The COVID-19 Impact on Our State’s Most Vulnerable

by Calvin Allen
Program Director
Rural Forward NC

COVID-19 is NC’s latest forecasted hurricane, but will its largest impacts on our most vulnerable be visible? 

We may not have experience with a disease like coronavirus, but in this current health crisis, we can see patterns of the natural disasPeople Working Togetherters that North Carolina knows too well. As the Public Education Team of the NC Inclusive Disaster Recovery Network, our organizations support our state’s public health experts in their call to wash our hands frequently, be thoughtful about travel and gathering with crowds of people, and to combat fear and anxiety as much as we combat the virus itself. We also offer lessons we have learned from the many hurricanes NC has faced. 

Like hurricanes, losses are likely to fall most heavily on people who are already having the hardest time, especially in rural communities, communities of color, communities of lower wealth, and others with special needs. 

Like hurricanes, those who are most affected are likely to be absent from planning the response and recovery — ignoring or eroding the strengths, creativity, and social networks that are present in every community. 

While small rural communities may benefit from their relative distance, an outbreak will further tax their stretched resources from previous disasters and threaten their access to needed services. 

However, unlike a hurricane, the damage from COVID-19 will be less visible. Flooded homes and businesses are easier to see than the loss of income for workers and small businesses. The emphasis on social distancing means that even the threat of an outbreak may be financially devastating to businesses as employees and customers self-quarantine or care for family members. These losses translate into missed mortgage or rent payments, high credit card bills, and long-term financial instability. 

Based on the broad collaboration that we deployed after our recent hurricanes, we know that it is critical for our state to use policies, public dollars and public institutions to provide income, job and housing security so people who are affected can stay home when their safety is threatened and seek treatment when they are ill. We can also advocate for and invest in local talent instead of bringing in contractors from outside the state, focusing job training on communities where the need for jobs is greatest and people are most likely to be affected. And we can create and participate in accessible opportunities for collaboration in the planning and response process. 

Just as hurricane relief gives way to recovery, North Carolina’s public and private organizations can help communities and community leaders prepare for the broader impacts of this epidemic. Those who have the least should not suffer the most, regardless of whether the disaster is wind, water, or a virus. 

The Public Education Team is the outreach arm of the NC Inclusive Disaster Recovery Network – a collaborative of public, private, non-profit, and faith organizations seeking avenues for community voice and equitable access to resources in the disaster recovery system. 

Public Education Team – Member Organizations 

  • Budget and Tax Center
  • Foundation for Health Leadership & Innovation
  • NC Association of Community Development Organizations
  • NC Housing Coalition
  • NC Justice Center
  • NC Pro Bono Resource Center
  • Rural Advancement Foundation International-USA

 

Contact Calvin Allen, Director, Rural Forward NC for more information about the NC Inclusive Disaster Recovery Network.

CARY— The North Carolina Oral Health Collaborative (NCOHC), a program of the Foundation for Health Leadership & Innovation (FHLI), has released a statewide map of emergency oral health resources for patients during the COVID-19 pandemic. 

The map is a first-of-its-kind resource to help patients with urgent oral health needs to find nearby Federally Qualified Health Centers, county health departments, free and charitable clinics, and other safety net practices.

“Oral health issues won’t just disappear as we continue to navigate this crisis, but we must reduce strain on our emergency departments, which is just one benefit that we hope this resource will provide,” said Dr. Zachary Brian, NCOHC’s program director. “The clinics and practice sites on this map are additional options to consider for urgent needs before visiting an ED, and we hope that communities across the state find this resource helpful.”

North Carolinians visit emergency departments for non-traumatic oral health issues at twice the national rate. While oral health providers have been prompted to postpone all elective procedures—following guidance from the American Dental Association and the North Carolina State Board of Dental Examiners—many are available to see patients who would otherwise have to seek care at an emergency department. 

If patients require care for an urgent oral health need, it is recommended that they find a nearby practice, but to call before going in. Practice sites may have special guidance to ensure the safety of staff and patients alike. Additionally, due to the strain on the entire public health system, hours of operation are subject to change. 

NCOHC developed its provider map in part to support the UNC Adams School of Dentistry’s efforts to provide safe ways for patients to manage oral health care while reducing strain on the healthcare system. NCOHC’s provider map will be updated regularly as new information is available. To access the map, visit https://oralhealthnc.org/covid-19/.  

If someone is experiencing a life-threatening emergency, they are urged to call 911 immediately.

 

CARY — The Foundation for Health Leadership & Innovation, a leading North Carolina nonprofit that develops and supports innovative partnerships for a healthier North Carolina, today announced that its Rural Forward NC Program Director Calvin Allen has been named to the Theory of Change Working Group for Thrive Rural, where he joins a broad array of leading practitioners, academics and experts who will share expertise to create dynamic, sustainable rural communities where all people can realize their full potential and live healthy lives.

“The Thrive Rural initiative aims to design peer-learning opportunities, concrete tools and policy proposals that are responsive to local wisdom, needs and experience,” said Katharine Ferguson, Associate Director of the Aspen Institute Community Strategies Group. “We strive not to be the experts, but rather to ensure rural people and places — in all their glorious diversity — are heard and in on the action.”

With an intentional emphasis on the intersection of race, class and place, Allen will join practitioners, policy makers and academics across sectors and regions to weave an organized, unified and powerful network dedicated to improving rural community conditions and advancing rural health and prosperity.

“I am thrilled that Calvin was selected to contribute to this important work given his extensive experience working so effectively with rural communities across North Carolina,” said FHLI’s President and CEO Anne Thomas. “I know he will contribute significantly to Thrive Rural’s objectives.”

In North Carolina, Allen leads the FHLI’s Rural Forward NC Program, providing capacity-building and organizational development consulting to leaders, organizations, and networks across ten rural counties. The work is a part of the Healthy Places NC initiative of the Kate B. Reynolds Charitable Trust.

“It has been a pleasure to work with some of the best rural thinkers across the U.S. in defining ideal rural leadership structures,” says Allen. “It’s even more humbling to test those ideals with the real-life experiences of our rural NC partners who strive daily to make their communities thrive.”

More About Thrive Rural

The Thrive Rural initiative brings together the strength, perspective and commitment of three distinct institutions. For more than 35 years, the Aspen Institute Community Strategies Group has worked with practitioners from the hills, hollows and highways of rural America — and with leaders from its markets, manufacturers and Main Streets. We are partnering with the University of Wisconsin Population Health Institute, ingenuity and innovation behind the County Health Rankings and Roadmaps, tapping their academic rigor and track record of creating accessible, useful tools that are changing how local leaders build more healthy and equitable communities. With rural health outcomes lagging, the Robert Wood Johnson Foundation has made rural health and well-being an integral part of its commitment to health equity nationwide.

CARY— The North Carolina Oral Health Collaborative (NCOHC), a program of the Foundation for Heath Leadership & Innovation (FHLI), announced today that the North Carolina Rules Review Commission has given its final approval of an important rule change that will open doors for access to quality, preventive oral health care for the state’s most underserved. 

The rule change — unanimously approved of by the North Carolina Board of Dental Examiners on December 13, 2019 — will allow dental hygienists to provide preventive services such as sealants and fluoride treatments to children in high-need settings without a dentist’s prior exam. 

“This is a critical step toward improving access to oral health care for North Carolina’s most vulnerable populations,” said Dr. Zachary Brian, director of NCOHC. “To address the oral health crisis in our state, we must reduce the regulatory burdens that prevent greater access to quality oral health care. This rule change does just that, and we are thrilled to see it pass this final step to become law.”

Increased access to oral health preventive measures is paramount when considering that tooth decay is the single most common chronic childhood disease, disproportionately affecting low-income populations. Nationwide, roughly 50 percent of children in low-income families experience tooth decay, and dental disease is responsible for a collective 51 million hours of school missed each year. 

Without the requirement for a prior exam by a dentist, dental hygienists can offer sealants in alternative settings like schools or after-school clinics more efficiently. School oral health programs, in particular, are very effective methods for reaching children who would otherwise not see a private dentist. 

In 39 states across the country, dental hygienists can apply dental sealants without a prior exam or supervision from a dentist. This procedure is within the clinical training of a hygienist. However, in states like North Carolina, regulatory barriers hinder access to and delivery of these preventive procedures. 

Co-sponsored by NCOHC and the North Carolina Dental Society, the rule change eliminates this regulatory obstacle, increasing access to preventive oral health care services for North Carolina’s most vulnerable populations.

About FHLI’s North Carolina Oral Health Collaborative

The North Carolina Oral Health Collaborative, a program of the Foundation for Health Leadership & Innovation, works to advance systems change, improving the overall health and well-being of all North Carolinians by increasing access and equity to oral health care. NCOHC advocates seek to influence policy at a statewide level, and through collaboration, listening, and knowledge-sharing, NCOHC works to provide maximum impact in achieving optimal oral health care to all North Carolina communities.

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For more information, contact:
Marni Schribman, Director of Communications & Public Relations
Foundation for Health Leadership & Innovation
Marni.schribman@foundationhli.org
919-259-4547

CARY— The North Carolina Oral Health Collaborative (NCOHC), a program of the Foundation for Heath Leadership & Innovation (FHLI), announced today that the North Carolina Board of Dental Examiners has unanimously voted to move for the permanent adoption of an important rule change that will open doors for access to quality preventive oral health care for North Carolina’s most vulnerable.

“The oral health needs of the state’s most disadvantaged groups are tremendous, but not insurmountable,” said Dr. Zachary Brian, NCOHC Director. “This rule change will be instrumental in improving access to critical preventive oral health care and is one step forward in addressing access disparities.”

On December 13, 2019, the North Carolina Board of Dental Examiners unanimously voted to move for permanent adoption of a change to Occupational Licensing Boards and Commissions Rule 16W. The rule change will allow dental hygienists to further practice to the full extent of their licensure by providing preventive services such as sealants and fluoride treatments in high-need settings without a dentist’s prior exam.

Before it goes into effect, the rule change, co-sponsored by the FHLI’s NCOHC and the North Carolina Dental Society (NCDS), must receive final approval from the Rules Review Commission. Approval is currently anticipated sometime in mid-January.

Tooth decay is the single most common chronic childhood disease, disproportionately affecting low-income populations. Nationwide, roughly 50 percent of children in low-income families experience tooth decay, and dental disease is responsible for a collective 51 million hours of school missed each year.

Dental Sealants: A Cost-Effective Opportunity for Preventive Oral Health Care

Cost of care is a significant barrier that prevents children and families from accessing oral health care. At one-third the cost of a cavity filling, dental sealants are a lower-cost solution that can dramatically reduce the likelihood that an individual will develop a cavity during childhood.

Unfortunately, North Carolina’s requirement that a prior exam from a dentist be completed before a dental hygienist can apply a sealant adds additional cost and delays to the process. In North Carolina, only 16 percent of children ages 6 to 9 have received a sealant on a permanent tooth.

Without the requirement for a prior exam by a dentist, dental hygienists can offer sealants in alternative settings like schools or after-school clinics rather than at a dentist’s office. School oral health programs, in particular, are very effective methods for reaching children who would otherwise not have access to preventive services from a private dentist.

According to the CDC, each tooth sealed saves more than $11 in treatment costs down the road. With just over one million low-income children in North Carolina, expanded access to dental sealants has the potential to save a tremendous amount downstream.

A dental sealant is a thin coating applied on the chewing surfaces of a child’s back teeth. The application of a sealant is a simple and painless procedure that adds an extra layer of protection to teeth which are most susceptible to decay because of the pits and grooves on their chewing surfaces. A dental sealant protects against 80 percent of cavities for two years, and 50 percent of cavities for up to four years.

Eliminating Regulatory Barriers to Increase Access to Oral Health Care in North Carolina

In 39 states across the country, dental hygienists can apply dental sealants without a prior exam or supervision from a dentist. This procedure is within the clinical training of a hygienist, but in states like North Carolina, regulatory barriers hinder access and delivery to these preventive procedures.

The rule change co-sponsored by NCOHC and NCDS would eliminate this regulatory obstacle, increasing access to preventive oral health care services for North Carolina’s most vulnerable populations.

About FHLI’s North Carolina Oral Health Collaborative

The North Carolina Oral Health Collaborative works to advance systems change, improving the overall health and well-being of all North Carolinians by increasing access and equity to oral health care. NCOHC advocates seek to influence policy at a statewide level, and through collaboration, listening, and knowledge-sharing, NCOHC  works to provide maximum impact in achieving optimal oral health care to all North Carolina communities.

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For more information, contact:
Marni Schribman, Director of Communications & Public Relations
Foundation for Health Leadership & Innovation
Marni.schribman@foundationhli.org
919-259-4547

CARY — The Foundation for Health Leadership & Innovation, a nonprofit organization that develops innovative programs to advance services and improve the overall health of North Carolinians, today announced the launch of its new brand that unifies all of its programs with one visual identity.

“The 2020 brand launch kicks off an exciting new chapter for FHLI and celebrates the culture of innovation built during the organization’s 37-year history of tackling health issues facing rural areas,” said Anne Thomas, president and CEO. “The new unified brand is a reflection of the collective value our programs bring to the communities we serve and will help us promote that collective value as we extend our reach across the state.” 

Although formatted in a consistent way, each new FHLI program logo has its own color palette and imagery associated with its offerings. Each logo also incorporates the iconic teal and purple graphic that represents the four pillars of FHLI: building leadership, shaping practice, affecting policy, and driving innovation. 

“Working with others, developing partnerships, and building healthy communities can only be accomplished with the support of the entire organization,” said Thomas. “And this new unified brand reflects the strength of that support.”

About FHLI
The Foundation for Health Leadership & Innovation is a nonprofit organization that envisions healthy communities across North Carolina where everyone can flourish. FHLI develops and supports innovative partnerships that build a healthier North Carolina through collaboration and respect. With a long history in the state — and a deep understanding of its health care needs — FHLI scales solutions that benefit the entire state. FHLI staff are thought leaders and experts who bring communities together for a better, healthier North Carolina. Learn more at www.foundationhli.org

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For more information, contact:
Marni Schribman, Director of Communications & Public Relations
Foundation for Health Leadership & Innovation
919-259-4547

CARY — The Foundation for Health Leadership & Innovation is pleased to announce that Dr. Susan Mims, M.D., MPH, Vice President for Children’s Services and Clinical Genetics and Personalized Medicine at Mission Health, Chief of Pediatrics for Mission Children’s Hospital, and Vice Chief of Staff for Mission Hospital, has been named as the 2019 recipient of the Foundation for Health Leadership & Innovation’s Community Achievement Award. 

Dr. Mims has served as the chief executive for Mission Children’s Hospital for more than a decade. She also serves on Mission Hospital’s leadership team, working to meet the healthcare needs of the people and families of western North Carolina and to promote health throughout the region.

“Susan Mims embodies all of the qualities essential to being a true healthcare innovator,” said FHLI President and CEO Anne Thomas. “She fearlessly spearheads those initiatives on the local, regional, and state levels that have led to significant improvements of the health and wellness of our children.”

Under Dr. Mims leadership, Mission Children’s Hospital has grown to serve children across western North Carolina and beyond with pediatric specialty care in 24 disciplines, a robust child life program, a child advocacy center, and other outreach programs. Several of the programs she spearheaded have attained national recognition, such as “The ToothBus” mobile dental care program, Asthma Outreach, and WNC Safe Kids Injury Prevention programs. She has implemented strategic plans resulting in program growth, improved efficiency, attainment of millions of dollars in grant and philanthropic support and significantly improved the financial performance of Mission Children’s Hospital. She takes great pride in managing resources in a fiscally responsible way to ensure program sustainability.

Before joining Mission, Dr. Mims served as Medical Director at the Buncombe County Health Department, where she oversaw clinical services in the county’s largest indigent care clinic and school-based health centers. She has led many quality improvement projects, including the transition to electronic medical records, establishing an open-access care delivery model, and integrating behavioral health in the medical clinic. She has practiced general public health, including oversight of immunizations, family planning, STI services, WIC and nutrition, community health, disaster preparedness, and disease control and coordinated several major disease outbreak investigations. Prior to her work as medical director at the Health Department, Dr. Mims worked as a physician in a private practice in Durham, NC.

About FHLI’s Community Achievement Award

The Foundation for Health Leadership & Innovation Community Achievement Award recognizes individuals who are invested in improving the health of their community or region. The recipient of this award exemplifies the FHLI’s whole-person and whole-community approach to health and reflects FHLI’s values. In addition, this award is presented to a recipient who is deeply respected among his/her peers. For more information about FHLI, please go to foundationhli.org.

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Photos of Dr. Mims accepting the award can be found on the FHLI website.

For more information, contact:
Marni Schribman, Director of Communications & Public Relations
Foundation for Health Leadership & Innovation
Marni.schribman@foundationhli.org
919-364-8067

CARY — The Foundation for Health Leadership & Innovation is pleased to announce that Sarah Thach, MPH, Assistant Director of the UNC Gillings School’s Masters of Public Health Program, and Adjunct Faculty with the Public Health Leadership Program at UNC Gillings School of Global Public Health, has received the 2019 Jim Bernstein Health Leadership Award for her exceptional representation as an alumnus of the ideals of the fellows program.

“Sarah exemplifies the spirit of the Jim Bernstein Fellows program by being an active, engaged and enthusiastic champion for quality rural healthcare,” said Anne Thomas, President and CEO of the Foundation for Health Leadership & Innovation. “She is aggressively putting her passions for rural health into action today.”

As a Bernstein Fellow, Sarah worked at the Mountain Area Health Education Center, in the Center for Healthy Aging. For her project, Sarah piloted models for primary care and public health collaborations to address environmental factors affecting the health of the aging population in Western North Carolina.

Through her work in the Bernstein program and with the Gillings School, Ms. Thach has promoted rural healthcare workforce pipeline development, training, recruitment, and retention of physicians in underserved rural Western North Carolina; developed models to help primary care physicians care for geriatric patients; trained health educators and broad-based health partnerships in assessing and addressing community health needs; and coordinated rural clinical training for health profession students and created faculty development for community-based physician-teachers.

Sarah has worked to promote community capacity and access to care in rural communities most of her career, and now she is responsible for placing MPH students in western NC communities and mentoring them. Sarah has published peer-reviewed articles about rural medical workforce development and has presented at national public health forums. Sarah’s extensive knowledge of WNC has brought her a reputation of a great resource of practical best practices, what works and what doesn’t work, and is the go-to person for prevention issues and implementation.

About the Jim Bernstein Health Leadership Distinguished Fellow Award
The Jim Bernstein Health Leadership Distinguished Fellow Award recognizes graduating Bernstein Fellows who exemplify the values lived by Jim Bernstein: everyone has a right to care; care should be delivered in a respectful, efficient, and effective manner; and healthcare belongs to the community it serves. For more information about the Foundation for Health Leadership & Innovation, as well as the Jim Bernstein Fellows Program, please visit www.foundationhli.org.

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Photos of Ms. Thach accepting the award can be found on the FHLI website.

For more information, contact:Marni Schribman, Director of Communications & Public RelationsFoundation for Health Leadership & Innovation

Marni.schribman@foundationhli.org

919-364-8067

CARY — The Foundation for Health Leadership & Innovation is pleased to announce that University of North Carolina – Pembroke Chancellor Robin Cummings has been named as the 2019 recipient of the Jim Bernstein Community Health Career Achievement Award. 

“Dr. Cummings exemplifies the values lived by Jim Bernstein and this award that was created in Jim’s honor,” said Anne Thomas, President and CEO of the Foundation for Health Leadership & Innovation. “Through his lifetime efforts to improve health, education and well-being for everyone in his community, Dr. Cummings has made a profound and long-lasting impact on the North Carolinians’ lives he has touched.”

A native of Pembroke and a member of the Lumbee Tribe, Chancellor Cummings earned his undergraduate degree in zoology from UNC at Chapel Hill where he was a James M. Johnston Scholar and founding member of the Carolina Indian Circle. He then attended Duke University Medical School as a UNC Board of Governors Medical Scholar and Henry J. Kaiser Merit Scholar, earning the Sandoz Award for Basic Science Research and the National Library of Science Award. After receiving his medical degree in 1983, he interned in surgery and completed residencies in surgery and cardiac surgery at Duke University Medical Center. During this period, he also earned a National Research Service Award that enabled him to complete a two-year research fellowship in cardiothoracic surgery. 

Dr. Cummings practiced cardiothoracic surgery at the Pinehurst Surgical Clinic and Moore Regional Hospital, where he chaired the Division of Cardiothoracic Surgery and Section of Cardiovascular and General Surgery. After retiring from surgery, he remained active in the work of the hospital, serving on the Moore Regional Hospital Board of Trustees and chairing the FirstHealth Moore Regional Hospital Foundation. He subsequently served as medical director and executive director of Community Care of the Sandhills, a regional healthcare organization that case-managed 75,000 Medicaid patients across seven counties and coordinated services provided by more than 100 primary-care practices. 

In March 2013, Dr. Cummings joined the N.C. Department of Health and Human Services as Director of the N.C. Office of Rural Health and Community Care. Six months later, he was named Deputy Secretary for Health Services and Acting State Health Director. In February 2014, he was given additional responsibility for the Division of Medical Assistance, overseeing Medicaid delivery for more than 1.8 million low-income parents, children, seniors and people with disabilities who cannot afford health care. 

About the Jim Bernstein Community Health Career Achievement Award

The Jim Bernstein Community Health Career 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. By being named as an award recipient, Chancellor Cummings is being recognized for his impact at the community, state, and federal level. For more information about the Foundation for Health Leadership & Innovation, as well as the Jim Bernstein Fellows Program, please visit www.foundationhli.org

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Photos of Chancellor Cummings accepting the award can be found on the FHLI website

For more information, contact:
Marni Schribman, Director of Communications & Public Relations
Foundation for Health Leadership & Innovation
Marni.schribman@foundationhli.org
919-364-8067