bertie County Integrated Behavioral Health Network has met throughout the year. Local community members joined state officials and several federal government officials for the day-long event.  

Read more 

Adding Maternal Health to the FHLI Portfolio 

Last year we launched the Maternal and Child Health Equity Action Network (MCHEAN) following our comprehensive landscape report, “Progress and Opportunities: Maternal and Child Health Equity in North Carolina.” 

Through this work, we can collaborate with mothers, birthing professionals, and advocates to map out a better future for maternal and child health. This area deserves special focus in North Carolina. According to the latest March of Dimes report card, we are among the worst states in the country for preterm births, with significant racial and economic disparities across the state. This issue is at the forefront of our minds, and we have incorporated a maternal and child health focus into our work in Bertie County and our Roadmap to Innovation, one of FHLI’s newest programs. 

Read more 

Medicaid Expansion 

Medicaid Expansion in North Carolina is a hard-won victory for public health, health care professionals, and everyone in our state. Advocates have been working to make this a reality since 2010 when the Affordable Care Act was passed.  

Expansion finally took effect statewide on December 1st, 2023, and is expected to provide over 600,000 people in the health care coverage gap, including veterans, frontline workers, small business owners, parents, and many more, with access to health insurance. This includes residents with incomes too high to qualify for Medicaid but too low to receive health care subsidies through the Affordable Care Act marketplace.   

Read more 

This comprehensive health coverage includes dental, behavioral health, and vision care. 

All of us at FHLI are thrilled to see this important step forward for North Carolina take effect, but we will also continue working hard to improve health access and equity for all North Carolinians.  

Specifically, we are focusing our energy on steps to move North Carolina closer toward truly healthy communities. In the new year, we will be developing a 2025-2026 policy advocacy agenda, among other efforts to improve access and equity in care for all North Carolinians.  

Read more 

National Rural Health Association (NRHA) Rural Health Policy Institute 

Early in 2023, we brought our collective voice to Capitol Hill, joining the NRHA for its 34th annual Rural Health Policy Institute.  

The Rural Health Policy Institute is an opportunity for rural health leaders across the country to bring community stories to Capitol Hill, guiding the future of rural health policy with NRHA leadership and advocating for important issues with new and returning members of Congress and the presidential administration.  

Read more 

2023 Legislative Breakfast 

Last April, the North Carolina Rural Health Association (NCRHA) and North Carolina Oral Health Collaborative (NCOHC) co-hosted this year’s legislative breakfast. At the event, we presented health care leadership awards to Representative Donna McDowell White (NC House District 26), Senator Jim Burgin (NC Senate District 12), Senator Jim Perry (NC Senate District 2), Dr. Amanda Stroud (Dental Director, AppHealthCare), and Michelle Fortune (CEO, St. Luke’s Hospital).  

Read more 

During the event, Fortune and Stroud both shared deeply personal stories about their experiences with health and health care in North Carolina.  

When Fortune’s father began experiencing chest pain, he was taken to St. Luke’s, his daughter’s hospital. He was cleared and almost sent home before a doctor took time, paid attention, and discovered he was having a heart attack. 

St. Luke’s didn’t have a cardiologist at the time. The only solution to a condition that kills nearly 19,000 North Carolinians each year was to load Fortune’s father into a helicopter and fly him to a different hospital equipped to treat heart disease. 

St. Luke’s has a cardiologist now, thanks to a sustained increase in funding. Fortune and her father’s story is all too common for people across North Carolina, however, and too many rural hospitals struggle and are unable to provide vital life-saving services. 

Stroud also spoke to attendees about her motivation to work as a public health dentist in rural North Carolina. 

Stroud grew up on food stamps, with parents who worked long hours in grueling jobs to make ends meet. She didn’t see her first dentist until a school-based program came to her school. Today, she provides that same school-based care to children in Ashe, Alleghany, and Watauga Counties. 

Stroud choked up as she talked about the safety net, how it saved her life, and how hard it can be to continue her life-saving work faced with limited funding and staffing shortages. 

“Where I’m from, dentures are the norm,” said Stroud. “We need to make dentists the norm.” 

Read more 

All Aboard the Momnibus! 

The signs said it all. “Black Maternal Health is Nonpartisan.”  

This was the message advocates, providers, and parents took to the legislature for Black Maternal Health Day of Action on April 19, 2023.   

We joined advocates, mothers, and providers from across the state to meet with elected officials and discuss the importance of policy action to reduce racial disparities in maternal health across North Carolina.   

Read more 

Thought leadership: 2023 Rural Health Snapshot and Maternal Health Landscape Report 

In 2023 we published another annual edition of the North Carolina Rural Health Association’s (NCRHA) Rural Health Snapshot. FHLI staff unveiled the 2023 report at our legislative breakfast and distributed copies to legislators working to improve rural health in our state.  

Our other report published in 2023, a Maternal and Child Health Equity landscape report, earned a prominent feature at the 2023 Black Maternal Health Day of Action at the North Carolina General Assembly. 

The Project ECHO Network in North Carolina (PEN-NC) 

Early in 2023, we launched a new program in partnership with the North Carolina Area Health Education Centers (NC AHEC). Leveraging NC AHEC’s technical assistance expertise alongside FHLI’s legacy of incubating innovative programs, PEN-NC will serve as the first statewide network of ECHO™ projects. 

The ECHO™ Model, originally developed out of the University of New Mexico, is a framework for virtual learning communities where peers can share support, guidance, and feedback.  

Read more 

Oral Health Day 2023 

Bright spots, pressing issues, and goals moving forward for oral health in North Carolina were on full display during Oral Health Day last June. The theme for this year’s event was, “Challenges and Opportunities for the Dental Team.” Keynote speaker Kathy Colville and the other panelists brought expertise and ideas for how North Carolina can become a healthier, more equitable state. 

Read more 

The 2023 Bernstein Event 

Thank you to all who joined us for this year’s Bernstein Event, for your generous contributions, and for your continued support of Jim Bernstein’s legacy! This year we recognized Dr. Skip Cummings and the Greensboro Health Disparities Collaborative for exceptional leadership improving access and equity in health care, and we presented our first-ever posthumous award to the late Dr. Jim Jones.  

Last year was a big year for North Carolina. After a decade of action and advocacy, as of this past December, Medicaid Expansion is finally in effect. This is no small accomplishment, even though it is just one step on the road toward truly healthy and equitable communities. Looking ahead, this policy victory will continue to play a major role as those of us at FHLI continue to act, change systems, and improve health.  

2023 was also a big year for FHLI. As we kick off the new year, we’re reflecting on everything we were able to accomplish alongside partner organizations and communities across our state. Read on for highlights from 2023 and look forward to what we have planned for 2024. 

During the 50th-anniversary celebration of the NC Office of Rural Health held on November 16th, 2023, National Rural Health Day, we had the privilege to announce that the Bertie County Behavioral Health Network received a $300,000 grant from the Merck Office of Social Business Innovation and Merck Foundation. Our partners at the Bertie County Council on Aging – Senior Center accepted it on behalf of the Network. 

The goal of the Network is to build health infrastructure in Bertie through community engagement and implement projects focused on reducing stigma about mental health and substance use, providing telebehavioral health services to youth in Bertie County Schools, and developing the local behavioral health workforce. 

This funding will help continue the collaborative work that two FHLI programs, the Center of Excellence for Integrated Care (COE) and Community Voice, have been doing with our partners over the past year and a half to develop community-driven solutions that address the health needs of residents across the county.  

Learn more about the many Network projects and initiatives this funding will help sustain in Bertie County. 

What Is the Bertie County Integrated Behavioral Health Network? 

Bertie is a rural county in eastern North Carolina. Communities throughout the county have consistently faced challenges related to health outcomes, especially regarding mental health and substance use, due to long-standing health access and equity issues.  

There is also a strong spirit of community across the county, along with a shared desire to address these challenges. The goal of the Bertie County Behavioral Health Network is to bring local organizations, providers, and residents together to drive community-based solutions. FHLI acts as the facilitator for the Network. 

Network partners include over 30 local and regional organizations including A Better Chance A Better Community, Access East, East Carolina University, Albemarle Regional Health Services, Greater Wynns Grove Baptist Church, FHLI, and many more. 

What Will the $300,000 Merck Grant Help Fund? 

The three goals of the Network are to:  

  1. Improve access to health care across the county. 
  2. Expand capacity and services for youth and families to address unmet health needs.
  3. Enhance outcomes by reducing stigma in the community regarding behavioral health and improving health prevention awareness.

Better Access to Health Care for All Bertie County Community Members

One of the major barriers to accessing health care throughout the county is lack of provider availability. The Network is especially focused on increasing the behavioral health workforce in Bertie and establishing career pathways for local youth to work in the behavioral health field. 

Greater Capacity and Services for Youth and Families to Help Address Unmet Health Needs

The Network is expanding access to youth services by integrating telehealth services in schools, including telebehavioral health. Additionally, there is a concerted effort to expand family-based services in the community as well as to engage community members in parenting classes at the local health department and other community organizations.ngage community members in parenting classes at the local health department and other community organizations. 

Improve Health Outcomes Via “Stop the Stigma” and Other Health Awareness Campaigns

Another significant barrier to accessing behavioral health care is stigma and lack of information about mental and behavioral health needs. The Network will continue its “Stop the Stigma” campaign for behavioral health as well as raise awareness and help drive community engagement through Mental Health First Aid training

To improve the community’s availability and awareness of overdose prevention resources, the Network will provide training on both harm reduction and administering Naloxone, a life-saving medication that can reverse an overdose from opioids. 

Additionally, the Network will continue promoting diabetes education and treatment, and 

cardiovascular disease prevention awareness campaigns and host educational events for both. 

What Is Behavioral Health? 

Behavioral health helps people address mental health and substance use disorders as well as lifestyle challenges, stress, crisis situations, and more. Behavioral health integration refers to primary and specialty care teams collaborating with behavioral health clinicians to provide whole-person care and improve health outcomes for the people they serve.  

Depending on the context, mental and behavioral health are sometimes used interchangeably, as the language continues to develop. In general, though, behavioral health is seen as a more all-encompassing term that includes the full spectrum of health and wellness. 

Why Is Integrated Care Important? 

Integrated health care is based on extensive collaboration and communication among health professionals. It benefits patients, caregivers, providers, and the whole health care system. Information-sharing enables providers to better develop and follow through with comprehensive treatment plans that address the full scope of people’s needs and support their whole health. 

Integrated care teams often include physicians, nurses, mental health providers, behavioral health specialists, and other health professionals. This approach has been shown to improve health outcomes, quality of care, and access to services as well as to low overall costs. 

Stay Connected & Support Community-Driven Solutions 

Integrated care, community-driven solutions, and systems-level policy changes are key to creating more accessible and equitable health care in Bertie County and across the state. Stay engaged and informed by following us on LinkedIn and signing up for North Carolina public health news updates

Bertie County Behavioral Health Network Members 
A Better Chance A Better Community 
Access East
Albemarle Alliance for Children and Families
Albemarle Regional Health Services
Alliance for a Healthier Generation
Bertie County Cooperative Extension 
Bertie County Council on Aging – Senior Center
Bertie County Schools
Bertie County Sheriff’s Office
Bertie County YMCA
Bertie Rural Health Association
Blue Cross and Blue Shield of NC
CareNet Counseling
East Carolina University Brody School of Medicine
Eastern Area Health Education Center
ECU Health Bertie Hospital
ECU Health Chowan Hospital
Eustress – The Good Stress Company
Family Support Network of Eastern North Carolina
Galileo Health
Greater Wynns Grove Baptist Church
Mid-East Commission
NC Agromedicine Institute
NC Farm and Ranch Stress Assistance Network
NC Office of Rural Health
Pittman’s Pharmacy
Retired Governmental Employees Association
Roanoke Chowan Community Health Center
Roanoke Chowan Community College
Trillium Health Resources

Medicaid Expansion finally took effect statewide on December 1st, 2023, thanks to over a decade of advocacy by countless organizations and individuals. All of us here at the Foundation for Health Leadership & Innovation (FHLI) are thrilled to see this important step forward for North Carolina take effect, but we will also continue working hard to improve health access and equity for all North Carolinians. 

Medicaid Expansion is expected to provide over 600,000 people in the health care coverage gap, including veterans, frontline workers, small business owners, parents, and many more, with access to health insurance. This includes residents with incomes too high to qualify for Medicaid but too low to receive health care subsidies through the Affordable Care Act marketplace.  

This insurance will include comprehensive health coverage, including dental, behavioral health, and vision care.  

Find out whether you may be eligible for benefits and what Medicaid Expansion means for rural and other underserved communities across our state. 

FAQs About Medicaid Expansion in North Carolina 

Here are answers to some frequently asked questions about Medicaid Expansion in North Carolina effective December 1st, 2023: 

Who is eligible for Medicaid Expansion in NC?  

Most adults ages 19-64 who earn up to 138% of the federal poverty line (e.g., singles earning about $20,000/year or families of three earning about $34,000/year) may be eligible. Read more about eligibility requirements

How can I apply for Medicaid in North Carolina?  

Applying online through ePASS is the quickest option. For a step-by-step tutorial, watch this how-to YouTube video from the NC Department of Health and Human Services (NCDHHS). You can also apply in person, by phone, or by mail. 

How long will it take for my Medicaid application to be processed?  

It may take up to 45 days (about 1 and a half months) for your application to be processed. Apply today to access your benefits as soon as possible.  

What does Medicaid health coverage include?  

Medicaid includes primary care, hospital stays, maternity care, vision and hearing, dental/oral health care, and more.  

What does Medicaid pay for?  

Full Medicaid health care coverage pays for your doctor visits, yearly check-ups, emergency care, mental health, and more. There are no monthly fees and copays are never more than $4. 

What Medicaid Expansion Means for Rural & Underserved Communities in NC 

The 2023 North Carolina Rural Health Snapshot [PDF] report compiled by the North Carolina Rural Health Association (NCRHA), an FHLI program, shows that rural residents are 40% more likely to be uninsured and eligible for Medicaid Expansion. 

It is expected to create an estimated 37,200 jobs, generate thousands in savings for small businesses, and bring billions of dollars in federal funding back to North Carolina annually. In addition to strengthening our economy, it will help our communities become more resilient and increase access to timely, affordable health care. 

According to the NCRHA’s sweeping analysis, previous studies also show that Medicaid Expansion is associated with improved hospital financial performance and fewer hospital closures. Since 2010, when Medicaid Expansion first became an option for every state, seven rural hospitals have closed in North Carolina. We need to rebuild and expand the rural health infrastructure to effectively serve our rural and other historically underserved communities. 

As hundreds of thousands of people gain access to coverage through Medicaid Expansion, we must continue to work at every level to create a more accessible and equitable health care system. This means expanding the number of culturally competent providers who accept Medicaid insurance for all types of care, including oral health and specialty services. 

Stay Tuned for More on Medicaid Expansion in North Carolina 

FHLI and all our programs will continue to advocate for all North Carolinians and leverage policies that increase health care access and equity across our state. While Medicaid Expansion is an important win expanding access to care across our state, much work will still need to be done to ensure those who gain coverage have access points to receive quality care.  

Follow us on social media and sign up for our updates to learn more about Medicaid Expansion and other important health news in North Carolina. 

Engaging conversation and connection-building were at the heart of this year’s Bernstein Event held on October 4th, 2023. A crowd of nearly 300 health care professionals and advocates gathered to celebrate a slate of awardees who all share the common value that connection, collaboration, and community must be front and center in our work to build a healthier North Carolina. 

Make sure to scroll all the way to the bottom of this post to see a full image gallery from the event!

FHLI CEO David Reese Talked About Centering Community for a Healthier North Carolina 

FHLI CEO David Reese talked about FHLI’s future, legacy, and building a healthier North Carolina. He invited all attendees to join him in celebrating Medicaid Expansion, which was fully enacted two weeks before the event. “We also know this isn’t the end of the road as we work to create more opportunity in North Carolina, more access, and more equitable care,” he said. “Medicaid Expansion is an important accomplishment, but it’s also an early step in the journey towards healthy communities. We have more work to do, but we can, and we should take a moment to celebrate this victory.” 

Reese spoke about his idea for “FHLI 2.0,” which he described as a radical re-envisioning of FHLI to truly center community in everything the organization does. “This will seed the work that we do and as we water that seed, it’s going to continue to grow. It’s going to grow with strong roots across our state, building a solid foundation for a healthy future that doesn’t leave rural or marginalized communities behind,” he said. 

Bernstein Health Leadership Fellows & Scholarship Recipients Recognized 

Before the Bernstein Event, the 2022-2024 class of Bernstein Health Leadership Fellows attended an FHLI board meeting to give presentations about their work to improve health in their communities. 

During the main event, board member and emcee Kim Schwartz recognized all current and past Bernstein Fellows and scholarship recipients, who are employees or dependents of employees working in rural health centers. Schwartz noted that there have been 49 Bernstein Fellows thus far, and over 90% of them still live and work in North Carolina. Bernstein Scholarships have also been awarded to more than 103 individuals to help offset the cost of their higher education, since the program’s inception in 2006. 
 

Governor Roy Cooper & NC DHHS Secretary Kody Kinsley Celebrated Medicaid Expansion  

Governor Roy Cooper and NC DHHS Secretary Kody Kinsley shared pre-recorded videos addressing Bernstein Event attendees. Among other remarks, they, too, celebrated the expansion of Medicaid in North Carolina, which is expected to provide coverage to 600,000 people beginning December 1st

Terence “TC” Muhammad & Kari Thatcher, MPH, Received the FHLI Community Achievement Award on Behalf of the Greensboro Health Disparities Collaborative 

The FHLI Community Achievement Award recognizes those who exemplify Jim Bernstein’s lived values: everyone has a right to care, care should be delivered respectfully and effectively, and health care belongs to the community it serves. This year was the first time the award was presented to a collective. Co-chairs Terence “TC” Muhammad and Kari Thatcher, MPH, accepted it on behalf of the Greensboro Health Disparities Collaborative (GHDC), a partnership of community members, academic researchers, and medical professionals working to address health disparities caused by systemic racism. 

The GHDC was founded by community activists in 2003 after they participated in an anti-racism training conducted by the People’s Institute for Survival and Beyond. Muhammad and Thatcher honored the decades of community organizing led by Nettie Coad, Suzanne Plihcik, and Barton Parks that laid the foundation for The Collaborative. They were joined by fellow founding member Sam Cykert, MD, as well as members Kimberly Alexander, MPG and Lizzie Biddle, MA. 

In their speeches, Muhammad and Thatcher spoke about the need to center community and directly address systemic racism to resolve health disparities. Muhammad said, “One of the things about the Health Disparities Collaborative is we don’t just address the health disparities without addressing the racial issues in America and things that go on in our community.” In the same vein, Thatcher said, “As we increase access for our North Carolinians who need it so much, we also need to increase our capacity and skill examining ourselves and how our systems that we love and advocate for may be, and in fact are, perpetuating inequities that we do not want to see.” 

Doyle “Skip” Cummings, PharmD, Received the Jim Bernstein Community Health Career Achievement Award  

The Jim Bernstein Community Health Career Achievement Award is given to someone deeply invested in improving the health of their community or region. This year, FHLI presented this award to Doyle “Skip” Cummings, PharmD. Among his many accomplishments and contributions to rural health care in North Carolina, he is currently the Berbecker Distinguished Professor of Rural Medicine at ECU. He has taught at the university for 35 years and is both a professor of public health and an adjunct professor of family medicine. 

“Remember that change happens at the speed of trust,” Dr. Cummings said in his acceptance speech. “And trust happens at the speed of human relationships. And so, we need to take the time to invest, establish, and build relationships that will eventually result in our ability to collaborate effectively and achieve change.” 

FHLI Honored the Late Dr. James “Jim” Jones, Recipient of the FHLI Lifetime Achievement Award 

The FHLI Lifetime Achievement Award recognizes exceptional contributions to the fields of medicine and public health and was presented for the first time this year. Dr. Jim Jones passed away in May 2023, and his wife, Dr. Michelle Jones, and their children received the award on his behalf.  Among his many accomplishments and contributions, Dr. Jim Jones founded the East Carolina University Department of Family Medicine and was the Associate Dean for Rural Health there for two decades. 

A member of the Lumbee Tribe, he grew up on a rural farm in Pembroke, North Carolina, raised by his grandparents alongside his four siblings. Dr. Jim Jones was famous for saying, “The quality of your health care should not be determined by your ZIP Code.” He was a trailblazer and a leader, and his impact on health care in rural North Carolina will impact generations to come. 

“If Jim were here today, he would challenge each and every one of us to consider how we can help make health care in North Carolina the highest quality across the entire state from the ivory towers to the rural farms and fishing villages,” said Dr. Michelle Jones as she accepted the award on behalf of her late husband. 

Thank You for Supporting Collaborative, Equity-Centered, & Community-Driven Health Care in North Carolina!

Thanks to all who attended the 2023 Bernstein Event and for your ongoing support. We look forward to connecting and engaging with you over the next year and beyond. 

When Jim Bernstein joined as the first director of our nonprofit, he wanted to ensure it played an ongoing role fostering new generations of leaders dedicated to improving health in North Carolina. This event and the Bernstein Fellows and Scholars it helps fund are manifestations of that legacy that includes:

  • More than $130,000 given in Bernstein Scholarships
  • 49 outstanding future health leaders who make up our Bernstein Fellows and Fellowship alumni. 

Additionally, the event’s sponsors and everyone who joined us is helping FHLI achieve our 2023 goals, including:

  • Expanding NC Rural Health Association membership
  • Developing key contacts in every rural county
  • Expanding programmatic work into more than half of all North Carolina counties
  • Engaging rural communities in Bertie and McDowell Counties to improve behavioral health access
  • Developing relationships with leaders in the North Carolina House and Senate and identifying top policy priorities
  • Establishing an advocacy network for rural hospitals, clinics, and health centers
  • Advocating for equitable, forward-thinking health access legislation
  • Signing NCCARE360 contracts with all active health systems and one additional system not currently on the platform.

If you didn’t have the chance to join us for the 2023 Bernstein Event, or if you did and are feeling extra generous, you can make a donation today to help support our ambitious vision for a healthier North Carolina!

Medicaid Expansion in North Carolina is a hard-won victory for public health, health care professionals, and everyone in our state. Advocates have been working to make this a reality since 2010 when the Affordable Care Act was passed. Legislation to expand Medicaid was approved in March 2023; however, after being tied to the passage of the state budget, it has not gone into effect until now. Last week, the North Carolina Legislature passed a budget, which will finally allow Medicaid Expansion to take effect.  

Governor Roy Cooper announced that he will let the budget take effect, but without his signature. According to the Governor, he is taking this approach to both allow Medicaid Expansion to take effect and voice his displeasure with what he has called a “bad budget.”  

Medicaid Expansion will provide timely, affordable health coverage to around 600,000 North Carolina residents in the health coverage gap. This includes residents with incomes too high to qualify for Medicaid but too low to receive health care subsidies through the Affordable Care Act marketplace. Newly eligible Medicaid recipients can expect to enroll by December 2023 or early 2024. 

What Does Medicaid Expansion Mean for North Carolina? 

Medicaid Expansion in North Carolina will: 

  • Improve the overall health, well-being, and quality of life of North Carolinians. 
  • Benefit working families, veterans, front-line workers, small business owners, parents, and many others.  
  • Strengthen economic security, create more resilient communities, and reduce uncompensated health care costs. 
  • Better support our rural health care systems and providers. 

With this map created by Care4Carolina, a consortium of health advocacy organizations, you can see the impact Medicaid Expansion is expected to have in each NC county. 

More to Do: Many North Carolinians Will Remain without Coverage or Access to Care 

While Medicaid Expansion is an important turning point, it is important to remember that there is much more work to do. Hundreds of thousands of uninsured residents will continue living without coverage, including those in our most under-served and vulnerable communities. Even with Medicaid coverage, many people will keep facing systemic barriers to accessing care, especially oral health and other specialty services.  

FHLI and our collaborative partners are here to help providers, patients, hospitals, and other stakeholders understand what Medicaid Expansion means and how to take advantage of it. If you would like to read more about the history of Medicaid Expansion in North Carolina, you can read this blog post from March 2023.  

Sign up for updates from FHLI and connect with us on social media today to stay informed about the impacts of Medicaid Expansion in North Carolina. 

Since 2006, the Foundation for Health Leadership & Innovation has gathered with public health leaders from across North Carolina each year to celebrate the life of our founder, Jim Bernstein. Jim left a lasting legacy on our state that thrives through FHLI and so many of our partner organizations and programs. 

As we look forward to this year’s event on Oct. 4, we wanted to take a moment to look back on how FHLI was founded on Jim’s vision of helping the people of North Carolina, especially in our rural areas. 

In 1973, Jim Bernstein established North Carolina’s Office of Rural Health under the Department of Health and Human Services, the first Office of Rural Health in the country. He worked closely with a hand-picked team of individuals to focus on the needs of rural and underserved communities in the state. This work was fundamental in the creation of local county health centers across our state.

He later established the North Carolina Foundation for Alternative Health Programs in order to develop and implement innovative programs to help increase access to quality health care for all North Carolinians. The foundation was established in 1982 with the help of then-Governor Jim Hunt and the UNC School of Medicine.  

By 1998, the Foundation launches Carolina ACCESS to help communities create systems for providing access to comprehensive care for low-income, uninsured residents. It was successfully implemented in 12 counties, and the General Assembly approved implementing it statewide. This led to the creation of Community Care of North Carolina. 

The Foundation’s name was then changed to the North Carolina Foundation for Advanced Health Programs and was later changed to what we know today as the Foundation for Health Leadership and Innovation (2015).  

And in 2006, we launched the Jim Bernstein Health Leadership Fellows Program with the first two Fellows and the Jim & Sue Bernstein Community Health Center Scholarship Program. The Fellows program, which was one of Jim’s ideas, has graduated 49 Fellows who continue to do innovative work and research in North Carolina’s rural communities. Since being established the scholarship program has awarded more than $130,000 to scholars from rural community health centers. 

Although Jim passed away in 2005, we are proud to continue his work today and into the future. 

Learn more about Jim and his work as told by his friends and colleagues on our YouTube channel.  

Don’t miss your chance to see all of the great work that is still being done as part of Jim Bernstein’s Legacy. Join us Oct. 4 at the Friday Center in Chapel Hill for the 2023 Annual Bernstein Event.  

Registration and Sponsorships are still available!

Ayana Simon’s passion is helping others, and that is something she learned at a young age while watching her parents work in and navigate the healthcare system. 

“I’ve always worked in spaces where what I did was what I called ‘heart work,’ what I did was not just the task but also who it influenced,” she said. “What motivates me and keeps me going is work that has a positive impact on an individual, community or system.” 

We are excited to welcome Ayana as the Director of NCCARE360

Although she began as the NCCARE360 Director on June 1, Ayana is not new to the NCCARE360 platform. She previously worked as the Healthy Opportunities Program Director with Carolina Complete Health. She oversaw the pilot program which is the nation’s first comprehensive program to test and evaluate the impact of providing non-medical interventions related to housing, food, transportation and interpersonal safety and toxic stress to high-needs Medicaid enrollees to improve their overall health.  

She is looking forward to working closely with the NCCARE360 team to build upon what the program has already accomplished and help make it sustainable for the future. This includes increasing the network coverage through a data-driven strategy that identifies pockets of need in our state as well as a comprehensive marketing and community engagement strategy to help spread the word about the platform and its benefits.  

She also has experience working at the University of North Carolina Medical Center where she served as a Readmissions Program Manager from 2018-2021. 

She has a bachelor’s degree in Public Health from the University of North Carolina at Greensboro, a master’s degree in Social Work from the University of North Carolina at Charlotte and a master’s degree in Healthcare Administration from the University of North Carolina at Chapel Hill.   

Her passion for helping others also extends beyond the office walls. She is an active member of Alpha Kappa Alpha where she serves as a Vice President of the Sigma Tau Omega chapter and oversees the group’s community service efforts. She also serves on the Board of Directors for the African American Culture Festival in Raleigh which is an annual celebration of African American culture as expressed through art, music, food and community which draws more than 30,000 people annually.  

The end of the COVID-19 Pandemic Public Health Emergency on May 11, 2023, was met with a mix of relief and anxiety. While the daily impact of the pandemic has dramatically decreased for most, fears persist about the virus, potential resurgences, and ongoing risk.  

States of emergency ending at the state and national level carry many implications for public health. From free access to at-home tests to the Medicaid continuous enrollment provision, financial and health care benefits extended to millions of Americans are coming to an end.  

For more about the end of the COVID-19 public health emergency and other public health information, check out our recently released 2023 Rural Health Snapshot. 

COVID-19 Impact on North Carolina 

For more than three years, every corner of our state felt the impact of the pandemic. There were nearly 3.5 million cases of COVID-19 across the state and 29,000 deaths since the start of the pandemic. We were all impacted by uncertainty, fear, illness, death, economic challenges, and more. 

The pandemic state of emergency may be over, but its lasting impact is not. We are still battling the effects of long COVID, increased mental health challenges, health workforce shortages, and economic recovery.  

It was especially hard for North Carolina’s rural communities where there are fewer medical professionals and facilities and there is less access to reliable internet. In fact, fewer than one in four Mountain residents have access to fiber internet which makes telemedicine difficult according to North Carolina Health News. And, according to Fortune, many rural hospitals are struggling financially now that COVID funding has ended. 

We’ve seen some positive signs for North Carolina as well. Approximately 90 percent of the state’s residents have received at least one dose of the COVID-19 vaccine, with 67 percent having received a full two-dose vaccination.  

Centering Rural North Carolina Post-Pandemic 

One of our programs, the North Carolina Rural Health Association (NCRHA), is hard at work continuing to advocate for policies that support local health departments and public health organizations. NCRHA program staff are partnering with community-based organizations to understand and uplift the needs of our state’s rural communities and historically marginalized populations to ensure that we address systemic inequities. 

The COVID-19 pandemic made a lasting impression that won’t be forgotten, but it also revealed the true strength, resiliency, and character of North Carolinians. It also showed just how impactful positive policy can be on public health. After three years of a global pandemic, two things are clear: access to health care is vital, and equity in that access can and should be addressed systemically at the policy level.  

FHLI recently published the NCRHA’s 2023 Rural Health Snapshot. Check out the report to learn more about the state of health across North Carolina and our plans to continue creating change.   

Maternal and Child Health Equity in North Carolina

Earlier this year we published the comprehensive landscape report, “Progress and Opportunities: Maternal and Child Health Equity in North Carolina,” which outlined a maternal and infant mortality equity crisis in North Carolina. 

North Carolina has the 8th highest infant mortality rate in the country, and black women are four times more likely to lose a child before their first birthday compared to white women. It is staggering that maternal mortality increased 58 percent from 1990 – 2017 in the United States, making America the only industrialized nation with rising maternal mortality. 

In response, FHLI announced the launch of the Maternal and Child Health Equity Action Network (MCHEAN), which will engage key partners, communities, and stakeholders to develop a sustainable, community-driven network dedicated to strengthening maternal and child health equity. 

What is the Maternal and Child Health Equity Action Network? 

At least 25 percent of MCHEAN participants have lived experience interfacing with maternal and child health equity issues. And, to ensure that community voices are represented and heard, FHLI will provide incentives for community participation among participants.  Participants in MCHEAN will partner to co-design action plans to improve maternal and child health equity in NC by developing three policy and advocacy plans. 

Our goals for MCHEAN are to: 

  • Form an equity and action-focused network with community representation 
  • Develop a community-informed report mapping and linking maternal and child health equity efforts in North Carolina 
  • Produce and publicize at least three action plans to achieve opportunities in partnerships, program development, and policy reform 

We are excited to get started! This year we plan to recruit a target of 40 participants from across North Carolina to participate in MCHEAN, and we can’t wait. 

For more information about MCHEAN or to learn about how you can be involved, click here