The state of local healthcare

Apr. 24—HENDERSON — Medical professionals provided a glimpse into the State of Local Healthcare, and that of the region and state as well, during the address of the same name on Tuesday at Southern Charm.

Granville-Vance Public Health Director Lisa Harrison spoke first about that organization, one of 86 local health departments in the state. North Carolina has a decentralized healthcare structure, meaning LHD employees are county employees, not those of the state.

"An ounce of prevention is worth a pound of cure," said Harrison.

Professionals with the department work to prevent health problems by investigating outbreaks via methods like contact tracing, or identifying with whom that person has been in close contact. The criteria for who falls into that camp changes depending on how the disease in question is transmitted.

Data gathered in 2021 showed LHDs investigated communicable diseases 103,000 times and saw 3,900 non-COVID-19 disease outbreaks and administered 3 million COVID-19 vaccines, 392,000 non-COVID vaccines and treated 1,700 people for rabies out of 19,000 investigations.

Lastly in 2022, departments vaccinated 20,000 people for monkeypox, née mpox.

A big aspect of prevention is healthy living, and the department works with other organizations locally to promote nutrition and physical activity among young people.

GVPH's patient is the entire community, which receives a triannual health assessment. The three priorities they found in the most recent one are a desire for greater focus on mental health, youth engagement and access to — read, affordable — healthcare. For many students, quarantining during the pandemic had an impact on their mental health.

Since the pandemic, depression, anxiety and opioid usage are on the rise across the state. The supply of professionals to treat those conditions is insufficient to meet the growing demand.

Maria Parham Health CEO Bert Beard spoke next about the hospital's recent wins, such as the number of primary care providers, which increased from four to six in 2023-24. Four locations — two in Henderson, one in Oxford and Louisburg — received rural health clinic designations, meaning they accept Medicare and Medicaid.

Uninsured patients can apply for Medical Access Plans, under which they are responsible for a co-payment while the Office of Rural Health pays off up to $100 for office visits.

Maria Parham Health reopened its geriatric behavioral health unit in Franklin County and is preparing to expand its two emergency facilities with a $5 million appropriation in the state budget for "safe spaces" — areas equipped to better treat those suffering from mental health crises that will take some pressure off law enforcement officers.

Beard shared some data, too, including how the average length of stay has increased to 6.13 days compared to 5.58 in 2022. That increase is driven by authorization delays and lack of availability of skilled nursing beds, he said.

Doug Heron is an associate vice president for Duke State Relations and a lobbyist for Duke University, Duke Health and Duke LifePoint Healthcare and their interests in the General Assembly. He spoke about some statewide healthcare developments — such as the Medicaid expansion that went live in December. Some 600,000 uninsured state residents were made eligible for the program.

The 2024-25 state budget also earmarked $835 million, the largest investment so far. Funds will be used to expand behavioral health services for those experiencing crises, help those with serious behavioral health issues avoid prison, expand services for children with complex needs and their families and expanding the workforce in that field, the North Carolina Department of Health and Human Services announced in October.

The NCGA voted to cut off abortion access somewhat, limiting the time frame to 12 weeks in cases of rape, incest or fetal genetic anomalies. The latter means that the child would be born with serious or even lethal disabilities.

In the short session that began Wednesday, a few things likely to get done are budget adjustments and more investments into mental health, said Heron. Other items on the docket include pre-authorization reforms for commercial insurance and Medicaid.

When a patient needs a procedure, such as an MRI scan, they need to submit a form requesting authorization to their insurance company. Then, they wait, until the request is denied or approved.

Some medical practitioners in the state want to see that process streamlined to reduce delays in care. The state Medical Society recommends standardizing timelines for approval, waiving prior authorization for highly rated clinicians or publicizing lists of which procedures require prior authorization.

Much more will be discussed going forward, but it's unclear exactly what will get passed.

The "State of" addresses began in 2022 as a series of informational sessions focused on a variety of topics including municipal governments, education and of course, healthcare.