The Legacy of James D. Bernstein: Part 3

“Change happens at the speed of trust, and trust happens at the speed of human relationships.” — Dr. Skip Cummings, East Carolina University, paraphrasing a Reverend Jen Bailey quote

The first two blog posts in this series covered Jim Bernstein’s background, work with the North Carolina Office of Rural Health (NCORH), and the impact of his legacy on individuals, communities, and rural health policy. Here, we explore the history of the Foundation for Health Leadership and Innovation (FHLI) and how our current work aligns with Bernstein’s vision.

The Foundation

In 1979, a special state legislative commission recommended the creation of a “Foundation for Prepaid Health Plans.” As the NCORH Director, Bernstein worked with UNC School of Medicine Professor Glenn Wilson to establish the “North Carolina Foundation for Alternative Health Programs” in 1982, with funding from the Henry Kaiser Foundation, the Hartford Foundation, and the Robert Wood Johnson Foundation.

The nonprofit, non-governmental organization accepted grants from private foundations. It aimed to develop and implement innovative programs, including launching health maintenance and other managed care organizations, to increase access to quality health care for all North Carolinians. Although it later changed names, the Foundation was established to advance collaborative, equity-centered, and community-driven solutions to improve North Carolinians’ overall health and well-being, as it continues to do today.

In 1992, the Foundation launched Carolina ACCESS to help communities create systems for providing access to comprehensive care for low-income, uninsured residents. The team successfully implemented the program in 12 counties, and the General Assembly approved its implementation statewide, leading to the creation of Community Care of North Carolina. The Foundation then became the North Carolina Foundation for Advanced Health Programs and, in 2015, the Foundation for Health Leadership and Innovation (FHLI).

Collaborative, Equity-Centered Solutions

Approximately 3.9 million people live in North Carolina’s 70 rural counties (defined by an average population density of 250 people per square mile or less). Our rural communities have unique opportunities and challenges. Many have been historically underserved by our health care systems, impacting longevity and quality of life.

Bernstein believed that community members have the best insights into how to support their community’s health and well-being, both now and in the future. This aligns closely with the phrase, “Nothing About Us Without Us.” Coined by the global disability rights movement, this message emphasizes inclusion, calling for full participation for and by communities in any decision-making that impacts them.

Following that same vein, during his 2023 Jim Bernstein Community Health Career Achievement Award speech, Doyle “Skip” Cummings, PharmD, shared some wise words he once heard from a Pitt County businessperson: True collaboration is when you lay your resources on the table and remove your hand. Building on this idea, Shannon Moretz of Compassion Health Care said, “…relationships require someone to cultivate and tend to them—it is long-term work,” during a health equity workgroup meeting facilitated by the NC Rural Health Association, an FHLI program.

FHLI has continued to launch programs and initiatives that carry forward Bernstein’s legacy of supporting community-based work grounded in these principles. Our Community Voice cross-program initiative aims to create the conditions for communities to bring their own seats to their own decision-making tables, ensuring those experiencing and directly impacted by existing health disparities lead the solutions. We aim to support communities throughout rural and underserved areas in defining their goals, identifying resources, and developing both local and system-wide solutions.

Community-Driven Decision-Making in Bertie County

Since 2022, FHLI has been collaborating with Bertie County through the Bertie County Integrated Behavioral Health Network, which celebrated its two-year mark in May 2024. This body of work centers community in the decision-making process, engaging residents, health and social organizations, and local leaders to address critical behavioral health needs across the county.

In November 2023, FHLI secured grant funding to extend the Bertie County Integrated Behavioral Health Network to October 2025. Throughout 2024 and 2025, FHLI staff and Bertie County residents will focus on:

Providing harm reduction trainings and resources.

Expanding youth and family-based services, including telehealth, in Bertie County schools.

Launching a “Stop the Stigma” campaign to raise awareness and help Bertie County residents access behavioral health resources.

Training two community members as Mental Health First Aid (MHFA) instructors.

MHFA training and work will also continue beyond FHLI’s work in the county.

In addition, FHLI is launching a new initiative called the Roadmap to Innovation, which aims to collaborate with rural communities to develop and implement their own paths to health equity. The program will start by supporting communities in the western part of the state in identifying their most pressing needs and connecting local community-based organizations with additional resources and funding to improve local impact and sustainability.

Stay tuned for more!

The Need for Systems-Level Change

Building on Bernstein’s legacy, we remain committed to advocating for more equitable systems in North Carolina. At the NC Oral Health Collaborative 2023 Oral Health Day event, keynote speaker Kathy Colville shared a powerful truth: “We have truly amazing and exceptional people holding up an inadequate system.” Putting this into context, Bernstein and his team achieved incredible things throughout their careers despite working within a flawed system—just as health equity leaders continue to do today.

Our vision is a state where everyone—from community members to public health workers, social service providers, and beyond—can reach their highest level of health and well-being. Through community-based work and a focus on sustainable, systems-level change, we strive to create integrated, interdisciplinary support networks that enable organizations to align their internal and external practices with their values.

Bernstein’s Legacy Continues to Grow Strong Roots in NC

Bernstein deeply valued everyone working directly in health clinics, and their work remains essential to establishing and maintaining rural health centers across the country. In 2006, a year after Bernstein’s passing, FHLI launched the Jim & Sue Bernstein Community Health Center Scholars program, which celebrates the invaluable contributions of rural health clinic staff members by helping them pay for clinical education and their dependents pay for college.

The Jim Bernstein Health Leadership Committee has awarded over $130,000 to scholars, including employees and dependents from eligible centers in North Carolina.

That same year, FHLI launched the Jim Bernstein Health Leadership Fellows. Inspired by Bernstein’s vision, this initiative supports future leaders dedicated to improving health in North Carolina’s rural and underserved communities.

Since the program began, 94% of Bernstein Fellows have remained in North Carolina to continue their work in creating healthier communities. Our 2022-2024 class will graduate this year’s Bernstein event! Get your tickets to learn more about how they’re advancing health access and equity in communities across our state.

Throughout all our work, FHLI proudly continues Bernstein’s legacy by helping provide the necessary resources for communities to drive their own solutions. Our programs include:

Center of Excellence for Integrated Care (COE)
NCCARE360
NC Oral Health Collaborative (NCOHC)
NC Rural Health Association (NCRHA)
Project ECHO Network in North Carolina (PEN-NC)
Roadmap to Innovation

Since 2006, the Bernstein Event has also been held every October to honor our history and celebrate today’s public health leaders advancing access and equity for all North Carolinians.

Inspired by Bernstein’s legacy of community-driven solutions for systems-level change? Join us to help continue his mission.

If you missed parts one and two of this blog series, be sure to check them out for the full story.