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Sen. Phil Berger

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Legislative leaders press pause on PED reports, could skew analysis on state health care spending

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Legislative leaders press pause on PED reports, could skew analysis on state health care spending - North Carolina Health News

Despite a history of reports sparking changes, the legislature wants more member involvement in oversight. But the analysis will now be performed by partisan staffers.

By Thomas Goldsmith and Rose Hoban

In 2016, the state prisons’ medical system was allowing millions to slip away by passing up federal discounts from costly inmates’ prescriptions, a legislative watchdog team observed.

Then came a pointed report from the agency, the Program Evaluation Division, that brought about a mandate for change in 2018. And legislation changing the practice resulted the next year.

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Despite legislators’ agreement that the PED report was of value and their action based on it, this February, the legislature’s leadership dissolved the division, laying off its staff and suggesting that politically appointed committee staffers could do the work instead.

One of the last reports generated by the Program Evaluation Division started to look at how billions in federal CARES Act coronavirus relief dollars were spent around the state. Included in that analysis were breakdowns of allocations made to hospitals under the state’s General Hospital Relief Fund ($15 million) and the Rural Hospitals Relief Fund ($65 million). Data courtesy: PED; Map: Liora Engel-Smith

All the work is still on the legislative website, for those who know how to find it. But easy links to sharp critiques and piercing analysis of state programs is now even harder to find.

In announcing the change, Republican leaders suggested that legislators should have more input into the evaluation process, which state agencies have sometimes found lacking in including knowledge of the reasons things are done.

“The leadership of the North Carolina General Assembly has decided to end the current operations of the Program Evaluation Division and take the oversight and audit functions in a new direction, giving members more involvement in the oversight,” an announcement of the move said.

“All current study projects and inquiries are being suspended for the immediate future.”

The prison medical system research was only one of multiple health care-related studies generated by the division, which had been in existence since 2007.

Sometimes unwelcome conclusions

This year, PED had multiple health care-related tasks on its work plan, a document that had been devised with the help of lawmakers. Planned projects included tracking where $3.6 billion in funding from the federal CARES Act and dispersed by the state had gone.

And the division was in the middle of an assessment of the state’s Medicaid Innovations Waiver program, which funds services and supports for Medicaid beneficiaries with intellectual and other developmental disabilities who are at risk for institutional care.

The program sometimes counseled against state support for an initiative it was asked to assess, which happened in several recent instances for health care initiatives examined by the organization.

One such conclusion was around a proposal to make permanent a pilot overnight respite service in adult day care facilities.

“PED identified several state-run facilities offering overnight respite at substantially lower rates than nearby adult day care facilities,” a 2016 report said.

In 2017, a report found that for North Carolina schools to meet national staffing standards for school nurses could cost $79 million a year.

“Of course, with the pandemic, we’ve got kids that are coming back into school right now that have, I’m sure, been exposed to many challenges in their lives, not just health related, but emotionally emotional situations in their families, and so forth,” said Rep. Cynthia Ball (D-Raleigh) who introduced a bill to fund school nurses in 2019 and this year.

“It would have meant a whole lot to have nurses this past year.”

By this year, the estimate to place a nurse in each of the state’s schools had grown to $102 million, according to a bill filed by Democrats in both the Senate and the House of Representatives.

And a report released last year found that the NC FAST software system developed under a state contract and designed to provide integrated applications for human services programs was functional, even as it was also difficult to use. PED analysts’ top conclusion was that issues in the child welfare system were not only attributable to the software, but that lack of consistency in practice and management was a hindrance to the state’s ability to implement a child welfare case management system.

This conclusion complicated the narrative around the software package.

Other health care related reports generated by PED in the past decade include:

  • A 2019 analysis of child welfare services screening and intake services that found the county-run system lacked consistency;
  • A 2018 look at disability services in schools that found little evidence of duplication of effort among school children with disabilities who were also Medicaid recipients. The report also found that the Department of Public Instruction was not performing systematic reviews of how effective services for children in the school system were;
  • A 2016 report which found Medicaid systems for identifying waste, fraud and abuse were inadequate, potentially costing the state millions annually;
  • A 2015 report which suggested the state could save $64 million annually by moving state-supported retirees to Medicare Advantage, a move eventually taken by the state Treasurer’s office;
  • A 2014 review of the state standards for opioid prescribing which made recommendations to strengthen guidelines and drive increased use of the Controlled Substances Reporting System.

Equivalent service? 

Sen. Phil Berger, president pro tem of the Senate, and Rep. Tim Moore, House speaker, decided to discontinue the program.

Instead, if these issues are studied at all, they’ll be picked apart by staff members of a committee chaired by the two legislative leaders. The newly reconfigured Joint Legislative Commission on Government Operations will be staffed by analysts hired by members from the two political parties, according to a March report in the NC Insider, a legislative affairs newsletter.

This past week, the NC Insider reported there has not been movement on making hires to staff the replacement commission.

John Turcotte, former executive director of the program, worried that with analysts hired by the Democratic and Republican caucuses, the issues studied will turn into political footballs.

“I think that’s one thing that was driving this change, firing the PED staff, etc, because [legislative leaders] didn’t have direct control over the PED staff,” he said.

Turcotte had advised on the formulation of North Carolina’s Program Evaluation Division as it was being formed. Then he moved to North Carolina to run PED in 2007.

“In those days, you had a Democratic legislature overseeing a Democratic administration, and now we’ve got this highly partisan Republican legislature overseeing a Democratic administration,” Turcotte said.

“So I’m guessing that the whole process ends up being that much more politicized.”

Since 2007, the division had been sending investigators to look into more than 100 government functions at the official requests of state legislators.

It’s not likely that these newly hired legislative staff can achieve the same in-depth, on-site probes of state agencies achieved by the Program Evaluation Division, former state Rep. Craig Horn (R-Weddington) said in a telephone interview.

Retired from the General Assembly, Horn was co-chair for six years of the supervising Joint Legislative Program Evaluation oversight committee.

“You still have to have someone do the research,” Horn said. “Legislators are not known personally for their deep dives.

“I don’t see how this is going to save the state any money, nor in my own opinion, will it add any particular efficiencies.”

Horn wants to know who will conduct the hard research that it takes to make sure state projects aren’t spending millions unnecessarily.

Exhaustive work

A spokesman for Moore told the Associated Press that staff of joint legislative committees could make sure that state agencies provide information in full and on time. Attempts were unsuccessful to reach Berger and Paul Coble, a former Raleigh mayor who was involved in the move as director of Legislative Services.

Turcotte said its work couldn’t be replaced by committee staff or the Fiscal Research Division of the legislature. The fiscal research staff, he said, remains in high demand during, before and after legislative sessions, leaving them with no time or inclination to do field work, he said in an interview.

“They’re trying to get information from OSBM (Office of State Budget and Management) and from the agencies, and to work with the agencies and the legislators and craft a legislative version of the budget. It’s exhaustive work,” Turcotte said.

“But they don’t do statewide surveys; they don’t do site inspections. An agency might take them to one of their facilities and show them around stuff. But it’s not anything like we would do.”

Turcotte wondered what agency would do the analysis of how effectively North Carolina spent federal dollars sent to address the coronavirus pandemic in 2020. Congress passed three multi-billion dollar spending packages which totaled more than $6 billion coming to North Carolina.

In one of its last reports, PED detailed North Carolina’s spending from the Coronavirus Relief Fund created when the federal CARES Act – Coronavirus Relief Fund allocated $3.6 billion to North Carolina. That money was appropriated by the General Assembly across more than 130 state departments and divisions.

The division was able to produce a high level report on spending to counties, hospitals and other health care providers. But a deeper understanding of the spending may end up taking more time, and be more opaque, without PED’s analysis.

shows a man at a podium holding up a face mask used as a COVID preventive as he speaks from behind a podium.

Gov. Roy Cooper’s proposed budget could get things hopping in the legislature

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Gov. Roy Cooper’s proposed budget could get things hopping in the legislature - North Carolina Health News

The legislature started out slowly this year, but will negotiations between the GOP and Democrats about Medicaid expansion kickstart other priorities?

By Anne Blythe, Thomas Goldsmith, Rose Hoban, Taylor Knopf

Two weeks have passed since Gov. Roy Cooper stood with Democratic and Republican lawmakers outside the North Carolina Museum of History to announce that, in a new spirit of bipartisan negotiating, both sides of the aisle had come to consensus on how and when to reopen the state’s public schools.

On Wednesday, Cooper presented his proposed biennial state budget that called for spending $27.4 billion in the next fiscal year that begins July 1, and $28.5 billion for the fiscal year after that.

The governor’s proposal calls for expanding Medicaid and giving teachers higher raises than other state employees, hot-button political issues that created an impasse between the Democratic governor and Republican lawmakers and left the state without an orthodox two-year budget in 2019.

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Since the 2020 election in which North Carolina voters again elected a Democratic governor while filling both General Assembly chambers with Republican majorities, lawmakers and the governor have made noises about trying to work together more.

The months ahead will tell whether the historic moment displayed outside the history museum two weeks ago is a harbinger of a more bipartisan future, or if the budget process once again will break down along party lines.

“Unlike the last budget cycle that we had, I have had numerous conversations with both Republican and Democratic leadership,” Cooper said during a briefing with reporters Wednesday. “One thing we agreed on is, first, the people of North Carolina elected us again so we’re back in the same situation that we were, and we owe to them to do the best that we can to find a path forward. We’ve all agreed that everything is on the table.”

Trying to persuade Sen. Phil Berger, the Rockingham County Republican leading the state Senate, to change his mind could prove difficult.

In an interview with the Associated Press a week ago, Berger dampened the enthusiasm among Democrats and some Republicans for the substantial incentives contained in the American Rescue Plan for states that have yet to expand Medicaid as allowed under the Affordable Care Act. The federal COVID-19 relief package would direct some $1.7 billion to North Carolina over the next two years if the state enacts the policy.

While acknowledging some gaps in health care coverage during the Associated Press interview, Berger described the federal assistance as temporary aid that might create a new level of dependence on government for able-bodied adults.

Charlie Perusse, the state budget director, added context for how the carrot being offered by the federal government could be used.

In North Carolina, that would mean some 600,000 people who are low-income workers without health insurance, people with disabilities and others who don’t now qualify for Medicaid, would have access to health care under the expanded federal program. The state would owe between $350 million to $400 million per year, Perusse estimated, for its share of the expanded coverage.

If North Carolina, one of 12 states to resist Medicaid expansion, received the $1.7 billion from the federal government, Perusse added, the state could cover its share of the expansion costs for four to five years without having to consider looking for a new revenue source or assessing health care providers.

“This is a very good incentive that the feds are providing us,” Perusse said. “There’s no better time than the present to expand Medicaid.”

GOP responds

After many school children did remote learning for nearly a year because of the COVID-19 pandemic, Cooper’s plan directs some $80 million to help the state’s 115 school districts hire more nurses, psychologists, social workers and counselors. Democrats in the legislature filed a bill to fund nurses this week and another one to fund school mental health professionals in February.

Cooper recommends putting a $4.7 billion general obligation bond on the November 2021 ballot to help public schools meet infrastructure needs, to do health and safety projects and more at UNC System campuses and more.

Cooper’s plan does not call for a tax increase.

Nonetheless, Republicans, who are weighing the possibility of income and corporate tax cuts, quickly responded to the Cooper proposal with concerns, raising questions about how much room there is for negotiations in the months ahead.

“We have concerns about the very high spending growth and billions in borrowing in Gov. Cooper’s proposed budget,” Sen. Brent Jackson, a Sampson County Republican and Senate budget writer, said in a prepared statement posted to Senator Berger Press Shop. “We don’t want to return to an era of rollercoaster-style budgets with huge spikes in the boom years followed by huge cuts in the lean years.

“Thanks to a decade of predictable, responsible budgeting, North Carolina weathered the COVID-19 pandemic and recession without cutting state services or freezing teacher pay.”

The lawmaker concluded his statement with an olive branch, of sorts.

“We look forward to working together to achieve an enacted budget,” Jackson said.

Starting to perk

Just a short hike from the governor’s Capitol offices, the General Assembly building on Jones Street typically bustles with lobbyists and lawmakers, but this year the scene has been unusually quiet. Most office doors were closed this week, only a handful of people hung around in areas usually humming with activity.

“Lobbying is about being down at the building, being in the committee rooms and meeting with legislators in the elevator or hallway,” said Valerie Arendt, a registered lobbyist for the NC Chapter of the National Association of Social Workers. “A lot of us are not prepared to do that because of COVID. Some legislators are willing to meet with us virtually and some are asking us to come into the office.”

She said that’s made her job harder.

But now that lawmakers, lobbyists, staff, and even members of the media are getting vaccinated against COVID-19, people are beginning to drift back into the building.

“People seem to be coming back. A bit more each week,” texted Cone Health lobbyist Ryan Blackledge.

Nonetheless, lobbyists and advocates have been making their priorities known, albeit less efficiently.

“There’s texts, there are phone calls, there are the painful Zoom meetings,” said Blackledge in a later call. He talked about the things he couldn’t do, “like after a committee meeting, grabbing three other people, getting the bill sponsor and having a three-minute conversation where you fix something that would take hours texting back and forth between people.”

Mental health funding priorities

When the pandemic hit and the need for mental health and substance use treatment services surged, North Carolina’s provider organizations were already at a disadvantage, according to advocates.

Because state legislators were unable to pass a new budget in 2019 or 2020, some programs were left hanging.

“New programming couldn’t come to fruition, and it was harder for programs to pivot and meet the new needs when the pandemic hit,” Arendt said.

Due to pandemic-related hardships and job losses, North Carolina saw an increase in Medicaid enrollment last year, Arendt said.

“There’s going to be a tsunami of behavioral health needs because of the pandemic, even if everyone does get vaccinated and things go ‘back to normal,’” Arendt said. “Folks are going to need mental health and substance use services for a long time.”

This increase in demand comes on the heels of five years of cuts — totaling $500 million — to mental health single-stream funding, the money set aside for people with critical behavioral health needs and intellectual and developmental disabilities. Cuts and use of this funding received a good deal of scrutiny from the state auditor in 2019.

In a letter to lawmakers, Arendt listed the state’s mental health budget needs and priorities on behalf of more than 30 organizations that make up The Coalition on Mental Health, Intellectual and Developmental Disabilities, and Substance Use Disorders.

“As a collective voice, we are louder,” she said of the coalition, which has jointly advocated for the mental health needs of North Carolinians for several decades.

Headlining their list of 14 budget priorities is the need for lawmakers to restore the single stream funding.

The coalition also requests that the 5 percent Medicaid provider rate increase allowed by federal and state lawmakers in response to the COVID-19 pandemic be extended to providers working in mental health, IDD and substance use.

“[Our] providers are experiencing the same financial stress as hospitals, nursing homes, and primary care physician practices,” Arendt wrote to lawmakers.

“Clinics are competing for expensive PPE resources, implementing special COVID infection prevention measures for clients living in congregate settings, and struggling to keep their direct care workers employed and their patient or client populations out of hospital emergency rooms,” she said. “More support is needed so that current services do not have to end.”

Helping older North Carolinians

A raft of significant legislation for older North Carolinians also fell along the wayside in 2020. Their advocates are hoping to make up some of that lost ground in the wake of the pandemic, which proved so devastating to so many older people.

Heather Burkhardt, executive director of the North Carolina Coalition on Aging, said the pandemic “shed light on existing lack of funding, certainly for home- and community-based services for older adults to be able to get adequate care in their homes, and the support needed for family caregivers.”

A product of the Older Americans Act and state funding, Home and Community Care Block Grants are parceled out to counties for needs including senior centers, congregate meals, transportation, respite care, and adult protective services. A “waitlist” for the services has stood at 10,000 people for years, but the demand likely exceeds that level.

Among other services that will seek funding are Community Alternatives Program for Disabled Adults (CAP/DA) and Program for All-Inclusive Care for the Elderly (PACE).

Also missing the cut was a bill pushed by Rep. Donna White (R-Clayton) that would have created a task force to look at the growing number of caregivers in the state.

NC Adult Protective Services is required to work in each North Carolina county to make sure vulnerable people remain safe from physical, mental or financial abuse. Despite mandating the work, the state picks up only a small portion of the cost, with major support flowing from already strapped counties and the federal government.

“By 2025, 89 counties in North Carolina are projected to have more people aged 60 years of age than 17 years and under,” the independent North Carolina Senior Tar Heel Legislature said in its list of upcoming priorities. “Many of these adults may be at risk of becoming victims of abuse, neglect or exploitation.”

A provision that’s been ripe for change for many years almost crossed the finish line in 2019 that would have increased the Personal Needs Allowance, money which residents of skilled nursing and assisted living homes use to buy cigarettes, toiletries, transportation and many other needs not covered by long-term care funding.

Advocates hope the Personal Needs Allowance provision isn’t the only priority left over from the past two years that receives some long overdue attention during this legislative session.

shows a man in a suit sitting at a desk signing a paper that strengthens Medicaid, in the background, a woman in a mask to prevent COVID transmission stands, watching.

The federal pandemic relief bill contains a big carrot to expand Medicaid. Will North Carolina bite?

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The federal pandemic relief bill contains a big carrot to expand Medicaid. Will North Carolina bite? - North Carolina Health News

The bill includes substantial incentives for states to expand Medicaid, as well as provide spending boosts to improve care for new moms, people with disabilities. But only if lawmakers in Raleigh say yes.

By Rose Hoban

For the third year in a row, leaders from rural parts of North Carolina came out to say that they believe the state should move to close the health care coverage gap that’s only widened since the start of the pandemic.

In a statement released on March 4, the five rural members of Gov. Roy Cooper’s Council on Health Care Coverage, which met throughout the winter, said they believed the answer was “obvious.”

That answer was to expand Medicaid.

Since 2013, the option to add more than 500,000 low-income North Carolinians to Medicaid has been on the table. But Republicans in the legislature have firmly resisted this policy, one of the most significant aspects of President Barack Obama’s landmark law, the Affordable Care Act (often called Obamacare). In the past year, countless numbers of North Carolina workers have lost their jobs, and their health coverage with it, because of the pandemic. That’s made the issue of expansion that much more urgent, as the probable number of people who would benefit from the policy has climbed.

By now, 38 other states have made the move to expand Medicaid, including a number of Republican-led states, including Montana, Oklahoma, Idaho and Ohio.

Now, another landmark piece of legislation, the American Rescue Plan (ARP), signed into law by President Joe Biden last week, provides substantial incentives for the holdout states to finally expand. The question is, will North Carolina legislators, who have firmly resisted expansion in the past, take the plunge?

Cooper has said he’s hopeful. In an interview with Politico, he said he’s been meeting with Republican leaders of the General Assembly hopes he can make a “grand bargain” with them.

NC Health News asked for comment from the offices of Senate leader Phil Berger (R-Eden) and House of Representatives Speaker Tim Moore (R-Kings Mountain) but has not received a response.

Mo’ money

The ARP amps up the incentives to Medicaid expansion in several ways, most of which include providing states with a lot more money, more flexibility or both.

The biggest chunk of change could come if North Carolina decided to allow those extra people onto the program.

For the past few years, states that expanded Medicaid have had the federal government pick up 90 percent of the costs for people earning up to 138 percent of the federal poverty line, which comes out to about $26,500 in annual income for a family of four. States that acted earlier had an even higher percentage paid by federal dollars for the first few years.

The incentive for states to add people onto their Medicaid rolls doesn’t come with adding extra dollars to pay for the expansion population, many of whom are low-income workers who are likely healthier than many of the traditional Medicaid adults – people with disabilities, low-income seniors, people who are blind. Instead, the ARP’s incentive is to pay more for those more expensive people.

“Which, actually, is more money in many states,” said Hemi Tewarson, a visiting policy fellow at the Duke Margolis Center for Health Policy. “It’s some of the other populations that are covered by Medicaid that can be more costly.”

bars represent Medicaid recipients: children, people with disabilities, pregnant women, elderly. Health, working aged adults are not eligible
Graph courtesy: Duke Margolis Center for Health Policy

Usually, the federal government pays the lion’s share for these “regular” Medicaid beneficiaries. In North Carolina, the federal government usually pays 67.62 percent out of every dollar spent on care. Since the passage of the Families First Coronavirus Response Act in early 2020, that percentage was bumped up for every state through the end of the federal emergency declaration, meaning that right now, the feds pick up close to 74 percent of each Medicaid dollar spent in North Carolina.

The American Rescue Plan would increase that even more, adding another 5 percent of federal matching dollars for two years after initiation of the policy. An estimate by the Kaiser Family Foundation found that for North Carolina, that boost to the bottom line would be about $1.7 billion overall, while the cost to the state would be about a half-billion dollars a year, a net gain of as much as $1.2 billion for the state.

State Medicaid director Dave Richard said his office’s estimate of the costs to the state is higher, in the neighborhood of $700 million, before any offsets that could take the form of a tax on insurers or hospital assessments, both of which were proposed in recent years.

Either way, there’s a lot of money on the table.

“There’s 1.2 million people uninsured in North Carolina, that’s a lot of people,” Tewarson said. “I think there’s a sincere interest in sort of doing something to address that. And, you know, this gives them some more money.”

“States already have a very good incentive to expand the 90 percent match,” said Edwin Park, a researcher at the Georgetown University Center for Children and Families. “This is an additional incentive to entice states to expand to finally get them over the line.”

Park said that any argument made against this incentive by state lawmakers, at this point, is not about finances.

“This is something else, you know, an ideological opposition that can’t be swayed by the numbers one way or the other because this is clearly going to be a big net win for the state in terms of its budget,” he said.

Resistance cracks in other states

Tewarson came to the Duke Margolis Center from the National Governors Association, where she was a health policy analyst. She said that of the 38 states that had already expanded, all of those governors felt they were able to continue paying for the expansion programs once any incentives expired, politics notwithstanding.

“[In] Montana, in Ohio, in Arizona, that have expanded earlier, I think they found that these investments have led to some really good coverage options for people in their states,” she said.

“Providers were able to expand operations and things like behavioral health, they were able to redirect state funding that had been focused on paying for some of those programs into other programs, which is helpful to make broader investments in healthcare and beyond health care.”

Park said that in some states the numbers had already become too compelling to ignore, even before the ARP dangled this new carrot in front of governors and legislatures in the holdout states.

“Wyoming, for example, reported out a Medicaid expansion bill out of committee, and obviously a very Republican legislature,” he said. “It’s headed toward the floor of one of their houses.”

He said there’s also a movement toward expansion in Alabama, which, like most other southern states, has resisted enacting the policy.

“The governor, unlike some other Republican governors hasn’t rejected it out of hand,” he said, noting that one or two states per year have opted into the policy.

“Hopefully this will, sort of, grease the wheels a little bit, overcome some opposition, because it’s such a good deal for states,” he said. “It was already a good deal. But this is an unequivocably great deal for states.”

“Medicaid expansion is extremely popular in North Carolina. And we’ve seen other red states pass it and pass it through referendum, we know people understand it, and why it’s important,” Cooper told Politico.

Extra coverage for new moms

Also included in the American Rescue Plan is an incentive targeted at helping address issues of maternal mortality in the U.S. About 700 women die after giving birth annually in this country, and the maternal death rate in the U.S. easily dwarfs the rate in other developed countries.

graph showing other countries represented by blue bars. The U.S. bar, represented in orange, doubles the rate of the next highest country
Other developed countries do a much better job at keeping new mothers healthy throughout pregnancy and beyond birth.
Data: OECD Health Data 2020, showing data for 2018 except 2017 for Switzerland and the UK; 2016 for New Zealand; 2012 for France.
Graph courtesy: The Commonwealth Fund

A paper prepared by the Commonwealth Fund last fall details how only fewer than half of maternal deaths happen during pregnancy or on the day a woman gives birth.

“The vast majority of pregnancy-related deaths occur after delivery,” said Mara Youdelman, an attorney with the National Health Law Program. “While about 21 percent [of deaths] occur between one and six weeks postpartum, 12 percent occur after that time.”

In North Carolina, the maternal mortality rate is around 27 women per 100,000 live births, according to America’s Health Rankings. For Black women, that number jumps to an eye-popping 56.8 per 100,000.

Federal rules currently allow states to use Medicaid to cover pregnant women up to birth and for 60 days afterward. That’s what North Carolina does, providing the benefit for women earning up to about twice the national poverty level, an annual income of $25,760 for a single woman.

In states that have expanded Medicaid already, women don’t need to be pregnant to get coverage, and so can continue with extended postpartum care.

“In Medicaid non-expansion states, like North Carolina, after the postpartum period, the person could lose Medicaid and may not understand that they could go to the marketplace and get coverage,” Youdelman explained.

But the COVID relief bill allows for states to extend that time period for up to a year, starting in April 2022.

This new ability to cover for the entire first year after pregnancy could go a long way to reducing complications that can lead to death in new mothers, Youdelman said.

Richard, the state Medicaid head, said he heard support for this kind of move during the governor’s health care council meetings this winter.

“I think that one probably has broad support across, you know, both Republican and Democrat legislators,” he said. “Certainly, we believe that’s absolutely an appropriate change in Medicaid to go forward.”

Richard said he’s cautiously optimistic that North Carolina will take advantage of this provision in the federal bill. He said that during the health care council meetings getting more coverage for postpartum women was one of the places for consensus.

The catch in the ARP is that this extended pregnancy benefit would expire after five years.

By then“a couple years of data will show that maybe it’s chipping away at the maternal mortality issue,” Youdelman said. “Then states will be induced to say, ‘Hey, it doesn’t cost too much, because most of these women are relatively healthy.’”

shows a man with a mask on rolling up his sleeve and receiving a COVID vaccine in his left arm as he looks ahead.

Coronavirus Today – March 9 – More than 1.1 million vaccinated with hugs on horizon; NC works on equitable distribution

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Coronavirus Today – March 9 – More than 1.1 million vaccinated with hugs on horizon; NC works on equitable distribution - North Carolina Health News

With nearly 10 percent of the NC population vaccinated, Gov. Roy Cooper offers cautious optimism.

By Anne Blythe

“Fast and fair.”

That’s how Gov. Roy Cooper describes the state’s mission to get coronavirus vaccines into as many arms across the state as possible.

In a state with more than 10.5 million people, nearly 1.1 million of them have been fully inoculated against the now not-so-novel coronavirus that upended so much of 2020 and continues to pose challenges and risks in 2021.

“This is a huge milestone,” Cooper told reporters at a briefing Tuesday afternoon. “This puts us even closer to a time when we can hug our loved ones and gather without fear of severe illness.”

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The Centers for Disease Control and Prevention issued new guidance this week for vaccinated people, giving a go-ahead for the fully vaccinated to visit others who also are fully vaccinated without masking or distancing themselves as they have had to do for nearly a year.

The CDC even opened the door for fully vaccinated people to visit indoors with children, grandchildren and others in a different household if those still not inoculated are at low risk for serious illness from the virus. The agency still discourages any gatherings larger than those small one- and two- household events.

Since the arrival of vaccines from Pfizer, Moderna and Johnson & Johnson over the past three months, many in North Carolina are beginning to think about times ahead when children will be in school five days a week, families can gather for holidays, and some of the more valued aspects of pre-pandemic life return.

Many school districts have brought students back for in-person instruction, a measure that Cooper, state lawmakers and education leaders have pushed for nearly a month.

“With children back in school and vaccine distribution well on the way, there are more signs of hope that we are making progress toward putting this pandemic behind us,” Cooper said.

shows a woman in a black dress and a facemask receiving an injection of COVID vaccine in her right arm as she stares straight ahead.
Department of Health and Human Services Secretary Mandy Cohen received her COVID-19 vaccine at the Wake County Health Dept’s vaccination clinic last week at PNC Arena. Rev. William Barber also received a vaccine that day during a widely publicized event. Photo courtesy: NC DHHS

North Carolina, with a total 875,905 lab-confirmed cases, reported only 997 new cases on Tuesday, a large drop from the highs shortly after the Christmas and New Year’s holidays when nearly 11,000 new cases were reported in a day.

The percentage of tests coming back positive hovers at the 5 percent rate now, a level that public health officials say they can accept. The number of people hospitalized on Wednesday was 1,147, nearly a third of the cases of severe illness that filled hospital beds in January and parts of February, and about the same as the number in the hospital in October.

Cooper, who has taken a more cautious approach than many southern governors steering the state through the pandemic, counseled North Carolinians to stay the course, using masks where needed, keeping gatherings small and following the social distancing measures touted by public health officials.

A sports fan and former high school athlete, he used a football analogy to remind North Carolinians that while the other side of the pandemic might seem close, that milestone hasn’t been reached yet.

“You know there are times in football when the runner nears the goal line and begins celebrating too early and is stripped of the football,” Cooper said. “Let’s not get caught celebrating too early.”

Praise for vaccine data collection

Cooper has celebrated the national attention that North Carolina has received recently for providing racial and ethnic data for nearly 100 percent of the people vaccinated for the coronavirus.

Bloomberg News has pointed that accomplishment out in its nationwide vaccine tracker. The kudos come after state lawmakers, mostly Republicans, criticized Cohen and Cooper in early January for a slow vaccine rollout as county health departments and other providers complained about how cumbersome it was to enter information into the state database created to track the vaccine distribution.

On Tuesday, the state Department of Health and Human Services announced that its vaccine data dashboard would be expanded to include even more data with week-by-week county-level data on the race, ethnicity, gender and age of those vaccinated.

The dashboard also will break down the information so users can see the percent of the population fully vaccinated or partially vaccinated.

There are some limitations. The data by demographics does not include information on doses administered through federal programs.

Hugs ahead

Cooper and Mandy Cohen, DHHS secretary, received vaccines last week.

Cooper received a first dose of the Pfizer vaccine at WakeMed and Cohen received a Johnson & Johnson one-dose vaccine at the Wake County health department’s vaccination clinic at PNC Arena.

“My arm was sore and I did feel a little achy that evening,” Cohen said. “But the reaction was mild and it didn’t last long.”

Cohen will be fully protected from COVID-19 after two full weeks, she said.

“It’s a great feeling of relief,” Cohen added. “One and done.”

Cohen, who has spoken about having to miss Thanksgiving and other annual events with her family, said she looks forward to embracing her loved ones again.

“I’m looking forward to hugging my parents for the first time in more than a year,” Cohen said. “They are now fully vaccinated and will be visiting at the end of the month.”

Nonetheless, vaccinated people should still wear masks in grocery stores and around others not yet vaccinated, Cohen said.

More work needed to vaccinate Hispanic North Carolinians

Although North Carolina has received accolades for its collection of demographics on vaccine administration, both Cooper and Cohen acknowledged that works need to be done for more equitable distribution.

Black North Carolinians make up 23 percent of the population but represent only 16.2 percent of the people vaccinated, the DHHS dashboard shows.

Though Hispanic people make up nearly 10 percent of the population, only 3 percent have been vaccinated, according to the DHHS dashboard.

“It’s important to point out that you can’t know about a problem until you can see it,” Cooper said, crediting DHHS and Cohen’s team for building a vaccine database that collects race, ethnicity and more for each shot administered.

The state has been working with churches, community leaders and the federal government to set up vaccine clinics, including a Federal Emergency Management Agency clinic that opens in Greensboro on Wednesday and will get a visit from the governor.

“There has been strong, intentional effort,” Cooper said. “That number needs to get better.”

Who will decide about schools?

Before Cooper’s briefing with reporters, Sen. Phil Berger, a Rockingham County Republican and president pro tempore of the state senate, and Sen. Deena Ballard, a Watauga County Republican, held a briefing with reporters to give an update on negotiations over Senate Bill 37.

The bill is an attempt by mostly Republican lawmakers to force school districts across the state to open their doors for in-person instruction as long as there are online options for at-risk students.

Cooper vetoed the bill on Feb. 26, issuing the following statement: “Students learn best in the classroom and I have strongly urged all schools to open safely to in-person instruction and the vast majority of local school systems have done just that.

“However, Senate Bill 37 falls short in two critical areas. First, it allows students in middle and high school to go back into the classroom in violation of NC Department of Health and Human Services and CDC health guidelines. Second, it hinders local and state officials from protecting students and teachers during an emergency. As I have informed the Legislature, I would sign the bill if these two problems are fixed.”

Three days later, the state Senate failed to get the supermajority necessary to override Cooper’s veto. Democrat Ben Clark, a state senator representing Hoke and Cumberland counties, had been a sponsor of the bill but was absent for the override vote, leaving 29 votes supporting override with 20 against.

After the failed override, Cooper issued another statement.

“The question on SB 37 that I vetoed is not whether our children should be in the classroom in person,” Cooper said. “They absolutely should. The question is whether we do it safely.

“The bill allows middle and high school students to be in school without following NCDHHS and CDC guidelines on social distancing. SB 37 also removes authority from state and local officials to put students in remote learning in an emergency like a new COVID variant hitting our schools. I have asked legislative leaders to compromise with me on these two issues but so far they have not. I will continue talking with legislators and I will work diligently with the State Board of Education and the Superintendent of Public Instruction to make sure all of our children and educators are in the classroom, in person and safe.”

Berger said Tuesday he thought a compromise could be close, but neither Ballard nor Cooper offered details about where there was common ground and what issues had yet to be resolved.

Cooper told reporters later that afternoon that he had not seen legislation that would envelop a compromise, but he acknowledged that he had been negotiating with Berger and others.

Coronavirus by the numbers

According to NCDHHS data, as of Tuesday afternoon:

  • 11,552 people total in North Carolina have died of coronavirus.
  • 875,903 have been diagnosed with the disease. Of those, 1,147 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with COVID-19 infections 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.
  • 837,824 people who had COVID-19 are presumed to have recovered. This weekly estimate does not denote how many of the diagnosed cases in the state are still infectious. Nor does it reflect the number of so-called “long-haul” survivors of coronavirus who continue to feel the effects of the disease beyond the defined “recovery” period.
  • To date, 10,581,557 tests have been completed in North Carolina. As of July 7, all labs in the state are required to report both their positive and negative test results to the lab, so that figure includes all of the coronavirus tests performed in the state.
  • People ages 25-49 make up the largest group of cases (39 percent). While 15 percent of the positive diagnoses were in people ages 65 and older, seniors make up 83 percent of coronavirus deaths in the state.
  • 485 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
  • As of Thursday, 300 COVID-19 patients were in intensive care units across the state.
  • As of March 8, 2,938,543 North Carolinians have received at least one dose of the coronavirus vaccine. At this point, 17.4 percent of North Carolinians have had at least one shot, and 10.6 percent of adults in the state have received both vaccinations.
A Graham polling center in Alamance County. Photo credit: Hannah Critchfield

In an election with unprecedented turnout, health care issues loom large, but can’t overcome economic concerns

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In an election with unprecedented turnout, health care issues loom large, but can’t overcome economic concerns - North Carolina Health News

Voters split their tickets on Tuesday, retaining Democratic Gov. Roy Cooper, while the presidential contest remains too close to call, with more than 100,000 absentee ballots still outstanding.

By Anne Blythe, Hannah Critchfield and Rose Hoban

Ballots in North Carolina did not list Medicaid expansion, the Affordable Care Act, the coronavirus pandemic response or the economy as something registered voters could mark as for or against.

In the outcome of the 2020 elections, it appears that North Carolina voters were willing to have Democratic Gov. Roy Cooper continue to lead the state response to the COVID-19 crisis while giving more seats to Republicans to lead on fiscal policy in the legislature.

“Voters made a clear choice in support of the Republican platform of low taxes, expanded school choice, and large investments in education and teacher pay,” said Senate leader Phil Berger (R-Eden) in a statement released late last night. “The Senate Republican majority will continue to deliver on those promises.”

North Carolina saw an unprecedented number of registered voters cast their ballots early, either in person or by mail with absentee ballots.

As a result, many polling places across North Carolina were filled with more poll workers and observers than voters at times during the day.

In Vance County, turnout was light at several polling sites in Henderson, where party partisans said they were seeing only 10 or 20 people an hour. Many folks at Perry Memorial Library walked out of the polling place with a print out of the correct precinct for their votes. A Democratic party observer who declined to give his name said that by mid-afternoon about 30 people had been redirected to other polling sites.

Some voters said that health care wasn’t really at the top of mind as they walked into their voting places, but for those who were thinking about the issue, it loomed large.

Ashley Boone-Roach perked up when asked about health care.

“Sometimes when I hear  ‘Affordable Care Act,’ I just want to cry, because it saved my life, having it,” she said.

Standing in front of her polling place at the Richard Thornton Library in Oxford, Boone-Roach told of being a 26-year-old who had just gotten off of her parents’ insurance policy when she discovered she had blood clots. Then, when she got married, she wasn’t able to get insured through her husband’s policy because of her pre-existing conditions. Because of the ACA, she was able to get covered.

Now that she has a job and has health insurance through her employer, she said she hasn’t been held back because of that pre-existing condition.

“I’m a living witness, I wish I could write to the founders of that piece, and say, ‘It saved my life, I wouldn’t be alive today.’”

Chatham County sees high turnout

By the time Election Day got here, Chatham County already had seen 75 percent of its registered voters vote early or cast absentee ballots — the highest percentage in the state.

Man and woman at a campaign site wearing red Make America Great Again hats
Toby and Maggie Considine, Bynum residents, outside a Chatham County voting site. Photo credit: Anne Blythe

In Chatham County, Maggie Considine and her husband Toby Considine stood outside a voting site in Pittsboro wearing red Make America Great Again caps and face masks.

He voted Tuesday morning because he likes the excitement of casting a ballot on Election Day. She voted early. The Bynum couple was on the same page, though, when it comes to who they think should lead the country for the next four years.

Maggie, a realtor, said Trump represents “prosperity, freedom, hope.” “The Democrats seem to be selling recession, repression and fear,” she added.

Toby touted the pre-pandemic economy when asked why he wanted four more years. At 62, he downplayed the pandemic, and pointed to his stomach as his biggest COVID-19 problem, hinting at a weight gain he hoped to soon shed.

Maggie said she thought the president’s response to the pandemic “could have been better.” “I don’t think anybody else could have done better,” she added. “His job is to be a cheerleader.”

Pandemic response spurs votes

In the same parking lot, Ana Carlson-King, a 37 year old who lives in northern Chatham County, gathered with other Democrats handing out information about their recommended candidates.

Woman wearing a dark-colored face mask and hat
Ana Carlson-King, a Chatham County resident, outside a voting site on Election Day. Photo credit: Anne Blythe

The 2020 election, to her, is about access to health care, the disparities she’s seen for the Special Olympics swimmers she coaches in Orange County, especially those who live in group homes, the Republican resistance to expanding Medicaid and her concern about the repeated attempts to overturn the Affordable Care Act.

“To me, it’s coming down to the pandemic and it’s coming down to health,” Carlson-King said, voicing her support for Democrats.

Johnny Shaw, a 69-year-old retired educator who lives in southern Chatham, was outside the same Pittsboro voting site, handing out candidate recommendations for Democrats.

He’s flummoxed, he said, by Republicans’ unwillingness to expand Medicaid and had heard no reason from state legislators who refuse to take federal funds for a program that could help expand health services.

“It’s just sort of a party thing,” Shaw said. “It’s just, ‘We’re going to show you we’re not going to expand.’”

As a former teacher and school administrator, Shaw also said it is time to expand broadband, especially in a pandemic when so many schools have moved to online teaching to keep students, teachers and staff safe from COVID-19. He was critical of Republicans for the access issues plaguing many.

Man wearing a blue vest, face mask and ball cap stands under a blue tarp
Johnny Shaw, a Chatham County resident, discusses the 2020 election. Photo credit: Anne Blythe

The fight for state House and Senate

How the vote comes down for state legislative races will be crucial in determining whether access to care in North Carolina is expanded.

Since 2013, Republicans have had control of the General Assembly, initially with a supermajority and a simple majority since 2018. Party leaders have staunchly resisted expanding Medicaid to some half-million low-income workers, a policy made possible because of the Affordable Care Act.

Democrats were hoping to pick up more seats in the chambers, to break that logjam. Instead, the party lost at least four seats in the House and several in the Senate. Many races remain too close to call with as many as 136,000 absentee ballots unaccounted for.

Erica Palmer Smith leads Care4Carolina, a coalition that’s been pushing for expansion for years. She said she hoped the legislature would make it “a number one priority” going into 2021, that more than 500,000 North Carolinians gain access to affordable, quality health insurance.

Palmer Smith said she thought there could be a “solid chance” that something similar to earlier bills, which have included employment requirements or screening requirements for recipients, would be likely.

She noted that Care4Carolina’s polling has shown strong support for expansion among voters.

“A whopping 75 percent of North Carolinians in a statewide poll conducted in August ringingly declared that they want to close NC’s health care gap,” she said in an email to NC Health News.

Some voters echoed that support.

“I just need for that Medicare, Medicaid to be a little bit better than what it is now,” said Henderson resident Roselyn Fields. “You know, younger folks can’t get Medicare or Medicaid. So it’s kind of hard with people who got heart problems like me.

“That’s the only reason why I’m voting.”

But getting the legislation passed may be a heavy lift especially as Democrats have lost seats, and with it, leverage.

shows a Black woman in a mask worn against COVID standing in front of a polling station
Henderson resident Roselyn Fields came to the Perry Memorial Library in town to cast her ballot on Tuesday. She said that she has a heart problem so health care is a big part of her decision making when she thinks about voting. “I need for the Medicaid to be better than what it is,” she said. “It’s kind of heard when people who got heart problems like me… I think that’s the only reason I’m voting.” Photo credit: Rose Hoban

In the House, many of the Republican champions of the policy have moved on. Representatives such as Josh Dobson (R-Nebo), who co-authored Republican bills to expand, won’t be returning. He ran for state labor commissioner, a race he appears to have won.

Another expansion proponent, former state Rep. Greg Murphy (R-Greenville), has moved onto Congress, where he was reelected, and other Republicans, such as Rep. Craig Horn (R-Weddington), who publicly supported the policy, recently retired.

Resistance to Medicaid expansion has been fiercest in the Senate, where Berger has made it clear for the past few years that he’s against the policy and no such bill would have a chance in his chamber.

Palmer Smith said it’s been difficult to have conversations with leaders in the majority for the past several months leading up to the election.

“But a lot of the private conversations we’re having, legislators recognize that this is an issue and I think that we’ll see enough… to show that this is a major issue for voters,” she said.

Race, health intersect

In Alamance County, Miguel Tatum, age 36, and his son, a first-time voter, cast their ballots at the Graham Civic Center in Graham on Tuesday.

“This pandemic showed that health care really is important,” said Tatum. “A lot of black and brown people are dying. It’s important to get people in that really care.”

Miguel Tatum, 36, and his son, a first-time voter, cast their ballots in Alamance County today. Photo credit: Hannah Critchfield

Dreama Caldwell, who is both a voter and a candidate for county commissioner, said she voted to improve local responses to the pandemic.

“I’m a formerly criminal justice-involved individual, and that particular part of the population needs a voice,” said Caldwell. “Our Sheriff, Terry Johnson, has not enforced masks. So him and his law officers have not worn masks, and as a result the jail had 120-plus cases of COVID. It was only after that outbreak, in my understanding, that inmates were given masks. We’re a very reactive county, we’re not a proactive county.”

Caldwell finished last in a field of six.

Frontline workers explain their votes

Veretta Hatley, a 48-year-old Carrboro resident who works at the Croasdaile retirement community in Durham, cast her ballot in person after work on Tuesday at Carrboro Town Hall for Democrats.

Hatley, a Black woman wearing a pink Black Lives Matter face mask, said health care and what happens if the ACA is gone were on her mind when she voted.

Woman wearing a pink Black Lives Matter face mask outside a building
Veretta Hatley, a Carrboro resident who works at a Durham retirement community, outside a voting site. Photo credit: Anne Blythe

“Personally, my mother battled cancer last year, and I don’t want her not to continue with her care because she has pre-existing conditions,” Hatley said, mentioning others in her family who might be more reluctant or unable to afford care if they lost their insurance.

She also supports Medicaid expansion as someone who could benefit from it.

As an essential frontline worker, she praised Gov. Roy Cooper’s handling of the pandemic.

“I love him,” Hatley said. “He got a lot of criticism for not opening up some things as fast. They were saying, ‘Why don’t you open this? What about this?’ But I’m saying, ‘People are dying. I’m out here on the front line. I see it.’”

A certified nursing assistant from Oxford who only gave her name as Mary who worried about her older patients.

“I know if they take their Medicaid and Medicare away, they won’t be able to survive,” she said.  “That’s not fair to any American of this United States, Black, white, Hispanic part of this United States. They have helped make the United States great, they deserve their benefits with the work that they put in.”

a small blonde girl in a t-shirt puts on a mask while a dark-haired woman stands by ready to help

Coronavirus Today – Sep. 17 – K-5 schools can open fully; Will ACC football team parents get stadium seats?; Contact tracing on college football teams

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Coronavirus Today – Sep. 17 – K-5 schools can open fully; Will ACC football team parents get stadium seats?; Contact tracing on college football teams - North Carolina Health News

Gov. Roy Cooper adds another learning option for elementary school children as NC COVID-19 trends and metrics improve.

By Anne Blythe

For all those parents of elementary school children in North Carolina struggling with remote learning and wondering when schools can open fully for in-person classes despite the coronavirus pandemic, the governor had an answer on Thursday.

Gov. Roy Cooper announced that on Oct. 5, public school districts and charter schools may choose to open under Plan A allowing instruction for kindergarteners through fifth graders inside full-capacity classrooms. The final decision remains up to each district to figure out what is best for the children, teachers and school staff in their areas.

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“I want to be clear,” Cooper told reporters at an afternoon briefing. “Plan A may not be right at this time for many school districts and for every family. Opportunities for remote learning need to be available for families who choose it. Districts will have the flexibility to select a plan based on their unique situation. We are able to open this option because most North Carolinians have doubled down on our safety and prevention measures and stabilized our numbers.”

Mandy Cohen, secretary of the state Department of Health and Human Services, presented an update on North Carolina’s metrics and trends. The number of people visiting emergency departments with COVID-19 symptoms has declined in recent weeks, though the visit numbers are still higher than Cohen would like to see.

The number of COVID-19 cases has been trending downward since a spike in August related to college campus openings, but Cohen would like to see daily new case counts drop below 1,000 per day, which has been the hovering rate lately.

 

The positivity rate has dropped into the 5-percent range, but she wants to make sure that’s a stable metric that continues through the coming weeks.

“Most North Carolinians are doing the hard work to improve our numbers and trends,” Cooper said. “Many people are wearing masks, keeping social distance and being careful to protect others as well as themselves. We have shown that listening to the science works.

“I’m proud of our resolve.”

Both Cooper and Cohen stressed that even under Option A, with full classrooms in the lower grades, face masks will be required, temperature checks will be employed, deep cleaning and sanitization is necessary, and social distancing requirements will be employed.

‘Not an opinion’

They said research has shown that children are at lower risk for serious illness from the virus and also less likely to spread it to adults.

When weighing that with the benefits of in-person learning, particularly as many teachers, parents and younger children struggle to make the remote-learning option a meaningful education experience, Cohen and Cooper said they thought North Carolina was ready to offer Option A.

Cohen stressed the importance that face masks will play in fully opening elementary schools. Everyone in the buildings will be required to wear masks.

“This is a science- and research-based decision, not an opinion,” Cohen said. “That’s why the American Academy of Pediatrics, an organization of 60,000 pediatricians, recommends masks for all children two and up. I’m proud that so many North Carolinians are following this medical guidance.”

Even with all the safety precautions, Cohen acknowledged that the risk of COVID-19 spread in the schools cannot be fully eliminated.

Families also will have to consider their own health risks when weighing whether to send children back to school. If someone in the household is at high risk for severe illness from COVID-19, remote learning might be a better fit.

“Regardless of the option a school district chooses, every family should have the option of remote learning,” Cohen said. “It’s up to us to protect our progress.”

Republicans respond

Cooper’s announcement came the day after Sen. Phil Berger, a Rockingham County Republican, Lt. Gov. Dan Forest, the Republican campaigning against Cooper in the governor’s race, and Catherine Truitt, a Republican running to be the state Superintendent of Public Instruction, held a briefing with reporters.

This summer, when COVID-19 cases were at a high in North Carolina, Cooper told school districts they could open for remote-learning only under Option C or through Option B, providing a mix of remote learning and in-person classes with reduced class sizes.

Many districts across the state chose to start the school year in August with remote-learning only.

Some districts such as Charlotte-Mecklenburg Schools have already decided to move toward a phased approach that brings students with disabilities and special needs back first. Pre-kindergarteners will come in the next phase with elementary school children following several weeks later and middle schoolers on Nov. 23.

High school students will return for End-of-Course exams in mid-December, but not start in-person classes until the first week of January.

Cooper said he and his public health team had been working closely on shaping their plans with Mark Johnson, the Republican who currently is the state superintendent, and state Board of Education chairman Eric Davis.

Forest, who has been holding campaign events without requiring attendees to wear masks, even when they are inside, gained headlines on Wednesday when he said he would not mandate masks in school.

“I don’t think there’s any science that backs that up,” Forest said, according to the Associated Press. “That’s my personal opinion.”

 

Cooper did not mention Forest by name when he responded to a question about those remarks.

Instead, he listed off the names of doctors and public health officials — Robert Redfield, head of the Centers for Disease Control and Prevention, Deborah Birx, the White House Coronavirus Task Force response coordinator, and Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases — all of whom have touted the efficacy of the face mask.

Challenging elected leaders discouraging mask use

“When elected leaders and people in important policy positions discourage the use of masks then that becomes part of the problem,” Cooper said. “Because what you do is increase community spread when fewer people wear masks, particularly at larger gatherings. Therefore you make it harder for us to get our children safely in school. You make it harder for us to be able to ease restrictions and to get our economy going full speed again and you make it harder to slow the spread of the virus.”

Berger posted a response to Berger Press Shop on Medium after the Cooper announcement, offering more criticism and some praise calling the governor’s action “a step in the right direction.”

“His new plan ignores the needs of low-income and exceptional students in middle and high schools for in-person instruction,” Berger said in a statement. “We continue to hear that these decisions are being made based on ‘science.’ What is the science that says it’s safe for 5th graders to be in school full time, but it’s not safe for 6th graders?”

Berger also questioned why Cooper left decisions up to individual school districts to decide what is best for their area.

“It’s puzzling to me how the Governor can insist that only he can make decisions about smaller issues like playground openings, but then pass off political responsibility for something as important as schools,” Berger continued. “That’s not leadership — it’s avoiding the tough calls in an election year.”

ACC players’ parents push for stadium access

On the same day that UNC-Charlotte 49ers informed the UNC-Chapel Hill Tar Heels that they would have to cancel Saturday’s football game because of COVID-19 cases on their team, parents of N.C. State Wolfpack players petitioned the governor on a different matter.

John Ruocchio, a Raleigh lawyer, parent of a player and a former N.C. Republican Party treasurer, led seven other Wolfpack team member parents to the state Department of Administration, where the governor’s office is, and hand-delivered a petition.

They want to know why the governor’s executive order limiting outdoor crowds to 50 people can’t be amended to allow all players on the team to invite their parents to their games.

Carter-Finley Stadium, where the Wolfpack is scheduled to play its first home game on Saturday, has the capacity to seat 57,500 people. Because of the executive order limiting outdoor crowd sizes, not all of the 110 players on the team get tickets during this season.

N.C. State is making 50 tickets available to seniors on the team, who then under NCAA rules must list who will use them. Ruochhio’s son is a senior tight end on the special teams and has invited his father to be one of the few parents present in Carter Finley Stadium on Saturday.

“I’ll be there,” Ruocchio said.

The petition, he said, is not about just one parent, though, it’s about trying to open up the experience for others. It’s also about trying to get answers to exactly why the crowd-limit is set at 50 in North Carolina, but a different number in other states.

Since ACC football season started this month, Ruocchio and other parents, as well as athletic directors and leaders of ACC schools in North Carolina, have asked Cooper to reconsider the crowd-size restriction. The Wolfpack parents’ petition asks the governor at least to explain why, inside large outdoor stadiums where social distancing could occur, all 110 members cannot invite their families.

Ruocchio said in a phone interview on Thursday that his push for answers is not political, despite his previous work with the Republican party.

He questioned why hundreds of people can be inside a Walmart or other large store, but not in an outdoor stadium.

“We just want to know why we can’t be there to support our kids,” Ruocchio said.

The state’s top public health leader said Thursday at the briefing with reporters that her public health team is looking at trends in response to the questions from parents and ACC schools.

“We very much recognize that parents want to see their kids play,” Cohen said. “We are looking at that issue as our trends continue to improve and hope to have more on that soon.”

What happened at UNC-Charlotte

Playing a contact sport amid a pandemic in which face masks have been touted as the best tool for limiting the spread of COVID-19 comes with challenges.

UNC-Charlotte announced on Thursday that it had to cancel its scheduled game against the Tar Heels because many members of its offensive line were in quarantine because of the school’s contact tracing protocols.

During the past two weeks, according to a news release from the athletic department, three players had tested positive for COVID-19. Those players are in isolation and receiving medical care, the release states. The other players affected had been notified by contact tracers to quarantine for 14 days.

“We’re extremely disappointed to have to cancel our game at North Carolina. While I know our team is heartbroken, due to the number of players in quarantine, we could not safely play,” Athletic Director Mike Hill said in a statement.

These kinds of issues have cropped up on other campuses.

Wolfpack coach Dave Doeren spoke about the challenges during a briefing with reporters on Monday highlighting the Wake Forest game scheduled for Saturday.

“The biggest challenge in all this has been the contact tracing piece,” Doeren said.

Some things are similar across the ACC campuses.

Practicing and planning for what the team might look like on game day can be difficult if players are waiting for test results to come back for someone they have been around or if they’re in quarantine because of safety protocols.

“There isn’t really a unified way of doing that and I think that’s been the biggest issue where you have, in our case, multiple tests a week for guys who are completely healthy and passing tests but are unable to come work on their skills because somebody that they were around at a certain point in time has symptoms or has a positive test,” Doeren said. “That has been the hardest piece to manage. As you all know, the symptoms for this, there’s many, many symptoms. So a guy can wake up with a stuffy nose and all of a sudden his three roommates can’t come in until that player passes a test. So you can have a position group be completely healthy and not be able to come into the building for a long period of time.”

Coronavirus by the numbers

According to NCDHHS data, as of Thursday afternoon:

  • 3,180 people total in North Carolina have died of coronavirus.
  • 189,576 have been diagnosed with the disease. Of those, 894 are in the hospital. The hospitalization figure is a snapshot of people hospitalized with COVID-19 infections 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.
  • 162,257 people who had COVID-19 are presumed to have recovered. This weekly estimate does not denote how many of the diagnosed cases in the state are still infectious. Nor does it reflect the number of so-called “long-haul” survivors of COVID who continue to feel the effects of the disease beyond the defined “recovery” period.
  • To date, 2,714,175  tests have been completed in North Carolina. As of July 7, all labs in the state are required to report both their positive and negative test results to the lab, so that figure includes all of the COVID-19 tests performed in the state.
  • People ages 25-49 make up the largest group of cases (41 percent). While 13 percent of the positive diagnoses were in people ages 65 and older, seniors make up 80 percent of coronavirus deaths in the state.
  • 332 outbreaks are ongoing in group facilities across the state, including nursing homes and correctional and residential care facilities.
  • There are 3,286 ventilators in hospitals across the state and 970 ventilators in use, not just for coronavirus cases but also for patients with other reasons for being in the hospital.
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