Acccess to Care

• Enhance the community’s capacity to provide primary care to uninsured and underinsured individuals and families
  • North Carolina Medicaid expansion launched December 1, 2023 XX Mecklenburg county residents enrolled through February 28, 2024
  • New primary care access points through 8 county-funded partnerships and health systems for uninsured and underinsured residents
  • Mecklenburg County Public Health launched new Colposcopy Clinic
• Strengthen and sustain expanded access to care partnerships
  • Mecklenburg County provided funding to 8 organizations including federally qualified health centers and charitable clinics expanding access to primary care services
  • Mecklenburg County and access to care partners established a core set of core performance indicators rooted in research to ensure quality and evidence-based best practices
• Strengthen coordination among programs focused on alternative pathways to accessing care (e.g. mobile units, Community Health Workers (CHW), telemedicine, etc.)
  • Mecklenburg County Public Health acquired new Medical (2) and Dental (1) Mobile Health Units; internal infrastructure was established to coordinate deployment logistics and maintenance
  • Community partner MedLink formed a committee to strengthen the coordination of alternative pathways to accessing care
  • Mecklenburg County Public Health expanded two local Community Health Workers (CHW) networks, including the 1) CHW Stakeholder Advisory Collaborative, a convening of organizations that employ and support CHWs; 2) Queen City Community Coalition Connect, a coalition led by local CHWs that aims to unify, equip, and empower CHWs to serve the community
  • CHWs convened for a countywide summit to strengthen coordination and collaboration 
  • Mecklenburg County secured funding to launch a pilot Promotora CHW program in partnership with the Latino Faith Coalition; the program slated to launch in Spring 2024 will expand the promotora workforce to include 10 additional Latino bilingual CHWs  

Pictured Below: Meck Health In Action (MHIA) Mobile Unit

Chronic Disease Prevention

• Implement Making Healthy Choices Easier Chronic Disease Prevention Plan
  • Subawarded CDC REACH grant funds to support tobacco prevention, physical activity, and healthy eating policy, systems, and environmental changes
  • Funded 20 grassroots organizations, nonprofits, and faith-based organizations to implement chronic disease prevention programs via Mecklenburg County Public Health, Health Equity Grant Program
• Increase and improve opportunities for physical activity with a focus on bicycle and pedestrian safety
  • Increased Safe Routes to School (SRS) partnership programs across Mecklenburg County
  • Initiated Health in All Policies(HIAP) Economic Development plan
• Increase and improve healthy food environments and strengthen healthy food access
  • Expanded access to healthy food via mobile markets, food distribution, and healthy corner store initiatives and new infrastructure investments in the Charlotte Mecklenburg Food Policy Council, West Blvd Neighborhood Coalition (Three Sisters Market Co-op), and Carolina Farm Trust Food Distribution Center
  • Expanded access to SNAP Double Bucks and SNAP EBT through 75% of Mecklenburg County Farmers Markets
• Increase and improve the number of tobacco-free environments and prevent youth tobacco use
  • Launched nationally recognized menthol focused education and awareness campaign
  • Promoted QuitlineNC services to residents, health care professionals, and community engagement partners through awareness campaign (quitline data and comparison of baseline, previous fiscal year, to be provided July 2024)

Pictured Below: Mecklenburg County Office of Chronic Disease Policy and Prevention Traffic Garden Demo

Maternal and Child Health

• Implement strategies outlined in the Mecklenburg County Prenatal-to-Three Strategic Plan
  • Began implementation of the Mecklenburg County PN-3 Strategic Plan
  • Local health systems expanded maternity care initiatives
• Support community-based supportive and wrap-around services for pregnant and postpartum women
  • Expanded community-based supportive programs for pregnant/postpartum women, including Nurse-Family Partnership
  • Implemented year two of A Guided Journey perinatal community health worker program
  • First-ever Healthy Start Initiative launched by Care Ring, with MCPH support
• Expand awareness and opportunities for breastfeeding and safe sleep
  • Conducted safe sleep and breastfeeding education campaigns
• Enhance data systems and data integration to ensure inform maternal and child health strategies and monitor impact
• Provide high-quality prenatal and postpartum health care
• Continue efforts to improve coordination among county services that serve women and infants
  • Developed new Community Pregnancy Resource Guide

Pictured Below: A Guided Journey COmmunity Health Workers

Mental Health

• Support implementation of the Mecklenburg County Behavioral Health Strategic Plan
  • Convened stakeholders to develop Behavioral Health Strategic Plan
  • Opened Behavioral Health Urgent Care facility
  • Established and implementing initiatives funded by Opioid Settlement Fund
  • Launched CDC Overdose Data to Action
  • Implemented Year One of SAMSHA ReCAST II to address community resilience and trauma informed capacity

Pictured Below: The Smith Family Behavioral Health Urgent Care

Violence Prevention

• Launch and sustain The Way Forward (TWF) community violence plan implementation coalition
  • Awarded SAMSHA ReCAST II funding to support trauma-informed approach to community violence prevention
  • Fully staffed Mecklenburg County Public Health Office of Violence Prevention serving as coordinating agency for countywide community violence prevention efforts
  • Launched The Way Forward Advisory Group including more than 50 diverse advisors
• Implement multi-media violence prevention (VP) campaigns with community partners
  • Implemented Clean Graffiti Campaign promoting violence prevention message in areas at increased risk of community violence
  • Launched Not Another Media Campaign 
  • Hosted more than 10 gun lock distribution and awareness events in partnership with local grassroots organizations
• Collaborate with local schools to reduce youth violence by implementing the 100 Youth Advisory Council
  • Launched 1oo Youth Advisory Council engaging more than 100 youth advisors in violence prevention work
  • Expanded Charlotte Mecklenburg Schools partnership to launch Handle with Care
• Provide performance-based funding and technical support for community partners to implement evidence-based strategies that reduce violence
  • Established infrastructure for performance based funding to launch Summer 2024
• Provide technical assistance and training to community-based organizations implementing violence prevention initiatives through the Peacekeepers Academy
  • Launched inaugural Peacekeepers Academy Cohort of ten grassroots organizations
• Implement and expand community violence interruption and hospital-based violence intervention initiatives
  • Expanded Alternatives to Violence (ATV) program to two new sites, totaling three community violence interruption sites
  • Expanded Hospital-Based Violence Intervention Program to two local healthcare systems

Pictured below: Peacekeepers Inagural Cohort

Declining immunization Rates

Since 2020, after 10 years of near 95% nationwide coverage, the CDC reports that kindergarten-entry vaccine rates have fallen to 93%. Declining immunization rates leave us vulnerable to outbreaks from diseases of childhood that due to vaccination are no longer frequently seen in this country. Measles, considered eliminated from the United States, is one example. An extremely contagious disease that requires a high coverage rate to maintain herd immunity, measles has caused more cases of disease in the US during the first quarter of 2024 than it did in all of 2023. Most index cases are imported from other countries but may spread to the unvaccinated and immune compromised. Declining vaccine uptake mixed with the ease and speed of international travel creates a situation requiring enhanced surveillance, an increased index of suspicion, and a rapid response to control and prevent further cases.

Congenital Syphilis

Once nearly eliminated in the United States, syphilis and congenital syphilis cases have risen rapidly in nearly every region of the Nation.  Reported congenital syphilis cases more than doubled within a five-year period in Mecklenburg making it a re-emerging public health concern. Rising syphilis cases among women of reproductive age, barriers to receiving high-quality prenatal care and ongoing declines in prevention infrastructure and resources are contributors to this increase.  Strategies to improve outcomes include access to innovative testing and treatment options as well as improved access to quality care during all stages of pregnancy.

Tension between Data Privacy and the Data-Driven Health Department

While there is a move toward and a demand for decisions made based on data in the Public Health arena, there is at the same time a cry for protecting individual privacy. Technology has made available more opportunities for understanding data at a small geographic level, but data privacy protection may oppose the release of such information. Attention must be paid by parties on all sides to intentionally developing guidelines that allow for sharing and using data to better inform community health concerns without compromising individual privacy.

A new organizing framework, Live Well Meck, was established to support the network of partners supporting the CHA, CHIP, and SOTCH implementation. The framework includes four core principles:

• Vision: Live Well is not only the brand used to communicate the local CHA, but a vision for a Healthy Mecklenburg County. It aligns the efforts of individuals, organizations, and government to help all Mecklenburg County residents live healthy lives.
• Priorities: Core areas of focus as identified through CHA primary and secondary data analysis and community input.
• MECKtrics: MECKtrics are core population health indicators used to assess the health status of Mecklenburg County. Each MECKtrick includes an established baseline, trend data, and goals associated with Community Health Assessment (CHA) priority areas of focus. MECKtrics are monitored and reported on annually via the State of the County Health (SOTCH) report to determine progress towards identified goals
• Community/Partners: Includes a network of county partners committed to implementing related CHIP strategies.

Additional New Initiatives 

• Health Equity Grants: The Mecklenburg County Health Equity Grants program provides grassroots, community, and faith-based organizations with funding, capacity-building resources, and technical support to implement programs or initiatives aligned with identified CHIP strategies.

• Community Health Worker Initiative: The CHWI envisions a sustainable infrastructure that supports and values CHWs in Mecklenburg County. It works internally and externally to support CHW programming by 1)Leading and Coordinating Collaborative Groups; 2) Facilitating and Coordinating Trainings and Technical Assistance; 3) Participating in Policy Development and System Change Management; 4)Implementing and Directing Programs and Strategies using the CHW Model.

• A Guided Journey: A Guided Journey is a Mecklenburg County Public Health maternal child health program delivered through a partnership with CareRing which aims to support pregnant women and women at least three months postpartum with linkage to care via NCCARE360 with support from Community Health Workers.

• ReCAST Cycle II: Resiliency in Communities After Stress and Trauma (ReCAST) is a grant-funded program through Mecklenburg County Public Health, running from December 2022 to December 2026. The program, which is currently in Cycle II, is funded by the Substance Abuse and Mental Health Services Administration (SAMHSA). The ReCAST II mission is to support community resilience by fostering evidence-based trauma-informed practices such as educational opportunities for the community, improving access to high-quality mental health services, and supporting efforts to curb community violence. The vision is to create a safer and more supportive environment for youth and families in Mecklenburg County.

• Overdose Data to Action: Overdose Data to Action is a Centers for Disease Control (CDC) funded program supporting Mecklenburg County in implementing prevention activities and collecting accurate, comprehensive, and timely data on nonfatal and fatal overdoses and in using those data to enhance programmatic and surveillance efforts.

• Peacekeepers Academy: Peacekeepers Academy is an interactive, eight-session learning series designed to build resiliency for community-based organizations working to address community violence in Mecklenburg County. Participant organizations receive 1) Education/technical assistance from experts focused on violence prevention; 2) Best practices on organizational efficiency; 3) Lessons on how to measure and track success; 4) Lessons on how to increase scalability of services; 5) Holistic public health approaches to prevent and interrupt the cycle of violence; 6) Financial grant to support efforts to learn, implement and achieve resiliency which may include dedicated computers to track an organization’s work

• Prenatal to Three Strategic Plan (PN3): The Mecklenburg County Manager’s Office assembled an Early Childhood Executive Committee to develop a strategic plan to identify policy recommendations to improve the trajectory of child and family wellbeing in the earliest years. Policy priority areas include 1)Healthy and Equitable Births; 2) Optimal Child Health and Development; 3) Parental Health and Emotional Wellbeing. A newly created Senior Public Health Manager was hired to led public health strategies associated with the plan.