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Shows text supporting Medicaid expansion that reads: The Graham County Commissioners strongly give their full support to Representative Kevin Corbin for House Bill 655... The Graham County Board of Commissioners understand that the majority of uninsured inividuals in North Carolina are employed, but do not make enough money to afford health insurance coverage."

Business leaders, conservatives across state warm to Medicaid expansion

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Business leaders, conservatives across state warm to Medicaid expansion - North Carolina Health News

In private, and increasingly in public, some are making their support for House Bill 655, which would allow for Medicaid expansion in North Carolina, in defiance of the state party leaders.

By Rose Hoban

Dale Wiggins thinks it’s time. Actually, he thinks it’s past due.

Wiggins, a retired businessman, is the head of the Graham County Board of Commissioners, which recently sent a resolution of support for expanding the state’s Medicaid program to legislative leaders and Gov. Roy Cooper.

The unanimous resolution, signed by four Republicans and one Democrat, throws local support behind House Bill 655, which recently passed through the General Assembly’s House Health Committee and awaits a vote on the House floor.

The bill would use the Affordable Care Act to extend the Medicaid program to provide health insurance coverage to many low-income workers who currently don’t qualify for the program.

You can’t get much further west in North Carolina than Graham County, two-thirds of which is made up of the Nantahala National Forest. There are about 8,700 residents, with a median household income of $37,748, according to the NC Department of Commerce. Image courtesy: Wikimedia Commons

“We’ve got people here that literally can’t afford to be sick, they’re living from paycheck to paycheck,” Wiggins said in a recent phone conversation. “If a parent gets sick, loses a couple of weeks work, you know, they could potentially lose a car and lose a home. You know, so there’s a sense of urgency, at least in their lives.”

In a scathing letter (see attached below) sent to Senate leader Phil Berger (R-Eden), Wiggins explains why his board told their local representative Kevin Corbin (R-Franklin) to vote for the bill.

“You know Senator Berger for some people who have good paying jobs and good health insurance it is easy to say that those without insurance just need to go to work isn’t it?” he wrote. “The reality is in places like Graham County those people are working.”

When asked about Wiggins’ letter, Berger’s press aide Pat Ryan responded, “Everybody is entitled to express their opinions on matters before the state legislature, and Senator Berger appreciates the thoughtful feedback Mr. Wiggins provided in his letter. Feedback is always welcome.”

Upwelling of support

The feedback from commissioners, business leaders, economic development experts and other conservatives across the state is that they’re reaching a conclusion similar to Wiggins’. In the past few months, reliably conservative Republican boards and business leaders have been making it known publicly and privately that they think it’s time for North Carolina to follow in the footsteps of 34 other states and the District of Columbia and get low-income workers covered.

It’s a policy that’s long been opposed by the state GOP.

Usually, Medicaid is limited to low-income children, a small number of their parents, pregnant women and seniors in financial need. But the Affordable Care Act opened the door for states to add low-income workers who make too much to qualify for the program but too little to qualify for subsidies to purchase health insurance on the online marketplace.

In North Carolina, individuals making between about $6,120 and $16,860 have been caught in this “coverage gap,” even as lawmakers in other states have extended the benefit to their low-income workforce. The federal government has committed to paying 90 percent of the cost, more than the usual two-thirds of the cost for regular Medicaid patients.

After almost seven years, the data supporting the benefits of Medicaid expansion to states and individuals are becoming overwhelming. In August, the Kaiser Family Foundation published a review of 324 studies that show “improved access to care, utilization of services, the affordability of care, and financial security among the low-income population.”

Research also overwhelmingly shows that expanding Medicaid saves states money, even as it stimulates health care spending, producing a widening circle of economic benefits. For example, in states that have expanded, fewer rural hospitals closed than in states that didn’t.

a woman gestures as she talks to a much taller man. They're talking about Medicaid expansion.
Former GOP gubernatorial candidate George Little speaks to NC Health News editor Rose Hoban after a business roundtable meeting in Pinehurst in August. Photo credit: Jill Hammergren

Those are some of the reasons conservative stalwarts such as Alamance County Sheriff Terry Johnson and former GOP gubernatorial candidate George Little have come out in favor of expansion.

“You’ve got to do something for people,” Little said in an interview with NC Health News this summer. He believes the party as a whole is coming around, and he’s talking to his friends in the senate.

“It’s the economy, and seeing people … It’s the need,” he said.

Tourist economies

“We have one count that tells us that over 6,000 people in Carteret County are without health insurance,” said Tom Kies, president of the Carteret County Chamber of Commerce. “Our free clinic, Broad Street Clinic, puts the number at 1 in 4 people in Carteret County with no health insurance.”

Carteret County is known for its conservatism, along with the beach communities where people working in the tourism industry lack steady year-round income.

“People who are working two or three part-time jobs, just to pay the mortgage, working to pay the rent, they can’t afford health insurance,” Kies said. “And they make too much money for Medicaid.”

Because it’s such a conservative area, Kies said he was surprised to get a positive response to the idea of supporting expansion. The Chamber voted to send resolutions of support to House Rep. Pat McElraft (R-Emerald Isle) and Sen. Norman Sanderson (R-New Bern), he said.

Hurricane Florence really helped a lot of people change their tunes, Kies said.

“We saw that divide between the folks, between the haves and the have-nots in this county become much more pronounced,” he said. “We actually lost a lot of folks who were working those part-time jobs and the restaurants and the hotels and the rental companies.”

Now, the struggle is to keep the workers they have, he said.

“If we have these people who are working, we want to try to keep them healthy,” Kies said. “These workers are like gold right now.”

Understanding the importance

Carteret’s chamber isn’t alone in throwing their weight behind HB 655. NCEast Alliance Chambers, a group partnering with chambers in 13 eastern counties (including Carteret) has also endorsed the expansion of health insurance that would come with HB 655.

“They haven’t specifically said, expand Medicaid,” said John Chafee from the organization. “They said we wanted to expand the reach of health insurance for more people.”

What gradually moved many people, Chafee said, was hearing about friends and neighbors unable to purchase insurance, about people who went without and then got sick.

Chafee has been in economic development for more than four decades, he also argued the insurance problem holds back entrepreneurship in eastern North Carolina.

“I’ve heard instances in terms of where people said, ‘Well, you know, I might have been interested in going out and starting a company, but I didn’t want to lose my health insurance,’” he said.

Finally, he said the NCEast Alliance members started to understand the importance of extending insurance to more people, and what that would mean to the hospitals in the area.

“So you’ve got a number of different stories that come at you as to what motivates people to maybe finally respond and say, ‘Well, maybe that’s not such a bad thing. Because it would help an awful lot of people,’” he said.

‘Big loser’

The more people get beyond the rhetoric of opposing Medicaid expansion, the more they support it, said Sophia Paulos, the economic development director for Graham County.  She said that when her commissioners heard how 600 Graham County workers would qualify, that the county would gain about $44,000 in tax revenue and the policy would spur almost a million dollars in economic growth per year, the decision to support it became a “no brainer.”

She’s also come to realize that it wasn’t Obamacare, per se, that caused people’s premiums to rise. Instead, the problem was people’s lack of coverage.

“They show up at the ER, and they’re in some kind of catastrophic health situation and now they can’t pay, because they have no semblance of insurance, they’re never going to be able to pay that bill. And so your premiums just went up because that’s how we afford to keep the hospital open,” she said. “And when I explain that to people, they were like, it made sense.”

The information helped change Wiggins’ mind too.

When Berger wrote back to Wiggins saying that “Medicaid expansion has busted budgets in other states, and studies show that Medicaid is an inefficient and ineffective government program that fails to improve health outcomes,” he fact-checked him.

A man in a suit hands out papers to people sitting in chairs with laptops, some television cameras are also in the room. Brger has long opposed Medicaid expansion.
Senate leader Phil Berger (R-Eden) hands out information during a press conference in June, 2019. Photo credit: Rose Hoban

“You know, in today’s world, it’s as easy as picking up your laptop or go to your computer and Google ‘What’s Medicaid expansion done in other states.’ You know, you get page after page that comes up, and they’re all highlighting all the good things that have happened,” he said. “You have to search multiple pages to find somebody that’s unhappy with Medicaid expansion in their state.”

He said that he doesn’t care what the national, or even the state party said he was supposed to believe.

“These people who need this assistance, who need this medical care, are people I know. They’re my neighbors, they’re my friends. So how can I go look them in the eye and say, ‘You know, the party says that we can’t support this, I’m not gonna support it,’” Wiggins said. “All the statistics bear out the fact that North Carolina has been a big loser.”


Correction: This story originally misidentified the photographer of the picture taken by Jill Hammergren.

Exchange of resolution/ letters from the Graham County Commissioners (Text)

shows a grouping of hot dog shaped bacteria, each with a single hairlike appendage, called a flagellum. It's a picture of vibrio vulnificus

Vibrio survivor, wife warn of bacteria’s risks

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Vibrio survivor, wife warn of bacteria’s risks - North Carolina Health News

After hurricanes, floodwaters can contain bacteria such as vibrio which can kill about one in five people who contract it. Officials urge caution in the wake of storms.

By Trista Talton

Coastal Review Online

Fifteen minutes.

That’s roughly the amount of time Richard Flaherty spent in 2 to 3 inches of flood waters helping a neighbor in Oriental the day after Hurricane Florence made landfall last year.

Twenty-four hours later, Flaherty’s left leg had been amputated above the knee. His odds of survival were 50-50 before his leg was removed.

“That’s when my prayers started immediately that he was going to be on the good side of 50,” said his wife, Penny Flaherty.

Within three days following the amputation in CarolinaEast Medical Center in New Bern, Richard Flaherty, then 77, was back in the operating room. This time, doctors removed a chunk of flesh and muscle from his right calf.

Bacteria known as Vibrio vulnificus, which he came into contact with in the floodwaters Sept. 15, 2018, had migrated.

Penny Flaherty remembers well what the doctor who amputated her husband’s leg said when he saw Richard three weeks after that initial operation: “You’re my miracle man.”

“I think it is,” a miracle, Penny Flaherty said.

Contaminated waters

According to the Centers for Disease Control and Prevention, about one in five people with the infection die, sometimes within a couple of days after the bacteria enter the body.

shows a man who has an artifical leg. He lost the leg as a result of a vibrio infection.
Richard Flaherty stands inside his home in Oriental on his new prosthetic leg. His left leg was amputated Sept. 16, 2018, after he contracted the bacteria Vibrio vulnificus while helping a neighbor in flood waters following Hurricane Florence. Photo credit: Contributed by Flaherty family

In the midst of hurricane season, which runs June 1 – Nov. 30, Penny Flaherty wants to warn others by sharing her husband’s story.

“This should promptly be put out there before hurricane season,” she said.

While V. vulnificus is a concern following hurricanes, the bacteria are not directly related to pollution, but occur naturally in warm waters such as bays, estuaries and rivers close to the ocean during the summer months.

About 80 percent of vibrio infections occur between May and October, according to the CDC.

The CDC estimates vibriosis causes 80,000 illnesses each year in the U.S. About 52,000 contract it as the result of eating contaminated shellfish. Vibrio parahaemolyticus is the most commonly reported species and is estimated to cause 45,000 illnesses a year in the U.S.

Between 1999 and 2003, 27 North Carolinians were infected by V. vulnificus, according to the North Carolina Department of Environmental Quality. Seventy percent of those cases were wound infections, many as a result of someone cutting or scratching themselves while handling crabs or having an open wound, cut or sore and coming into contact where there were high levels of the bacteria in brackish waters.

A Wilmington man died Sept. 25 last year after cutting his leg during hurricane cleanup and getting floodwater into the wound. That same day, New Hanover County officials issued a press release warning about the risk of vibrio.

Richard Flaherty did not have so much as a scratch on his ankle when he walked into the floodwaters last September, his wife said. But, he has thin skin, she added, and a history of skin cancers resulting from radiation exposure during his time in the Air Force. Those factors may have made him more susceptible to the bacteria.

Those who cannot avoid coming into contact with flood waters are urged to take the following precautions:

  • Wear clothes and shoes that protect you from cuts and scrapes when in brackish or salt water.
  • Wear protective gloves.
  • Wash wounds and cuts thoroughly with soap and water if they have been exposed to brackish, salt, flood waters, or even raw seafood or seafood juices.
  • Cover your wound with a waterproof bandage if there’s a possibility it could come into contact with brackish or salt waters, floodwaters or raw seafood or seafood juices.
  • If you develop a skin infection, tell your medical provider if your skin has come into contact with brackish or salt waters, floodwaters or raw seafood or seafood juices.
  • Always wash your hands with soap and water after handing raw shellfish.
  • Avoid contaminating cooked shellfish with raw shellfish and its juices.
  • Have the following vaccines: Hepatitis A, Td (Tetanus & Diphtheria), and Tdap (Tetanus, diphtheria and pertussis).

The symptoms of infected wounds include pain, swelling and redness that may rapidly spread or blister.

“It looked like it could have been a spider bite, maybe a snake bite,” Penny Flaherty said of her husband’s wound, which started as a little red mark on his right ankle.

Tense 24 hours

Emergency medical technicians who responded to her 911 call on the evening of Sept. 15 gave her husband Benadryl and Tylenol and instructed him to take those medications every few hours, she said.

When Penny Flaherty started to administer the medications to her husband at 5 a.m. the following day, the red spot had spread to blood-filled, oozing blisters, she said.

“I was so stunned that I called 911 immediately,” she said. “He was in a lot of pain and his temperature was about 103.”

shows a burly bearded guy in shorts and a t shirt inside a lab, he's displaying some equipment on a table
After Hurricane Florence in 2018, UNC associate professor Brett Froelich distributed kits containing a sterile swab, culture medium, gloves, instructions and consent forms to be given to providers around the coastal area who might see patients with wounds infected by Vibrio species. Photo credit: Rose Hoban

Emergency responders assisted her husband down the stairs from the front door of their home and into an ambulance, she said. Richard Flaherty was diagnosed with V. vulnificus at the hospital.

Pamlico County officials do not have a record of anyone contracting the bacteria last September, according to Chris Murray, Pamlico County’s Emergency Management director and fire marshal.

“We are very aware of waterborne illnesses,” he said. “We’re very versed in it and aware of it.”

Richard Flaherty spent almost 22 days in the intensive care unit. He was discharged from the hospital after 41 days.

There’s been nearly six months of wound care and physical therapy. The Flahertys’ bedroom in their home across the street from the Neuse River in Oriental has been converted to something more of hospital room.

They’ve dealt with red tape while seeking help to cover some of the costs for everything from his wheelchair to physical therapy teaching him how to walk on a prosthetic leg.

They continue to travel to Durham every two weeks for immune infusion treatments, something he has been receiving for three months now, Penny Flaherty said.

“I have been the ever-present nurse on duty 24/7,” she said. “My care for him is what I do. That’s my full-time job. We’re making changes almost every week about something. But there’s things that will never change and things he will never do again. We both cry a lot. We laugh a lot.”

A county by county map of US colored to show opioid death risk, including access to medication-assisted treatment

Forty-one N.C. counties classified as “high risk” in new opioid study

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Forty-one N.C. counties classified as “high risk” in new opioid study - North Carolina Health News

In a national study, researchers classified 41 North Carolina counties as “opioid high-risk” with few providers of medication-assisted treatment and many opioid-related deaths.

By Yen Duong

While conversations about the national opioid epidemic often focus on hardest-hit states such as Ohio, West Virginia and Kentucky, few people have analyzed county-by-county trends, where those state’s policies can make a difference.

But a new study, published last month in an open-access version of the Journal of the American Medical Association, classified 412 counties as “high-risk” and 1,485 as “not high-risk.” Among those, 41 of North Carolina’s 100 counties qualified as “opioid high-risk” counties.

“That was one of the highest states that we found in terms of the number of counties relative to the total number of counties in the state,” said Rebecca Haffajee, a University of Michigan public health professor who ran the study. “That tells us that North Carolina and these counties in particular need to think about how to get more providers to those areas.”

Counties were deemed high risk if they had higher than the national rate of 12.5 opioid-related deaths per 100,000 people, and lower than the national rate of 9.7 providers of medication-assisted treatment, or MAT, for opioid use disorders.

North Carolina’s Department of Health and Human Services is spending two-thirds of a recent $12 million federal grant to fight the opioid epidemic on direct treatment for uninsured people with the remaining third spent on “linkages to care” or support for housing, case management, employment and other social factors, said Kody Kinsley, who works in behavioral health for DHHS.

“A lot of other states that have expanded Medicaid are able to use their Medicaid program to pay for treatment, and they can pump almost all of their federal grant money into linkages to care,” Kinsley said. “That’s a big reason why we continue to struggle in this fight.”

What ‘high risk’ means

High-risk counties had a few common characteristics: fewer primary care physicians per 100,000 residents, higher unemployment, a higher proportion of whites, fewer people with a high school education and fewer residents under the age of 25.

Of rural counties in the U.S., 71 percent had no publicly listed providers of any of the three medications, versus 46 percent of all counties with no such providers. But urban areas were also likely to be high risk.

“We were a little surprised by that finding,” Haffajee said. “The reason, we think, is because we use more recent death data … We’re picking up the risks of fentanyl and [other] illicits that other studies haven’t yet, because those hadn’t become super prevalent and saturated urban areas in the earlier years.”


41 of 100 N.C. counties were classified as opioid “high risk” counties in a recent JAMA study, with higher than national rates of opioid overdose deaths and lower than national rates of providers of medication assistant treatment. Map: Yen Duong

Although Henderson County, south of Asheville, has a federally qualified health center that offers methadone, it was classified as high risk. Steven Smith, the health director in Henderson County, thinks that may be because, with more education, more deaths have been identified as opioid-related.

“Henderson County overall is a pretty well-off county in terms of their percentage of primary care physicians and relatively low amount of uninsured,” said Smith, who is also the president of the North Carolina Association of Local Health Directors “We have been focused with community partners for years here, doing a lot of work upstream with prevention and harm reduction.”

Many barriers to MAT

People who want to get medication-assisted therapy face multiple barriers before they can access the three forms of MAT: buprenorphine, methadone and naltrexone. To dole out buprenorphine, the most common MAT, doctors complete an eight-hour training and apply for a federal waiver to prescribe to up to 30 patients. They can apply for a waiver to prescribe up to 100 patients, and after a year they can reapply to prescribe to 275 per year.

Currently, only about 7 percent of the nation’s physicians have taken the extra time and effort to train for prescribing the medications.

Methadone can only be given under a physician’s supervision in opioid treatment programs approved by the federal Substance Abuse and Mental Health Services Administration. There are 76 such approved programs in North Carolina listed on the SAMHSA website.

“It’s still crazy that both buprenorphine and methadone are regulated more strictly than opioid analgesics,” Haffajee said. “Any prescriber can prescribe hydrocodone or oxycodone [opioid painkillers] without any hoops they have to jump through.”

For naltrexone, patients need to be entirely free from opioids for seven to 10 days before starting treatment; otherwise, they’ll have serious side effects. For those with opioid use disorder, that means withdrawing from opioids first, a hurdle that can be insurmountable for many. But naltrexone has no waiver requirements for prescribing and can be useful for some patients.

“What might work for one patient might not work for another,” Haffajee said. “Having the full panoply of options available and you try one and then [if] that doesn’t work as well, you try other is the best course of treatment.”

Because of how costly MAT is, DHHS funds have gone toward treating “ten to twelve thousand people,” which is not enough, Kinsley said.

“The truth is, we’re still scratching the surface. We suspect one in 20 people have a substance use disorder in North Carolina,” Kinsley said. “It’s a long-term treatment. It’s a chronic disease like diabetes; people don’t go to one dialysis visit and they’re done. It’s a lifetime thing. We’re really behind the curve in keeping up with that.”

Ideas to address the whole person

The study argues that increasing access to these medications in high-risk opioid counties could reduce deaths by up to 60 percent. Haffajee said states should encourage doctors to prescribe more buprenorphine, help more doctors get the waiver, and also focus on policies that address the other conditions of high-risk counties—the linkages to care mentioned by Kinsley.

“If you don’t have a high school education, if you don’t have a safe place to live, if you don’t have access to transportation, the least of your problems is getting a provider to give you a medication for your substance use disorder,” Smith said. “You have to start addressing that whole person in a meaningful way to give them even a chance of climbing out of that abyss.”

Right now, federally waivered doctors who prescribe buprenorphine must also register with the state. House Bill 325, which was just signed by Governor Cooper, gets rid of that requirement and gives more support to needle exchange programs and people who test drugs for contaminants.

In addition to that legislative change, DHHS is hoping to change rules to build up “satellite” dosing offices. In that case, patients could go to a usual MAT provider for their first few doses, and then the provider could send out a nurse or doctor out to rural satellite offices near the patient a few times a week, Kinsley said.

“Right now, if you live in Rutherford County, and you’re on medication-assisted treatment, you’re probably driving to Buncombe County two to three times a week to receive your dose,” Kinsley said. “I couldn’t drive 60 miles somewhere three times a week and keep a job and maintain a family and that sort of stuff.”

Smith said that even if lawmakers do not expand Medicaid, “the cost of this crisis does not go away.”

“Communities are paying for it every day, in terms of support services, human services, legal intervention, detention facilities, emergency departments,” Smith said. “We’re all paying for this, one way or another, regardless of whether or not it shows up on the balance sheets at the state.”

a pretty white church with a red door sits in the background, in front of the building is a large pile of wooden debris

With Homes Destroyed by Florence, this Tiny ENC County Struggles to Find a Foothold

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With Homes Destroyed by Florence, this Tiny ENC County Struggles to Find a Foothold - North Carolina Health News

For a small, low-income Eastern North Carolina county such as Jones, the recovery from Hurricane Florence can be daunting.

By Thomas Goldsmith

When the Trent River overran the Haiti community of Jones County, Linda Faith Perry lost her mobile home, her car, even her dog Kujo.

Starting Sept. 14, Hurricane Florence sent torrents coursing through Jones’ county seat Trenton, with the Haiti neighborhood where Perry lived hit especially hard. In the weeks since, many Trenton residents and others in the 10,000-resident county have lived betwixt and between, flooded out of their customary homes, but unable or unwilling to relocate permanently.

an African American woman stands looking at the camera, behind her are a car and a church steeple.
Linda Faith Perry, of Trenton, lost her trailer home, car and dog when Hurricane Florence surged through her neighborhood in September. Photo credit: Thomas Goldsmith

“I’ve been through two hurricanes here,” Perry said, referring to Florence and the catastrophic Hurricane Floyd, which clobbered the town in 1999. “Now I’m living at a hotel.”

The Federal Emergency Management Agency gave housing help to Perry and more than 129,000 other North Carolinians who have registered as disaster survivors since Florence. In Jones County, 650 homeowners and renters were awarded $4.4 million in state and federal housing grants.

A slow recovery

“It was by far the worst flooding we’ve ever experienced in Jones County,” said county manager Frank Howard. “There are parts of the county that saw five to seven more feet than in Floyd. We don’t know for sure because our flood gauges went out of order. They were under water.”

Protecting the public by regulating the practice of nursing NC Board of Nursing

In a county where manufactured homes such as Perry’s make up as much as 30 percent of housing, the slow-moving storm was particularly damaging. Some applicants to FEMA were provided with travel trailers or manufactured housing as a temporary solution, Alex Bruner in the agency’s public affairs office said via email.

“It’s a slow recovery process — folks are trying to get their homes back in order,” Howard said. “We’re still in the process of getting debris off the road.”

Countywide estimates to date say the county suffered $16 million in damage from Florence from heavy rain and the overflowing Trent River, Howard said. Anyone whose house was torn up by a hurricane can live with disruption and stress, but it’s safe to say money usually helps. The median household income in Jones is $34,080, about seven-tenths of the statewide figure of $48,256.

Decisions about rebuilding won’t be easy. On Haiti Street, next door to a house with a man-sized cross and a statue of the Virgin Mary in the yard, Victor Guadarrama was at work clearing mounds of sodden debris from his mobile home.

a man stands in boots and work clothes at the top of a wooden ramp that leads up to the front of a house.
Hurricane Florence devastated Victor Guadarrama’s trailer, with water coming up to the bottom of the window to his right, in the Trenton neighborhood of Haiti. Photo credit: Thomas Goldsmith

“I bought it from my parents three months before the storm,” said Guadarrama, who had no insurance on the dwelling.

Residents from Haiti, one of the neighborhoods closest to the river, were driven from their homes and are staying with relatives, at motels, or wherever they can find lodging, neighbors said. Even before the storm, the county had a shortage of affordable housing.

“I have a family of six living with me,” said Trenton resident Angela Wilson. “They’re not kin, but they were flooded out. They were living with another lady and it was too cramped at that house.”

Like others throughout the state, many Jones County residents face the decision of whether to repair a badly damaged long-time home or accept money for it from the government to move on, Howard said.

“It just depends on their abilities,” he said. “A lot of folks are inquiring about the FEMA buyout process.”

The buyout process is a complex one but may result in a market-value payment so the homeowner can make a new start.

Public, private help

Many Jones County residents first saw their FEMA applications rejected because of paperwork difficulties, Wilson said. But FEMA brought counselors to a temporary center on Highway 58 to help those who’d gotten discouraging answers.

For now, some Haiti residents who can’t go home make daily visits to their former houses, checking on belongings and remaining neighbors.

“After the storm, everyone was pretty much at a loss for words,” said Jennifer Bruinton, accepting customer payments at the Old Plant Diner, just blocks from Haiti and from the Jones County Courthouse. “It really affected the community a lot. They seemed very worried and upset.”

“Many of these people didn’t have much before the flood and now they have nothing.”
Along with the millions in federal and state assistance coming into Jones County, the private sector is also pitching in. Old Plant Diner owner Michael Murrell, whose establishment escaped serious damage, offered free hot meals to survivors and workers the day after the storm. Haughton Chapel Free Will Baptist Church, where Bruinton is a member, sold meals in the parking lot of the Red & White Store to raise money for disaster victims.

And celebrity chef Vivian Howard, whose restaurant in Kinston is 20 miles and change from Trenton, is also raising money for Jones County, through sales of T-shirts. On her website, Howard pointed out the low profile of Jones County, where about two-thirds of working residents have jobs outside the county.

Sponsored

“It’s a place that can be easily overlooked,” she said. “Many of these people didn’t have much before the flood and now they have nothing.”

“Trying to thrive”

Wilson, the woman who’s sharing her home with flood survivors, said Jones County had maintained its population in recent years and had been looking to grow.

an african american woman stands at the register, behind the counter at a luncheonette, talking to someone off camera
Jennifer Bruinton greets customers at the Old Plant Diner in Trenton. The diner gave away hot dinners the day after Hurricane Florence swamped much of the town. Photo credit: Thomas Goldsmith

“I would say in Jones County, we are a county that is trying to thrive,” she said.

“We are the fourth poorest county in North Carolina. In trying to overcome that obstacle, we are trying to take advantage of all the opportunities that are available to us.”

While Wilmington received national publicity because flooded roads cut off land access for days after Florence, similar isolation Jones County went mostly unnoticed.

“We couldn’t get out of Jones Count after the hurricane for about five days,” Wilson said. After that, it was an hour and a half drive just to New Bern.”

It usually takes about 20 minutes to get to New Bern, where Wilson works as a prison re-entry case manager for Craven and Pamlico counties and as a job-readiness counselor at Craven County Community College.

SNAP logo of stylized food in a bag that reads, "SNAP"

Residents of Counties Hit by Florence Can Get Extra Help with Food

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Residents of Counties Hit by Florence Can Get Extra Help with Food - North Carolina Health News

State programs approved by USDA will increase federally funded payments for people in counties hit hard by Hurricane Florence.

By Thomas Goldsmith

In the North Carolina counties hit hardest by Hurricane Florence, people who already get help buying food will be given more, and those not on a state or federal food program can receive assistance going forward, federal and state officials said Thursday.

The announcement follows by a few days a visit to the state by U.S. Department of Agriculture (USDA) Secretary Sonny Perdue, who arrived Monday to hear more about Florence’s devastation from Gov. Roy Cooper, Commissioner of Agriculture Steve Troxler and Secretary of Environmental Quality Michael Regan. Torrential rains from the storm brought destruction and weeks of flooding to some counties that hadn’t completely recovered from Hurricane Matthew’s 2016 destructive visit.

Help is on the way for people who qualify for the federal Disaster Supplemental Nutrition Assistance Program (D-SNAP). Families will have a one-time deposit placed on a special debit card, with the amount based on the size of the household.

“We want to do everything we can to help families recover from Hurricane Florence,” state NC Department of Health and Human Services Secretary Dr. Mandy Cohen said in a statement. “This program will help people who have suffered losses buy food for their families as they begin the long process of rebuilding their lives.”

As an example, DHHS said, a family of one would receive $192, a family of four would get $640 and bigger families would get more.

The state Department of Health and Human Services listed the counties as Bladen, Beaufort, Brunswick, Carteret, Columbus, Craven, Cumberland, Duplin, Harnett, Hoke, Hyde, Johnston, Jones, Lee, Lenoir, Moore, New Hanover, Onslow, Pamlico, Pender, Pitt, Richmond, Robeson, Sampson, Scotland, Wayne and Wilson.

Sponsored

“Our department is committed to providing the assistance needed to our neighbors, as they pull themselves to recovery,” Perdue said in a statement. “The D-SNAP program USDA is announcing today is an important step forward in bringing back normalcy to those impacted.”

Tailored by county

Some groups of counties are covered by special provisions. The help will come in several different forms.

For people in Bladen, Brunswick, Carteret, Columbus, Craven, Duplin, Harnett, Hoke, Hyde, Jones, Lee, Moore, New Hanover, Onslow, Pamlico, Pender, Richmond, Robeson, Sampson and Scotland counties:

++ Everyone who already gets help from the federal Food and Nutrition Service, commonly known as “food stamps,” will automatically have 60 percent of their monthly deposit replaced on their electronic benefit transfer (EBT) card.

++ A number of households in the affected counties will get additional spending power on their EBT cards if they don’t already get the maximum amount based on the size of their households.

++ People or households who experienced loss of food that cost more than 60 percent of their benefit for September can apply for a larger replacement from their county Department of Social Services.

In Beaufort, Cumberland, Johnston, Lenoir, Pitt, Wayne and Wilson counties:

People on the FNS program who have experienced food loss can ask to have a portion of their benefits for September replaced. Households that experienced loss of food and receive less than the maximum benefit can apply for additional amounts from their county Department of Social Services. They’ll need to complete an affidavit available at county DSS offices.

Who’s eligible for D-SNAP?

To be eligible for the Disaster-Supplemental Nutrition Assistance Program an applicant must:

  • Live in a disaster-declared county.
  • Apply in person between Friday, Sept. 28, and Oct. 6.
  • Be prepared to wait at state-designated D-SNAP locations (below).
  • Be a victim of damage from Florence in areas such as property damage, lost income or food supplies.
  • If available, show proof of identity and residency.
  • Have levels of income and worth below certain guidelines.

    Source: North Carolina DHHS

 

County

Physical Address

Times of Operation

Beaufort
Beaufort County Department of Social Services, 632 West Fifth St., Washington, NC 27889
Mon. – Fri.: 8 a.m.-6 p.m.
Sat.: 9 a.m.-5 p.m.
Chocowinity Fire Department, 512 NC 33 Chocowinity, NC 27817
Fri., Sept. 28: 8 a.m.-6 p.m.
Sat., Sept. 29: 9 a.m.-5 p.m.
Aurora Community Center, Main St., Aurora NC 27806
Fri., Sept. 28: 8 a.m.-6 p.m.
Sat., Sept. 29: 9 a.m.-5 p.m.
White Plains Church, 718 Pine St., Belhaven, NC 27810
Fri., Sept. 28: 8 a.m.-6 p.m.
Sat., Sept. 29: 9 a.m.-5 p.m.

Bladen
Bladen County DSS, 208 E McKay St., Elizabethtown, NC 28337
8:30 a.m.-6:30 p.m., Mon. – Sat.
NC Cooperative Extension, 450 Smith Circle, Elizabethtown, NC 28337
8:30 a.m.-6:30 p.m, Mon. – Sat.
Bladenboro Fire Department, 519 West Seaboard St., Bladenboro, NC 28320
8:30 a.m.-6:30 p.m, Mon. – Sat.
Centerville Baptist Church, 18577 NC Highway 53 East, Kelly, NC 28448
8:30 a.m.-6:30 p.m, Mon. – Sat.
Tar Heel Town Hall (Old Fire Dept.), 14865 Hwy 87 West, Tar Heel, NC 28392
8:30 a.m.-6:30 p.m, Mon. – Sat.

Brunswick
Odell Williamson Auditorium/Brunswick Community College Main Campus, 50 College Road NE, Bolivia, NC 28422
Mon. – Fri. 8:30am-5pm
Sat. 9am-5pm

Carteret
Carteret County DSS, 210 Craven Street, Beaufort, NC 28516
8 a.m.-5 p.m., Mon. – Sat.
Newport Baptist Church, 312 Chatham St., Newport, NC 28570
Mon.-Fri.: 8 a.m.-5 p.m.
Sat. 9 a.m.-5 p.m.
Western Park Community Center, 275 Old NC-58, Cedar Point, NC 28584
Mon.-Fri.: 8 a.m.-5 p.m.
Sat. 9 a.m.-5 p.m.
Atlantic Fire Department, 967 Seashore Drive, Atlantic, NC 28511
Mon.-Fri.: 8 a.m.-5 p.m.
Sat. 9 a.m.-5 p.m.
South River Fire Department, 1329 S. River Road, Beaufort, NC 28516
Mon.-Fri.: 8 a.m.-5 p.m.
Sat. 9 a.m.-5 p.m.

Columbus
Columbus County DSS, 40 Government Complex Road, Whiteville, NC 28472
Mon.-Fri.: 8 a.m.-5 p.m.
Sat. 9 a.m.-5 p.m.

Craven
Craven County Department of Social Services, 2818 Neuse Blvd.New Bern, NC 28562
8 a.m.-5p.m., Mon. – Sat.

Cumberland
Cumberland County Department of Social Services, 1225 Ramsey St., Fayetteville NC 28301
7:30 a.m.-5 p.m., Mon. – Sat.
St Luke AME Church, 522 Hillsboro St., Fayetteville, NC 28301
Mon.-Fri.: 8 a.m.-5 p.m.
Sat. 9 a.m.-5 p.m.

Duplin
Duplin County Events Center, 195 Fairgrounds Drive, Kenansville, NC 28349
Mon.-Fri.: 8a.m.-6 p.m.
Sat.: 9 a.m.-5 p.m.
Duplin County Department of Social Services (Basement Community Room), 423 N. Main St., Kenansville, NC 28349
Fri., Oct. 5: 8 a.m.-6 p.m.
Sat., Oct. 6: 9 a.m.-5 p.m.

Harnett
First Choice Health Center, 40 Autumn Fern Trail, Lillington, NC 27546
8 a.m.-5 p.m., Mon. – Sat.

Hoke
Cape Fear Conference B Headquarters, 10225 Fayetteville Road, Raeford, NC 28376
7 a.m. – 5:30 p.m., Mon. – Sat.

Hyde
Hyde County Department of Social Services, 35015 Hwy 264, Engelhard, NC 27824
8 a.m.-5 p.m., Mon. – Sat.
Ocracoke Community Center, 999 Irvin Garrish Hwy, Ocracoke, NC 27960
Oct. 2: 8 a.m.-5 p.m.
Oct. 3: 8 a.m.-11:30 p.m.
O. A. Peay School, 1430 Main Street, Swan Quarter, NC 27885
8 a.m.-5 p.m., Mon. – Sat.

Johnston
Johnston County DSS, 714 North St., Smithfield, NC 27577
Mon. – Fri. 8 a.m. – 5 p.m.
Sat. 9 a.m. – 5 p.m.

Jones
Lenoir Community College – Jones County Site, 509 NC Hwy 58 North, Trenton, NC 28585
8 a.m.-5 p.m., Mon. – Sat.

Lee
Lee County Department of Social Services, 530 Carthage St., Sanford, NC 27330
8 a.m. – 5 p.m., Mon. – Sat.

Lenoir
Vernon Park Mall (Old Eckerd Drug Store), 534 Hardee Road, Kinston, NC 28504
Mon. – Fri. 8 a.m. – 5 p.m.
Sat 9 a.m. – 5 p.m.
La Grange Community Center, 410 E. Washington St., La Grange, NC 28551
Mon.-Fri.: 8 a.m.-5 p.m.
Sat. 9 a.m.-5 p.m.
Pink Hill Town Hall, 303 South Central Ave., Pink Hill, NC 28572
Mon.-Fri.: 8 a.m.-5 p.m.
Sat. 9 a.m.-5 p.m.

Moore
Moore County DSS, 1036 Carriage Oaks Drive, Carthage, NC 28327
Mon. – Fri. 8 a.m. – 5 p.m.
Sat. 9 a.m. – 5 p.m.

New Hanover
3500 Oleander Drive, Wilmington, NC 28403 (Previous Sears Location at Independence Mall entrance)
Mon. – Fri. 8 a.m. – 5 p.m.
Wed. 8 a.m. – 6 p.m.
Sat. 9 a.m. – 5 p.m.

Onslow
Consolidated Human Services, 612 College St., Jacksonville, NC 28540
7 a.m. – 5 p.m., Mon. – Sat.

Pamlico
Pamlico County Human Services Center, 828 Alliance Main St., Bayboro, NC 28515
8 a.m.- 5 p.m., Mon. – Sat.

Pender
Agricultural Building, 810 South Walker St., Burgaw, NC 28425
8 a.m.-5 p.m., Mon. – Sat.

Pitt
Salem United Methodist Church, 785 McDonald Street, Simpson, NC 27879
8 a.m. – 5 p.m., Mon. – Sat.
Phillippi Church, 3760 Phillippi Dr, Greenville, NC, 27834
8 a.m. – 5 p.m., Mon. – Sat.
Peace Presbyterian Church 301 Guiness Dr., Winterville, NC, 28590
8 a.m. – 5 p.m., Mon. – Sat.

Richmond
Richmond County Health and Human Services, Complex125, Caroline Street, Rockingham NC 28379
Mon. – Fri. 8 a.m. – 5 p.m.
Sat. 9 a.m. – 5 p.m.

Robeson
Robeson County Department of Social Services, 120 Glen Cowan Road, Lumberton, NC 28360
Mon. – Fri. 8 a.m.-5 p.m.
Sat. 9 a.m.-5 p.m.

Sampson
Sampson County Department of Social Services,, 360 County Complex Road Suite 100, Clinton NC 28328
8 a.m.-6 p.m., Mon. – Sat.

Scotland
Scotland County Department of Social Services,, 1405 West Boulevard, Laurinburg, NC 28352
7 a.m. – 6 p.m., Mon. – Sat.

Wayne
Bussmann Building, 210 Dixie Trail, Goldsboro NC 27530
8 a.m.-5 p.m., Mon. – Sat.

Wilson
The Wilson Daily Times Bldg., 2001 Downing Street Wilson, NC 27893
Mon. – Fri. 8 a.m.-5 p.m.
Sat. 9 a.m.-5 p.m.

Click here for all our coverage of Florence: https://www.northcarolinahealthnews.org/missed-hurricane-florence-story-find-it-here/Keep up with the latest health news in NC. Click here: https://www.northcarolinahealthnews.org/subscribe/

 

We see the backs of two men, who are staring down at a submerged boat just off of a dock.

Florence Adds to Stress for Seafood Industry

by

Florence Adds to Stress for Seafood Industry - North Carolina Health News

Fishermen brace for a difficult winter financially after the hurricane ruined much of their fall catch.

By Taylor Knopf

During a major hurricane, fish migrate away, oysters get contaminated and shrimp are blown to sea, scattered to deeper waters.

Though sometimes unnoticed, the seafood industry takes a big hit after storms like Florence. Not only does the crop move, but fishermen often live and work in the coastal communities that take the brunt of the storm’s rage.

a shrimp boat, its masts in the air, sits in a dock slip next to a house boat that's half-submerged
Half-submerged house boat in the Marshallberg harbor following Hurricane Florence. Photo credit: Taylor Knopf

“We get overlooked real easy. We are isolated to the coast. And unlike the agricultural industry, this affects everyone,” said Glenn Skinner, executive director of the North Carolina Fisheries Association. “Everyone who fishes is affected by this.”

Their boats, gear, docks and packing houses take a blow.

Anticipating the power outages, many fishermen got as much seafood as they could out of their giant cooling lockers and shipped it north and west. Any inventory that touches flood waters must be discarded.

Florence struck Pamlico County fishermen the hardest, according to Skinner. Some fish packing operations in Oriental and Vandemere were completely destroyed.

“It’s going to be a real hard winter for the industry,” Skinner said.

“We are kind of like farmers, we have a fall crop,” he explained. “The fall fisheries are big. We use that money and put it away for the winter time. The fisheries are going to be gone after this strong blow for several days. It will be next spring before we can make that up.”

Jerry Schill, government affairs liaison for the fisheries association, said these types of storms have a big impact on the mental health of fishermen and other working class North Carolinians.

“These guys don’t get a W2 at the end of the year, they get a 1099. If they don’t catch anything, they get nothing. It doesn’t matter how hard they work. The crew is paid the same as the captain.

“That’s a lot of stress on a family,” he added.

It’s these types of stressors that could contribute to some of the mental health problems providers see in the area.

shows a string of power lines down on the side of the road, at least 7 poles are down
Power lines pulled down by Florence outside of Beaufort on Sept. 21. Photo credit: Taylor Knopf

‘Neighbors helping neighbors’

In the wake of the storm, some fishermen used their unique assets to assist neighbors.

Fish packing houses have walk-in ice freezers that hold mounds of shaved ice, like piles of snow plowed to the roadsides after a blizzard.

Local fishermen offered and delivered ice to anyone without power after the storm. With electric poles knocked down and stripped of wire, it took more than a week to restore some parts of the coast.

Brent Fulcher, who owns a large seafood operation out of Beaufort, posted to Facebook that he was offering ice and hot showers on his boats. The larger boats, like Fulcher’s, go out to sea for days at a time and are equipped with showers.

A hot shower and a little ice to keep your drinks and food cool can make a big difference after a hurricane.

shows a flooded piece of land, trees ringing the furthest extent of the water, one can see some raised areas where the ground is visible.
Looking down into Glenn Skinner’s flooded front yard. Visible is his porch roof at the bottom of the frame. Skinner said he’s never heard that this piece of land was in a flood zone. Others in Newport said the waters pushed in higher and further even than Hurricane Hazel in 1954. Photo credit: courtesy of Glenn Skinner

In some instances, local fishermen also used their smaller boats to rescue friends and neighbors from their flooded homes.

Skinner lives on land that’s been in his family for about 200 years, noting that his Newport neighborhood is not considered a flood zone. But during Hurricane Florence, he said the water was chest deep in his front yard and over his head in his backyard.

“The flooding in areas that normally don’t flood, that surprised a lot of people in our area,” he said. “If they aren’t in a flood zone, they don’t have flood insurance. But many houses flooded anyway.”

Skinner tied his 27-foot fishing boat to his front porch as it floated off its trailer. He planned to take his family through the second story windows and onto the boat if the waters came into the house. Luckily, his house sits up on a concrete block foundation and was spared.

Skinner rescued a nearby friend and his cousin and some of her animals from flooding. He managed to escort two horses through the flood waters to safety, as well as a dog and a goat.

Gov. Roy Cooper visited Newport last week, which was ravaged by flood waters and tornados.

“The people that I’ve been talking to today are helping each other. Neighbors are helping neighbors,” Cooper said.

“I talked to one woman whose house had been destroyed. She was out serving meals to other people. That is the spirit of North Carolina,” he said.

man stands next to a heat pump that's on a raised platform. His hand is about waist height, where he's showing the height of the water, halfway up the apparatus.
Glenn Skinner shows the place where water came up to on his property in the wake of flooding caused by Hurricane Florence’s storm surge. Photo credit: Rose Hoban

Scattered shrimp and bad oysters

Though many are focused on what happens above water during a hurricane, marine scientists at University of North Carolina are interested in the critters below.

Rachel Noble, professor at the UNC Institute of Marine Sciences, said for many, their habitat is disrupted and they can be blown out to sea or pushed away by waves.

It’s hard for those making a living catching shrimp, clams and oysters, she said.

Many shrimp species are found in estuaries, which are between five and 10 feet deep. The high concentration of shrimp and shallow waters allow fishermen use trawlers to run back and forth across the sea floor — like a lawn mower — collecting shrimp.

After a hurricane, those shrimp are blown out of estuaries and into deeper waters. They become difficult to find and the return on investment for going out to shrimp is simply not worth it, Noble said.

The shrimp will begin to regrow in the estuaries in the spring, but must grow to some maturity throughout the early summer before they are worth collecting.

shows a shrimp boat, which has long arms that hold the nets that dip down and haul out shrimp
Shrimp trawler in the Marshallberg harbor. Photo credit: Taylor Knopf

John Willis, from Harkers Island, has been fishing full time for 37 years and says it’s always tough after a big storm.“What a hurricane will do to the seafood — the fish, the shrimp, the crab or the flounder or any of it — they feel the effects of it coming and they leave. They go different places,” he said. “When they go out of our reach, we can’t get to where they are at to catch them. So we don’t really have a good season after the hurricane.”

The past few days, he’s been trying to catch the few shrimp that are left near Cedar Island.

“It’s the last of the Mohicans out there. They aren’t doing real great,” he said.

The storm waters also brings in contamination.

“If the water is too polluted, oysters can’t filter like they usually do and they shut down,” Noble said. She explained that the bivalves go into a dormant phase and stop filtering the sediments and industrial and sewage waste that enters the water through storm flooding.

shows a house that's on a raised foundation, its windows are boarded with plywood.
A house in Beaufort which remains boarded up a week after Florence made landfall on the North Carolina coast. Photo credit: Taylor Knopf

Even when they start filtering again, Noble said that the bacteria and viruses that make people sick remain in the shellfish tissues even after the pollutants are filtered out.

She and her graduate students in Morehead City at the institute have been testing and monitoring shellfish since Florence blew through a few weeks ago.

She said the conventional wisdom that an oyster only needs about 30 days to recover is inaccurate.

“It’s not one size fits all,” Noble said. “The shellfish won’t be magically ready to eat again in 30 days.”

‘Oversized foot in your Southern posterior’

Last week, Donald “Pancho” sat on the Marshallberg dock holding a Bud Light and staring down into the water at his 20-foot fishing boat.

“That little one is just a miniature, but it does the same things as the shrimp boats but on a smaller scale. It was my little retirement thing. It made it through the storm, but that last rain… The pump couldn’t keep up with it,” Pancho said.

He’s spent his life fishing, but now he’s moved to part time.

shows a boat that's completely submerged
Photo credit: Taylor Knopf

“I go clamming, oystering, I work the water. Whatever I catch, I take over to the fish house and it’s a nice little supplement for my social security,” he said.

He’s not giving up on his boat just yet. But he said he has to wait for a low tide to pump the water back out of it.

“This is like an oversized foot in your southern posterior,” he said shaking his head.

Pancho said the 38-year-old boat was built by a guy on Harkers Island, and he’s only the second owner. It’s unique and almost an antique.

“At least seven people have offered to buy it from me because you just don’t find many like that anymore,” he said.

 

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