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.  

FHLI President and CEO David Reese and staff members 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.  

We were pleased to meet with Representative Julie Von Haefen to discuss this issue in detail before attending her joint press conference with Senator Natasha Marcus. During the press conference they announced the refiling of the MOMnibus Act, which has been filed during three consecutive sessions in the North Carolina General Assembly. This year, the MOMnibus Act is one of a slate of bills that promise to improve outcomes and reduce racial disparities if passed.  

In addition, a federal MOMnibus Act was introduced by U.S. Rep. Alma Adams and includes more than a dozen bills designed to address black maternal and infant health. Rep. Adams is one of the original architects of a “MOMnibus” approach to tackling maternal mortality.  

If passed, North Carolina’s MOMnibus Act would establish an annual $395,500 grant pool for maternal mortality prevention, create an implicit bias training program within the North Carolina Department of Health and Human Services, and appropriate $500,000 every two years to support recruiting, training, and retaining a diverse lactation consultant workforce. 

Representative von Haefen heavily cited FHLI’s recently released landscape analysis, “Progress and Opportunities: Maternal and Child Health Equity in North Carolina,” during the press conference. This report on the state of maternal and child health in North Carolina was released to the public during Black Maternal Health Week and was funded and supported by the HopeStar Foundation and The Duke Endowment. 

The recently filed maternal health package in the North Carolina legislature, FHLI’s landscape report, and our newly announced Maternal and Child Health Equity Action Network (MCHEAN) all come on the heels of data released by the CDC in the first months of 2023.  

The statistics are shocking: 

  • Across the United States, maternal mortality increased 60 percent from 2019 – 2021. This rate is estimated to have continued to rise since 2017, making America the only industrialized nation with rising maternal mortality. 
  • Black women are 2.9 times more likely than white women to die while pregnant or within a year of childbirth. 
  • Black women in North Carolina are 4 times more likely to lose a child before their first birthday compared to white women. 

It’s like the sign said: black maternal health is nonpartisan. In fact, it should be everyone’s issue. The MOMnibus legislation filed at the state and national level as well as the rest of North Carolina’s maternal health package are all hopeful signs of change to come.  

NC Rural Health Association and North Carolina Oral Health Collaborative event centered policy action while celebrating rural champions and highlighting ongoing needs.

RALEIGH – Michelle Fortune, the CEO of St. Luke’s Hospital in Polk County, North Carolina, shared a personal rural health story with attendees of the North Carolina Rural Health Association’s (NCRHA) annual legislative breakfast.

When her father began experiencing chest pain and was taken to St. Luke’s, he was cleared and almost sent home before a doctor took time, paid attention, and discovered he was in fact 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 does have 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.

At NCRHA’s legislative breakfast, the organization unveiled its 2023 North Carolina Rural Health Snapshot, a sprawling analysis of rural health, access gaps, and inequities across the state. Beyond the 11 hospital closures in North Carolina since 2005, NCRHA’s Snapshot dives deep into the social factors that impact health, trends in behavioral health, oral health access, and workforce trends.

The organization and its co-host, the North Carolina Oral Health Collaborative (NCOHC), two programs of the Foundation for Health Leadership & Innovation (FHLI), presented awards to five rural health champions at the breakfast. NCRHA co-chairs Patrick Woody of the NC Rural Center and Emily Roland of the North Carolina Healthcare Association recognized Senator Jim Burgin and Representative Donna McDowell White for their work to improve rural health in the North Carolina General Assembly.

Among the topics of discussion at the breakfast was the recent passage of Medicaid Expansion in North Carolina, a policy that advocates have worked toward since the Affordable Care Act was passed in 2010. Burgin and White both were instrumental in cultivating the bipartisan support necessary to pass the legislation.

The pair also presented Fortune and Dr. Amanda Stroud with community champion and equity awards, respectively. During the event, 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.”

It’s never too early to talk about how to improve health across North Carolina!

Which is why we hosted an early morning breakfast at the N.C. Museum of History on April 26.  FHLI along with our friends and family from various organizations and numerous legislators met to discuss how to address the growing health care needs of North Carolinians from all corners of the state. 

As we stood surrounded by artifacts of our state’s rich history, we realized that North Carolina is now at a pivotal crossroads and has the opportunity to make real, substantive change to improve access to healthcare for so many in our state. 

And, it’s great to know we have solid partners to help us do just that. 

We were proud to present awards to leaders already making a difference across the state. The 2023 award recipients were 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). 

It was incredibly powerful and moving to hear how each of our award winners has been impacted by healthcare in our state and hear their vision for tomorrow. From Rep. White’s experience as a registered nurse in public healthcare to Sen. Burgin’s experience in the General Assembly to Dr. Stroud’s experience going from a student in a rural community to a dentist now serving that community, and Ms. Fortune’s experiences as a hospital administrator in a rural area, their stories and experiences inspired us to take action now. 

We hope you’ll join us on this exciting journey to help all North Carolinians receive the healthcare they deserve. As we kick off this 2023 Legislative Season, we’ll be focused on some key areas to help us achieve our goals. 

The 2023 Legislative Priorities for the North Carolina Rural Health Association are:  

  • Medicaid Expansion and Access to Care: NCRHA supports Medicaid expansion and efforts to expand coverage and access to quality, affordable, and equitable health care for all North Carolinians. 
  • Health Workforce Pipeline: NCRHA supports initiatives to recruit and retain health workers, create equitable access to health career pathways, build workforce capacity in rural and underserved communities, and expand scholarship and loan forgiveness programs.  
  • Maternal and Child Health: NCRHA supports efforts to ensure that every person has access to and receives the best care possible during and after pregnancy and childbirth regardless of zip code, age, race, ethnicity, religion, ancestry, disability, medical condition, genetic information, marital status, sex, gender identity, gender expression, sexual orientation, socioeconomic status, citizenship, nationality, immigration status, primary language, or language proficiency.  
  • Broadband for All: NCRHA supports access to affordable, high-speed internet anywhere and anytime for all North Carolinians. 

In addition, the North Carolina Oral Health Collaborative is focused on the following legislative priorities for 2023: 

  • Enact a state budget to allow House Bill 76 to take effect: More than 500,000 North Carolinians stand to gain health coverage, including oral health care, when House Bill 76 takes effect. 
  • Create a Rural Areas Forgiveable Loan Pilot Program that includes dental staff: Encourage dentists, hygienists, and assistants trained in North Carolina to stay, and bring more providers to rural parts of our state by adding funding for dental staff loan forgiveness to any rural area forgiveable loan pilot program proposals. 
  • Promote legislation to allow all dental staff to practice at the full scope of their licensure: Removing regulatory burdens and allowing dental staff, including hygienists and assistants, to practice to the full extent of their licensure will create opportunities for care in schools, retirement homes, and other non-traditional locations. 

For more on these priorities and how you can help, sign up to join FHLI’s coalition of health advocates! 

Black Maternal Health Week is April 11-17, 2023, and we can’t think of a better time to raise awareness of the need for strong healthcare for mothers and infants in North Carolina.  

The statistics are staggering: 

  • North Carolina has the 8th highest infant mortality rate in the country. 
  • Black women are 4 times more likely to lose a child before their first birthday compared to white women. 
  • Black women are 2.9 times more likely than white women to die while pregnant or within a year of childbirth. 
  • Across the United States, maternal mortality increased 58 percent from 1990 – 2017. This rate is estimated to have continued to rise since 2017, making America the only industrialized nation with rising maternal mortality. 

It’s time to act. And that’s exactly what we’re doing. 

This week we unveiled the “Progress and Opportunities: Maternal and Child Health Equity in North Carolina” report, which is a comprehensive analysis of maternal and infant health in North Carolina. It outlines the current landscape in North Carolina and identifies actionable policy, workforce, health systems, and funding opportunities. The report was sponsored by the HopeStar Foundation and validated by The Duke Endowment.  

But that’s only the start. This report reveals how much we need to turn this conversation into action and which organizations and communities are ready to do just that. 

Over the next few months, FHLI will be launching the Maternal and Child Health Equity Action Network (MCHEAN). MCHEAN will convene individuals with lived experience, organizations working on maternal and infant health issues, and communities that disproportionately experience higher rates of mortality. The network will be charged with creating partnerships, developing programs, and reforming North Carolina’s policy structure and will be comprised of 40 participants with lived experience interfacing with maternal and child health equity issues. 

This work wouldn’t be possible without our strong partnerships from the HopeStar Foundation and The Duke Endowment. Both organizations have been involved from day one, providing funding and thought partnership as we developed the landscape analysis and MCHEAN program. 

We have a long way to go, but we are excited about the possibilities ahead of us with the MCHEAN and with the dedication of our partners statewide. Together we can reverse these trends and help improve health care for mothers and infants statewide. 

We are excited to announce a new partnership between FHLI and the North Carolina Area Health Education Centers (NC AHEC), with funding support from The Duke Endowment, to develop and manage Project ECHO Network in North Carolina (PEN-NC). Through this project, we will work to improve the health and well-being of all North Carolinians.

We will launch PEN-NC with a website and membership drive soon, but for now we want to share some information about what the Network will be and what we plan to accomplish.

An ECHO project is a virtual learning community, connecting subject matter experts with their peers to listen, share, and learn together. The model was developed out of the University of New Mexico with the goal of creating digital spaces to share life-saving knowledge, mentorship, and support across professions in the health, education, and civics spaces. 

There are ECHO projects are already active across North Carolina and around the country and globe. PEN-NC will build upon FHLI’s legacy of collaboration and NC AHEC’s leadership in workforce development. We believe that convening diverse groups of stakeholders is key to solving the biggest problems we face. PEN-NC will serve as the first statewide Project ECHO Network, connecting these existing projects and helping launch new ones. 

Stay tuned for our full PEN-NC launch! We’ll be in touch soon. 

Sincerely, 

Dr. Jill Forcina
NC AHEC

Dr. Steve Cline
FHLI

NC AHEC was established in 1972 to provide and support educational activities and services with a focus on primary care in rural communities and those with less access to resources to recruit, train, and retain the workforce needed to create a healthy North Carolina.

Medicaid Expansion will bring access and opportunity, opening new doors for progress across the state.

For health care advocates across North Carolina, the first few months of 2023 may have felt surreal. More than a decade of hard work and advocacy from countless organizations and individuals passionate about access to health care has paid off with the North Carolina legislature voting to expand Medicaid.

At FHLI, we recognize the benefits this legislation will bring to hundreds of thousands of people in our state. We are proud of the advocacy efforts so many of our staff participated in, and we are thankful to the organizations and individuals who never wavered in their focus on the individuals and communities across North Carolina that stand to benefit from Medicaid Expansion.

By expanding Medicaid, more than 600,000 North Carolinians will gain access to quality, affordable health care. Working families across our state, including veterans, front-line workers, small business owners, parents, and so many more, will all benefit from expansion.

With an estimated creation of 37,200 jobs, thousands in savings for small businesses, and billions in federal funding brought back to the state each year, Medicaid Expansion will also strengthen North Carolina’s economy, create more resilient communities, and reduce uncompensated care costs.

A Long Road Behind Us

Medicaid Expansion first became an option for states when the Congress passed the Affordable Care Act in 2010. North Carolina, along with many other states, did not pass their own enabling legislation necessary to expand Medicaid. In recent years, many of the states that originally passed have changed course, leaving North Carolina among just 11 states that hadn’t enacted Medicaid Expansion.

In recent years, nearly three quarters of rural hospital closures happened in states that failed to expand Medicaid. Breaking this trend and providing much-needed funding to North Carolina’s rural hospitals will provide vital support to rural communities.

Seven rural hospitals in North Carolina closed since Medicaid Expansion was first on the table in 2010. There is re-building that needs to happen. Medicaid Expansion isn’t the end of the road – it is a huge step in a positive direction that opens doors for new opportunities to build a future where all North Carolinians have access to the care they deserve.

The Work Doesn’t Stop With Medicaid Expansion

The North Carolina Senate amended the Medicaid Expansion bill, tying the legislation to the passage of the state budget. Some parts, such as a provision allowing hospitals to use the Healthcare Access and Stabilization Program (HASP), will become effective immediately. But other parts of the legislation, including the main provision expanding Medicaid eligibility to more than 600,000 North Carolinians, wouldn’t go into effect until the legislature and Governor Cooper agree on and pass a biennial state budget.

This provision ties Medicaid Expansion to many other issues, such as teacher pay, education funding, and taxes. In recent legislative sessions, the budget has proven to be a difficult issue to reconcile. In 2019, the legislature and Governor did not reach an agreement, failing to enact a budget before the end of the year.

At the end of the day, North Carolina is closer to expanding Medicaid than it has ever been. There is reason to celebrate this massive achievement, but it is also important to recognize that there is potential for significant roadblocks to arise between where we are and where we need to be.

Medicaid Expansion will make a massive dent in health disparities, increasing access and equity across our state. However, there will still be hundreds of thousands of uninsured North Carolinians unable to access the care they deserve. Many of those who gain Medicaid coverage will struggle to find providers who accept their insurance, especially for oral health and other specialty services.

FHLI’s Work Will Leverage Medicaid Expansion To Help All North Carolinians

FHLI is well-positioned to continue increasing access and equity across North Carolina. Our programs will use Medicaid Expansion as an opportunity, leveraging the policy as we work directly with rural communities and advocate for systems-level change.

  • Working directly with providers, NCCARE360 will continue connecting hundreds of thousands of people with the resources they need, enabling a community-oriented, person-centered approach to care in all 100 North Carolina counties.
  • The Center of Excellence for Integrated Care will continue to find new and exciting opportunities to ensure behavioral health is accessible to everyone by helping health care clinics provide whole-person care.
  • The North Carolina Oral Health Collaborative will have plenty of work to do. With so many people poised to gain oral health benefits, safety net clinics will face a combination of opportunity and challenge. NCOHC is actively supporting workforce initiatives across the state that will help these clinics grow to meet the need.
  • FHLI’s Bernstein Fellows and scholars will enter the workforce or continue their careers with new avenues to positively impact communities with limited access to care.
  • Acting as a convener, the North Carolina Rural Health Association will play an important role in coordinating resources for rural communities across North Carolina.
  • Results NC’s data collection trainings will prove vital in tracking progress and opportunity as Medicaid Expansion takes effect and impacts North Carolina communities.

FHLI’s Community Voice team attended the National Rural Health Association’s (NRHA) 34th Rural Health Policy Institute in Washington, DC, from February 7 – 9, 2023. 

The Rural Health Policy Institute is an annual 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. 

NRHA is a national nonprofit and nonpartisan membership organization with a diverse membership of more than 21,000 individuals and organizations, all of whom share the goal of improving rural health. NRHA strives to improve the health of the 60 million people who call rural America home. FHLI is home to the NC Rural Health Association (NCRHA), the official state affiliate of NRHA.  

Returning to an in-person gathering for the first time since 2020, Donald Hughes, FHLI’s Director of Community Voice and the NC Rural Health Association, led a delegation of 18 attendees from across North Carolina to the Rural Health Policy Institute. The group included representatives from the NC Healthcare Association (NCHA), NC Rural Center, American Psychological Association, ECU Health, Atrium Health, Duke, UNC, and the NC Department of Health and Human Services (NCDHHS).  

During their time at the nation’s capital, the NCRHA delegation met with several members of Congress and their staffs to discuss the state of rural health in North Carolina, educate them on their respective organizations’ work, and advocate for policies that support rural health providers, organizations, and community members. In 2023, attendees met with Representatives Don Davis (NC-01), Deborah Ross (NC-02), and Jeff Jackson (NC-14). Attendees also met with staff for Representatives Greg Murphy (NC-03), Valerie Foushee (NC-04), Chuck Edwards, Richard Hudson (NC-09), Patrick McHenry (NC-10), and Chuck Edwards (NC-11).

NCRHA is a collaborative network of associations, organizations, and individuals representing healthcare, education, economic development, local government, and a variety of rural stakeholders invested in supporting rural health. It is committed to amplifying the voice of North Carolina’s rural communities with the intention of improving the health and well-being of all citizens. Learn more about NCRHA and how to become a member at https://foundationhli.org/ncrha/.

Dr. Viviana Martinez-Bianchi and Randy Jordan honored for their contributions to the state

Chapel Hill, N.C. – In its first in-person event since 2019, the Foundation for Health Leadership and Innovation welcomed hundreds of the state’s most dedicated public and rural health advocates to the UNC-Chapel Hill Friday Center for the 2022 Annual Bernstein Dinner. The event took place Thursday, Oct. 6.

Event highlights:

Recognition of Bernstein Fellows

Hugh Tilson, North Carolina AHEC Director and Chair of the Bernstein Fellows Program, recognized the current class of Bernstein Fellows. The Bernstein Fellows Program honors Jim Bernstein’s legacy by cultivating the next generation of health care leaders through training in leadership, community/rural health and advocacy.

“These fellows demonstrated extraordinary resilience and commitment as they completed their trainings and experiences while navigating all COVID threw at them,” Tilson said. “I’m so proud of them as leaders and as wonderful, caring people.”

Dr. Viviana Martinez-Bianchi Received Community Achievement Award

Dr. Viviana Martinez-Bianchi co-founder of Latin-19 and a member of the Duke University Department of Family Medicine and Community Health was awarded FHLI’s Community Achievement Award. LATIN-19, honors all voices and facilitates safe spaces for meaningful conversations about the forces that inadvertently disconnect and exclude the Hispanic AND Latinx communities from the health care system – as well as other critical resources.

“Every person, every community has a voice and a story to tell,” Dr. Martinez-Bianchi said in her acceptance speech. “The issue is: who is listening, or who is able to listen, or who decides to take the time to understand the language of the voices of the community.”

Randy Jordan Given Career Achievement Award

Randy Jordan, who served as President of the North Carolina Association of Free and Charitable Clinics for six years, received the Jim Bernstein Career Achievement Award. Jordan’s career has included service as a pharmacist, an attorney, and a tireless advocate for underserved and marginalized communities.

“I’m so very thankful tonight for my close friends who every day are serving the underserved through our state’s free and charitable clinic network,” Jordan said. “They are the real heroes of this evening and I’ve had the genuine privilege of working alongside them and putting into practice the values of service exemplified by Jim Bernstein.”

FHLI CEO David Reese Shared Vision

FHLI’s new CEO David Reese noted that COVID had highlighted systemic challenges in meeting the health needs of underserved and marginalized populations and challenged attendees to keep those challenges top-of-mind.

“It’s going to take all of us, stacking hands and working together, to identify the root causes of health inequities, bring forward evidence-based solutions, connect organizations and best practices, and advocate for necessary policy and system change. This is the work FHLI has been doing for 40 years, but I daresay it has never been more important than it is right now.”

NC DHHS Secretary Kody Kinsley Emphasized the Importance of a Diverse Health Care Workforce

Secretary Kody Kinsley, head of North Carolina’s Department of Health and Human Services, noted that leading the state’s COVID-19 pandemic provided a valuable reminder of the importance of bringing more people of color into the health care and public health professions.

“Equity matters. The words that you choose matter. Who speaks to them matters.” Kinsley said. “Like FHLI, we know the importance of working from within communities, rather than using a top-down approach.”

Photos and video from the event are available at URL.

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FOR IMMEDIATE RELEASE  
August 18, 2022  

FHLI Names 2022 Health Leadership and Community Achievement Honorees 

Award Winners to Be Honored at Annual Bernstein Dinner in October 

CARY, NC – The Foundation for Health Leadership and Innovation (FHLI) announced the winners of its annual awards today. The awards will be presented on Oct. 6 during the organization’s Annual Bernstein Dinner at the Friday Center in Chapel Hill. 

“These award winners represent innovation, empathy, and a deep dedication to improving health outcomes,” said David Reese, president and CEO of FHLI. “It’s an honor to recognize their decades of service in North Carolina.”  

The 2022 Jim Bernstein Community Health Career Achievement Award will be presented to Randy Jordan, outgoing CEO of the North Carolina Association of Free and Charitable Clinics. Jordan, who retired in 2022, is a longtime supporter and partner of FHLI.  

The Jim Bernstein Community Health Career Achievement Award recognizes individuals who are invested in improving the health of their community or region. The award recipient exemplifies the Foundation’s whole-person and whole-community approach to health and reflects the Foundation’s values. The award recipient is deeply respected among their peers, they can be mid-to-late career, and they likely work in partnership with at least one of FHLI’s programs. 

The 2022 FHLI Community Achievement Award will be presented to Dr. Viviana Martinez- Bianchi, M.D., FAAFP, of the Department of Family Medicine at Duke Health. During the COVID-19 pandemic, she co-founded the Latinx Advocacy Team & Interdisciplinary Network for COVID-19, better known as LATIN-19. 

“LATIN-19 is creating space for leaders across North Carolina to collaborate on innovative solutions to the unique barriers faced within the Latinx community,” said Reese. “This organization and Dr. Martinez-Bianchi’s leadership are testaments to the importance of diverse voices having a seat at the table to create more equitable health systems.” 

“I want to make sure that this recognition goes also to those who have worked tirelessly with LATIN-19, collectively joining in the effort to improve the health outcomes of the comunidad latina in North Carolina and the US,” said Dr. Martinez-Bianchi. 

The 2022 FHLI Community Achievement Award recognizes individuals who have dedicated their careers to improving the health of communities, exemplifying the values lived by Jim Bernstein: everyone has a right to care; care should be delivered in a respectful, efficient, and effective manner; and health care belongs to the community it serves. The award recipient has had an impact, like Bernstein, at the community, state, and federal level and is deeply respected among their peers. 

The 2022 Annual Bernstein Dinner will celebrate FHLI’s 40 years of serving communities across North Carolina and will focus on the theme, “Allyship. Advocacy. Action.”  

In addition, FHLI will honor the 2022 Class of Bernstein Fellows. The Jim Bernstein Community Health Leadership Fellows Program was founded in 2006 to honor Bernstein’s legacy of developing future leaders to carry on his work. 

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About Jim Bernstein 

The Bernstein Event honors the late Jim Bernstein, the founder and first president of the Foundation for Health Leadership & Innovation. Bernstein dedicated his life and work to improving health care in rural communities across North Carolina. An innovator and a motivator, he served as a role model for how to address some of rural health care’s most pressing challenges.  

About FHLI 

Launched in 1982, under the leadership of James D. Bernstein, the Foundation for Health Leadership & Innovation develops innovative programs and establishes strong partnerships that advance affordable, sustainable, quality health services that improve the overall health of communities in North Carolina and beyond. 

FHLI programs include: 

  • Jim Bernstein Community Health Leadership Fellows 
  • Jim & Sue Bernstein Health Center Scholarship 
  • Center of Excellence for Integrated Care (COE) 
  • Results NC 
  • NCCARE360 
  • NC Oral Health Collaborative (NCOHC) 
  • The NC Rural Health Association 

For more information, contact:  

Brady Blackburn 
Foundation for Health Leadership & Innovation 
Brady.Blackburn@foundationhli.org  
919.533.9934 

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