NC Rural issues

Missing vaccinations: The canary in the rural health care coal mine

This is a systemic failure, not a religious backlash:

Pitt County Schools was forced to suspend a number of students who did not receive vaccines after sending warnings to about 300 as a deadline approached last month, officials said.

State law requires students have standard vaccinations in place 30 days after enrollment unless they have a religious exemption. If students do not have the vaccines, they are suspended until they receive them. The number of suspended students was not available at the meeting. The school system did not respond to subsequent requests to provide the information.

Pitt County is actually in better shape coverage-wise than other regional counties, but when you get outside of Greenville, it doesn't seem that way. The lack of vaccinations signals another troubling issue: A lot of the children are not receiving periodic well-care treatment, and that is unsettling, to say the least:

Rural healthcare crisis: NC loses another maternity ward

It's long past time for the state to step in:

The Quorum Health hospital announced in a press release earlier this month that it was discontinuing labor and delivery services effective Oct. 21 “to better meet the community’s long-term needs.” With birth centers at three Vidant facilities in a 35-mile radius — in Washington, Tarboro and Greenville — the hospital said, pregnant women in the region still have options.

An EMT by training, Bullock said it wasn’t that simple. Every minute matters in labor, she said, and longer trips to a hospital could pose risks to mothers and their babies. “Anything can happen in 35 minutes,” she added. “I mean, anything can happen in five minutes. It’s just like a blink of an eye and you can lose both lives.”

To say this is unsettling would be an understatement. There are already huge geographic gaps in maternity care in Rural NC, and economics has played a major role in that deterioration. There are 100 counties in our state, with only 80 maternity wards to serve them. And 50 of those wards are located in urban centers (mostly I-40/85 Corridor):

Dollars and sense: Medicaid expansion in NC is long overdue

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If saving lives isn't enough for you, how about saving rural hospitals?

The data are overwhelming. In states that have expanded, the move has been a boon, both for the health of patients, the strength of local economies bolstered by thousands of new health care jobs, and increased stability, in particular, for rural hospitals that have been buffeted by changes rocking the health care system.

“There’s more data that’s showing a link to employment, overall better economic conditions,” said Hemi Tewarson, director of the health division at the National Governors Association. “There have been studies done that show rural hospitals have done better in expansion states compared to non-expansion states, primarily because they have another stream of reimbursement that has kept them more stable.”

As long as the bulk of our health care system remains in the private sector, we must enact programs that make rural hospitals and clinics "economically viable." If we don't, rural folks will end up having to travel 75 miles or more to be treated. That's simply too far for "well-care" visits, so most of those trips will be for serious (if not life-threatening) injuries or illnesses. It's those regular visits that can extend lives and improve the quality of those lives:

Washington County Hospital joins ranks of NC's failing rural health care system

Another victim of privatization:

Washington County Hospital CEO Melanie Perry tells WCTI in New Bern that the facility's owner has plans to resolve several problems, including dwindling medical supplies and workers not getting paid for two weeks. Empower HMS promised 50 employees that checks would arrive Monday, but staff members said they never came. There has been no word on when or if the medical supplies will be replenished.

Perry said closing the county's only hospital would be devastating to the town of Plymouth, approximately 125 miles east of Raleigh.

Before we dig deeper into this unfortunate situation, a few words on how this could have been avoided are in order. When a public (municipal) entity provides a service, whether it's health care, transportation, water & sewer, or any other critical infrastructure issue, all considerations about turning a profit (net revenue gain, if you will) or even "breaking even" should be disregarded. Providing services to citizens is what government is for, and that's why we pay taxes. And this goes double in rural areas, where the economy simply cannot support/sustain a perpetually profitable business. Had local elected officials understood that back in 2007, they might not have sold this hospital in the first place. Because once a facility like this enters the private sector, the sharks start circling:

NC DOT needs to encourage rural transit, not stifle it

Bus route in Henderson County is on the chopping block:

The route serves 150 to 180 people per month with a 12-seat transit van with three trips each morning and three each afternoon. It takes riders from the east side of Hendersonville on a loop that travels Sugarloaf Road, Ridge Road and Pilot Mountain Road to the Edneyville Post Office before heading back into Hendersonville via Chimney Rock Road.

But WCCA can no longer get grant funding for the route under the state’s new interpretation of what constitutes a consolidated system, Crisp told Times-News staff writer Andrew Mundhenk. Henderson County’s website states that the service is being discontinued “due to state budget cuts,” and directs people to call 828-698-8571 for more information.

As readers are likely aware, I'm a big proponent of public transportation. And not just the high-density metro systems, but also smaller systems that connect rural and suburban areas to commercial hubs and county seats. Money is always an issue, but there are two sides to that money debate. Especially in our current economy, physical mobility is critical in the pursuit of financial independence. But people's health is at stake, too:

Homeless in NC: Gastonia to tear down "nuisance" hotel

Some residents have lived there for decades:

The city of Gastonia takes the keys Friday of a motel it declared a nuisance and bought for $1.2 million in December 2016. Owner Jay Patel, who paid $825,000 for the motel in April 2014, started telling guests three months ago that on Monday morning they would all have to find a new place to live.

After 60 years, the Budget Inn will give way to the city’s multi-million dollar plans for a Franklin Urban Sports and Entertainment District and stadium that city leaders hope will bring new life to west Gastonia. City leaders hope the district, which will be called “FUSE,” connects a reinvigorated downtown with the redevelopment that transformed the Loray Mill from the site of the deadly 1929 textile strike into luxury loft apartments and retail space.

As many reading this already know, I've become deeply involved in downtown revitalization efforts in my small town. I'm all for new development and re-development of existing and sometimes historical structures, but I'm also very keen on watching out for that 18%-20% who live at or below poverty level. In this particular case, it doesn't appear the City of Gastonia is lifting a finger to help relocate these folks, something that any responsible government body should at least attempt to do:

The struggle to save Belhaven's hospital continues

And the LLC that owns it has some serious internal conflicts:

A superior court judge issued a temporary restraining order Monday to stop the demolition of the old Pungo Hospital building after some members of Pantego Creek LLC, which owns the hospital, filed a complaint against the four managers of Pantego Creek.

“The mangers of Pantego Creek LLC ... and their lawyer, Arey Grady, represented to the members that if we voted to continue operation of the hospital, we would each be held personally liable for $28,000,” the affidavits said. “Because of this, 79 out of the 105 members voted against operating the hospital.”

It appears the "managers" engaged in a sustained effort to misinform members about potential solutions to the crisis, probably in an effort to line their pockets somewhere down the road. I can't help but recall some of the "pay me twice" shenanigans people like Robert Pittenger have pulled on unsuspecting associates when looking at this situation, and come to the inevitable conclusion that "limited liability partnerships" have a hell of a lot more liability than their smiling salesmen would admit. Here are more "we'll tell you what we think you need to know" jewels:

Op-Ed: Solar farms a way to ease economic struggles in rural NC

In which I preach from my digital soapbox:

One of the most difficult issues facing lawmakers and rural advocates is how to bring some level of prosperity back to areas that used to have textile mills and lucrative tobacco farms. Our consumer-based economy, which generates so much revenue in densely populated regions, fails miserably where populations aren’t so dense. And the very thing that makes these areas attractive to many who live there, the lack of bustling crowds and traffic jams, is the very thing that’s killing them.

I'm going to ask a favor of you dear readers. No, it's not money for some critical cause or organization (not this time, anyway), I just want you to click through and read the article. The N&O graciously published this piece in a timely fashion, and the number of reads or hits might encourage them publish more in the future. But here's a little more before you go:

Another rural NC hospital closes its doors

Hammering another nail in the coffin of free market health care:

On Friday May 22, just past 6 p.m., Yadkin Valley Community Hospital was shut down by HMC/CAH Consolidated Inc., the Missouri-based company licensed to operate it under a lease agreement with Yadkin County that runs through July 31.

That afternoon, the county filed a temporary restraining order in superior court in Raleigh to keep the hospital open. Records indicate that the restraining order was emailed at 5:59 p.m. to Dennis Davis, chief legal officer for Rural Community Hospitals of America, which manages the hospital for HMC/CAH. At 6:04, Davis responded, “The hospital is already closed.”

I really hate to add insult to injury, but that's what you get for contracting with a Kansas City management firm to run your local hospital. Especially one that has bounced in and out of bankruptcy:

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