The NCGA House Health COVID-19 Committee met on April 14, 2020.

You can provide input for the House Select Committee on COVID-19 here.

Listen to the entire meeting here.

Impact of COVID-19 on Rural Health Care

Dr. Roxie Wells, MD, President of Cape Fear Valley Hoke Hospital provided a rural hospital perspective to the group. She noted that she is passionate about rural hospitals surviving and providing equitable care to patients. She explained that rural communities are the most vulnerable to disparities, and that our rural communities are aging.

Some specific barriers to rural communities include, minimal PPE, lack of equipment for testing, loss of revenue from non essential procedures.

She expressed grave concern about our state’s rural hospitals, and the patients that live there. Currently, some skilled nursing facilities are unsure if they should accept new patients.

She closed with stating that North Carolina has 49 rural and independent hospitals in the state, and she was confident we could end the COVID-19 pandemic with that same number.

Impact of COVID-19 on the Delivery of
Behavioral Health/IDD Services

Kody Kinsley, Deputy Secretary, Behavioral Health and Intellectual and Developmental Disabilities, Department of Health and Human Services, stated that their main goals were to maintain services and reduce the need for emergency department visits to keep hospital beds open for COVID-19 patients.

He added that this pandemic increases the potential worsening anxiety and depression disorders due to lack of control and social isolation.

Key DHHS Behavioral Health Actions

  • Medicaid flexibility (appendix K and 1135 Waiver)
  • New telehealth policies
  • Paused oversight functions that do not impact consumer health and safety

Resources and Funding

  • Immediate release of remaining single stream funds for current fiscal year
  • Authorized use of up to 15% of LME/MCO risk reserve
  • Category B funds from FEMA Disaster Declaration
  • Increase of 1.5% in Medicaid rates for LME/MCOs

Dr. Atezaz Saeed, MD, MS, Executive Director, NC Statewide Telepsychiatry Program informed the group about challenges psychiatrists are experiencing during COVID-19. A national poll released by the APA in late March found that more than 36% of Americans say that coronavirus is having a serious impact on their mental health.

He added that mental health and substance abuse disorders are common, but services have been in short supply even before the COVID-19 pandemic.

He states that 26.2% of americans ages 18 and older have a mental disorder and about 6% suffer from a serious mental illness.

He advocated on behalf of the NC-STEP program which makes collaborative linkages and develops innovative models of mental health care. The web portal is accessible to all participating providers, and creates a central point for coordinated care.

Impact of COVID-19 on Pharmacists

Rep. Wayne Sasser (R-Stanly), PharmD, presented on behalf of the pharmacy community. He stated that pharmacists are essential and a large number of pharmacies are increasing delivery services. CMS pays 6.2% in Medicaid match to pay for these extra services which helps compensate pharmacists for delivery. This helps pay pharmacists for their delivery.

He informed added that some contracts are not allowing patients to choose their drugstores. He provided an example of a constituent who was forced to get a prescription from a chain drugstore without a pick up window or delivery service which put the patient at risk. Rep. Sasser said “We need to do better for patients.”

Another suggestion he added was to loosen restrictions for pharmacists reviewing prescriptions for assisted living facilities. Currently, they are required reviews every 3 months in these settings.

He also suggested that providing halo one to potential overdose patients could be a way to keep them out of the emergency rooms.


Impact of COVID-19 on Populations with
Health Disparities

Cornell Wright, MPA, Director of Office of Minority Health and Health Disparities, NCDHHS informed the group about the health inequities relating to COVID-19.

He said that there are a variety of factors that impact disparities including the following:

  • Environment
  • Education,
  • Housing,
  • Health Care
  • Food/Nutrition
  • Violence
  • Poverty

He noted, trust is a big factor that is not typically discussed.

He spoke about the specific demographics in North Carolina. Minority populations experience higher rates of unemployment. Yet, 63% of all jobs require post secondary education.

Currently, 1 in 5 North Carolinians live in poverty.

People of color may be disproportionately at higher risk for more severe illness from COVID-19. 21% of NC residents are African American. 38% of positive COVID-19 cases are African American. He repeatedly informed the group that more data is needed in order to better understand the layers of factors that may impact this data.

(*Interpret data with caution.)

Impact of COVID-19 on the Health Insurance

Ken Lewis, NC Association of Health Plans Executive Director provided the health plan perspective to the Committee.

Their member companies provide insurance for more than 6 million North Carolinians. He asked the NCGA to consider assisting providers who have been affected by the emergency, but have not received assistance with CARES Act funding.

He asked for any policy decisions relating to this emergency sunset to end at the sunset in order to allow for a full review of a discussion of what worked and what did not work.