NC's rural, mental health care 'in dire straits' due to virus outbreak

A state House coronavirus working group on health care heard sobering reports from experts Tuesday on how the outbreak is affecting the state's health system.

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Laura Leslie
, WRAL Capitol Bureau chief
RALEIGH, N.C. — A state House coronavirus working group on health care heard sobering reports from experts Tuesday on how the coronavirus outbreak is affecting the state's health system.

The experts came from an variety of fields, but they all shared a common theme: The pandemic is likely to worsen systemic problems that have plagued the state's health care system for years.

Dr. Roxie Wells, president of Cape Fear Valley Health's Hoke Hospital, said the cost of preparing for the expected surge in cases has left already struggling rural and independent hospitals "in dire straits." She called on lawmakers to take "swift action to ensure the solvency" of those hospitals.

Wells said those financial problems are worsened because many hospitals have canceled "non-essential" surgeries to create more bed space at the request of state heath officials. But those elective surgeries are often the top revenue source for hospitals, especially those who treat many uninsured patients.

Wells said elective surgeries should be allowed to resume once hospitals can obtain "appropriate amounts" of personal protective equipment and as soon as rapid testing is available to make sure incoming patients are not infected.

Dr. Sy Saeed, chairman of the psychiatry department at East Carolina University's Brody School of Medicine, said the state's mental health system "was already in crisis before COVID-19," adding that demand for mental health care is likely to increase due to the virus.

According to Saeed, 31 counties in North Carolina have no psychiatrist. Thirteen counties have no behavioral health providers at all, and 90 out of the state's 100 counties would qualify as shortage areas for mental health providers.

Saeed is director of the state's telepsychiatry program, NCStep, which began in 2013. He said the state is "ahead of the curve" because the program is already providing services to dozens of underserved locations across the state.

Rep. Wayne Sasser, R-Stanly, a pharmacist, also spoke to the committee, asking them to tweak a law that allows pharmacists to administer some vaccines to include testing for the coronavirus and a vaccine when it becomes available.

Texas, he said, is already implementing drive-thru testing at pharmacies to keep potentially infected people away from those with other illnesses at doctor's offices.

"It's imperative for North Carolina to do this now," Sasser said.

Cornell Wright, director of the Office of Minority Health at the state Department of Health and Human Services, said the virus is disproportionately affecting black North Carolinians because of a range of health inequalities ranging from unemployment and income to access to health care.

"The health disparities highlighted by COVID-19 have always been here," Wright told lawmakers, "and we have to make sure we’re continuing to put work into illuminating these."

Wright stressed that coronavirus data in North Carolina is limited at this point. But he said, according to the data available, 38 percent of positive cases of COVID-19 in the state so far are blacks, far higher than their 21 percent representation in the population.

"This is why we need to expand Medicaid at this time," Wright told the committee.

Ken Lewis with the North Carolina Association of Health Plans sounded grim as he described all the ways insurers are trying to help policyholders during the outbreak, from waiving cost-sharing for COVID-19 treatment to suspending rules that make health care less accessible.

He said many are working with customers who've lost jobs, trying to help them find a way to keep their coverage.

However, Lewis said, with many businesses and customers dropping coverage right now, "Our resources are finite."

Chairman Rep. Donny Lambeth, R-Forsyth, said the panel will meet Thursday to talk about what they want to see in a bill to address health care issues. He said they hope to have a proposal ready to file by next week.


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