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By North Carolina Health News staff

DHHS secretary not happy with Senate spending plan

When Gov. Roy Cooper introduced his coronavirus spending proposal last week that he planned to send to the state lawmakers who control the purse strings for the state, he did so, he said, without including his entire wish list in a spirit of compromise and consensus.

After seeing pandemic-related proposals released by the House and Senate on Tuesday, Mandy Cohen, secretary of the state Department of Health and Human Services, said the Senate’s $1.2 billion proposal falls short.

The proposal from the House of Representatives calls for spending more than Cooper recommended, a $1.6 billion package that provides more support to the homeless, child protective and domestic violence services, food stamp recipient programs, rural and underserved communities, and research at universities across the state.

“We know we’re fighting the largest public health battle that our state has ever faced,” Cohen said. “We need our public health teams, our doctors and clinicians, our first responders, frontline workers and others leading the charge, and they’re going to need the financial resources in order to appropriately respond to this crisis.”

The General Assembly convened on Tuesday for what has been billed as a brief session to respond to needs brought on by the COVID-19 pandemic.

“Yesterday the Senate released their original package around the budget, which I do not believe provided the appropriate level of funding needed,” Cohen said. “We need to see continued work this week to include some of the critical funding that’s not yet included.”

The Senate budget, Cohen said, falls short of what Cooper’s plan and the House plan recommend for public health funding at the state and local levels. It also falls short on what those plans would allocate for rural and underserved communities and the doctors and hospitals in those regions, she said.

Cohen would like to see more funding for food, shelter and other safety items recommended in the governor’s proposal.

In the first month of the pandemic, North Carolina set up 1,000 meal sites and served more than 11.6 million breakfasts, lunches and dinners, Cohen said. The North Carolina National Guard has helped get supplies to seven food banks across the state that are supplying households with sustenance while more than 600,000 people have applied for unemployment benefits.

“North Carolinians have pulled together to respond to this crisis from day one,” Cohen said. “I’m particularly proud of the rapid and extensive work our team has done to make sure there is food on the table of our friends and neighbors during this challenging time. School nutrition and transportation staff have worked tirelessly to ensure children continue to receive the nutritious meals that they need while they are out of school.”

Senate leader Phil Berger, a Republican from Eden, and Cooper, a Democrat, have been policy opponents through much of the governor’s term. Cohen hopes to persuade Berger and other leaders in the Senate to put more funding toward rural and underserved communities and other safety net programs designed to help those most in need.

“I’ve shared these priorities with Senate leadership and I’m looking forward to continued work this week so that those are reflected in the final package,” Cohen said. — Anne Blythe

Gaston County bucks statewide order

Tracy Philbeck, chairman of the Gaston County board of commissioners, announced plans to sign an order 10 days before the statewide stay-at-home order expires letting businesses and houses of worship know that county leaders are on board with them opening up now as long as social distancing measures are taken.

Gaston County, surrounded by Mecklenburg, Lincoln, York and Cleveland counties, reported three COVID-19 deaths and 302 positive cases in its most recent count.

Mandy Cohen, secretary of the state Department of Health and Human Services, was asked about the Gaston County plan, which county leaders refer to as “Gaston Promise,” and the impact such activity might have on the efforts to “flatten the curve” statewide.

“We’re in a crisis. Confusion is really, really damaging during a crisis,” Cohen responded. “I want folks to know throughout the state of North Carolina that the governor’s executive order is still in place, it still stands. We’re still asking folks to stay at home to slow the spread of the virus and save lives. So that’s the state of the state.”

Cohen acknowledged the frustration and difficulties brought on by the pandemic with businesses closing, jobs lost and lives turned upside down.

“We’re trying to move through this in the best way possible to protect health,” Cohen said. “We’re trying to look at the data from across North Carolina so that we can step through different phases of loosening restrictions. We already know businesses are open right now and are protecting their employees, are protecting their consumers and we’re going to slowly expand that over the next coming weeks.”

Cohen and Gov. Roy Cooper have so far tried to maintain a statewide approach, but have said there could come a time when regional approaches work.

Both Cooper and Cohen have sidestepped questions about any actions the state might take for those violating the stay-at-home order while consistently thanking all for adhering to the restrictions.

“Hang in there with us,” Cohen said. “Just so you know the order is still in place for the full state of North Carolina. I’m appreciative of everything everyone is doing to slow the spread of the virus. What I can say is, it’s working. You have truly flattened the curve. We’re doing great as a state. Let us walk through this together. That’s how we’re going to be strongest.”

By the end of the afternoon, Gaston County Manager Kim Eagle had sent a memo to county employees that they still needed to operate under the governor’s executive order.

“We would never ask our employees to break the law,” she wrote. — Anne Blythe

Updated model results

Scientists affiliated with Duke University, RTI International and the University of North Carolina at Chapel Hill who have been modeling the different scenarios that could occur in North Carolina during the COVID-19 pandemic released their latest report on Tuesday.

The modelers found that North Carolina appears to have the capacity in its health care system to accommodate a gradual reopening “as long as vigilance is maintained, since exceeding hospital capacity remains a plausible possibility.”

Health and Human Services Secretary Mandy Cohen said her team has followed the model reports as they also look at other metrics and data to determine how quickly social distancing restrictions should be eased.

“The researchers model shows us that a phased approach to ease restrictions will help us avoid any worse case scenarios when it comes to the capacity of our health care systems,” Cohen said. “They do warn that complacency could change that and that we need to be sure to keep up the actions as we slow the spread of the virus as we continue to loosen restrictions.” — Anne Blythe

What’s in store for people with underlying medical conditions?

As social distancing restrictions are eased, some of the chronically ill might not feel comfortable or be able to return to work in the so-called “new normal” in which people wear masks and have their temperatures checked to enter businesses and schools that are currently closed.

Secretary of Health and Human Services Mandy Cohen said public health leaders are having discussions with business leaders about how they plan to protect their own employees with underlying health conditions and offer statewide advice for going forward.

Questions have arisen about whether some would be eligible for unemployment benefits and other safety-net programs that might not be available to them if employers require them to be on the job.

Cohen said she was just looking at data specific to North Carolina and the estimated 10.5 million people who live here for what percentage of the population has chronic underlying health conditions that might make them at higher risk for a severe reaction to COVID-19.

“It’s close to half of North Carolinians that have either heart disease, high blood pressure, diabetes, obesity or other chronic conditions,” Cohen said. “We’re hoping to be able to release all of that information. But we’ve known for a while — that North Carolina — our overall health is not as good as I’d want it to be. As the secretary of health and human services, I have been working to try to improve the health of North Carolina, but we know that we have some challenges and have a lot of chronic disease here.”

That’s why Cohen is encouraging employers, the state and local governments to come up with ideas for protecting people with chronic disease.

“I don’t have all the answers today,” Cohen said. “This is where we need to work together on ways to look out for each other as we move through phases. It’s exactly why we want to move through these phases slowly because the more we can keep down the spread of the virus, the more it helps those who may be at high risk.” — Anne Blythe

Coronavirus by the numbers

According to NCDHHS data, as of Wednesday morning:

  • 354 people total in North Carolina have died of coronavirus.
  • 9,948 have been diagnosed with the disease. Of those, 551 are in the hospital. The hospitalization figure is a snapshot of people with coronavirus on a given day and does not represent all of the North Carolinians who may have been in the hospital throughout the course of the epidemic.
  • More than 118,000 tests have been completed thus far, though not all labs report their negative results to the state, so the actual number of completed coronavirus tests is likely higher.
  • Most of the cases (40 percent) were in people ages 25-49. While 23 percent of the positive diagnoses were in people ages 65 and older, seniors make up 87 percent of coronavirus deaths in the state.
  • 86 outbreaks are ongoing in group facilities across the state, including nursing homes, correctional and residential care facilities.
  • There are 3,193 ventilators in hospitals across the state and 759 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.

Bonuses coming for day care teachers

Child care workers are going to be getting even bigger bonuses for staying on the job.

Full-time teachers will receive $950 in both April and May, while other day care staff will get $525. (They had been getting $300 and $200 monthly bonuses from the state before).

Part-time staff will get half those amounts, all bonuses will be paid through their workplaces but funded through the state Department of Health and Human Services.

The bonuses are significant: Child care workers and early education teachers often earn low wages. The average hourly wage for an early education teacher was $10.50 in 2015.

The bonuses, announced through a set of N.C. DHHS child care payment policies updated Tuesday, are to incentivize day care centers to keep their doors open during the COVID-19 pandemic for the health care, emergency workers and other essential employees that need care for their young children while working.

Nearly half – 44 percent – of the state’s child care centers have closed their doors, with great variance around the state, according to N.C. DHHS and Michele Rivest of the N.C. Early Education Coalition.

She and others have raised concerns that many day care centers, which are often locally owned and operated on thin margins, will struggle to reopen after the strict stay-at-home measures are lifted. – Sarah Ovaska

Mental Health Moment

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