Structure of the NC SHIP Community Council

The NC SHIP Community Council provides oversight on policy initiatives for the 21 HNC 2030 indicators throughout the decade (2020-2030):  

• Convenes annually in July
• Comprised of 18 working groups (two clusters of similar HNC 2030 indicators and 16 stand-alone indicators)
• Each working group has a minimum of three co-leads
• Co-leads must include at least one DHHS representative, one or more community advocates, and one or more partnering agency, institution, or non-DHHS representatives
• All designated co-leads constitute the NC SHIP Community Council

Calendar of Events

• May 2022: NC DHHS designated co-leads leads for each indicator  
• June 7, 2022: DHHS co-leads review the proposed policy initiatives in the 2022 NC SHIP in preparation for the annual NC SHIP Community Council meeting
• July 2022:  NC SHIP Community Council Program Manager hired
• July 19, 2022: Inaugural Meeting of the NC SHIP Community Council

The  2022 NC SHIP Community Council met July 19, 2022 to 

• Complete recruitment and engagement of NC SHIP Community Council members
• Review proposed policy intiatives 
• Schedule work group meetings for 2022-2023
• Discuss/recruit additional work group members to assist with strategic planning

2022-2023 COMMUNITY COUNCIL STRUCTURE

Strategic planning for prioritized policies is tracked in the NC SHIP Scorecard by the NC SHIP Community Council Program Manager.

HNC 2030 Priorities

HNC2030 Priorities

Healthy North Carolina (HNC 2030) provides the foundation for the NC State Health Improvement Plan.  Using the Robert Wood Johnson-County Health Ranking's Population Health Framework,  planners apportioned the number and type of indicators used in the model. 

The quality of our life and how long we live is dependent upon four types of factors: 

• Health Behaviors (about 40%),
• Clinical Care (about 20%),
• Physical Envionment (about 10%), and
• Social and Economic factors (about 40%).

HNC 2030 addresses 21 wicked problems based upon the above allocation:

• 6 Indicators for Health Behaviors
• 4 Indicators for Clinicare Care
• 3 Indicators for Physical Environment
• 6 Indicators for Social and Economic 
• 2 Overarching Indicators

This Scorecard tracks policy initiatives specific to the 21 headline indicators highlighted in HNC 2030 and the NC State Health Improvement Plan.

Healthy People 2030 Priorities

Healthy People 2030 is our nation's plan that focuses on eight global outcome measures that impact overall health and well-being. In addition to the global measures, there are 355 core objectives that have 10 year targets.

Healthy North Carolina 2030 tracks 21 indicators with 10 year targets. NC's 21 indicators are aligned with Healthy People 2030, with two exceptions that were of specific interest to North Carolinians (Sugar-Sweetened Beverage Consumption and Short-term School Suspensions),

Read more at: https://health.gov/healthypeople 

2022-2023 Meeting Schedule

2022-2023 NC STATE HEALTH IMPROVEMENT PLAN COMMUNITY COUNCIL MEETING SCHEDULE

There are 18 work groups across the 21 indicators. Meeting schedules are included below by work group and were updated on March 2, 2023 (*indicates pending confirmation).

Public participation is welcome. For more information on how to attend the virtual meetings, please email Ashley Rink at ashley.rink@dhhs.nc.gov or HNC2030@dhhs.nc.gov.

Policy/Program Status

THE POLICY/PROGRAM ADVOCACY CYCLE

• The NC SHIP Policy/Program Scorecard monitors the status of state-level policies/ programs proposed by the NC SHIP Community Council and its partners to improve the quality of life for North Carolinians.   
• The dashboard is updated semi-annually to reflect the status of the proposed policy as it moves along the continuum from proposed to full adoption and evaluation. 
• Each policy/program is tracked numerically according to defining criteria for each stage of development.  The five stages are: 1) Proposed, 2) Designed, 3) Adopted, 4) Implemented, and 5) Evaluated.
• The monitoring period is January 2021 through December 2029.
• The status value is found in the note field under each policy/program

1 - Proposed

Proposed policies/programs developed in a two-year process (2020-2022) are identified.  The NC SHIP Community Council prioritize which policies/programs receive the most attention.  Working with stakeholders, community members, and established advocacy groups, the NC SHIP Community Council defines the scope of work annually in July.

2 - Designed

At this stage, strategic planning occurs for each of the prioritized policies/programs. Lead organizations are identified, and an action plan is developed for the next 12 months.  Activities include setting objectives, identifying the cost and estimating the effect of solutions, choosing from a list of solutions and proposing precise language of policies or details of a program. 

3 - Adopted

Once a policy/program has been fully designed, the NC SHIP Community Council advances to adoption.  In adoption, the program/policy has support. It can involve one or a combination of: legislative approval, executive approval, seeking consent through consultation with interest groups, and referenda. 

 4 - Implemented

Policies/programs are implemented when an institution, organization, government agency, or legislative body takes responsibility for implementation. The organization demonstrates that it has the resources the resources (such as staffing, money and legal authority) to do so, and makes sure that policy/program decisions are carried out as planned.

5 - Evaluated.

During the last stage of policy advocacy, the effect of policy/program is evaluated. This includes assessing the extent to which the policy/program was successful, if the policy decision was the correct one; if it was implemented correctly and, if so, had the desired effect.  

Priorities

The Poverty and Unemployment Work Group is continuing to form. The following policies were proposed in the 2022 NC SHIP report are under consideration.

Poverty:

• Create and expand legislation and advocate with employers to provide paid family medical leave, earned paid sick leave, kin care, and safe days for all caregivers
• Ease negative impact of “benefits cliffs” caused by reductions in benefits, by lengthening phase-out periods
• Eliminate taxation on sanitary products including menstrual supplies, diapers, and breastfeeding supplies
• Expand Medicaid eligibility
• Expand the availability and amount of childcare subsidies to reflect the cost of care more adequately
• Raise the minimum wage to $15.00 per hour
• Restore the North Carolina Earned Income Tax Credit
• Support “early college while in high school” programs, such as REaCH and SEarCH

Unemployment:

• Create and expand legislation and advocate with employers to provide paid family medical leave, earned paid sick leave, kin care, and safe days for all caregivers
• Expand access to higher educational opportunities
• Expand transit options in rural and low-income communities
• Improve access to personal finance credit scores
• Increase access to affordable childcare
• Increase access to broadband internet
• Pass fair chance hiring policies for county and local employees, and work with employers to pass fair chance hiring policies for themselves
• Seek a national health insurance / national service program, e.g., An Economic Bill of Rights for the 21st Century
• Shift funding from industrial recruitment to support small businesses and social enterprises
• Support people with disabilities and those in recovery, veterans, and reentry populations to live their lives as fully included members of the community by implementing key employment initiatives like Competitive Integrated Employment and Employment First

Action Plan

As of July 1, 2023, the Poverty and Unemployment Work Group is continuing to form and has not prioritized the policies/programs from the 2022 NC SHIP. 

Meeting Notes

May 2023, Co-Lead Planning Meeting

Discussion:

Co-Leads: Fenaba Addo and Marionna Poke-Stewart

• Identified the following goals and tasks to provide a strategy to increase work group members.
  • Present a brief (2-3 slide presentation) at the State Conference/ OEO Workshop to 33 Executive Directors and respective staff of the community action agencies in North Carolina.
  • Send the Effect of COVID & Poverty.
  • Provide access for someone to follow-up at the June 14th Executive Management meeting (12-1:30pm) regarding work group members.
  • Share background/ comparison for proposed policies.
  • Touchbase on results of briefer comments from conference.

April 11, 2023, Community Council Orientation

Co-Leads: Fenaba Addo and Marionna Poke-Stewart (New NCDHHS Co-Lead)

Discussion:

• Completed orientation to NC SHIP Community Council, including background, structure, and process.
• Reviewed proposed policies from 2022 NC SHIP report.
• Discussed potential work group members and a new Community Co-Lead.
• Identified action steps:
  • Schedule co-leader planning meeting.
  • Share copy of effects of COVID-19 and poverty report
  • Share background/ comparison for proposed policies

September 12, 2022, 1:30 to 2:00 pm, Co-Lead Planning Meeting

Co-Leads: Fenaba Addo and Carla West

Discussion:

• Discussed updates on potential work group members the co-leads had contacted. 
• Continued discussions on potential work group members and next steps.

August 23, 2022, 8:30 to 9:00 am, Co-Lead Planning Meeting

Co-Leads: Fenaba Addo, L.A. Jones (absent), and Carla West

Discussion:

• Decision made to reschedule the meeting and for that meeting to be an opportunity for the co-leads to plan and organize for the first work group meeting.
• Discussed co-leads contacting potential work group members and continuing to add to the list.
• Discussed inviting established groups and partners and then asking them if they would recommend program participants.
• Reviewed NC SHIP Community Council work groups are tasked with prioritizing/ selecting policies they would like to work on for the year, identifying strategies, and creating an action plan.

Priorities

The Short-Term Suspensions Work Group identified the following priorities for action planning. Work group members engaged in discussions and review of best practices to reduce the use of school suspensions and expulsions and increase diversity among school and childcare leadership and staff.

• Disrupt the school-to-prison pipeline, beginning with early childhood programs by reducing the use of school suspensions and expulsions and increasing the use of counseling services and community-based programs and initiatives
• Increase racial, ethnic, gender, and disability status diversity among school and childcare leadership and staff and the institutions that train them

Action Plan

The Short-Term Suspensions work group identified the following during asset mapping in preparation for action planning. Refer to meeting notes from December 9, 2022, for additional asset mapping questions discussed. 

Priority: Disrupt the school-to-prison pipeline, beginning with early childhood programs by reducing the use of school suspensions and expulsions and increasing the use of counseling services and community-based programs and initiatives

• Recommendations for lead agencies for this policy work:
  • U.S. Department of Education
  • Office of Civil Rights
  • American Academy of Pediatrics
• Short-Term strategies to move this policy forward:
  • Educate the public that 4, 5, 6, and 7-year-olds are receiving out-of-school suspensions for minor offenses.
  • Improve practices by teachers and administrators.
  • Build in accountability (fiscal, reporting, etc.).
  • Hold statewide summit to share, learn and develop call to action steps.
  • Continue to get buy-in from principals, administrators, sheriffs, SROs, students, teachers, and parents.
  • Campaign for local district moratoriums and/or adoption of appeal processes.
• Additional assets needed:
  • Training of staff, teaching assistants in each classroom, and access to school counselors, social workers, and community health workers
  • Mental health counselors and resources in schools
  • Need accurate data; funding; training; coaching; accountability; continuous improvement
  • Revised codes of conduct with suspension alternatives in policy

Priority: Increase racial, ethnic, gender, and disability status diversity among school and childcare leadership and staff and the institutions that train them

• Recommendations for lead agencies for this policy work:
  • Refer to the Developing a Representative & Inclusive Vision for Education Final Report and Recommendations for potential lead agencies.
• Short-Term strategies to move this policy forward:
  • Have each local district draft and adopt educator diversity plans with goals and key performance indicators for improvement.

Meeting Notes

June 2, 2023, 9:00 to 10:00 am, Work Group Meeting

Co-Leads: Gerri Mattson, Laura Gerald, and Letha Muhammad

Attendees: Carlton Powell, Dawn Meskil, Debbie Walker, Devonya Govan-Hunt, Graham Palmer, Paul Ford, Peter Rawitsch, Rachel Zarcone

Presenters: Adam Parent and Kelley Blas

Discussion:

• Received presentation on Understanding EC Funding: CCEIS/CEIS from Adam Parent, IDEA Fiscal Consultant, and Kelley Blas, IDEA Information Analyst, with the Office of Exceptional Children, Division of Educator & Student Advancement at the NC Department of Public Instruction.
  • Additional information on Significant Disproportionality is available at https://www.dpi.nc.gov/districts-schools/classroom-resources/exceptional-children/educational-equity-and-significant-disproportionality/significant-disproportionality.
• Asked work group members to answer the following questions outside of the meeting regarding the two priorities:
  • Where is this policy occurring, local, regional, or state level?
  • Who are the actors/ people actually doing the policy change and are they involved?
  • Who are/could be the lead agencies?
  • Who should we target to make the policies happen?
• Reviewed next steps:
  • Next Iteration of Work Group: The proposed charge for the 2023-2024 NC SHIP Community Council, including the Short-Term Suspensions Work Group, will be to take action on the priorities the work group has identified.
  • Continuing as work group member: The following work group members present shared they were willing to continue to be involved with the work group: Carlton Powell, Peter Rawitsch, Graham Palmer, Paul Ford, and Dawn Meskil. Work group members not present will be contacted about continuing. 
  • Continuing and new leadership: Letha Muhammad and Gerri Mattson are continuing to be co-leaders for the work group. Laura Gerald is stepping down as a co-leader. Work group members interested in being a co-leader can contact Ashley Rink.
  • New partners/ member recommendations: Work group members are welcome to invite additional partners to be involved with the work group.
  • Next action steps: There will be an opportunity to reevaluate the work group’s meeting schedule and meeting length. Work group members will be contacted about the next steps after the NC SHIP Community Council’s Annual Meeting in July.

May 5, 2023, 9:00 to 10:00 AM, Work Group Meeting

Co-Leads: Gerri Mattson and Laura Gerald; Absent: Letha Muhammad

Attendees: Carlton Powell, Dawn Meskil, Debbie Walker, Devonya Govan-Hunt, Jerry Wilson, Paul Ford, Peter Rawitsch

Discussion:

• Asked work group members if they were willing to continue being a work group member after June 2023.
• Discussed other partners to engage about joining the work group. Recommended the group continue to talk about who should be at the table as continuing action and leave the door up to all sectors of the state. Suggestions for additional partners included the following:
  • National Black Child Development Institute- Charlotte
  • Teachers Union- NC Association of Educators
  • NCAE- North Carolina Association of Educators
  • National or NC PTA
  • Village of Wisdom
  • Exceptional Children Assistance Center (ECAC) is a parent center in NC
  • DPI- adding members from different perspectives
  • Child Care Commission
  • North Carolina School Boards Association
  • LatinxEd
  • EPIC
  • UNC School of Social Work
• Received an update from Peter Rawitsch on the disproportionality of out-of-school suspensions for special education students in New Hanover County Schools. 
• Reviewed topics for next work group meeting:
  • Letha Muhammad: Share about school resource officers and their impact on school discipline
  • Graham Palmer: Share about training for school resource officers
  • Rachel Zarcone: Share about NC SEL State Implementation Team during
  • Significant Disproportionality/ Mandatory Comprehensive Coordinated Early Intervening Services (CCEIS)- Dawn Meskil to invite someone to speak about this process
  • Review and agreement on recommendations and summary of work

April 12, 2023, 11:00 to 12:00 PM, Work Group Meeting          

Co-Leads: Laura Gerald, Gerri Mattson, and Letha Muhammad

Attendees: Paul Ford, Dawn Meskil, Graham Palmer, Peter Rawitsch, Rachel Zarcone

Discussion:

• Reviewed the two policy priorities identified at the previous work group meeting:
  • Disrupt the school-to-prison pipeline, beginning with early childhood programs by reducing the use of school suspensions and expulsions and increasing the use of counseling services and community-based programs and initiatives
  • Increase racial, ethnic, gender, and disability status diversity among school and childcare leadership and staff and the institutions that train them
• Shared potential models to disrupt the school-to-prison pipeline and increase diversity among school and childcare leadership and staff. Models and topics discussed included:
  • New Hanover County’s Policy 4351 Short-Term Suspensions
  • Pyramid Model
  • School resource officers
  • Short-term suspension clinics/ policy education for parents and students
  • Building capacity through philanthropic structures
  • Social-emotional learning
  • Governor’s DRIVE (Developing a Representative and Inclusive Vision for Education) Task Force recommendations
• Identified next steps were:  
  • All Work Group Members: Review resources shared during work group meeting
  • Letha Muhammad: Share about efforts around school resource officers during May 5 meeting.
  • Graham Palmer: Share about training for school resource officers during June 2 meeting.
  • Rachel Zarcone: Share about NC SEL State Implementation Team during June 2 meeting.

March 3, 2023, 9:00 to 10:00 am, Work Group Meeting

Co-Leads: Laura Gerald and Letha Muhammad; Absent: Gerri Mattson

Attendees: Carlton Powell, Dawn Meskil, Devonya Govan-Hunt, Jerry Wilson, Karen Fairley, Lindsey Guyton, Peter Rawitsch

Discussion:

• Decided to keep the priority policies separate:
  • Disrupt the school-to-prison pipeline, beginning with early childhood programs by reducing the use of school suspensions and expulsions and increasing the use of counseling services and community-based programs and initiatives
  • Increase racial, ethnic, gender, and disability status diversity among school and childcare leadership and staff and the institutions that train them
• Received highlights and recommendations from Karen Fairley on the Consolidated Data Report, 2021-2022, presented to the State Board of Education.
• Identified next steps for work group members to complete by the next meeting in April. 
  • Bring examples of alternatives to help reduce the use of suspensions as a disciplinary action in schools.
  • Identify where “Increase racial, ethnic, gender, and disability status diversity among school and childcare leadership and staff and the institutions that train them” is already happening.
  • Identify a list of offerings related to ““Increase racial, ethnic, gender, and disability status diversity among school and childcare leadership and staff and the institutions that train them.”

February 2, 2023, 10:00 to 11:00 am, Work Group Meeting

Co-Leads: Gerri Mattson and Letha Muhammad; Absent: Laura Gerald

Attendees: Carlton Powell, Devonya Govan-Hunt, Ellen Fox, Graham Palmer, Jerry Wilson, Karen Fairley, Paul Ford, Rachel Zarcone

Discussion:

• Discussed each of the prioritized policies and next steps. A summary of the policy discussion and next steps are included below.
  • Include suspension rate in measures of school quality
    • Concerns were voiced about including suspension rates in measures of school quality, including that suspension rates are disproportionally high at schools with lower resources or accessibility and may perpetuate a negative reputation and lower suspensions rates are not indicative of how children are treated and the inequities that continue to exist.
    • The consensus of the work group members present was for this policy to not be a priority.
  • Disrupt the school-to-prison pipeline, beginning with early childhood programs by reducing the use of school suspensions and expulsions and increasing the use of counseling services and community-based programs and initiatives AND Increase racial, ethnic, gender, and disability status diversity among school and childcare leadership and staff and the institutions that train them
    • Consensus was that starting in the early childhood education space was important. There are not policies in place that prohibit three- and four-year-old children from being suspended from early childhood education. There are a disproportionate number of black and brown children being pushed out of early childhood education spaces.
    • The second policy is more about cultivating belonging, affirming identities, and creating more inclusive spaces, including adding credible messengers in schools with lived experiences. Research shows that teacher diversity benefits all students, regardless or race or ethnicity; refer to https://edtrust.org/resource/educator-diversity-state-profile-north-carolina/.
    • The work group members present were in favor of keeping both of these policies as priorities, either as separate policies or combining them.
    • Next steps shared were to synthesize the conversations from the work group meeting, decide to combine the two priority policies or to keep them separate, and consider who else needs to be invited to share additional information regarding these policy areas.

December 9, 2022, 9:00 to 10:00 am, Work Group Meeting

Co-Leads: Gerri Mattson and Laura Gerald; Absent: Letha Muhammad

Work Group Members Present: Carlton Powell, Dawn Meskil, Ellen Fox, Graham Palmer, James E. Ford, Karen Fairley, Paul Ford, Peter Rawitsch, and Rachel Zarcone

Discussion:

• Reviewed the policies prioritized at the previous meeting.
  • Disrupt the school-to-prison pipeline, beginning with early childhood programs by reducing the use of school suspensions and expulsions and increasing the use of counseling services and community-based programs and initiatives
  • Include suspension rate in measures of school quality
  • Increase racial, ethnic, gender, and disability status diversity among school and childcare leadership and staff and the institutions that train them
• Discussed asset mapping using the following questions for each of the three prioritized policies.
  • Are you working in an area related to this policy? If so, who do you work with related to this?
  • Do you have sources of data to assess the progress of this policy?
  • What plans, programs/initiatives, and/or policy agendas are you aware of related to this policy?
  • What would be short-term strategies to move this policy forward?
  • What sources of funding are and/or may be available for this policy initiative?
  • What are additional assets needed?
  • Who are additional agencies and/or people that should be involved in the work related to this policy?
  • What are recommendations for lead agencies for this policy work?
  • What other questions, comments, and/or concerns do you have related to this policy?
• Identified next steps were to continue to add responses to the asset mapping Jamboard and to continue discussions at the next meeting on potential strategies and action planning.

October 19, 2022, 9:00 to 11:00 am, Work Group Meeting (Short-Term Suspensions, Adverse Childhood Experiences, and Third Grade Reading Proficiency)

Co-Leads: Gerri Mattson, Jessica Lowery Clark, Laura Gerald, Letha Muhammad, Mary Mathew, Mebane Boyd (Absent), Wanda Boone

Work Group Members Present: Amber Pierce, Amber Robinson, Carlton Powell, Crystal Kelly, Crystal Taylor, Dawn Meskil, Devonya Govan-Hunt, Dr. Ronda Taylor Bullock, Elizabeth DeKonty, James E. Ford, Jess Bousquette, Karen Fairley, Kella Hatcher, Micha James, Morgan Forrester Ray, Na’im Akbar, Reverend Paul Robeson, Paula Wilkins, Peter Rawitsch, Rebecca Swofford, Stacie Kinlaw, Susanne Schmal, Trina Stephens, Trishana Jones, Vichi Jagannathan,

Discussion:

• Reviewed purpose of the work group, grounding/group norms, and overview Healthy North Carolina 2030 and North Carolina State Health Improvement Plan (NC SHIP).
• Divided into breakout sessions for Short-Term Suspensions, Adverse Childhood Experiences, and Third Grade Reading Proficiency to review, discuss, and prioritize policies. Prioritized policies by indicator breakout session are included below.
• Shared next steps were for the work group to complete asset mapping for each of the prioritized policies. The indicators will meet separately going forward and will discuss strategies and action planning at the December meetings. Work group members are welcome to join multiple indicator groups.

Indicator 3: Short-Term Suspensions Breakout Session

• Co-Leads Present: Dr. Laura Gerald and Dr. Gerri Mattson
• Work Group Members Present: Carlton Powell, Crystal Kelly, Dawn Meskil, Devonya Govan-Hunt, James E. Ford, Karen Fairley, Reverend Paul Robeson, Peter Rawitsch, Dr. Ronda Taylor Bullock, Vichi Jagannathan
• Prioritized Policies:
  • Disrupt the school-to-prison pipeline, beginning with early childhood programs by reducing the use of school suspensions and expulsions and increasing the use of counseling services and community-based programs and initiatives
  • Include suspension rate in measures of school quality
  • Increase racial, ethnic, gender, and disability status diversity among school and childcare leadership and staff and the institutions that train them

August 15, 2022, 2:00 to 4:00 pm, Co-Lead Planning Meeting (Short-Term Suspensions, Adverse Childhood Experiences, and Third Grade Reading Proficiency)

Co-Leads: Wanda Boone, Mebane Boyd, Laura Gerald, Jessica Lowery Clark, Mary Mathew, Gerri Mattson, and Letha Muhammad

Discussion:

• Set ground rules and norms for the co-leads and work group.
• Reviewed the proposed policy initiatives from the NC SHIP for Indicator 3: Short-Term Suspensions, Indicator 5: Adverse Childhood Experiences, and Indicator 6: Third Grade Reading Proficiency. Identified questions and discussed recommended revisions.
• Planned for work group meetings, including meeting structure and first meeting agenda topics.

Priorities

The 2022-2023 Incarceration Work Group identified the following priorities for action planning.

• Ensure access to behavioral health treatment, adequate medical care, and stable housing for those returning from incarceration
• Expand existing or create community Medication Assisted Treatment programs for people with substance use disorder detained in prisons and jails or transitioning to and from prison
• Improve access to treatment for substance use disorders, physical illnesses, and mental illnesses
• Improve resources and legislation pertaining to jails and prisons to reduce harmful impact of incarceration and foster successful reintegration into the community
• Increase access to multisystemic therapy for juvenile offenders
• Invest in public health alternatives to traditional law enforcement and sentencing, particularly for behavioral health issues

Action Plan

The Incarceration Work Group identified the following next steps/ action items for each priority. 

• Priority: Ensure access to behavioral health treatment, adequate medical care, and stable housing for those returning from incarceration
  • Communicate with Local Reentry Council (meant to be bridge/hub to connect resources not be a resource) to determine what would be helpful to expand resources in this area.
  • Determine who may be the right contact to initiate this discussion.
  • Start with State Reentry Council Collaborative to elicit what changes to state support or services would affect improvement in reentry resources within the community for…
    • Education and Vocational Training
    • Employment
    • Faith/Community-based Organizations
    • Family Reunification
    • Housing
    • Legal
    • Mental Health, Substance Misuse and Medical
    • Transportation
    • Women and Incarceration
  • Use the database of resources categorized by age groups (child, adolescent, early adulthood, and adult); county; and resource type to identify community resource gaps.
• Expand existing or create community Medication Assisted Treatment programs for people with substance use disorder detained in prisons and jails or transitioning to and from prison
  • Educate jails on who should be maintained on MAT and what to look for in programs.
  • Provide technical assistance on this subject.
• Improve access to treatment for substance use disorders, physical illnesses, and mental illnesses
  • LMECO discussion to expand resources (keeping in mind that trained personnel not available in those areas).
• Improve resources and legislation pertaining to jails and prisons to reduce harmful impact of incarceration and foster successful reintegration into the community
  • Educate legislators and government leadership on the differences between prisons and jails to effect change and improve legislation and resources.
• Increase access to multisystemic therapy for juvenile offenders
  • Research available diversion resources for juveniles and those age group 18-25 (identified as key group to focus efforts that could significantly impact incarceration rate) pointing out differences and drop-off of services.
• Invest in public health alternatives to traditional law enforcement and sentencing, particularly for behavioral health issues
  • LMECO discussion to expand resources (keeping in mind that trained personnel not available in those areas).

Meeting Notes

April 18, 2023, 10:00 to 12:00 pm, Work Group Meeting

Co-Leads: Dr. Anita Wilson-Merritt and Jennifer C. Jackson; Absent: Rick Glazier

Attendees: Dr. Gary Junker, Dr. Evan Ashkin, Nicole Sullivan

Discussion:

• Completed a brief review of six policy initiatives. 
  • Invest in public health alternatives to traditional law enforcement and sentencing, particularly for behavioral health issues
  • Increase access to multi-systemic therapy for juvenile offenders
  • Improve conditions (resources/legislation) in jails and prisons to reduce harmful impact of incarceration and foster successful reintegration into the community
  • Improve access to treatment for substance use disorders, physical illnesses, and mental illnesses
  • Expand existing or create community Medication Assisted Treatment programs for people with substance use disorder detained in correctional facilities prisons and jails or transitioning to and from prison
    • Suggestion made to differentiate prisons from jails and highlighting the bridge from jail to prison.
• Discussed next steps and/or action items from the previous work group meeting for each of the prioritized policy initiatives. ​​​​​​​
  1. LMECO discussion to expand resources (keeping in mind that trained personnel not available in those areas).
  2. Research available diversion resources for juveniles and those age group 18-25 (identified as key group to focus efforts that could significantly impact incarceration rate) pointing out differences and drop-off of services.
  3. Educate legislators and government leadership on the differences between prisons and jails to effect change and improve legislation and resources.
  4. Educate jails on who should be maintained on MAT and what to look for in programs. Provide technical assistance on this subject.
  5. Communicate with Local Reentry Council (meant to be bridge/hub to connect resources not be a resource) to determine what would be helpful to expand resources in this area.

January 31, 2023, 10:00 to 12:00 pm, Work Group Meeting

Co-Leads: Dr. Anita Wilson-Merritt and Jennifer C. Jackson; Absent: Rick Glazier

Attendees: Dr. Arthur Campbell, Kenneth Lassiter, Dr. Evan Ashkin, Nicole Sullivan

Discussion:

• Completed a brief review of six policy initiatives.
• Identified at least one recommendation for each initiative and specified next steps and/or action items.
  1. Invest in public health alternatives to traditional law enforcement and sentencing, particularly for behavioral health issues
     • LMECO discussion to expand resources (keeping in mind that trained personnel not available in those areas)
  2. Increase access to multi-systemic therapy for juvenile offenders
     1. Research available resources for juveniles including age group 18-25 (identified as key group to focus efforts that could significantly impact incarceration rate) pointing out differences and drop off of services.  
  3. Improve conditions (resources/legislation) in jails and prisons to reduce harmful impact of incarceration and foster successful reintegration into the community
     1. Next step is to educate on the differences to create change (Research how this can be effectively done)
  4. Improve access to treatment for substance use disorders, physical illnesses, and mental illnesses
     1. LMECO discussion to expand resources (keeping in mind that trained personnel not available in those areas)
  5. Expand existing or create community Medication Assisted Treatment programs for people with substance use disorder detained in correctional facilities
     1. Next step is to educate jails on who should be maintained on MAT and what to look for in programs/ provide technical assistance
  6. Ensure access to behavioral health treatment, adequate medical care, and stable housing for those returning from incarceration
     1. Communicate with Local Reentry Council (meant to be bridge/hub to connect resources not be a resource) to determine what would be helpful to expand resources in this area
• The next Incarceration Work Group meeting will be on Tuesday, April 18, 2023, from 10:00 to 12:00 pm via Microsoft Teams.

October 18, 2022, 10:00 to 12:00 pm, Work Group Meeting

Co-Leads: Dr. Anita Wilson-Merritt; Absent: Jennifer C. Jackson and Rick Glazier

Attendees: Dr. Arthur Campbell, Gary Junker, Dr. Evan Ashkin, Nicole Sullivan, Marie Evitt

Discussion:

• Provided a brief overview of the North Carolina State Health Improvement Plan (NC SHIP). Reviewed roles and responsibilities for work group members. Shared that the Co-Leads had prioritized 6 of the 10 proposed policies.
• Discussed each of the prioritized policies, including related resources, programs, funding, partners, and clarifications needed to move the policies forward. 

August 16, 2022, 10:00 to 12:00 pm, Co-Lead Planning Meeting 

Co-Leads: Dr. Anita Wilson-Merritt and Jennifer C. Jackson; Absent: Rick Glazier 

Discussion:

• Reviewed NC SHIP proposed policies/programs and prioritized 6 of 10 policies. 
  • Ensure access to behavioral health treatment, adequate medical care, and stable housing for those returning from incarceration
  • Expand existing or creating community Medication Assisted Treatment programs for people with substance use disorder detained in correctional facilities
  • Improve access to treatment for substance use disorders, physical illnesses, and mental illnesses
  • Improve conditions in jails and prisons to reduce harmful impact of incarceration and foster successful reintegration into the community
  • Increase access to multi-systemic therapy for juvenile offenders
  • Invest in public health alternatives to traditional law enforcement and sentencing, particularly for behavioral health issues
• Reviewed list of potential work group members for the work group meeting on October 18, 2022.  
• Planned to add behavioral health representation. 

Priorities

The 2022-2023 Adverse Childhood Experiences Work Group identified the following priorities for action planning. Work group members engaged in discussions and review of best practices and resources related to community-led solutions and data. The work group recognizes there is a strong correlation between poverty and ACEs. Strategies that reduce poverty, such as increasing employment opportunities with living wages and affordable housing reduce stress on families, which results in preventing many of the ACEs.

• Improve data available on trauma and ACEs at the local level
• Increase funding for and embed community-rooted, culturally affirming family and community support programs into existing initiatives

Action Plan

The Adverse Childhood Experiences Work Group began action planning during their work group meeting on June 15, 2023. Other considerations included who should be at the table and available resources. 

Priority: Improve data available on trauma and ACEs at the local level

• Action Step:
  • Get grant (Referring to Essentials for Childhood funding opportunity from the Centers for Disease Control and Prevention (CDC).)

Priority: Increase funding for and embed community-rooted, culturally affirming family and community support programs into existing initiatives

• Action Steps:
  • Explore groups who are doing this successfully to learn best practices (in NC and other states)
  • Any training done on trauma-informed communities for state leadership would include strategically formed discussions that include everyone – bring local voices to training
  • Informing foundations and other funding institutions about ACEs work happening at state level and local districts.
  • Institutions with power redirect funding or use existing funding to programs that meet this criteria
  • Identify where there are barriers to access to funding
  • Find opportunities for local organizations to build relationships with funding, Hold ourselves accountable to build relationships with local organizations
  • Identify organizations that have resources
  • Create checklist to help non-profits and other organizations to know what requirements are in order to access funds from institutions with power
  • Provide TA to organizations to get to point where they can access funding
  • Finding new ways to communicate with non-profits so they can know what funding might be available.
  • Prepare organizations without 501c3 about how to access funding
  • Identify local organizations which can help grassroots organizations (not state, county governments),
  • Create network/bank of organizations who could serve as a “fiscal sponsorship organizations” – manage HR, fiscal side of things
  • Provide TA, advocacy to funding agencies about how to fund grassroots organizations and help them understand the barriers. (What it might look like administratively.)
  • Changing federal statues – advocacy with policy makers.

Meeting Notes

June 15, 2023, 2:00 to 3:00 pm, Work Group Meeting

Co-Leaders: Wanda Boone, Mebane Boyd; Absent: Gerri Mattson

Attendees: Catherine Joyner, Elizabeth DeKonty, Ellen Carroll, Micha James, Molly McCambridge, Sharon Hirsch, Trina Stephens

Discussion:

• Reviewed prioritized policies:
  • Increase funding for and embed community-rooted, culturally affirming family and community support programs into existing initiatives
  • Improve data available on trauma and ACEs at the local level
• Received an update on the Essentials for Childhood funding opportunity from the Centers for Disease Control and Prevention (CDC). Notification on if the grant is received or not will occur in August.
• Reviewed at the previous work group meeting the group discussed opportunities and barriers to community-led solutions. Similar ideas were combined to guide action planning.
• Began identifying potential action steps for “Increase funding for and embed community-rooted, culturally affirming family and community support programs into existing initiatives”:
  • Explore groups who are doing this successfully to learn best practices (in NC and other states)
  • Any training done on trauma-informed communities for state leadership would include strategically formed discussions that include everyone – bring local voices to training
  • Informing foundations and other funding institutions about ACEs work happening at state level and local districts.
  • Institutions with power redirect funding or use existing funding to programs that meet this criteria
  • Identify where there are barriers to access to funding
  • Find opportunities for local organizations to build relationships with funding, hold ourselves accountable to build relationships with local organizations
  • Identify organizations that have resources
  • Create checklist to help non-profits and other organizations to know what requirements are in order to access funds from institutions with power
  • Provide TA to organizations to get to point where they can access funding
  • Finding new ways to communicate with non-profits so they can know what funding might be available.
  • Prepare organizations without 501c3 about how to access funding
  • Identify local organizations which can help grassroots organizations (not state, county governments),
  • Create network/bank of organizations who could serve as a “fiscal sponsorship organizations” – manage HR, fiscal side of things
  • Provide TA, advocacy to funding agencies about how to fund grassroots organizations and help them understand the barriers. (What it might look like administratively.)
  • Changing federal statues – advocacy with policy makers.
• Identified next steps were to continue refining the action steps and determine specific steps including how, who is going to be at the table, what specifically is the plan, if action steps should be prioritized, and if subgroups are needed for different action steps.  Another next step would be creating a logic model to identify intermediate steps more closely. This work will be ongoing after July.  

May 18, 2023, 2:00 to 3:00 pm, Work Group Meeting

Co-Leads: Mebane Boyd and Gerri Mattson; Absent: Wanda Boone

Attendees: Catherine Joyner, Elizabeth DeKonty, Ellen Carroll, Ingrid Bou-Saada, Kella Hatcher, Micha James, Molly McCambridge, Morgan Forrester Ray, Stacie Kinlaw, Trina Stephens, Trishana Jones

Discussion:

• Reviewed prioritized policies:
  • Increase funding for and embed community-rooted, culturally affirming family and community support programs into existing initiatives
  • Improve data available on trauma and ACEs at the local level
• Received an update on the Essentials for Childhood funding opportunity from the Centers for Disease Control and Prevention (CDC). The focus of the funding is to expand from child maltreatment prevention to all ACEs prevention with an emphasis on data to action. The data is intended to inform implementation strategies.
• Discussed what allows a community to implement community-led solutions and barriers to community-led solutions being implemented. 
• Discussed creative, no-boundary solutions and strategies to address the community-rooted priority. Themes included:
  • Provide built in planning time to fund opportunities to provide stability for communities to determine what their community needs.
  • Let the community share what they want and need and work with them instead of for them. Allow time for the community to develop their plan and be able to shift focus based on community needs over  funding years.
  • Pay communities for their ideas to lead the planning and solutions. Fund people to lead the solutions within their communities.
  • Consider assistance with payroll, reporting, infrastructure, etc.; such as a regional hub. A similar model is being used with doulas in the Medicaid model; successful networks have an entity providing infrastructure support.
  • Engage community peers to work with communities to translate what they need share in grant speak and have cross-working teams with mutual respect.  

April 20, 2023, 2:00 to 3:00 pm, Work Group Meeting

Co-Leads: Wanda Boone, Mebane Boyd, and Gerri Mattson

Attendees: Na'im K. Akbar, Jess Bousquette, Elizabeth DeKonty, Kella Hatcher, Sharon Hirsch, Micha James, Trishana Jones, Molly McCambridge, Morgan Forrester Ray

Discussion:

• Reviewed the policies prioritized at the previous work group meeting.
  • Increase funding for and embed community-rooted, culturally affirming family and community support programs into existing initiatives
  • Improve data available on trauma and ACEs at the local level
• Shared an update regarding a notice of funding opportunity (NOFO) from the CDC for PACEs and ACEs data.
• Discussed the following questions related to, “Increase funding for and embed community-rooted, culturally affirming family and community support programs into existing initiatives.”
  • What organizations in North Carolina are working to embed community-led solutions?
  • What is being done from the statewide perspective to embed community-led solutions?
  • What allows grassroots organizations to lead community-led solutions?
  • What gets in the way of grassroot leadership?/ What are roadblocks?
  • How do we/they overcome those roadblocks?
• Identified next steps were to ask the questions discussed to more community-based organizations to better understand the actions needed to increase funding and embed community-rooted, culturally affirming family and community support programs into existing initiatives. 

March 16, 2023, 2:00 to 3:00 PM, Work Group Meeting

Co-Leads: Wanda Boone and Mebane Boyd; Absent: Gerri Mattson

Work Group Members Present: Na'im K. Akbar, Sharon Hirsch, Micha James, and Catherine Joyner

Discussion:

• Discussed clarifications on the strategies the work group would be voting on for their top four strategies. There were 13 strategies total across all four of the big buckets.
• Voted on the top four strategies. The results of the voting survey from the work group members present and the work group members that submitted their top four strategies prior to the meeting were:
  • 8 votes: Increase funding for and embed community-rooted, culturally affirming family and community support programs into existing initiatives
  • 6 votes: Improve data available on trauma and ACEs at the local level
  • 5 votes: Ensure businesses promote family friendly workplace policies, including flexible scheduling, etc.
  • 5 votes: Increase access to affordable quality childcare
  • 5 votes: Increase trauma informed procedures and treatment in schools
  • 4 votes: Develop communication and advocacy guides specifically developed for local ACEs/ resilience task forces
  • 3 votes: Develop public awareness campaign about the Four Realms of ACEs
  • 2 votes: Gather information on mental health delivery systems in early childhood care, primary care, schools, and specialty care across North Carolina
  • 1 vote: Develop a guide to educate on the Four Realms of ACEs
  • 1 vote: Increase trauma informed procedures and treatment in early childhood care
  • 0 votes: Increase intentional funding support for services for childhood exposure to domestic violence
  • 0 votes: Increase trauma informed procedures and treatment in primary care
  • 0 votes: Increase trauma informed procedures and treatment in specialty care
• Reviewed the top strategies and discussed questions, comments, and clarifications. Work group members present all agreed on the importance of including funding when embedding community-rooted, culturally affirming family and community support programs into existing initiatives. 
• The top two strategies identified for action planning were:
  • Increase funding for and embed community-rooted, culturally affirming family and community support programs into existing initiatives
  • Improve data available on trauma and ACEs at the local level

February 16, 2023, 2:00 to 3:00 pm, Work Group Meeting

Co-Leads: Wanda Boone, Mebane Boyd, and Gerri Mattson

Work Group Members Present: Catherine Joyner, Elizabeth DeKonty, Micha James, Na'im K. Akbar, Sharon Hirsch, Stacie Kinlaw, Trina Stephens, and Trishana Jones

Others Present: Kathy Dail and Liz Star

Discussion:

• Reviewed the goal for the NC SHIP Adverse Childhood Experiences (ACEs) Work Group was to reduce North Carolina Children with 2 or more ACEs from 23.6% to 18% by 2030.
• Wanda Boone provided an overview of SAMHSA’s (Substance Abuse and Mental Health Services Administration) Strategic Prevention Framework and the Seven Strategies for Community Change from the Community Anti-Drug Coalitions of America (CADCA).
• Discussed capacity for advancing policies and strategies for consideration related to the four big buckets.
  • Expand Community Prevention Programs
  • Increase Access to Economic Supports
  • Increase Access to Children’s Mental Health Services
  • Data
• Determined next steps were to:
  • Clean up the policy lists to identify strategies, resources, etc.
  • Add additional descriptions of what is meant to provide more context on the topics of the strategies
  • Share any annotations related to policies they were passionate about.
  • Vote on strategies at the next work group meeting under each of the policy buckets

January 9, 2023, 12:30 to 1:30 pm, Work Group Meeting

Co-Leads: Wanda Boone and Mebane Boyd; Absent: Gerri Mattson

Work Group Members Present: Catherine Joyner, Elizabeth DeKonty, Ingrid Bou-Saada, Jess Bousquette, Kella Hatcher, Micha James, Morgan Forrester Ray, Na'im K. Akbar, Sharon Hirsch, Stacie Kinlaw, Susanne Schmal, Trina Stephens

Discussion:

• Reviewed the prioritized policies from the work group meeting on December 12, 2022.
  • Expand community prevention programs
  • Increase access to children’s mental health services by expanding mental health services in primary care, schools, and specialty care
  • Increase access to economic supports
  • Data
• Discussed and added responses to asset mapping questions for each of the prioritized policies. Updated two of the prioritized policies as follows:
  • Increase access to children’s mental health services by expanding mental health services beginning at birth in primary care, schools, specialty care, and early childhood care
  • Identify data related to ACEs and resilience

December 12, 2022, 12:30 to 1:30 pm, Work Group Meeting

Co-Leads: Wanda Boone, Mebane Boyd, and Gerri Mattson

Work Group Members Present: Catherine Joyner, Crystal Taylor, Elizabeth DeKonty, Ellen Carroll, Jess Bousquette, Melissa Radcliff, Micha James, Sharon Hirsch, Stacie Kinlaw, Trina Stephens, and Trishana Jones

Discussion:

• Provided an overview of the North Carolina State Health Improvement Plan and shared that more priorities and policies can be discussed. The work group is not limited to the prioritized policies.
• Discussed what was missing from the prioritized policies and any related plans. Revised the prioritized policies as follows:​​​​​​
  • Expand community prevention programs
  • Increase access to children’s mental health services by expanding mental health services in primary care, schools, and specialty care
  • Increase access to economic supports
  • Data 
• Shared next steps were to add additions for asset mapping for each of the prioritized policies to the Jamboard or email responses before the next work group meeting on Monday, January 9, 2023, at 12:30 pm.

October 19, 2022, 9:00 to 11:00 am, Work Group Meeting (Short-Term Suspensions, Adverse Childhood Experiences, and Third Grade Reading Proficiency)

Co-Leads: Gerri Mattson, Jessica Lowery Clark, Laura Gerald, Letha Muhammad, Mary Mathew, Mebane Boyd (Absent), Wanda Boone

Work Group Members Present: Amber Pierce, Amber Robinson, Carlton Powell, Crystal Kelly, Crystal Taylor, Dawn Meskil, Devonya Govan-Hunt, Dr. Ronda Taylor Bullock, Elizabeth DeKonty, James E. Ford, Jess Bousquette, Karen Fairley, Kella Hatcher, Micha James, Morgan Forrester Ray, Na’im Akbar, Reverend Paul Robeson, Paula Wilkins, Peter Rawitsch, Rebecca Swofford, Stacie Kinlaw, Susanne Schmal, Trina Stephens, Trishana Jones, Vichi Jagannathan,

Discussion:

• Reviewed purpose of the work group, grounding/group norms, and overview Healthy North Carolina 2030 and North Carolina State Health Improvement Plan (NC SHIP).
• Divided into breakout sessions for Short-Term Suspensions, Adverse Childhood Experiences, and Third Grade Reading Proficiency to review, discuss, and prioritize policies. Prioritized policies by indicator breakout session are included below.
• Shared next steps were for the work group to complete asset mapping for each of the prioritized policies. The indicators will meet separately going forward and will discuss strategies and action planning at the December meetings. Work group members are welcome to join multiple indicator groups.

Indicator 5: Adverse Childhood Experiences Breakout Session

• Co-Leads Present: Wanda Boone
• Work Group Members Present: Crystal Taylor, Jess Bousquette, Kella Hatcher, Na’im Akbar, Rebecca Swofford, Stacie Kinlaw, Susanne Schmal, Trina Stephens, Amber Robinson, Elizabeth DeKonty, Micha James, Morgan Forrester Ray, Trishana Jones
• Prioritized Policies:
  • Expand community and domestic violence prevention programs
  • Increase access to children’s mental health services by expanding mental health services in primary care, schools, and specialty care
  • Increase minimum wage and employment opportunities

August 15, 2022, 2:00 to 4:00 pm, Co-Lead Planning Meeting (Short-Term Suspensions, Adverse Childhood Experiences, and Third Grade Reading Proficiency)

Co-Leads: Wanda Boone, Mebane Boyd, Laura Gerald, Jessica Lowery Clark, Mary Mathew, Gerri Mattson, and Letha Muhammad

Discussion:

• Set ground rules and norms for the co-leads and work group.
• Reviewed the proposed policy initiatives from the NC SHIP for Indicator 3: Short-Term Suspensions, Indicator 5: Adverse Childhood Experiences, and Indicator 6: Third Grade Reading Proficiency. Identified questions and discussed recommended revisions.
• Planned for work group meetings, including meeting structure and first meeting agenda topics.

Priorities

The 2022-2023 Third Grade Reading Proficiency Work Group identified the following priority for action planning. Work group members engaged in discussions and review of best practices and resources related to reinforcing the talent pipeline for educators.

• Reinforce the talent pipeline for early educators for children from birth through third grade by increasing compensation through dedicated funding, ensuring pay parity, and sustaining investments in training and professional development

Action Plan

The Third Grade Reading Proficiency's proposed work included including help planning, promoting, and participating in the event, contacting legislators regarding current ECE bills, organizing local postcard writing campaigns with parents, etc. The work group considered this priority as the most urgent need at this time and opportunities for aligning with other initiatives and legislative asks. The work group also considered who were the decision-makers, key influences, and if there was alignment with another work group. 

Priority: Reinforce the talent pipeline for early educators for children from birth through third grade by increasing compensation through dedicated funding, ensuring pay parity, and sustaining investments in training and professional development

•  Strategies:
  • Promote engagement in Child Care for NC Advocacy Event on April 20th to help build awareness of policy priority and support for strategies/ legislative asks.
  • Regroup after April 20th to review budgets, event, and work group contributions to event, as needed, and discuss next steps.
• Tasks:
  • Confirm strategy with NC SHIP
  • Sign up for updates on website: https://childcarefornc.org/ 
  • Review toolkit and participate in upcoming trainings​​​​​​​
  • Sign Commitment Form
  • Work group members will choose tasks from toolkit below to implement as they are able: (Advocacy Toolkit https://express.adobe.com/page/YxSXBUPrsisc0/)​​​​​​​
    • Talk with my co-workers about Child Care for NC.
    • Talk with the parents in my child care program about Child Care for NC.
    • Talk with business leaders in my community about Child Care for NC.
    • Organize a group to come to Raleigh on April 20, 2023.
    • Serve as a local/regional contact to help mobilize your community.
    • Share materials about the event (hanging flyers, distributing postcards, buttons, etc.).
    • Spread the word on social media, write a letter to the editor/op-ed, or share in newsletters, blogs, etc.

Deferred (Not Prioritized Policies)

The following policies were discussed by the Third Grade Reading Proficiency Work Group and were not prioritized for action planning for 2022-2023. 

• Increase access to evidence-based home-visiting, parent education, and early literacy programs
• Expand community and domestic violence prevention programs
• Expand statewide access to NC Pre-K, 4-, and 5-star early learning programs and other high-quality early childhood programs
• Fund statewide multisector community collaboration efforts to include children from low-income families and people of color
• Implement attendance interventions for chronically absent students
• Increase funding to public schools and early learning programs that serve those children with the highest barriers to success, including children from low-income families and people of color
• Invest in better data to readily identify households facing barriers to early childhood learning
• Strengthen Juvenile Crime Prevention Councils
• State campaign around building book access and culture of literacy in communities
• Focus on Medical home  for connecting early literacy and health, screening, etc.

Meeting Notes

March 27, 2023, 9:00 to 10:00 AM, Work Group Meeting

Co-Leads: Mary Mathew, Gerri Mattson; Absent: Jessica Lowery Clark

Attendees: Rhiannon Chavis-Wanson, Muffy Grant, Jenna Nelson, and Dan Tetreault

Discussion:

• Reviewed the purpose of the work group and the policy priority the work group selected. Discussed the action planning from the previous work group meeting.
  • Reinforce the talent pipeline for early educators for children from birth through third grade by increasing compensation through dedicated funding, ensuring pay parity, and sustaining investments in training and professional development.
• Reviewed legislative areas related to policy priority:
  • EdNC- Early childhood caucus shares priorities, including $300 million child care request
  • General Assembly of NC- House Bill 483- Auto Subsidy Eligibility/Childcare Teacher/Pilot
• Discussed Child Care for NC: United for Change event on April 20, 2023, from 10:00 to 12:00 pm. Reviewed ideas for promoting the event from the Advocacy Toolkit. Work group members shared what their organizations were doing to support the event and what could be done. 
• Action steps included:
  • Follow the House and Senate budgets to see appropriations for child care bills. (The NC Early Education Coalition is tracking and is a resource for information, https://ncearlyeducationcoalition.org/.)
  • Sign commitment form, including what work group members are able to do for the event. (Child Care for NC: United for Change Commitment Form)
  • Regroup as a work group after April 20 to review budgets, event, work group contributions to the event, and discuss next steps.

February 16, 2023, 11:00 to 12:15 pm, Work Group Meeting

Co-Leads: Jessica Lowery Clark, Mary Mathew, and Gerri Mattson

Discussion:

• Completed asset mapping and began action planning to address policy priority:
  • Reinforce the talent pipeline for early educators for children from birth through third grade by increasing compensation through dedicated funding, ensuring pay parity, and sustaining investments in training and professional development.
• Identified the following strategy and related tasks:
  • Promote engagement in Child Care for NC Advocacy Event on April 20, 2023, to help build awareness of policy priority and support for strategies/ legislative ask

January 19, 2023, 12:30 to 2:00 pm, Work Group Meeting

Co-Leads: Mary Mathew, Jessica Lowery Clark, Gerri Mattson

Attendees: Amber Pierce, Ashley Lindsay, Greer Cook, Jenna Nelson, Muffy Grant, Rhiannon Chavis-Wanson, Sara van Driel, Tonia Parrish,

Discussion:

• Reviewed meeting goals:
  • Finalize one or two policy areas to prioritize as a part of the NC SHIP to impact third grade reading proficiency.
  • Complete asset mapping for selected policy area(s).
  • Identify action steps for the work group to reasonably accomplish with others in the next six months.
• Reviewed that the following polices prioritized at the previous work group meeting.
  • Increase access to evidence-based home-visiting, parent education, and early literacy programs.
  • Reinforce the talent pipeline for early educators for children from birth through third grade by increasing compensation through dedicated funding, ensuring pay parity, and sustaining investments in training and professional development.
• Received presentations about the following programs and/or organizations and policy-level considerations related to third grade reading proficiency and the prioritized policies.
  • North Carolina Maternal, Infant and Early Childhood Home-Visiting (MIECHV) Program
  • Triple P- Positive Parenting Program
  • North Carolina Early Education Coalition
• Selected the following policy priority given the current urgency of this work and potential legislative asks and other actions that can support this in the next six months, which are also based on the voices of families, communities, educators and providers. Recognized the importance of increasing access to evidence-based home-visiting and parenting education programs (HVPE) and early literacy programs and suggest potentially focusing on this next year. This may include aligning with HVPE systems building work, future MIECHV (Maternal, Infant and Early Childhood Home-Visiting) expansion, health and education system-based early literacy efforts, etc., and being clearer about the policy focus and scope.
  • Reinforce the talent pipeline for early educators for children from birth through third grade by increasing compensation through dedicated funding, ensuring pay parity, and sustaining investments in training and professional development.

December 1, 2022, 12:30 to 1:30 pm, Work Group Meeting

Co-Leads: Mary Mathew, Jessica Lowery Clark, Gerri Mattson

Work Group Members Present: Muffy Grant, Rhiannon Chavis-Wanson, Amber Pierce, Paula Wilkins

Discussion:

• Shared and discussed ideas for new work group members.
• Reviewed policies prioritized during the work group meeting on October 19, 2022, and updated rankings. The work group felt all the proposed policies were important and prioritized the policies they felt they could make progress on by July 2023.
  • Increase access to evidence-based home visiting and parenting education, early intervention, and early literacy programs
  • Reinforce the talent pipeline for early educators for children from birth through third grade by increasing compensation through dedicated funding, ensuring pay parity, and sustaining investments in training and professional development
• Established the following action steps:
  • Share any ideas for new group members with Jessica and Mary.
  • Invite state and local organization leaders to the next meeting to understand current efforts for evidence-based home visiting and parenting education, early intervention, and early literacy programs. These conversations will be used to help with finalizing priorities and asset mapping.
• Scheduled next work group meeting for Thursday, January 19, 2023, from 12:30 to 2:00 pm. 

October 19, 2022, 9:00 to 11:00 am, Work Group Meeting (Short-Term Suspensions, Adverse Childhood Experiences, and Third Grade Reading Proficiency)

Co-Leads: Gerri Mattson, Jessica Lowery Clark, Laura Gerald, Letha Muhammad, Mary Mathew, Mebane Boyd (Absent), Wanda Boone

Work Group Members Present: Amber Pierce, Amber Robinson, Carlton Powell, Crystal Kelly, Crystal Taylor, Dawn Meskil, Devonya Govan-Hunt, Dr. Ronda Taylor Bullock, Elizabeth DeKonty, James E. Ford, Jess Bousquette, Karen Fairley, Kella Hatcher, Micha James, Morgan Forrester Ray, Na’im Akbar, Reverend Paul Robeson, Paula Wilkins, Peter Rawitsch, Rebecca Swofford, Stacie Kinlaw, Susanne Schmal, Trina Stephens, Trishana Jones, Vichi Jagannathan,

Discussion:

• Reviewed purpose of the work group, grounding/group norms, and overview Healthy North Carolina 2030 and North Carolina State Health Improvement Plan (NC SHIP).
• Divided into breakout sessions for Short-Term Suspensions, Adverse Childhood Experiences, and Third Grade Reading Proficiency to review, discuss, and prioritize policies. Prioritized policies by indicator breakout session are included below.
• Shared next steps were for the work group to complete asset mapping for each of the prioritized policies. The indicators will meet separately going forward and will discuss strategies and action planning at the December meetings. Work group members are welcome to join multiple indicator groups.

Indicator 6: Third Grade Reading Proficiency Breakout Session

• Co-Leads Present: Mary Mathew and Jessica Lowery Clark
• Work Group Members Present: Amber Pierce and Paula Wilkins
• Prioritized Policies:
  • Increase access to evidence-based parenting (including fatherhood programs), early intervention, and home visiting programs
  • Reinforce the talent pipeline for early educators for children from birth through third grade by increasing compensation through dedicated funding, ensuring pay parity, and sustaining investments in training and professional development

August 15, 2022, 2:00 to 4:00 pm, Co-Lead Planning Meeting (Short-Term Suspensions, Adverse Childhood Experiences, and Third Grade Reading Proficiency)

Co-Leads: Wanda Boone, Mebane Boyd, Laura Gerald, Jessica Lowery Clark, Mary Mathew, Gerri Mattson, and Letha Muhammad

Discussion:

• Set ground rules and norms for the co-leads and work group.
• Reviewed the proposed policy initiatives from the NC SHIP for Indicator 3: Short-Term Suspensions, Indicator 5: Adverse Childhood Experiences, and Indicator 6: Third Grade Reading Proficiency. Identified questions and discussed recommended revisions.
• Planned for work group meetings, including meeting structure and first meeting agenda topics.

Priorities

The Access to Exercise Opportunities Work Group recommended an updated focus from access to exercise opportunities to access to physical activity opportunities to be more inclusive, as physical activity refers to any bodily movement that requires energy. This is aligned with CDC's shift toward more inclusive and holistic language such as physical activity and movement.

The Work Group identified the following priorities for action planning related to safe and well-lit sidewalks, bike trails and lanes, walking trails, greenways, and multi-modal transit options.

• Increase the number of safe and well-lit sidewalks, bike trails and lanes, walking trails, and greenways to improve connectivity and accessibility
• Promote, improve, and maintain the number of safe and well-lit sidewalks, bike trails and lanes, walking trails, and greenways to improve connectivity and accessibility
• Promote, sustain, and expand multimodal transportation options to increase access to places for physical activity

Action Plan

The Access to Exercise Opportunities Work Group identified the following potential short-term and long-term strategies to move the priorities forward.

• Priority: Increase the number of safe and well-lit sidewalks, bike trails and lanes, walking trails, and greenways to improve connectivity and accessibility
  • Short-Term Strategies:
    • Use sidewalks, biking trails, lanes, walking trails, and greenways available.
    • Promote walking audits, making sure to target areas of historical disinvestment (Steps to Health).
    • Involve youth in promotion and assessment (walk audits).
    • Engage youth to promote need (for example, youth empowerment groups).
  • Long-Term Strategies:
    • Ensure long-term equitable funding, making sure to target areas of historical disinvestment.
• Priority: Promote, improve, and maintain the number of safe and well-lit sidewalks, bike trails and lanes, walking trails, and greenways to improve connectivity and accessibility
  • Short-Term Strategies:
    • Educate on sidewalk maintenance (more education).
    • Market events, such as connecting greenways, walk to school day, etc.
    • Highlight and connect to wider transportation network.
    • Promote Rails to Trails.
  • Long-Term Strategies:
    • Ensure long-term equitable funding, making sure to target areas of historical disinvestment.
• Priority: Promote, sustain, and expand multimodal transportation options to increase access to places for physical activity
  • Short-Term Strategies:
    • Encourage Medicaid to expand transportation options.
    • Complete asset mapping of existing rideshare programs.
    • Examples of rideshare programs: Edgecombe, Craven Area Rural Transit System (CARTS), and Fuquay-Varina- seniors to growers markets.
    • Increase connectivity to daily life destinations.
    • Build bike racks into infrastructure for schools.
    • Educate LEAs (local educational agencies) on biking and walking to schools.
  • Long-Term Strategies:
    • Ask Integrated Mobility Division at NC DOT about long-term policies to support this.

Meeting Notes

April 24, 2023, 10:00 to 12:00 pm, Work Group Meeting

Co-Leads: Alice Ammerman, Jayne McBurney, Rachel Poehlman, and Tish Singletary

Attendees: Alex Rotenberry, Brandy Bynum Dawson, Katie Harmon, Leah Mayo

Discussion:

• Reviewed at the top three policies revised at the previous meeting the work group. No changes recommended to the wording of the top policy priorities.
  • Increase the number of safe and well-lit sidewalks, biking trails, lanes, walking trails, and greenways to improve connectivity and accessibility.
  • Promote, improve, and maintain the number of safe and well-lit sidewalks, biking trails, lanes, walking trails, and greenways to improve connectivity and accessibility
  • Promote, sustain, and expand multi-modal transit options to increase access to places for physical activity
• Discussed the following questions for each of the three top policy priorities. The responses from the asset mapping worksheet and meeting chat are included after the notes.
  • What are recommendations for lead agencies for this policy work?
  • What would be short-term strategies to move this policy forward?
  • What would be long-term strategies to move this policy forward?
  • What are additional assets needed?
  • What sources of funding are and/or may be available for this policy initiative? 
• Next steps were for work group members to add any additional responses to the asset mapping questions by May 8, 2023. The Co-Leads will meet to review the responses to discuss strategies and action planning.

December 5, 2022, 10:00 to 12:00 pm, Work Group Meeting

Co-Leads: Alice Ammerman, Jayne McBurney, Rachel Poehlman, and Tish Singletary

Attendees: Alex Rotenberry, Brandy Bynum Dawson, Jason Uroz, Katie Harmon, Kelly Kavanaugh, Kenneth Withrow, Leah Mayo, Michelle Nance, Mike Edwards

Discussion:

• Reviewed the purpose of the meeting was to review the proposed policy initiatives/ strategies to prioritize them, discuss what others are doing in this space, and revise and add to the policies as needed.
• Provided an overview of the NC SHIP Community Council and Healthy North Carolina 2030.
• Reviewed and discussed the policy initiatives for Access to Exercise Opportunities, including the results of the policy ranking survey. The work group reviewed each of the policies and discussed recommendations for revisions and challenges associated with each of the policies.
• Identified the top priorities for asset mapping were:  
  • Maintain safe and well-lit sidewalks
  • Increase the number of biking trails and lanes, walking trails, and greenways
  • Expand transit services to increase access to places for physical activity
  • Rethink prioritization measures for improvements, such as crash data, identification of marginalized populations, and infrastructure needs for vulnerable communities
  • Increase the number of joint use/open use policy agreements for school playground facilities
• Planned for work group members to answer the asset mapping questions regarding each of the prioritized policies before the next work group meeting.

October 20, 2022, 10:00 to 11:00 am, Co-Lead Planning Meeting

Co-Leads: Alice Ammerman, Jayne McBurney, Rachel Poehlman, and Tish Singletary

Discussion:

• Reviewed work group invitee list and responses to policy survey.
• Drafted agenda and planned for work group meeting on December 5, 2022.

August 25, 2022, 9:00 to 10:45 am, Co-Lead Planning Meeting

Co-Leads: Alice Ammerman, Jayne McBurney, Rachel Poehlman, and Tish Singletary

Discussion:

• Discussed and added to the list of potential work group members. 
• Identified process for prioritizing the proposed policy intiaitives and discussed that the policies for Indicator 7: Access to Exercise Opportunities were more infrastructure related. 
• Set next work group meeting dates. 

Priorities

The Severe Housing Problems Work Group prioritized the following policies for action planning. Work group members engaged in thorough discussions with considerations of existing plans and resources and review of research on housing needs, burdens, and efforts to increase access to safe, affordable, quality housing opportunities.

• Increase measures and funding to provide tenants with access to mediation, legal representation, and legal education to secure and protect housing
• Remove legal barriers, institute enabling legislation, and facilitate lending to promote Community Land Trusts and other shared equity models of homeownership
• Simplify and expand the Weatherization Assistance Program, Low-Income Energy Assistance Programs, and other healthy homes and utility assistance programs by affirmatively engaging low-income communities through targeted outreach to help families meet their energy needs
• Support funding, loans, and other resources for housing providers in agricultural areas to improve safe and healthy home environments for migrant workers
• Support programs designed to increase home ownership for historically disenfranchised communities

Action Plan

The Severe Housing Problems Work Group identified the following for action planning and next steps.

• Engage identified organizations in policy, workgroup convening or with other organization (NC Housing/ NCHFA Annual Conference, Homeless Conference- May
• Affirmatively furthering fair housing- comments periods
• Advocacy groups to help to initiate/ deliver the prioritized policies; legislative liaisons
• Open discussion item: Manufactured/mobile homes- getting expertise to move forward
• More education and awareness on migrant housing
• Explore if there are other organizations that could help, related to purchasing homes, legal issues, community resources; getting information for each locality about resources available; after explore, identify how to utilize those relationships- who contacting and why

Meeting Notes

June 27, 2023, 4:30 to 5:30 pm, Work Group Meeting

Co-Leaders: Stephen Sills and Pat Macfoy

Attendees: Bill Rowe, Brian O’Donnell, Josh Walker, Lea Henry, Stefanie Ledwell

Discussion:

• Reviewed the draft pages for Severe Housing Problems for the 2023 NC SHIP report. Discussed why the priorities were important, additional readings/listenings, and additional partners that could help with this work.
• Identified new Organization Co-Lead, Lea Henry, and DHHS Co-Lead, Josh Walker. Pat Macfoy will continue as the Community Co-Lead.
• Confirmed continuing work group members and discussed recommendations for additional partners, especially from rural areas. The work group will continue to add people strategically. Recommendations included:
  • Carolinas Council of Housing Redevelopment & Codes Officials
  • Council of Governments (COGs)- those active in rural space
  • Upper Coastal Plain Council of Governments
  • The Episcopal Diocese of North Carolina- Affordable Housing
  • Hinton Rural Life Center, Clay County
  • LISC Charlotte
  • MDC
  • NC Association of Realtors/ NC Realtors
  • NC DOA (North Carolina Department of Administration) Indian Affairs
  • Rural Center

April 25, 2023, 4:30 to 5:30 pm, Work Group Meeting

Co-Leads: Stephen Sills; Absent: Pat Macfoy and Sam Hedrick

Attendees: Bill Rowe, Brad Owen, Brian O’Donnell, Lea Henry, and Stefanie Ledwell

Discussion:

• Conducted a straw poll on work group members' willingness to continue after June.
• Identified other organizations that could help the work group to be more representative of the issues across the state related to severe housing problems and impacting policy.
• Discussed topics for a potential panel session at a conference in early October 2023.
• Identified next steps were to:
  • Create and share a spreadsheet with organizations and contacts discussed.
  • Add contact information to the organization spreadsheet.
  • Share if willing to co-lead this work group.
  • Ask the conference team about having a session.
  • Contact absent work group members to ask if they are willing to continue with the work group.

February 28, 2023, 4:30 to 6:00 pm, Work Group Meeting

Co-Leads: Pat Macfoy, Sam Hedrick, and Stephen Sills

Attendees: Brad Owen, Brian O’Donnell, Ken Edminster, Stefanie Ledwell, and Stephanie Williams

Discussion:

• Discussed and revised the prioritized policies. Ranked the revised policies from most to least important/ difficult:

1. Support programs designed to increase home ownership for historically disenfranchised communities.
2. Increase measures and funding to provide tenants with access to mediation, legal representation, and legal education to secure and protect housing.
3. Remove legal barriers, institute enabling legislation, and facilitate lending to promote Community Land Trusts and other shared equity models of homeownership.
4. Support funding, loans, and other resources for housing providers in agricultural areas to improve safe and healthy home environments for migrant workers.
5. Simplify and expand Weatherization Assistance Program, Low-Income Energy Assistance Programs, and other healthy homes and utility assistance programs by affirmatively engaging low-income communities through targeted outreach to help families meet their energy needs.
6. Tabled (more information needed): Consider regulatory change allowing mobile homes to be registered as real property (homes), not as personal property (vehicles)

• Brainstormed and compiled a list of assets and needs/ gaps for each of the prioritized policies.
• Began action planning and reviewed next steps.
  • Engage identified organizations in policy, workgroup convening or with other organization (NC Housing/ NCHFA Annual Conference, Homeless Conference- May
  • Affirmatively furthering fair housing- comments periods
  • Advocacy groups to help to initiate/ deliver the prioritized policies; legislative liaisons
  • Open discussion item: Manufactured/mobile homes- getting expertise to move forward
  • More education and awareness on migrant housing
  • Explore if there are other organizations that could help, related to purchasing homes, legal issues, community resources; getting information for each locality about resources available; after explore, identify how to utilize those relationships- who contacting and why

January 3, 2023, 4:30 to 6:00 pm, Work Group Meeting

Co-Leads: Pat Macfoy and Stephen Sills

Work Group Members Present: Antonio Blow, Bettie Teasley, Bill Rowe, Brian O’Donnell, and Stefanie Ledwell

Discussion:

• Reviewed, discussed, and revised the prioritized policies as follows:
  • Support funding/loans for housing providers in agricultural areas to improve safe and healthy home environments for migrant workers
  • Increase measures and funding to provide tenants with access to mediation, legal representation, and legal education to secure and protect housing
  • Simplify and expand Weatherization Assistance Program, Low-Income Home Energy Assistance Programs, and other assistance programs from utility providers by affirmatively engaging low wealth communities through targeted outreach to help low-income families meet their energy needs
  • Support programs designed to increase home ownership for historically disenfranchised communities
  • Remove legal and other barriers, institute enabling legislation, and facilitate lending to promote Community Land Trusts and other shared equity models of homeownership
• Identified additional information was needed to for review and discussion of the following policy:
  • Consider regulatory change allowing mobile homes to be registered as real property (homes), not as personal property (vehicles)

November 29, 2022, 3:30 to 4:30 pm, Work Group Meeting

Co-Leads: Pat Macfoy and Stephen Sills

Work Group Members Present: Antonio Blow, Bill Rowe, and Stefanie Ledwell

Discussion:

• Reviewed the four policies prioritized during the previous work group meeting.
  • Consider regulatory change allowing mobile homes to be registered as real property (homes), not as personal property (vehicles)
  • Implement “right to counsel” measures to provide tenants with access to legal representation when facing landlords in court
  • Increase measures to provide tenants with access to legal representation when facing landlords in court
  • Institute community land trusts in which the community purchases the land a home is on to lease to homeowners with low and middle incomes and require homeowners to sell the home back to the trust or to another resident with low income upon moving
• Reviewed and discussed the following proposed policies not reviewed at the previous meeting. All work group members present were in favor of prioritizing the four policies reviewed and discussed during the meeting. The work group prioritized a total of eight policies.
  • Promote the Weatherization Assistance Program and Low-Income Home Energy Assistance Programs to help low-income families meet their energy needs
  • Support programs designed to increase home ownership for people of color
  • Update housing standards for agriculture workplace housing (H2A housing), as regulated by the federal Occupational Safety and Health Administration
  • Update the Migrant Housing Act of North Carolina to promote safe and healthy home environments for migrant workers
• Identified next steps of refining the list of prioritized policies, using the lead/partner/support model to determine strategies for action planning, and aligning with other work and proposing new work as needed.

October 25, 2022, 4:30 to 4:50 pm, Work Group Meeting

Co-Leads: Pat Macfoy and Stephanie Williams; Stephen Sill (Absent)

Work Group Members Present: None

Discussion:

• Reviewed responsibilities of community co-lead.
• Planned for rescheduling this work group meeting in November. The new meeting date is to be determined.

August 30, 2022, 4:30 to 6:30 pm, Work Group Meeting

Co-Leads: Pat Macfoy, Stephen Sill, and Stephanie Williams

Work Group Members Present: Antonio Blow, Jennifer Olson, and Stefanie Ledwell

Discussion:

• Dr. Sills provided context around housing and health based on the following research: 
  • Affordable and Healthy Homes in North Carolina
  • The Status and Impact of Severe Housing Problems and Evictions in North Carolina
  • Affordable & Workforce Housing: A Public Opinion Study for New Hanover County & The City of Wilmington
  • Policy Agenda – Increase Affordable, Fair, & Healthy Housing Options
• Reviewed and discussed the proposed policy initiatives for Indicator 9: Severe Housing Problems. Prioritized 4 policies, deferred 4 policies already addressed in the Strategic Housing Plan and/or the Olmstead Plan, and 4 policies will be reviewed later.
• Identified other partners to invite to be involved with the work group to address the prioritized policies and who would contact them.
• Set meeting schedule for the 4th Tuesday of every other month from 4:30 to 6:30 pm. The next meeting will be on October 25, 2022. 

August 26, 2022, 11:00 to 12:00 pm, Co-Lead Planning Meeting

Co-Leads: Pat Mcfoy, Stephen Sill, and Stephanie Williams

Discussion: 

• Set agenda for first work group meeting on August 30, 2022.  An overview of the NC SHIP Community Council will be provided. Dr. Sills will provide context around Housing & Health based on some of the research he has completed. The proposed policy initiatives for Indicator 9: Severe Housing Problems will be reviewed and prioritized. 

Priorities

The following priority areas are from North Carolina’s Opioid and Substance Use Action Plan (OSUAP). For additional information refer to the current OSUAP and data dashboard at https://www.ncdhhs.gov/about/department-initiatives/overdose-epidemic/north-carolinas-opioid-and-substance-use-action-plan/.

• Center Equity and Lived Experiences by acknowledging systems that have disproportionately harmed historically marginalized people (HMP), implementing programs that reorient those systems, and increasing access to comprehensive, culturally competent, and linguistically appropriate drug user health services for HMPs
• Prevent future addiction and address trauma by supporting children and families
• Reduce Harm by moving beyond just opioids to address polysubstance use
• Connect to Care by increasing treatment access for justice-involved people and expanding access to housing and employment supports to recover from the pandemic together

Action Plan

The Opioid and Substance Use Action Plan broadens its focus to include polysubstance use and centers equity and lived experience (OSUAP, 2021). Strategies included in the action plan are available at https://www.ncdhhs.gov/about/department-initiatives/overdose-epidemic/north-carolinas-opioid-and-substance-use-action-plan.   

The a data dashboard provides integration and visualization of state, regional, and county-level metrics for partners across North Carolina to track progress toward reaching the goals outlined in the NC Opioid and Substance Use Action Plan at https://www.ncdhhs.gov/opioid-and-substance-use-action-plan-data-dashboard.

Meeting Notes

March 3, 2023, NC Opioid and Prescription Drug Abuse Advisory Committee (OPDAAC) Meeting

• The agenda, slides, and recording for the meeting are available online at OPDAAC Meetings: Agendas and Presentations | NCDHHS.
• The meeting focused on drug checking as an overdose prevention and harm reduction strategy.
• Instead of an OPDAAC meeting in June, members are encouraged to attend the NC Summit on Reducing Overdose, June 7-8, 2023 at the Durham Convention Center. The next OPDAAC meeting will be in September 2023.  

December 9, 2022, NC Opioid and Prescription Drug Abuse Advisory Committee (OPDAAC) Meeting

• The agenda, slides, and recording for the meeting are available online at OPDAAC Meetings: Agendas and Presentations | NCDHHS.
• The meeting focused on justice system diversion programs for overdose prevention work.
• The next OPDAAC meeting will be in March 2023. 

October 21, 2022, Update

• The Co-Leads revisited the best way to incorporate the HNC 2030/NC SHIP work in the overdose space and decided that the NC Opioid and Prescription Drug Abuse Advisory Committee (OPDAAC) is a better home for this work instead of the Syringe Services Programs Advisory Group.
• The OPDAAC is an existing statewide advisory group responsible for the development of and implementation of the existing statewide action plan. One of the main goals of the action plan is to reduce the number of overdose deaths.
• OPDAAC resources, including past meeting presentations and the statewide action plan are available at https://www.ncdhhs.gov/about/department-initiatives/overdose-epidemic/nc-opioid-and-prescription-drug-abuse-advisory-committee.

August 22, 2022, 1:00 to 2:30 pm, Syringe Services Programs Advisory Group Meeting

Co-Leads: Alyssa Kitlas and Mary Beth Cox (Absent)

Discussion: 

• Provided overview of the NC SHIP and next steps. At the next Syringe Services Programs Advisory Group meeting on September 26, 2022, the group plans to  discuss the prioritized policy initiatives and finalize plan for the coming year's work. Prior to that meeting, the Co-Leads will do preliminary prioritizing of the policy initiatives. 

Priorities

The SHIP Tobacco Committee recognizes that effective tobacco control includes tobacco price increases, smoke-free policies, targeted media campaigns, and access to cessation services. Addressing availability, pricing and promotion, advertising and display bans, age of sale, and retail licensure are strategies for boosting tobacco control efforts.

The term tobacco use refers to commercial tobacco use, which includes all tobacco products offered for sale, not tobacco used for sacred and traditional ceremonies by many American Indian tribes and communities.

Point of Sale

• Explore policy strategies to prohibit the sale of tobacco products in pharmacies
• Remove state preemption of local government regulations on the sale, promotion, distribution, and display of tobacco products
• Revise zoning ordinances to control placement of shops that sell tobacco, limiting the number of these shops per area and ensuring they are placed a safe distance from children’s areas

Price and Funding

• Fund comprehensive state tobacco control programs to levels recommended by Centers for Disease Control and Prevention (CDC)
• Increase number of paid staff at the state/local level to conduct comprehensive tobacco control programs
• Increase the price of tobacco products by raising the current state tax on cigarettes and increase other tobacco products taxes to parallel levels

Providing Barrier Free Access to Tobacco Treatment

• Ensure Medicaid reimbursement for provision of tobacco cessation counseling and treatment for parents in any pediatric setting, not just during a tobacco-related sick visits
• Expand Medicaid eligibility to include coverage for all tobacco cessation treatment without barriers; this includes Medicaid coverage of group counseling for tobacco treatment
• Expand the accessibility of tobacco use treatment for Medicaid beneficiaries into more settings and modalities, with a broader array of providers
• Explore seeking reimbursements for Certified Tobacco Treatment Specialists (CTTS) for their work in providing standard of care tobacco treatment- counseling and tobacco treatment medications under the supervision of a prescriber
• Increase access to treatment based on the N.C. Tobacco Treatment Standard of Care, to include counseling and FDA-approved medications
• Provide nicotine replacement options and services to the uninsured and underinsured
• Support Tobacco Treatment Specialist Training for historically marginalized communities

Raise State Minimum Sales Age/ Retailer Permitting System

• Raise state minimum sales age from 18 to 21 and establish a tobacco retailer permitting system to protect NC youth; this includes taking action to:
  • Increase compliance of retailers to ask purchasers for a photo ID to buy tobacco products to prevent sales to anyone under the age of 21;
  • Educate NC merchants and the NC public that the minimum sales age for tobacco is 21 is federal law.
  • Adopt change in state law that allows for full implementation of the federal Tobacco 21 law, including changing the minimum legal sales age from 18 to 21; an amended definition of tobacco products to include nicotine from any source, including synthetic nicotine; prohibits the sale of loose cigars and cigarettes; prohibits free samples of all tobacco products; requires ID to be shown for delivery of most internet sales, and that tobacco products be sold from behind the counter.
  • Repeal preemption to allow NC and communities in NC to restrict the sale of flavored tobacco products

Smoke-Free and Tobacco-Free Environments

• Enforce the federal law that calls for smoke-free multi-unit public housing and promote smoke-free multi-unit affordable housing
• Implement state and local tobacco-free and smoke-free air policies that include electronic cigarettes
• Increase the number of tobacco-free public parks
• Recommend an electronic cigarette policy for restaurants and bars

Meeting Notes

June 15, 2023, Hybrid Work Group Meeting (In-Person at Poe Center for Health Education)

Attendees: Kim Bayha, Teresa Beardsley, Ronny Bell, Catherine Bonniot, Anna Brown, Heather Burkhardt, Kim Canady, Megan Canady, Lisa Dalton, Kaycee Deen, Evangeline Eure, Stephanie Gans, Krysta Gougler-Reeves, Sanquis Graham, Morgan Wittman Gramann, Courtney Heck, Sally Herndon, Mona Hood, Kearston Ingraham, Virginia Johnson, Camaryn Jones, Susan Kansagra, Rita Krosner, Noxxie Malinga, Jim Martin, Viviana Martinez, Erin McClain, Keith McCoy, Lu McCraw, Beth McDermott, Kimberly McDonald, Mallory Moran, Michelle Mulvihill, Tiffany Munday, Sharon Nelson, Sherry Nethercutt, Dana Painter, Sherrie Parish, Susan Peebles, Amy Perry, Richard Peters, Leah Ranney, Ashley Rink, Ray Riordan, Ann Rollins, Delton Russell, Charlene Sampson, Lou Simmons, Kyle Smith, Anna Stein, Deidre Sully, Joyce Swetlick, Tiffany Thigpen, Natalie Thompson, Elizabeth Tilson, D’Asia Thompson, Tenika Walker, Mary Ward, Ernest Watts, Tori Whitley, David Willard, Juliana Wilson, Rachel Yip, Emily Yost, Christine Zazzaro

Topics: Refer to the presentation slides for information shared during the panel discussions on the following topics.

• Leadership Panel: How far we have come in 5 Years and Why this is a Great Step in North Carolina
• Level Setting: What is the Medicaid Policy? To Whom does it Apply/Not Apply?
• The Road Ahead to April 1, 2024: Training, Technical Assistance, and Change for Life: A Successful Peer Support Coalition Model

Below are the links shared during the panel discussions.

• BreatheEasyNC
  • FAQs for medical, behavioral, and IDD/TBI providers
  • Training calendar
  • Evidence-based treatment and policy information with citations and links to resources
  • Sample policies, sample signage
  • Regional tobacco control staff map
• Tobacco Treatment Standard of Care
• North Carolina Standard Plan, Tailored Plan and LME/MCO Tobacco-Free Policy Requirement (NC Medicaid’s Bulletin)
• QuitlineNC

April 14, 2023, 1:00 to 2:30 pm, Work Group Meeting

Co-Leads: Ronny Bell, Sally Herndon, and Delton Russell

Attendees: Joshua Batten, Kim Bayha, Teresa Beardsley, Anna Bess Brown, Kimberly Canady, Carleen Crawford, Ashley Curtice, Lisa Dalton, Kaycee Deen, Krysta Gougler-Reeves, Sanquis Graham, Morgan Wittman Gramann, Cierra Hamlet, Eric Harbour, Courtney Heck, Mona Hood, Kearston Ingraham, Jaimie Lea, Noxxie Malinga, Viviana Martinez, Molly Monath, Tamra Morris, Michelle Mulvihill, Tiffany Munday, Sharon Nelson, Dana Painter, Sherrie Parish, Leah M. Ranney, Vera Reinstein, Hope Rife, Ray Riordan, Ann Rollins, Faith L. Samples, Charlene Sampson, Jasmine Simmons, Lou Ann Simmons, Ann Staples, Gregg Stave, Antoinette Stein, Joyce Swetlick, Tiffany Thigpen, Natalie Thompson, Steph Trilling, Mary Ward, Ernest Watts, Cathy Weedman, David Willard, Larissa Williams

New QuitlineNC Services

• Joyce Swetlick, Director of Tobacco Cessation, North Carolina Tobacco Prevention and Control Branch, provided an overview of QuitlineNC and new services available.
• Participants can enroll by calling 1-800-QUIT-NOW (1-800-784-8669), going to the website www.quitlinenc.com, or texting 234191, which will send a link to the web enrollment. Spanish speakers can call 1-855-DÉJELO-YA (1-855-335-3569) or text LISTO to 34191. The website is also available in Spanish.

Progress on Rescue Agency “Behind the Haze” Campaign

• Ann Staples, Senior Media Consultant, NC Tobacco Prevention and Control Branch, shared updates from “Behind the Haze,” one of the campaigns purchased from the Rescue Agency.
• “Behind the Haze” targets teenagers ages 13 to 18, who are either using vapes or are susceptible to vapes. The first message package, the Great Manipulator, ran between January 10 to March 8, 2023, on Instagram, Snapchat, and TikTok. Due to the state ban, the next package will not be on TikTok.
• Down & Dirty, another message package purchased from Rescue, will target teenagers ages 13 to 18. A cessation program from Rescue, Quit the Hit, will include small, adult-facilitated Instagram Groups.

North Carolina Alliance for Health (NCAH) Legislative Updates

• Morgan Wittman Gramann, Executive Director, North Carolina Alliance for Health, shared there has been a lot of discussion around Tobacco 21 that would increase the age from 18 to 21 to purchase tobacco products and would also implement a retail permitting system for retailers that sell tobacco products.
• Mogan shared during this legislative session the Alliance is focusing on strategic education with specific lawmakers and continuing to build coalition support. Also, continuing to focus on funding for commercial tobacco use prevention and cessation programs like the QuitlineNC that Joyce shared, the Rescue campaign that Ann shared, and some youth focused activities.
• For additional information about Senate Bill 116, 2023 Youth END (End Nicotine Dependence) Act, refer to https://www.ncleg.gov/BillLookUp/2023/s116.

Unity Conference and Tobacco Survey of NC Tribes

• Dr. Ronny Bell shared the North Carolina American Indian Unity Conference happens the second Thursday, Friday, and Saturday of March each year. This year’s conference was very well attended.
• The Southeastern American Indian Cancer Health Equity Partnership, which includes the community outreach and engagement programs for the three NCI-Designated Cancer Centers at Wake Forest, Duke, and UNC, did a workshop on their partnership and the work they are doing with the V Foundation to engage with the tribal communities across the state.
• They had a wonderful session with representatives from the North Carolina Native American Youth Organization where they trained them to do photovoice in three of the tribal communities.
• Through partnership with the North Carolina Tobacco Prevention and Control Branch a survey to gain a better understanding of the use of commercial tobacco and alternative tobacco products in tribal communities in North Carolina will be conducted. The North Carolina Commission on Indian Affairs will organize and administer the survey. Their goal is to have about 2,000 surveys completed.

Medicaid Bulletin

• Sally Herndon shared the Medicaid Bulletin released recently clarifies and articulates the work done over the past five years in North Carolina to move all behavioral health facilities tobacco free and to offer tobacco treatment concurrently with substance use treatment and mental health disorder treatment.
• The bulletin is available at https://medicaid.ncdhhs.gov/blog/2023/03/15/north-carolina-standard-plan-tailored-plan-and-lmemco-tobacco-free-policy-requirement.

Next Steps on SHIP

• The next meeting will be in-person on Thursday, June 15, 2023, from 12:30 to 3:00 pm at the Poe Center in Raleigh. This will be a kickoff to the Medicaid Tobacco-Free policy that goes into effect in 2024. Dr. Betsey Tilson will be leading a panel discussion. There will be a question-and-answer session on the policy and implementation, including who this policy will and will not affect, and planned training and technical assistance. Another presentation will be on a peer-based model to help organizations that want to go tobacco free.

February 10, 2023, 1:00 to 2:30 pm, Work Group Meeting

Co-Leads: Ronny Bell, Sally Herndon, and Delton Russell

Work Group Members & Attendees Present: Ami McGarity, Ann Staples, Anna Bess Brown, Beverly Gray, Carleen Crawford, Charlene Sampson, Cierra Hamlet, Courtney Heck, Dana Painter, Danna Thompson, David Willard, Eric Donny, Erin McLain, Ernest Watts, Faith Samples, Heather Burkhardt, Jim Martin, Joyce Swetlick, Juliana Wilson, Kathy Dail, Kearston Ingraham, Kim Bayha, Kimberly McDonald, Krysta Gougler-Reeves, Larissa Williams, Lisa Dalton, Lou Ann Simmons, Lu McCraw, Mary Ward, Megan Williams, Michelle Mulvihill, Mona Hood, Natalie Thompson, Ray Riordan, Richard Peters, Ronda Doward, Sanquis Graham, Sarah Arthur, Shamika Howell, Sheryl Parish, Stacy Thiedeman, Stella Blankenship, Steph Gans, Tenika Walker, Teresa Beardsley, Thomas Carr, Tiffany Munday, Tiffany Thigpen, Vera Reinstein, Viviana Martinez

Tobacco 21 Updates

• Jim Martin provided an update on providing educational presentations about the benefits of Tobacco 21 and aligning North Carolina’s law with the federal law. Organizations that have voiced their support for Tobacco 21 include:
  • The Justus-Warren Heart Disease and Stroke Prevention Task Force, a legislatively appointed task force, unanimously voted to have this as part of their policy agenda for this year.
  • The North Carolina Association of Local Health Directors voted in December to have this as part of their legislative priorities for 2023.
  • The North County Public Health Association, the North Carolina Association of School Nurses, and the North Carolina Association of School Resource Officers have also voiced their strong support.
  • Other key organizations wanting to lend their support were the Alcohol and Drug Council of North Carolina, the North Carolina Psychiatric Association, Community Impact of North Carolina, Addiction Professionals of North Carolina, North Carolina Substance Use Disorder Federation, and Poe Center for Health Education.
  • Population Sciences at UNC, Duke, Atrium Health, and Wake Forest Baptist have also voiced lending their strong support.
  • The North Carolina Alliance for Health has this as their strongest policy priority for this year and are moving this forward as it relates to the legislature with strong support from multiple organizations.
• Ray Riordan shared the regional tobacco control managers have been speaking with and providing education on Tobacco 21 (T21) to County Commissioners, Boards of Education, and Boards of Health. As a result of the conversations, ten Boards of Health, three Boards of Education, some school health advisory councils (SHACs), and other regional groups have signed onto the T21 resolution.

American Lung Association: State of Tobacco Control, North Carolina

• Thomas Carr, National Director for Policy with the American Lung Association, provided a presentation on the “State of Tobacco Control.”
  • The 2023 “State of Tobacco Control” report is available at https://www.lung.org/research/sotc. The report is intended to be used as a tool to advance policy change at the federal, state, and local levels.
  • North Carolina’s state highlights are available at https://www.lung.org/research/sotc/state-grades/highlights/north-carolina. North Carolina had Fs in all five grade categories, https://www.lung.org/research/sotc/state-grades/north-carolina.

LGBTQ Tobacco Engagement and Data

• Juliana Wilson, MSW, Sexual and Gender Minority Tobacco Treatment Coordinator with the North Carolina Tobacco Prevention and Control Branch, provided a presentation on LGBTQ+ tobacco/nicotine product use and preferences for quitting.
  • The goal of this work was to begin to understand how and how much North Carolinians with minoritized gender identities and sexual orientations used tobacco and nicotine products, and how can begin to work toward improving access to use of an awareness of quitting services.
  • The NC LGBTQ+ Tobacco Assessment data was collected in-person by predominantly LGBTQ survey takers. Surveys were collected between June to November 2022. Data was collected at 20 pride events, 2 regional conferences, and a health fair across the state from over 1300 current and former tobacco and nicotine product users. The survey was for adults over eighteen.

December 9, 2022, 1:00 to 2:30 pm, Work Group Meeting

Co-Leads: Sally Herndon and Delton Russell; Absent: Ronny Bell

Work Group Members Present: Ami McGarity, Anna Bess Brown, Carleen Crawford, Charlene Sampson, Courtney Heck, Dana Painter, Erin Sutfin, Georgia Childs, Heather Burkhardt, Jaimie Lea, Jim Martin, Joyce Swetlick, Juliana Wilson, Kearston Ingraham, Kim Bayha, Kimberly McDonald, Kimberly Sumrell, Kyle Smith, Leah M Ranney, Lu McCraw, Mary Ward, Megan Canady, Megan Williams, Meghan Kissell, Michelle Mulvihill, Mona Hood, Natalie Thompson, Noxxie Malinga, Peg O'Connell, Richard Peters, Rita Krosner, Sanquis Graham, Shamika Howell, Sharon L. Greer, Steph Gans, Tiffany Munday, Trina Fullard, Vera Reinstein, Viviana Martinez

Announcements:

• Jim Martin provided an update on support from partner organizations for establishing a tobacco retailer permitting system and raising the sales age from 18 to 21.
• Peg O’Connell, Chair of the Stroke Advisory Council, shared that the Stroke Advisory Council is part of the Justus-Warren Heart Disease and Stroke Prevention Task Force. The Council’s focus is to reduce the incidence and revert heart disease and stroke in North Carolina. The Task Force is composed of both legislators and civilians, including heart disease and stroke survivors. Anna Bess Brown shared a link to the Justus-Warren Task Force’s action agenda, https://www.startwithyourheart.com/justus-warren-heart-disease-and-stroke-prevention-task-force/action-agenda/.    
• Shamika Howell introduced Michelle Mulvihill, Wake County’s new Tobacco Prevention and Control Coordinator. Michelle is the former Region 7 Tobacco Control Manager. Michelle Mulvihill shared Wake County’s tobacco-free policy ordinance includes tobacco-free areas in the unincorporated areas of the county. Wake County now has the most comprehensive tobacco-free policy in the state. They are now working with municipalities to pass their own ordinance/ resolution and/or opt-in.

Data Updates:

• Courtney Heck, Director of Surveillance and Evaluation with the North Carolina Tobacco Prevention and Control Branch, provided an update on adult and youth commercial tobacco use in North Carolina.

Success Stories:

• Delton Russell shared his personal story and why prevention work is so important to him.
• Trina Fullard shared the story of Charlotte Rescue Mission in becoming a tobacco-free campus. Charlotte Rescue Mission is a recovery related program that is spiritual based. Their mission to provide food, clothing, and shelter for those facing the intersection of homelessness and addiction. Their program is not connected to insurance, LMEs, or treatment plans and are solely funded by private donations and grants.

Next Steps: 

• Workgroup members were asked to share suggestions for future agendas. Suggestions for meeting topics included:
  • Data collection from NC Pride events
  • Work being done to replicate rapid data collection at tribal events/ tribal survey
  • How Tobacco 21 will impact NRT sales
  • Asking any of the tobacco-free behavioral health facilities talked to this group about how they implemented the policy, outcomes and lessons learned

October 14, 2022, 1:00 to 2:30 pm, Work Group Meeting

Co-Leads: Ronny Bell, Sally Herndon, and Delton Russell

Work Group Members Present: Ann Staples, Anna Bess Brown, Antoinette Stein, Ashley Curtice, Beverly Gray, Carla Alston Daye, Carleen Crawford, Dana Painter, David Willard, Ellen Essick, Erin McLain, Ernest Watts, Faith Samples, Heather Burkhardt, Jim Martin, Joyce Swetlick, Juliana Wilson, Julie Kokocha, Kearston Ingraham, Kim Bayha, Kim Caldwell, Kim Canady, Kimberly McDonald, Kyle Smith, Leah M Ranney, Les Spell, Mary Ward, Meghan Kissell, Morgan Wittman Gramann, Natalie Thompson, Ray Riordan, Richard Peters, Rita Krosner, Sanquis Graham, Sarah Arthur, Sarah Jacobson, Steph Gans, Steph Trilling, Susanne Schmal, Tenika Walker, Tiffany Munday, Vera Reinstein, Viviana Martinez

Discussion:

• Reviewed results of policy prioritization survey. All the policies, including the ones added at the August work group meeting, will be prioritized as the work group recognized that all are intertwined. All the policies will be added to the NC SHIP Policy Scorecard and included in the 2023 NC SHIP. None of the policies will be deferred.
  • Raise state minimum sales age from 18 to 21 and establish a tobacco retailer permitting system to protect NC youth. (19 votes)
  • Increase the price of tobacco products by raising the current state tax on cigarettes and increase other tobacco products taxes to parallel levels (17 votes)
  • Expand Medicaid eligibility to include coverage for all tobacco cessation treatment without barriers. This includes Medicaid coverage of group counseling for tobacco treatment. (11 votes)
  • Fund comprehensive state tobacco control programs to levels recommended by Centers for Disease Control and Prevention (CDC). (10 votes)
  • Remove state preemption of local government regulations on the sale, promotion, distribution, and display of tobacco products. (10 votes)
  • Implement state and local tobacco-free and smoke-free air policies that include electronic cigarettes (8 votes)
  • Expand the accessibility of tobacco use treatment for Medicaid beneficiaries into more settings and modalities, with a broader array of providers. (6 votes)
  • Increase number of paid staff at the state/local level to conduct comprehensive tobacco control programs (4 votes)
  • Support Tobacco Treatment Specialist Training for historically marginalized communities (4 votes)
  • Increase access to treatment based on the N.C. Tobacco Treatment Standard of Care, to include counseling and FDA-approved medications (3 votes)
  • Enforce the federal law that calls for smoke-free multi-unit public housing and promote smoke-free multi-unit affordable housing. (3 votes)
  • Revise zoning ordinances to control placement of shops that sell tobacco, limiting the number of these shops per area and ensuring they are placed a safe distance from children’s areas. (3 votes)
  • Provide nicotine replacement options and services to the uninsured and underinsured (2 votes)
  • Explore seeking reimbursements for Certified Tobacco Treatment Specialists (CTTS) for their work in providing standard of care tobacco treatment - counseling and tobacco treatment medications under the supervision of a prescriber (2 votes)
  • Recommend an electronic cigarette policy for restaurants and bars (2 votes)
  • Ensure Medicaid reimbursement for provision of tobacco cessation counseling and treatment for parents in any pediatric setting, not just during a tobacco-related sick visits. (2 votes)
  • Increase the number of tobacco-free public parks (1 vote)
  • Explore policy strategies to prohibit the sale of tobacco products in pharmacies. (1 vote)
• Received updates from workgroup members on relevant work they were doing, successes, and challenges.
• Jim Martin, Director of Policy and Programs with the Tobacco Prevention and Control Branch, provided a presentation on protecting our kids from vaping and nicotine addiction by establishing a tobacco retailer permitting system and raising the minimum legal age to purchase tobacco from 18 to 21.
• Discussed next steps and input for future meetings.

August 26, 2022, 1:00 to 2:30 pm, Work Group Meeting

Co-Leads: Ronny Bell and Sally Herndon; Absent: Delton Russell

Work Group Members Present: Ami McGarity, Ann Staples, Anna Bess Brown, Antoinette Stein, Aubrey Cuthbertson, Beverly Gray, Carleen Crawford, Charlene Sampson, Courtney Heck, David Willard, Elizabeth Brewington, Ellen Essick, Erin McLain, Erin Sutfin, Ernie Watts, Faith Samples, Jarret Stone, Jim Martin, Joshua Batten, Joyce Swetlick, Juliana Wilson, Julie Kokocha, Kearston Ingraham, Kim Bayha, Kim Caldwell, Kim Sumrell, Kimbery Canady, Kyle Smith, Larissa Williams, Leah Ranney, Lu McCraw, Mary Ward, Molly Monath, Morgan Wittman Gramann, Natalie Thompson, Nicole Johnson, Ray Riordan, Richard Peters, Rita Krosner, Ronda Doward, Sanquis Graham, Sarah Jacobson, Steph Gans, Steph Trilling, Susanne Schmal, Tenika Walker, Teresa Beardsley, Terri Bell, Tiffany Thigpen, Tobin Lee, Vera Reinstein, Viviana Martinez

Discussion: 

• Built connections with work group members present. Everyone asked to share their name, organization, their work with tobacco control, where they were from, and their favorite restaurant from their early days.
• Reviewed result statement, targets and baselines for youth and adult tobacco use, and proposed policy initiatives for Indicator 11: Tobacco Use. 
• Discussed recommendations for additional policies and questions from work group members. Two additional policy initiatives were added: 
  • Ensure Medicaid reimbursement for provision of tobacco cessation counseling and treatment for parents in any pediatric setting, not just during a tobacco-related sick visits.
  • Expand the accessibility of tobacco use treatment for Medicaid beneficiaries into more settings and modalities, with a broader array of providers.
• Asked work group members to submit their top three policy priorities by end of day on Friday, September 9, 2022. 
• Set schedule for meetings. The work group will meet every other month on the second Friday from 1:00 to 2:30 pm. 

August 12, 2022, 8:00 to 8:45 am, Co-Lead Planning Meeting

Co-Leads: Ronny Bell, Sally Herndon, and Delton Russell

Discussion:

• Discussed potential revisions to the proposed policy initiatives from the NC SHIP for Indicator 11: Tobacco Use.
• Reviewed list for gaps in potential work group members.
• Planned agenda for first work group meeting on August 26, 2022.
• Identified process for prioritizing the proposed policy initiatives.

Priorities

The Limited Access to Healthy Foods Work Group identified the following priorities for action planning related to equitable access to food nutrition services, supporting the state’s food system, and access to school meals.

• Enhance how children and families access programs supporting their well-being, including SNAP, WIC, CACFP, Medicaid, and NCCARE360 through better data and analysis, infrastructure, and integration
• Provide financial incentives such as “Double Up Food Bucks” and Produce Prescriptions for SNAP/ FNS recipients for purchasing fresh fruit and vegetables from grocery stores and farmers markets
• Continue, expand, and institutionalize the Supplemental Nutrition Assistance Program (SNAP) online purchasing pilot
• Support equitable, food-oriented development that drives economic growth in low-income and historically marginalized communities
• Support regional food hubs connecting local farmers, growers, producers, and ranchers with expanded market opportunities and the community to improved access to local, nutritious food
• Implement competitive pricing for healthy foods
• Collaborate with community partners to provide nutritious options at food banks and pantries and soup kitchens
• Support farmers’ markets and enable Electronic Benefit Transfer payment at farmers’ markets
• Support, promote, and encourage participation in the School Breakfast and National School Lunch Programs

Action Plan

The Limited Access to Healthy Foods Work Group identified the following potential short-term and long-term strategies to move the priorities forward.

• Priority: Enhance how children and families access programs supporting their well-being, including SNAP, WIC, CACFP, Medicaid, and NCCARE360 through better data and analysis, infrastructure, and integration
  • Short-Term Strategies:
    • Refer to NCDHHS State Action Plan for Nutrition Security: 2023-2024
  • Long-term Strategies:
    • Utilize GIS to get very granular data to identify gaps in services.
    • State Health Center for Food Access.
• Priority: Provide financial incentives such as “Double Up Food Bucks” and Produce Prescriptions for SNAP/ FNS recipients for purchasing fresh fruit and vegetables from grocery stores and farmers markets
  • Short-Term Strategies:
    • Farmers Market Network would like to pursue state funding.
    • Medicaid transformation/ Healthy Opportunities Pilots providing vouchers for fruits and vegetables.
  • Long-term Strategies:
    • Get the double up and bonus purchase programs into a system that works directly with EBT payment.
• Priority: Continue, expand, and institutionalize the Supplemental Nutrition Assistance Program (SNAP) online purchasing pilot
  • Short-Term Strategies:
    • Online systems to meet consumers’ needs and addressing access issues, including barriers to access.
• Priority: Support equitable, food-oriented development that drives economic growth in low-income and historically marginalized communities
  • Short-Term Strategies:
    • Work force development and programs related to related to food business and distribution.
    • Food recovery and regulatory efforts.
    • Commercial shared-use kitchen space.
  • Long-term Strategies:
    • Cooperative Extension- HACCP (Hazard Analysis Critical Control Point), GAP (Good Agricultural Practices), food processing
• Priority: Support regional food hubs connecting local farmers, growers, producers, and ranchers with expanded market opportunities and the community to improved access to local, nutritious food
  • Short-Term Strategies:
    • Build capacity in communities for food processing.
    • Provide training for HACCP (Hazard Analysis Critical Control Point) and GAP (Good Agricultural Practices); coordinate efforts of small business centers (SBCs) and food training.
    • Commercial shared-use kitchen space.
    • NC-NIK: North Carolina Network of Incubator Kitchens
  • Long-term Strategies:
    • Ready sources of funding, refer to Policy Effort to Watch: South Carolina Healthy Food Financing Initiative: https://www.policylink.org/policy-efforts-and-impacts/state-and-local/south-carolina.
• Priority: Implement competitive pricing for healthy foods
  • Short-Term Strategies:
    • Dialogue with the retail merchants to learn what motivates them through listening sessions.
  • Long-term Strategies:
    • Expand the audiences that can receive food, including expanding eligibility for  SNAP, WIC, Healthy Opportunities  Pilots (HOP), etc.
• Priority: Collaborate with community partners to provide nutritious options at food banks and pantries and soup kitchens
  • Short-Term Strategies:
    • Working partners together to expand and target the work. ACCESS for patrons to pick up....then how to use it. Assessing how many pantries are tied to a local food bank system, connecting them.
  • Long-term Strategies:
    • Food safety concerns (sell by and use by dates)
• Priority: Support farmers’ markets and enable Electronic Benefit Transfer payment at farmers’ markets
  • Short-Term Strategies:
    • Include this as part of the following priority, as funding flow through may be easier to track.
      • Priority: Provide financial incentives such as “Double Up Food Bucks” for SNAP/ FNS recipients for purchasing fresh fruit and vegetables from grocery stores and farmers markets
  • Long-term Strategies:
    • Access to broadband for pop-ups/ farmers markets. Pop-ups/ farmers markets need Broadband connectivity.
• Priority: Support, promote, and encourage participation in the School Breakfast and National School Lunch Programs
  • Short-Term Strategies:
    • Support advocacy efforts for Free School Meals for All.
    • Learn what children/ students WILL eat.
    • Provide culturally appropriate menus.
  • Long-term Strategies:
    • Consideration of a quality review of meals.
    • Support Farm to School initiatives.

Meeting Notes

May 15, 2023, 1:00 to 3:00 pm, Work Group Meeting

Co-Leads: Alice Ammerman and Jayne McBurney; Absent: Tish Singletary and Brandon Teal

Attendees: Amanda Hege, Courtney Ramsey-Coleman, Diane Beth, Gideon Adams, Jennifer Bedrosian, Karen Stanley, Konnie Tran, Morgan Cooper

Discussion:

• Reviewed policy rankings. The top nine policies were as follows:

1. Enhance how children and families access programs supporting their well-being, including SNAP, WIC, CACFP, Medicaid, NCCARE360 through better data and analysis, infrastructure, and integration    
2. Provide financial incentives such as “Double Up Food Bucks” for SNAP/ FNS recipients for purchasing fresh fruit and vegetables from grocery stores and farmers markets
3. Continue, expand, and institutionalize the Supplemental Nutrition Assistance Program (SNAP) online purchasing pilot
4. Support equitable, food-oriented development that drives economic growth in low-income and historically marginalized communities 
5. Support regional food hubs connecting local farmers/growers/producers/ranchers with expanded market opportunities and the community to improved access to local, nutritious food         
6. Implement competitive pricing for healthy foods
7. Collaborate with community partners to provide nutritious options at food banks and pantries and soup kitchens    
8. Support farmers’ markets and enable Electronic Benefit Transfer payment at farmers’ markets         
9. Support, promote and encourage participation in the School Breakfast and National School Lunch Programs 

• Discussed the following questions for each of the nine top policy priorities. The responses from the asset mapping worksheet and meeting chat are included after the notes.
  • What are recommendations for lead agencies for this policy work?
  • What would be short-term strategies to move this policy forward?
  • What would be long-term strategies to move this policy forward?
  • What are additional assets needed?
  • What sources of funding are and/or may be available for this policy initiative?
• Next steps were for work group members to add any additional responses to the asset mapping questions. The Co-Leads will meet to review the responses to discuss strategies and action planning.

January 9, 2023, 1:00 to 3:00 pm, Work Group Meeting

Co-Leads: Alice Ammerman, Brandon Teal, Jayne McBurney, and Tish Singletary

Attendees: Amanda Hege, Courtney Ramsey-Coleman, Diane Beth, Gideon Adams, Karen Stanley, Morgan Cooper, Nicole Johnson, Paula Swepson-Avery, Renee Harvey, Robyn Stout

Discussion:

• Provided a high-level overview of the priority strategies discussed at the previous work group meeting. The priority strategies were:
  • Continue, expand, and institutionalize the Supplemental Nutrition Assistance Program (SNAP) online purchasing pilot
  • Establish a public-private fund for stimulating the development/ renovation/expansion of new and existing community-supported venues
  • Implement competitive pricing for healthy foods
  • Implement school breakfast programs and school fruit and vegetable gardens
  • Provide technical assistance for grants that provide financial incentives such as “Double Up Food Bucks” for SNAP/ FNS recipients for purchasing fresh fruit and vegetables from grocery stores and farmers markets
  • Support farmers’ efforts to maintain active crop production in areas with high land prices
  • Support regional food hubs in adopting solid business models, with built-in reliance on subject matter experts
• Discussed the two policies that were not reviewed during the previous work group meeting.
  • Support farmers’ efforts to maintain active crop production in areas with high land price
    • Recommendations: Cooperative Extension should be engaged to elevate this strategy. Define “at-risk agriculture land.” Change this policy to two policies. Support farm transition.
    • Potential Policy Revisions: Support farmers' efforts to maintain active crop production for financial sustainability. Promote preservation of arable land/resources to promote agricultural diversity.
• Support regional food hubs in adopting solid business models, with built-in reliance on subject matter experts
  • Recommendations: Be clear what support means. Think about verbiage in strategies. Include monetary, policy, and outreach recommendations for each strategy
  • Potential Policy Revisions: Prioritize procurement from local farmers and local food hubs to sustain markets for regional food hubs
• Reviewed next steps were to wordsmith/ revise the wording of the strategies/ polices, rank the strategies/ policies, and share recommendations. The next Limited Access to Healthy Foods Work Group meeting will be on Monday, May 15, 2023, from 1:00 to 3:00 pm.

November 1, 2022, 1:00 to 3:00 pm, Work Group Meeting

Co-Leads: Alice Ammerman, Brandon Teal, Jayne McBurney, and Tish Singletary

Attendees: Amanda Hege, Dawn Daly Mack, Gideon Adams, Jennifer Bailey, Konnie Tran, Morgan Cooper, Renee Harvey, Robyn Stout, Tracey Bates

Discussion:

• Reviewed the purpose of the meeting was to review the proposed policy initiatives/ strategies to prioritize them, discuss what others are doing in this space, and revise and add to the policies as needed.
• Provided an overview of the NC SHIP Community Council and Healthy North Carolina 2030.
• Reviewed and discussed the policy initiatives for Limited Access to Healthy Food. For each of the proposed policy initiatives, the work group had in-depth discussions about current related programs, strategies, and organizations working in those spaces. 
• Planned for work group members to rank each of the proposed policy initiatives in follow-up to the meeting. The next meeting for the Limited Access to Healthy Food Work Group is Monday, January 9, 2023, 1:00 to 3:00 pm. 

August 9, 2022, 9:00 to 11:00 am, Co-Lead Planning Meeting

Co-Leads: Alice Ammerman, Jayne McBurney, Tish Singletary, and Brandon Teal (absent)

Discussion:

• Discussed and added to the list of potential work group members.
• Reviewed proposed policy initiatives from the NC SHIP for Indicator 8: Limited Access to Healthy Food and identified process for prioritization.
• Set next work group meeting dates.

Priorities

The North Carolina State Excessive Alcohol Advisory Committee (NC SEAAC) has identified priority areas related to actions that impact access to alcohol (i.e., focusing on place, product, promotion, and price); reduction of harms (i.e., focusing on short- and long-term harms of alcohol); key populations (i.e., youth, pregnant persons, veterans, BIPOC, etc.); and access to care (i.e., increasing screening and brief interventions). All areas center equity, while highlighting disparities. 

• Consider local ordinances related to the sale and consumption of alcohol at local events, including adoption, implementation, and regulation of alcohol social districts

Action Plan

Meeting Notes

April 27, 2023, North Carolina State Excessive Alcohol Advisory Committee (NC SEAAC) Meeting

• Discussed local alcohol education and engagement efforts across North Carolina.
• Discussed the impactful work partners from the North Carolina Alcohol Policy Alliance, Poe Center for Health Education, Community Impact North Carolina, Orange Partnership for Alcohol and Drug Free Youth, Coastal Horizons Center, Inc., and Western Youth Network, Inc. do every day in their communities.
• Shared the following resources during the meeting:
  • The Societal Cost of Excessive Drinking in North Carolina, 2017 was a study conducted to estimate the cost of excessive drinking in North Carolina. In 2017, excessive drinking cost North Carolina $9.72 billion dollars, which is approximately $2.09 per standard drink.
  • NC GS 18-B Rule 15C.0201 provides legislative guidelines on malt beverage products.
  • Community Impact North Carolina has created a map that tracks social districts across the state. The map and more information can be found here.
  • GS 105-113.80 provides legislative guidelines on excise taxes on malt beverages, wine, and liquor.
  • Talk it Out encourages the entire community to work together to reduce underage drinking and all the harm it causes. For more information and resources, please visit their website here.
• The next NC SEAAC meeting is on October 26, 2023, from 1:00 to 2:30 pm.

January 26, 2023, North Carolina State Excessive Alcohol Advisory Committee (NC SEAAC) Meeting

• Discussed the public health considerations for the adoption and implementation of alcohol districts. An interactive map of alcohol districts can be found here. The map allows the user to click on a pin to find out more information regarding an alcohol district in a given municipality. In addition, partners highlighted several needs when discussing alcohol districts, such as talking points for various audiences and evidence-based research around alcohol districts.
• Included two reports of interest that discuss the impact of alcohol on communities in North Carolina.
  • The UNC-CH Color of Drinking Project conducted a survey of undergraduate UNC students to gather their experience with UNC’s drinking culture. The study aimed to explain the secondhand harms of alcohol, with particular attention paid to harms on students of color and LGBTQ+ students.
  • The Burden of Excessive Drinking in Orange County, North Carolina report aimed to explore the harms and costs attributable to excessive drinking in Orange County, North Carolina in 2017.  
• Next steps: To build upon state capacity to provide excessive alcohol use data, resources, and technical assistance, committee members were asked to complete the anonymous alcohol epidemiology working partner survey.
• The next NC SEAAC meeting is on April 27, 2023 from 1:00 to 2:30 pm.

December 16, 2022, NC SEAAC Steering Committee Meeting

• Discussed potential actions that would impact access to alcohol. 
• Discussed a main priority area, the regulation of social districts. Partners identified a need for resources on the impacts of social districts and guidance for implementation of districts with public health and safety best practice in mind.  
• Next steps: Group members will reach out to additional partners (i.e. law enforcement, other partners that have experience with social districts) to gain more insight into guidance that can be provided. Our next full NC SEAAC meeting, scheduled for January 26th, will also focus on social districts with a presentation from co-chair Jennifer Matthews.  

November 17, 2022, NC SEAAC Steering Committee Meeting

• Launched the NC SEAAC Steering Committee. 
• Reviewed the purpose and goals of the committee.  
• Discussed time commitment of committee. The group decided to meet monthly to produce an action plan to address statewide excessive alcohol use. The group will use meetings as a working meeting to identify actions in each identified priority area. 
• Discussed potential priority areas that the group would like to discuss further. The main areas identified were actions that impact access to alcohol (i.e., focusing on place, product, promotion, and price); reduction of harms (i.e., focusing on short- and long-term harms of alcohol); key populations (i.e., youth, pregnant persons, veterans, BIPOC, etc.); and access to care (i.e., increasing screening and brief interventions). All areas will center equity, while highlighting disparities.  
• Next steps: Group members will identify actions that address the access to alcohol focus area. 

October 27, 2022, NC State Excessive Alcohol Advisory Committee (NC SEEAC) Meeting

• Launched the NC State Excessive Alcohol Advisory Committee. Provided an overview of the NC State Health Improvement Plan (NC SHIP) and Healthy North Carolina 2030 (HNC 2030), including the proposed list of NC SHIP policy initiatives. 
• Reviewed the history, goals, and committee structure. Reviewed purpose and goals of committee: 
  • Network and collaborate with partners across the state 
  • Discuss excessive alcohol use topics of interest 
  • Develop a statewide plan for excessive alcohol use and its related harms 
• Connected with partners to gain insight into the work being done across the state. 
  • Reviewed related statewide action plans, including the NC Early Childhood Action Plan and NC Opioid and Substance Use Action Plan, and brainstormed focus areas that should be included in the excessive alcohol action plan. 
• Identified topic areas of interest for future meetings.  
• The next NC State Excessive Alcohol Use Advisory Group Meetings: 
  • NC State Excessive Alcohol Steering Committee: November 17, 2022 
  • NC State Excessive Alcohol Advisory Committee: January 26, 2023 
  • NC State Excessive Alcohol Advisory Committee: April 27, 2023 

August 23, 2022, 2:00 to 3:00 pm, Co-Lead Planning Meeting

Co-Leads: Fisher Charlton, Mina Cook, Mary Beth Cox, and Jennifer Matthews

Discussion:

• Identified list of potential work group members to invite to first work group meeting on October 27, 2022.
• Scheduled a follow-up meeting with smaller steering committee for November 17, 2022.
• Planned to develop an action plan and focus on developing resources for locals around social districts (in reference to the policy initiative, “Consider local ordinances related to the sale and consumption of alcohol at local events”).

Priorities

The Sugar-Sweetened Beverage Consumption Work Group identified the following priorities for action planning related to promotion and access to drinking water in schools, healthy food procurement, and default beverage options for children’s meals.

• Integrate “Rethink Your Drink” toolkit into school curricula, promoting water as a healthy alternative to sweetened beverages
• Establish healthy food procurement policies that support public and private investment in healthy food, and increase availability of healthy alternatives to sugary drinks
• Recommend NC Department of Public Instruction (DPI) adopt a statewide policy permitting students to bring water bottles to school (containing only water)
• Ensure access to safe and clean water in schools at water-filling stations that have been tested for safety
• Limit “default beverage” options for children’s meals at food venues to include only milk, 100% fruit juice, or water
• Implement healthy choice beverage in vending machines at schools and parks

Action Plan

The Sugar-Sweetened Beverage Consumption Work Group identified the following potential short-term and long-term strategies to move the priorities forward.

• Priority: Integrate “Rethink Your Drink” toolkit into school curricula, promoting water as a healthy alternative to sweetened beverages
  • Short-Term Strategies:
    • Encourage health education teachers include "Rethink Your Drink" in their curriculum.
    • Connect to healthful living curriculum standards.
    • Incorporate into classroom curriculum (Healthful Living Standards and Resources).
    • Connect WIC with "Rethink Your Drink" toolkit resources.
    • Provide information to schools for E-letters, social media, health fairs.
    • Have key agencies like NC Nutrition and Dietetics or NC Pediatric Society hold a press conference to educate about sweet beverages and their alternatives.
    • Have a resolution signed by the Governor to declare a “Rethink your Drink” day.
  • Long-Term Strategies:
    • North Carolina Dental Society to include literature in their bags for patients.
    • North Carolina Pediatric Society/ NC Academy of Family Physicians
    • Social Marketing campaigns showing oral health issues due to sugar-sweetened beverage consumption.
• Priority: Establish healthy food procurement policies that support public and private investment in healthy food, and increase availability of healthy alternatives to sugary drinks
  • Short-Term Strategies:
    • Encourage following the policies public schools have in place for healthy options during school hours, after dismissal, at athletic events, etc.
  • Long-Term Strategies:
    • NC Alliance for Health is lobbying for long-term change.
    • Priority selection of entities seeking procurement that promote healthy beverages.
• Priority: Recommend NC Department of Public Instruction (DPI) adopt a statewide policy permitting students to bring water bottles to school (containing only water)
  • Short-Term Strategies:
    • Work through PTAs, PE teachers, school nurses, etc.
  • Long-Term Strategies:
    • Mobilize parent groups, educators, and school nurses.
• Priority: Ensure access to safe and clean water in schools at water-filling stations that have been tested for safety
  • Short-Term Strategies:
    • Identify allies to promote this message among decision-makers.
  • Long-Term Strategies:
    • More water filling stations at schools, community colleges, state government facilities, and other places that people are and ensuring they are safe.
• Priority: Limit “default beverage” options for children’s meals at food venues to include only milk, 100% fruit juice, or water
  • Short-Term Strategies:
    • Bring restauranters and food service operators together to share resources and educational pieces.
  • Long-Term Strategies:
    • Commitments for food suppliers "we have made a commitment to kids health."
• Priority: Implement healthy choice beverage in vending machines at schools and parks
  • Short-Term Strategies:
    • Advocate for contracts to have language about healthy choice options (could include labeling, marketing, advertising, pricing; training for people that stock the machines that meet the healthy criteria)
    • Education

Meeting Notes

May 1, 2023, 1:00 to 3:00 pm, Work Group Meeting

Co-Leads: Alice Ammerman, Jayne McBurney, Tish Singletary; Absent: Fiorella Horna

Attendees: Courtney Ramsey-Coleman, Crystal Adams, Lisa Shock, Sarah Tomlinson, Tracy Bates, Yasmine “Yaz” Shepard

Discussion:

• Reviewed the top six policies and revised as needed.
  • Integrate “Rethink Your Drink” toolkit into school curricula, promoting water as healthy alternative to sweetened beverage
  • Establish healthy food procurement policies that support public and private investment in healthy food, and increase availability of healthy alternatives to sugary drinks
  • Recommend NC Department of Public Instruction (DPI) adopt a statewide policy permitting students to bring water bottles to school (containing only water).
  • Ensure access to safe/ clean water in schools at water-filling stations that have been tested for safety.
  • Limit “default beverage” options for  meals at food venues to include only milk, 100% fruit juice, or water
  • Implement healthy choice beverage in vending machines at (schools) and parks
• Discussed the following questions for each of the six top policy priorities. The responses from the asset mapping worksheet and meeting chat are included after the notes.
  • What are recommendations for lead agencies for this policy work?
  • What would be short-term strategies to move this policy forward?
  • What would be long-term strategies to move this policy forward?
  • What are additional assets needed?
  • What sources of funding are and/or may be available for this policy initiative?
• Next steps were for work group members to add any additional responses to the asset mapping questions. The Co-Leads will meet to review the responses to discuss strategies and action planning.

January 23, 2023, 1:00 to 2:30 pm, Work Group Meeting

Co-Leads: Alice Ammerman and Jayne McBurney; Absent: Fiorella Horne and Tish Singletary

Attendees: Lisa Shock, Mary Anne Burghardt, Sarah Blanton, Tracy Bates, and Yasmine Shepard “Yaz”

Discussion:

• Reviewed and continued discussion of policies identified as priorities:
  • Consider “price point pain,” including who gets what to sell sugar-sweetened beverage products (excise taxes, sales taxes, etc.) instead of implementing a SSB tax
  • Integrate “Rethink Your Drink” DCD and SNAP-Ed toolkit into school curricula, promoting water as healthy alternative to sweetened beverages
  • Ensure access to safe and clean water
  • Implement healthy choice beverages in vending machines at parks
• Discussed policy not reviewed during the previous work group meeting:
  • Limit “default beverage” options for children’s meals in restaurant and educational settings to include only milk, 100% fruit juice, or water 
• Set next steps to rank the priorities in early April before the next work group meeting on May 1, 2023.

October 10, 2022, 1:00 to 3:00 pm, Work Group Meeting

Co-Leads: Alice Ammerman, Jayne McBurney, and Tish Singletary; Absent: Fiorella Horna

Attendees: Courtney Ramsey-Coleman, Mary Anne Burghardt, Sarah Blanton, Sarah Tomlinson, Susanne Schmal, Yasmine Shepard, and Zachary Brian

Discussion:

• Reviewed the purpose of the meeting was to review the proposed policy initiatives from the North Carolina State Health Improvement Plan (NC SHIP), identify which were most important to focus on, share what the Community Council does, discuss partners to add to the work group, and review the next meetings. 
• Provided an overview of the NC SHIP Community Council and Healthy North Carolina 2030.
• Reviewed and discussed the policy initiatives for sugar-sweetened beverage (SSB) consumption. The highest priorities discussed included:
  • Access to safe clean water
  • Consider “price point pain,” including who gets what to sell sugar-sweetened beverage products (excise taxes, sales taxes, etc.)
  • Implement healthy choice beverages in vending machines at parks
  • Integrate “Rethink Your Drink” DCD and SNAP-Ed toolkit into school curricula, promoting water as healthy alternative to sweetened beverages
• Identified additional partners and/or agencies to invite to join the work group and provide additional information on the priority areas.

August 22, 2022, 10:00 to 12:00 pm, Co-Lead Planning Meeting

Co-Leads: Alice Ammerman, Fiorella Horna, Jayne McBurney, and Tish Singletary

Discussion:

• Discussed and added to the list of potential work group members.
• Reviewed proposed policy initiatives from the NC SHIP for Indicator 13: Sugar-Sweetened Beverage Consumption and discussed the process for prioritization.
• Reviewed next work group meeting dates.

Priorities

The HIV Diagnosis Work Group identified the following priorities for action planning:

• Expand affordable housing programs for persons living with HIV
• Expand North Carolina’s provider network for HIV care and prevention services
• Identify and address gaps in HIV healthcare access for formerly incarcerated populations
• Identify barriers to HIV post exposure prophylaxis being delivered by pharmacists
• Improve provider comfort with incorporating sexual health assessments into routine healthcare services
• Increase access to pre-exposure prophylaxis (PrEP) for individuals at high risk for HIV transmission
• Increase the number of harm reduction programs, including needle exchange programs
• Increase the number of people who know their HIV status and are linked to prevention or treatment services through high impact, coordinated interventions
• Understand the impact of NC’s Medicaid Managed Care Plans on health outcomes for CMS clients living with HIV

Meeting Notes

March 13, 2023, Small Group Meeting (Small group met to discuss specific objective.)

• Small Group Objective: Increase the number of people who know their HIV status and are linked to prevention and treatment services through high impact, coordinated intervention
  • Discussed writing up RAO and ECU ED testing programs as a best practice
  • Discussed how Medicaid expansion could increase opportunities to educate Emergency Department physicians on importance of testing for HIV

January 30, 2023, Small Group Meeting (Small group met to discuss specific objective.)

• Small Group Objective: Improve provider comfort with incorporating sexual health assessments into routine healthcare services, including HIV/STI screening by providing continuing professional development through NC  AHEC, UNC HTEC, AL/NC STI/HIV PTC to reach providers, as well as residency and medical school programs
  • Attendees: Matt Martin, Veleria Levy, Alicia Diggs, and Victoria Mobley
  • Action Plan/ Next Steps:
    • Defined providers to prioritize for outreach
    • Identify trainings/webinars already developed that can be disseminated (UNC HTEC and AL_NC STI/HIV PTC)
    • Identify partners to help champion importance and disseminate training resources

December 19, 2022, Small Group Meetings (Small groups met to discuss specific objectives.)

• Small Group Objective: Expand NC’s Provider network for HIV care and Prevention
  • Attendees:  Frankie Simmons, Veleria Levy, JeaNelle Plummer, and Victoria Mobley
  • Action Plan/ Next Steps:
    • Prioritize increasing primary care provider adherence to the USPTF recs for HIV screening
    • Assess feasibility and comfort by PCPs for rapid ARV initiation after initial HIV diagnosis to decrease infectious period
• Small Group Objective: Increase access to pre-exposure prophylaxis (PrEP) for individuals at high risk for HIV transmission
  • Attendees: Allison Rice, Hannah Dermitt, and Matt Martin
  • Action Plan/ Next Steps:
    • Plan to meet with the Gilead PrEP team to better understand resources
    • Identify way to disseminate Medicaid FPP enrollment more broadly (covers PrEP clinical care and STI/HIV testing for men and women who qualify)
• Small Group Objective: Expand affordable housing programs for persons living with HIV
  • Attendees: Veleria Levy & Latoya Gardner
  • Action Plan/ Next Steps:
    • Learn best practices from successful programs in existence (House of Mercy, Doorways, Cooper House etc.)
    • Consider feasibility of developing a HIV housing continuum

November 21, 2022, Large Group Member Meeting

Attendees: Matt Martin, Cameron Pruette, Allison Rice, Hannah Demeritt, Matt Jenkins, JeaNelle Plummer, Jeff Thomas, Veleria Levy, Victoria Mobley

Discussion

• Finalized which objective(s) each group member would focus on with smaller group.
• Directed members to plan to meet with smaller groups for more focused work on their identified objectives.
• Changed bi-monthly large group meeting cadence to monthly to allow time for smaller group work. Each small group will document meeting date, summary of discussion, and any action items on shared google document for tracking by larger group.
• Scheduled next Large Group Meeting for Monday, December 5, 2022, from 3:00 to 4:30 pm.

November 7, 2022, 3:00 to 4:30 pm, Work Group Meeting

Attendees: Matt Jenkins, Hannah Demeritt, JeaNelle Plummer, Bernard Davis, Jeff Thomas, Alicia Diggs, Allison Rice, Brittan Joseph, Matt Martin, Veleria Levy, Victoria Mobley

Members not in attendance: Jeffrey Long, Chelsea Golden, Cameron Pruette, Ester Ross, Morgan Hopley

Discussion: 

• Reviewed the HIV Diagnosis policy/program objectives discussed during the Co-Lead meeting and gathered feedback from larger group on feasibility of each objective.
• Settled on the final policy/program objectives the group will work on over the next several months and brainstormed potential action items to pursue for each objective.
  1. Improve provider comfort with incorporating sexual health assessments into routine healthcare services
  2. Identify barriers to HIV post exposure prophylaxis being delivered by pharmacists
  3. Expand affordable housing programs for persons living with HIV
  4. Increase the number of harm reduction programs, including needle exchange programs
  5. Expand North Carolina’s provider network for HIV care and prevention services
  6. Increase the number of people who know their HIV status and are linked to prevention or treatment services through high impact, coordinated interventions
  7. Increase access to pre-exposure prophylaxis (PrEP) for individuals at high risk for HIV transmission
  8. Identify and address gaps in HIV healthcare access for formerly incarcerated populations
  9. Understand the impact of NC’s Medicaid Managed Care Plans on health outcomes for CMS clients living with HIV
• Established the following action items: 
  • Each group member was asked to review the final objectives and identify 1-3 objectives they would like to take the lead on.
  • Next NC SHIP HIV Diagnosis Work Group  meeting will be on November 21, 2022. 

August 31, 2022, 10:00 to 11:00 am, Co-Lead Meeting

Co-Leads Present: Matt Jenkins, Hannah Demeritt, Chelsea Golden, JeaNelle Plummer, Jeffrey Long, Veleria Levy, Victoria Mobley

Discussion:

• Reviewed the HIV Diagnosis policy/program recommendations to identify work that is already ongoing across the state and prioritize the objectives by feasibility.
• Action items from the meeting included:
  • Identify which objectives should be prioritized and which are important, but additional information is needed to determine the feasibility of taking them on during the year.
  • Schedule the first larger work group meeting in the next 2 weeks.

August 30, 2022, 2:00 to 2:30 pm, Co-Lead Planning Meeting

Co-Leads Present: Veleria Levy and Victoria Mobley

Discussion:

• Discussed expectations for the NC SHIP effort and next steps. 

Priorities

The Perinatal Health Equity Collective Policy Workgroup prioritized the following NC Perinatal Health Strategic Plan (PHSP) strategy that aligns with the 2022 NC SHIP. The numbers included with the prioritized policies refer to the strategy numbers in the PHSP, https://wicws.dph.ncdhhs.gov/phsp/.

Teen Births

• 12F. Increase same-day access to all methods of contraception

Early Prenatal Care

• 1E. Perinatal health care providers should participate in training around health equity, implicit bias, and cultural competency
• 7E. Increase the number of Prepaid Health Plans (PHPs) that cover doula services
• 7G. Elevate the role of community health workers in addressing the social drivers of health
• 9A. Expand Medicaid to provide affordable, comprehensive health, behavioral health, and dental insurance coverage, including mobile health and telehealth for all
• 9I. Implement the NC Area Health Education Centers (AHEC) scholars program to recruit and train students of color and students from rural backgrounds to become providers in underserved areas
• 10A. Expand the use of evidence-based and evidence-informed models of perinatal care highlighted in the Maternal Health Innovation Program, including doula services, group prenatal care, group child visits, and community health workers

Infant Mortality

• 1D. Provide training to all NCDHHS staff and ongoing professional development on equity that builds understanding of and competencies to advance health equity
• 1E. Perinatal health care providers should participate in training around health equity, implicit bias, and cultural competency
• 7E. Increase the number of Prepaid Health Plans (PHPs) that cover doula services
• 7G. Elevate the role of community health workers in addressing the social drivers of health
• 7J. Expand efforts to prevent infant deaths related to unsafe sleep environments
• 9A. Expand Medicaid to provide affordable, comprehensive health, behavioral health, and dental insurance coverage, including mobile health and telehealth for all
• 10A. Expand the use of evidence-based and evidence-informed models of perinatal care highlighted in the Maternal Health Innovation Program, including doula services, group prenatal care, group child visits, and community health workers
• 10F. Adopt maternal and neonatal risk-appropriate levels of care that align with national standards
• 10Q. Support the creation of a statewide 24-hour breastfeeding support hotline
• 12F. Increase same-day access to all methods of contraception

Action Plan

The Perinatal Health Equity Collective (PHEC) Data and Evaluation Work Group compiles data annually for the Perinatal Health Equity Strategic Plan’s data indicators and monitors new data sources. In addition, they promote data quality improvement and assist other PHEC work groups to move data to action, focusing on a research action plan and providing technical assistance for the environmental scan.

Progress on the Perinatal Health Equity Strategic Plan is also being tracked internally by the North Carolina Division of Public Health; the most recent plan is available on the Division of Public Health’s website at https://wicws.dph.ncdhhs.gov/phsp/.

Meeting Notes

October 27, 2022, 2:00 to 3:00 pm, PHEC Policy Workgroup Meeting

Attendees: Elizabeth Hudgins, Morgan Forrester Ray, Kelly Kimple, Brittany Garner, Jessica Johnson, Sarah Verbiest, Erin McClain, Belinda Pettiford, Susan Gutierrez, Jill Sergison, Velma Taormina, Kaylan Szafranski, David DiMatteo, Karen Saxer, Kella Hatcher

Discussion:

• Elizabeth Hudgins shared the NC Pediatric Society’s 2022 Policy Agenda and their anticipated policy agenda for 2023.
• Dr. Kelly Kimple shared the NC State Health Improvement Plan (NC SHIP) priorities and Perinatal Health Strategic Plan alignment. The workgroup discussed potential policy areas to focus on for the teen births, early prenatal care, and infant mortality indicators.

September 22, 2022, 9:00 to 10:00 am, PHEC Policy Workgroup Meeting

Discussion:

• MomsRising and the March of Dime’s shared their anticipated policy agendas and alignment with the 2022-2026 Perinatal Health Strategic Plan. 
• The Policy Workgroup meeting in October 2022 will include presentations from the NC Pediatric Society and the NC SHIP, along with their alignment with the Perinatal Health Strategic Plan.

September 16, 2022, Update

• The Co-Leads were invited to join the Perinatal Health Equity Collective’s Policy Workgroup to begin discussing policy strategies that are supported by both the NC SHIP and the 2022-2026 Perinatal Health Strategic Plan. Additional members that have been engaged in NC SHIP work will be invited to attend future workgroup meetings

August 31, 2022, 12:00 to 2:00 pm, Perinatal Health Equity Collective (PHEC) Meeting

• Celebrated the release of the 2022-2026 Perinatal Health Strategic Plan.

August 10, 2022, 3:00 to 4:00 pm, Co-Lead Planning Meeting

Co-Leads: Annette Carrington, Brittany Garner, Kelly Kimple, and Velma Taormina

Discussion:

• Agreed to combine all three indicators, Teen Births, Early Prenatal Care, and Infant Mortality, into one group and that all three indicators could fall under the Perinatal Health Equity Collective.
• Discussed potential work group members and community co-leads.
• Determined need to contact the Perinatal Health Equity Collective (PHEC) to ask about including this group in their Policy Work Group. Kelly Kimple to contact the PHEC.
• Invited potential work group members contacted to attend the Perinatal Health Equity Collective (PHEC) meeting on August 31, 2022. This meeting would be an opportunity to learn more about the PHEC.

Priorities

The Uninsured Work Group identified the following priorities for action planning. Work group members engaged in discussions and review of best practices related to Medicaid eligibility criteria, financial support for community health workers, health clinic sustainability, and opportunities to leverage savings from Medicaid transformation.

• Determine the need for expanding and sustaining financial support for Community Health Workers
• Determine the need for sustaining health clinics for the uninsured
• Expand Medicaid, including expanding recipient eligibility criteria
• Repurpose savings and surpluses created by Medicaid transformation and expansion and leverage the community benefit programs of health systems to fund programs for the uninsured

Action Plan

The Uninsured Work Group's priority recommendations are included below.

Priority: Expand Medicaid, including expanding recipient eligibility criteria

• Strategies and Action Plans
  • Develop an awareness campaign on the characteristics of the uninsured population in North Carolina, including the numbers of uninsured remaining after Medicaid expansion, their demographic information and employment status.
  • Develop strategies for addressing the large numbers of current Medicaid recipients who will lose coverage through Medicaid redetermination efforts commencing in May 2023 due to termination of continuation of coverage provisions in federal law.
  • Increase awareness of the impact of current healthcare workforce shortages on the limitations of health insurance as a solution for the uninsured (i.e., having insurance doesn’t guarantee access).

Priority: Determine the need for expanding and sustaining financial support for Community Health Workers

• Strategies and Action Plans
  • Develop emergency strategies and action plans for addressing the cessation on December 31, 2022 of federal and state funding for community health workers (“CHW”) resulting in immediate lay-offs for hundreds.
  • Explore with NCDHHS and NC General Assembly other funding models for expanding and sustaining the CHW workforce.
  • Develop a common definition of a community health worker.  The definition used by the American Public Health Association is recommended by the work group.

Priority: Determine the need for sustaining health clinics for the uninsured

• Strategies and Action Plans
  • Focus on sustaining the human and operational capacity of existing free and charitable clinics, community health centers, donated care networks and other safety net providers as a first priority.
  • Develop strategies and action plans to expand services to the uninsured through existing free and charitable clinics, community health centers, donated care networks and other safety-net providers in counties without the infrastructure to support and sustain new clinics.

Priority: Repurpose savings and surpluses created by Medicaid transformation and expansion and leverage the community benefit programs of health systems to fund programs for the uninsured

• Strategies and Action Plans
  • Develop strategies and action plans to utilize the $1.8 billion in recurring revenues projected for the state due to Medicaid expansion and the community benefit programs of health systems for the benefit of the uninsured.

Developmental Policies for Additional Consideration

• Designate “ownership” of the uninsured problem in North Carolina. Responsibility for the uninsured is fragmented in our state and not focused on a single agency. Appoint a safety-net provider collaboration, a public-private coalition or a state agency to own and address issues affecting care for the state’s uninsured population, including improving data collection about the uninsured and addressing social drivers of health services for the uninsured.

Meeting Notes

April 17, 2023, 10:00 to 11:45 AM, Work Group Meeting

Co-Leaders: Chris Shank, Randy Jordan, and Mark Snuggs

Attendees: Elizabeth Byrum, April Cook, Brandy Bynum Dawson, Abby Carter Emanuelson, Honey Yang Estrada, Kathy Hodges, Richard Hudspeth, Alice Salthouse, Kristen Spaduzzi, Sally Wilson

Discussion:

• Reviewed and discussed comments related to the prioritized policies, strategies, and action plans.
  • Policy: Expand Medicaid, including expanding recipient eligibility criteria
    • Strategies and Action Plans:
      • Develop an awareness campaign on the characteristics of the uninsured population in North Carolina, including the numbers of uninsured remaining after Medicaid expansion, their demographic information and employment status.
      • Develop strategies for addressing the large numbers of current Medicaid recipients who will lose coverage through Medicaid redetermination efforts commencing in May 2023 due to termination of continuation of coverage provisions in federal law.
      • Increase awareness of the impact of current healthcare workforce shortages on the limitations of health insurance as a solution for the uninsured (i.e., having insurance does not guarantee access).
  • Policy: Determine the need for expanding and sustaining financial support for Community Health Workers
    • Strategies and Action Plans:
      • Develop emergency strategies and action plans for addressing the cessation on December 31, 2022 of federal and state funding for community health workers (“CHW”) resulting in immediate lay-offs for hundreds.
      • Explore with NCDHHS and NC General Assembly other funding models for expanding and sustaining the CHW workforce.
      • Develop a common definition of a community health worker.  The definition used by the American Public Health Association is recommended by the work group.
  • Policy: Determine the need for sustaining health clinics for the uninsured
    • Strategies and Action Plans:
      • Focus on sustaining the human and operational capacity of existing free and charitable clinics, community health centers, donated care networks and other safety net providers as a first priority.
      • Develop strategies and action plans to expand services to the uninsured through existing free and charitable clinics, community health centers, donated care networks and other safety-net providers in counties without the infrastructure to support and sustain new clinics.
• Decided the following policy should be moved from a developmental policy for additional consideration to a prioritized policy.
  • Policy: Repurpose savings and surpluses created by Medicaid transformation and expansion and leverage the community benefit programs of health systems to fund programs for the uninsured
    • Strategies and Action Plans:
      • Develop strategies and action plans to utilize the $1.8 billion in recurring revenues projected for the state due to Medicaid expansion and the community benefit programs of health systems for the benefit of the uninsured.
• Reviewed the following developmental policy for additional consideration.
  • Designate “ownership” of the uninsured problem in North Carolina. Responsibility for the uninsured is fragmented in our state and not focused on a single agency. Appoint a safety-net provider collaboration, a public-private coalition or a state agency to own and address issues affecting care for the state’s uninsured population, including improving data collection about the uninsured and addressing social drivers of health services for the uninsured.

January 23, 2023, 10:00 to 11:45 am, Work Group Meeting

Co-Leads: Chris Shank, Mark Snuggs, and Randy Jordan

Attendees: Abby Emanuelson, Alice Salthouse, April Cook, Ashley Rink, Brandy Bynum Dawson, Honey Estrada, Kristen Spaduzzi, Patrick Brown, Sally Wilson

Presenters: Kathy Dail

Discussion:

• Kathy Dail acknowledged the work group had done exactly what they needed to do within the scope of work of Healthy North Carolina 2030 with the proposed policies. As the work group wraps up this year’s work, the work group is empowered to make decisions to pursue the prioritized policies, designate lead organizations, and identify others that should be a part of this work group. All work group members are invited back for the next year of the work group.
• Reviewed and discussed the comments from subject matter experts received prior to the meeting about the approved priorities. Discussion highlights are included below each policy.
  • Policy: Expand Medicaid, including expanding recipient eligibility criteria
    • Reasons why Medicaid has not expanded yet: lack of awareness of the voices of the people that do not have access, lack of information, and politics
    • Importance of all sharing the same story and numbers of uninsured and those that would remain uninsured after Medicaid expansion.
    • Concerns about redetermination issue of Medicaid eligibility and the devasting impact on patients.
    • Awareness that having insurance does not guarantee access.
  • Policy: Determine the need for expanding and/or sustaining financial support for Community Health Workers
    • Contracts between the Department of Health and Human Services (DHHS), the Office of Rural Health, and their vendors ended as of December 31, 2022. Several hundred community health workers (CHWs) are now out of jobs.
    • North Carolina Community Health Worker Association is continuing to have conversations with DHHS and legislation to fund this workforce and to explore models occurring across the nation.
    • Recommendation to keep both sustaining and expanding CHWs included in the policy. All work group members were in favor of putting forward a common definition for CHWs.
  • Policy: Determine the need for expanding and/or sustaining health clinics for the uninsured.
    • Recommendation to expand programs in existing free and charitable clinics. Counties without free and charitable clinics do not have the infrastructure to support the clinics.
    • Focus on increasing the human and operational capacity of existing health clinics as a first step. All work group members were in favor that the priority should be sustaining existing health clinics.
• Reviewed the two developmental policies:
  • Repurpose savings and surpluses created by Medicaid transformation and expansion and leverage the community benefit programs of health systems to fund programs for the uninsured.
  • Designate ownership of the uninsured problem, including improving data collection about the uninsured and addressing Social Drivers of Health services for the uninsured.
• Asked work group members to consider who else should be invited to the next meeting on April 17, 2023.

November 16, 2022, 1:00 to 2:00 pm, Co-Lead Planning Meeting

Co-Leads: Randy Jordan, Chris Shank (Absent), and Mark Snuggs

Others Present: Anshita Chaturvedi

Discussions:

• Reached a consensus on which ongoing priorities to continue and which ones to move to developmental policy status. Revised wording of ongoing policies and clarified which policies required additional input from external sources to allow to moving forward with strategies and action plans for each ongoing priority.
• Approved Policy Priorities:
  1. Expand Medicaid, including expanding recipient eligibility categories. Randy Jordan to contact the Division of Medicaid to learn of possible Medicaid recipient eligibility requirements that could be expanded under Medicaid.
  2. Determine the need for expanding and/or sustaining financial support for Community Health Workers. Randy Jordan to contact Honey Estrada of the NC Association of Community Health Workers on the question of whether the presence of CHWs needs to be expanded or sustained or both. Mark will also contact John Resendes of NC ORH for input on this question.
  3. Determine the need for expanding and/or sustaining health clinics for the uninsured. Randy Jordan to contact the NCCHCA and NCAFCC for input on the questions of whether more health clinics are needed for the uninsured and whether funds are needed to sustain existing health clinics.
• Developmental Policies:
  1. Repurpose savings and surpluses created by Medicaid transformation and expansion and leverage the community benefit programs of health systems for funding programs for the uninsured. Medicaid expansion is projected to create a surplus of $1.7 billion for NC and community benefit (i.e., charity care) programs sponsored by health systems are being reviewed to monitor the extent of charity care being provided.
  2. Designating ownership of the uninsured problem, including improving data collection about the uninsured and addressing Social Drivers of Health services for the uninsured. It was acknowledged that there is no centralized place either in or outside of state government for issues and accountability about the uninsured to reside. 
• Eliminated or Repositioned Policy Proposal:
  1. Increase the number of bilingual healthcare and insurance providers. NC AHEC used to have programs that focused on language competency and training, but has since discontinued the program. It was suggested that provider associations and groups seem to be in the forefront for fostering this type of training. This issue, while still important, may not be as sensitive to policy decisions as first thought.
  2. Improve data collection about the uninsured. It was acknowledged that absence of measurable and reliable data is an issue in developing policies for the uninsured. This issue has been incorporated into another proposed developmental policy.
  3. Extending the reach of existing safety-net programs for the uninsured. Safety-net providers indicated that the existing safety-net covers all 100 counties. The question of extending safety-net services is the subject of another approved policy priority.
  4. Other topics. The topics of support for CHWs and addressing social drivers of health for the uninsured are incorporated into another approved developmental policy.

October 17, 2022, 10:00 to 11:45 am, Work Group Meeting

Co-Leads: Randy Jordan, Chris Shank, and Mark Snuggs

Attendees: Abby Emanuelson, Anshita Chaturvedi, April Cook, Elizabeth Byrum, Honey Estrada, Hugh Tilson, Jessica Alexander, Richard Hudspeth, Sally Wilson, William Massengill, Zenobia Edwards

Presenters: Brieanne Lyda-McDonald and Mark DeHaven

Discussions:

• Received the following presentations:
  • Brieanne Lyda-McDonald, MSPH-MPH, Project Director, NCIOM (staffed Healthy North Carolina 2030), shared how and why the Healthy North Carolina 2030 uninsured indicators was selected. 
  • Mark DeHaven, PhD, Dean W. Colvard Distinguished Professor, College of Health and Human Services, UNC Charlotte; Director, Academy for Research on Community Health, Engagement and Services (ARCHES), shared about the UCITY Family Zone: A Community Health Science Approach.
• Reviewed approved policy priorities and related strategies and action plans. Discussed questions and clarifications needed to move forward.
  • Expand Medicaid eligibility criteria. It was suggested that this policy priority be paired with "expanding Medicaid" until such time as Medicaid expansion is approved by the General Assembly. The Division of Medicaid was identified as a state agency that should be contacted about developing strategies and action plans around the Medicaid eligibility issue and Care4Carolina about the Medicaid expansion issue.
  • Expand community health workers to empower communities to ensure all individuals can access healthcare. Received input that a better definition of what is a community health worker is needed for this policy priority to have value. The question of whether the presence of CHWs needed to be expanded or sustained or both was also explored. The state's Community Health Workers association and the relevant section of the NC Office of Rural Health were identified as good resources to further explore strategies and action plans for this policy priority.
  • Leverage community benefit dollars from Medicaid Transformation to meet the needs of the uninsured. It was suggested that two themes were conflated: Community benefit dollars from hospitals and new funds invested through Medicaid Transformation that might be used indirectly to benefit the uninsured (i.e., Health Opportunity pilot programs). It was suggested that the Division of Medicaid was the best place to start. NCHA might be the best source on hospital-based community benefit. Strategies and action plans cannot be developed until this policy priority is better understood.
  • Determine need in communities for more health clinics to serve the uninsured. While this policy priority is clear, the question of whether more clinics are needed should be paired with a proposed policy of how to best extend the reach and sustain existing safety-net programs for the uninsured. It was suggested that NCCHCA and NCAFCC are good resources for this topic. 
  • Increase the number of bilingual healthcare and insurance providers and staff. Targeting who within the state government or otherwise might be addressing this issue needs to be determined. It was suggested that provider associations and groups seem to be in the forefront for fostering this type of training. The relevance of having bilingual insurance providers as a priority was also questioned as it seems that market forces would address this issue. This topic needs more exploration and discussion before strategies and action plans can be pursued.
• Reviewed proposed policies.
  • Improve data collection about the uninsured. It was acknowledged that an absence of measurable and reliable data was an issue in developing policies for the uninsured. Further discussion on this topic is merited.
  • Extending the reach of existing safety-net programs for the uninsured. Safety-net providers indicated that the existing safety-net covers all 100 counties.  There may still be pockets where primary care requires excessive travel, but the infrastructure for a competent safety-net system already exists and could expand if properly funded. There is a provider distribution and recruitment and retention problem, that is not answered by simply creating new clinic sites.

September 12, 2022, 4:00 to 4:30 pm, Co-Lead Planning Meeting

Co-Leads: Randy Jordan, Chris Shank, and Mark Snuggs

Others Present: Rebecca Hayes

Discussion:

• Decided to advance 5 existing policy priorities for future consideration and consider 1 policy priority for further development.
  • Current Policy Priorities
    • Expand Medicaid eligibility criteria
    • Expand community health workers to empower communities to ensure all individuals can access healthcare
    • Leverage community benefit dollars from Medicaid Transformation to meet the needs of the uninsured
    • Determine need in communities for more health clinics to serve the uninsured
    • Increase the number of bilingual healthcare and insurance providers and staff
  • Proposed Policy Priorities to be Developed
    • Improve data collection about the uninsured to assist in health policy planning (e.g., how many uninsured currently have a medical home)
• Discussed continuing to review the policy priorities as work continues to assure that each priority has a reasonable expectation of making progress. All the policy priorities will be reviewed at the next work group meeting and any new policy priorities will be considered.
• Discussed making inquiries of relevant state agencies and stakeholders to request their proposals regarding strategies and action plans for each priority.
• Finalized the meeting schedule for the Uninsured Work Group. The next meetings will be from 10:00 to 11:45 am on October 17, January 23, and April 17.

August 15, 2022, 1:00 to 3:00 pm, Work Group Meeting

Co-Leads: Randy Jordan, Chris Shank, and Mark Snuggs

Work Group Members & Others Present: Abby Emanuelson, Alice Salthouse, Anshita Chaturvedi, April Cook, Brandy Bynum Dawson, Charlene Green, Don Holloman, Erica Palmer Smith, Honey Estrada, John Resendes, Kathy Hodges, Katye Griffin, Khristian Curry, Kristen Spaduzzi, Richard Hudspeth, Sally Wilson, Savannah Junkins, Torie Keeton, William Massengill, Jr., and Zenobia Edwards

Discussion: 

• Received the following special presentations: 
  • Medicaid Expansion – Abby Emanuelson, Care4Carolina 
  • Remaining Gaps in Care for the Uninsured – Randy Jordan
    • oral health, behavioral health, specialty care, geographic distribution of these services (Persistent Rural Problem), health care coverage expansion needs,  medical home gaps, social service gaps, undocumented people, data collection gap
    • Who owns the problems?
  • Connections to Care – Kathy Hodges and Khristian Curry, Office of Rural Health, CHW Program
• Reviewed 7 proposed policies and advanced 6 of 7 policies for strategic planning. Refer to proposed policies tagged Uninsured below. 
  • Expand Medicaid eligibility criteria (10 votes)
  • Expand community health workers to empower communities to ensure all individuals can access healthcare (9 votes)
  • Leverage community benefit dollars from Medicaid Transformation to meet the needs of the uninsured (9 votes)
  • Determine need for more community health clinics by employing data analysts (7 votes)
  • Increase the number of bilingual healthcare and insurance providers and staff (3 votes)
  • Increase publicity and navigator funding to provide instruction and access for open enrollment (1 vote)
  • Support bans or limitations on short-term health plans (0 votes)
• Discussed possibility of new policies related to: 
  • Capacity to serve more patients by expanding the reach of existing programs
  • Designating ownership of the wicked problem – no health care
  • Expanding data collection on uninsured

Priorities

The Primary Care Clinicians Work Group identified the following priorities for action planning. Work group members engaged in discussions and review of best practices related to leveraging Medicaid to support the viability of primary care clinicians in rural settings, provider loan repayment programs, and the need for provider trainings within rural communities.

• Expand healthcare provider training onsite in rural communities
• Increase funding for provider loan repayment programs
• Leverage Medicaid, including Medicaid Expansion, to support the viability of all primary care clinicians in rural settings

Action Plan

The Primary Care Clinicians Work Group's priority recommendations are included below.

Priority: Leverage Medicaid, including Medicaid Expansion, to support the viability of all primary care clinicians in rural settings

• Strategies and Action Plans
  • Making primary care economically viable for prospective providers also results in communities becoming more economically viable.  Consider the lack of success in primary care provider recruitment to be an economic issue and invest accordingly, similar to attracting new industry to North Carolina through economic incentives.
  • Improving primary care reimbursement and simplifying related administrative burdens will result in healthcare students making rational choices to enter all forms of primary care practice while in school and residency programs.
  • The states of Massachusetts and Rhode Island offer two examples of states and health insurers reaping rewards by investing differently in primary care and simplifying the process for administering primary care reimbursements.
  • Establish a Center on Workforce for Health to develop, coordinate and implement strategies to meet primary care workforce needs in targeted geographies of greatest need.

Priority: Increase funding for provider loan repayment programs

• Strategies and Action Plans
  • Explore the growing number of conditional acceptance programs for primary care clinicians that align with and incentivize providing primary care in rural and underserved communities.
  • Be intentional about recruiting primary care clinician students that match the demographic of the communities where they will serve.
  • Consider how to simplify, enhance and improve the current process for incentive and loan repayment programs currently administered in North Carolina that are based on HPSA (Health Professional Shortage Areas) scores.
  • In addition to loan repayment programs, support scholarship programs for primary care clinicians that are tied to service in rural and underserved communities.

Priority: Expand healthcare provider training onsite in rural communities

• Strategies and Action Plans
  • Develop a plan to financially support rural preceptors in rural and underserved communities as primary care clinicians are more likely to practice in those areas if they are trained there and have exposure to rural settings. More rural rotations are needed for all types of providers.
  • Consider creative uses of Medicaid and other funding sources to address health provider recruitment in rural communities (e.g., New Mexico uses Medicaid dollars to pay for more Graduate Medical Education (GME) slots in rural communities).
  • Align community development, provider training and provider recruitment programs in rural and underserved communities to increase primary care clinician retention. 

Meeting Notes

April 17, 2023, 3:00 to 4:00 pm, Work Group Meeting

Co-Leaders: Mark Snuggs and Randy Jordan; Absent: Anshita Chaturvedi

Attendees: Greg Griggs, Becca Hayes, Elizabeth Hudgins, Chris Shank, Kristen Spaduzzi, Hugh Tilson, Jr., Adam Zolotor

Discussion:

• Reviewed and discussed comments related to the prioritized policies, strategies, and action plans.
  • Policy: Leverage Medicaid, including Medicaid Expansion, to support the viability of all primary care clinicians in rural settings.
    • Strategies and Action Plans
      • Making primary care economically viable for prospective providers also results in communities becoming more economically viable.  Consider the lack of success in primary care provider recruitment to be an economic issue and invest accordingly, similar to attracting new industry to North Carolina through economic incentives.
      • Improving primary care reimbursement and simplifying related administrative burdens will result in healthcare students making rational choices to enter all forms of primary care practice while in school and residency programs.
      • The states of Massachusetts and Rhode Island offer two examples of states and health insurers reaping rewards by investing differently in primary care and simplifying the process for administering primary care reimbursements.
      • Establish a Center on Workforce for Health to develop, coordinate and implement strategies to meet primary care workforce needs in targeted geographies of greatest need.
  • Policy: Increase funding for provider loan repayment programs.
    • Strategies and Action Plans
      • Explore the growing number of conditional acceptance programs for primary care clinicians that align with and incentivize providing primary care in rural and underserved communities.
      • Be intentional about recruiting primary care clinician students that match the demographic of the communities where they will serve.
      • Consider how to simplify, enhance and improve the current process for incentive and loan repayment programs currently administered in North Carolina that are based on HPSA (Health Professional Shortage Areas) scores.
      • In addition to loan repayment programs, support scholarship programs for primary care clinicians that are tied to service in rural and underserved communities.
  • Policy: Expand healthcare provider training onsite in rural communities.
    • Strategies and Action Plans
      • Develop a plan to financially support rural preceptors in rural and underserved communities as primary care clinicians are more likely to practice in those areas if they are trained there and have exposure to rural settings. More rural rotations are needed for all types of providers.
      • Consider creative uses of Medicaid and other funding sources to address health provider recruitment in rural communities (e.g., New Mexico uses Medicaid dollars to pay for more Graduate Medical Education (GME) slots in rural communities).
      • Align community development, provider training and provider recruitment programs in rural and underserved communities to increase primary care clinician retention. 

January 23, 2023, 3:00 to 4:45 pm, Work Group Meeting

Co-Leads: Anshita Chaturvedi, Mark Snuggs, and Randy Jordan

Attendees: Adam Zolotor, Alice Salthouse, Ashley Rink, Becca Hayes, Chris Shank, Christopher Ray Vann, Elizabeth Hudgins, Gregg Griggs, Hugh Tilson, Kristen Spaduzzi, Patrick Brown , Savannah Junkins, Stephanie Nantz

Presenters: Kathy Dail

Discussion:

• Kathy Dail shared her deep appreciation to each work group member for their leadership within the NC SHIP Community Council. As the work group wraps up this year’s work, the work group is empowered to make decisions to pursue the prioritized policies, designate lead organizations, and identify others that should be a part of this work group. All work group members are welcome to continue to be involved.
• Reviewed and discussed the comments from subject matter experts received prior to the meeting about the approved priorities. Discussion highlights are included below each policy.
  • Policy: Expand Medicaid to support the viability of primary care clinicians in rural settings.
    • Lack of primary care provider recruitment being considered an economic issue. Primary care needs to be economically viable, which makes communities more economically viable.
    • From an education and training perspective, as providers are going through school, they make rational choices and if reimbursement is not fixed, cannot expect providers to go into primary care.
    • Massachusetts and Rhode Island are two examples economic drivers. There needs to be greater recruitment in rural areas where primary care is needed. Consider ways to invest differently in primary care and simplify the process and long-term planning.
  • Policy: Increase funding for provider loan repayment programs.
    • There are a growing number of conditional acceptance programs for students that might not always be admitted to medical school with alignment with rural and underserved communities.
    • Important to recruit people that look like the community they are serving; this is important for recruitment and sustainability.
    • North Carolina administers several incentive programs and loan repayment programs. Incentives are influenced for some programs based on HPSA (Health Professional Shortage Area) scores. Simplification of these processes and programs is needed.
  • Policy: Expand healthcare provider training onsite in rural communities.
    • Need to financially support rural preceptors. Clinicians are more likely to go to rural areas if are from there and have exposure to rural settings. Need rural rotations for all kinds of providers.
    • Recommendation for a strategic planning process for health provider recruitment in rural communities. Referred to the New Mexico example to use Medicaid dollars to pay for more GME (Graduate Medical Education) slots.
    • Alignment of community development and provider recruitment can make a bigger difference in providers staying in communities. 
• Reviewed next steps were to narrow comments and consider who all should be included in this work group and who could pick up this work and keep it moving forward.

November 16, 2022, 1:00 to 2:00 pm, Co-Lead Planning Meeting

Co-Leads: Randy Jordan, Anshita Chaturvedi, and Mark Snuggs

Discussions:

• Reached a consensus on which ongoing priorities to continue and which ones to move to developmental policy status. Revised wording of ongoing policies and clarified which policies required additional input from external sources to allow to moving forward with strategies and action plans for each ongoing priority.
• Approved Policy Priorities: (Further input on all policies will be solicited from NC AHEC.)
  1. Expand Medicaid to support the viability of primary care clinicians in rural settings. Making progress on this policy priority was considered preeminent in achieving a long-term solution to the primary care crisis. Primary care cannot be sustained, particularly in rural NC, under the current reimbursement rate structure.
  2. Increased funding for provider loan repayment programs. This policy was also considered a high priority and the topic of scholarships for providers is a related topic. Loan or scholarship programs should be available for physician assistants and nurse practitioners as they by far represent the fastest growing resource for primary care in rural communities.
  3. Expand healthcare provider training onsite in rural communities. The retention rate for preceptorships and other forms of experience-based training in rural communities are better than expected. Investing in this type of training of primary care physicians, physician assistants and nurse practitioners might be the best short-term solution to rural workforce issues. 
• Eliminated or Repositioned Policy Proposals:
  1. Solutions for healthcare workforce challenges. This topic was considered important, but needed more work by other groups who are currently focusing on the broad subject of healthcare workforce shortages.

October 17, 2022, 3:00 to 4:45 pm, Work Group Meeting

Co-Leads: Anshita Chaturvedi, Randy Jordan, and Mark Snuggs

Attendees: Alice Salthouse, Chris Shank, Christopher Ray Vann, Elizabeth Hudgins, Gregg Griggs, Hugh Tilson, Kristen Spaduzzi, Savannah Junkins

Presenter: Adam Zolotor

Discussion:

• Received the following presentation:
  • Adam Zolotor, M.D., provided an overview of Healthy North Carolina 2030 process and current efforts to expand primary care clinician services.
• Reviewed approved policy priorities and related strategies and action plans. Discussed questions and clarifications needed to move forward.
  • Expand Medicaid to support viability of primary care clinicians. Making progress on this policy priority was considered preeminent in achieving a long-term solution on the primary care crisis. Primary care cannot be sustained, particularly in rural NC under the current rate structure.
  • Increased funding for provider loan repayment programs. This policy was also considered a high priority, although retention rates in rural settings are relatively low from loan repayment programs. There was discussion about the value of scholarships for primary care providers as opposed to loans. Scholarship recipients who failed to serve in rural settings, could have their scholarships revert to loans. Also, loan or scholarship programs should be available for physician assistants and nurse practitioners as they by far represent the fastest growing resource for primary care in rural communities.
  • Solutions for healthcare workforce challenges. There was a suggestion that this issue should be referred to a group that was already conducting strategic planning on workforce training. Additional discussions are needed to determine whether this policy priority should be retained.
  • Expand medical school training on practice in rural communities. Adam Zolotor from NC AHEC presented data that suggested the retention rate for preceptorships and other forms of experience-based training in rural communities were better than expected. A variety of such programs were identified, and it was suggested that investing in this type of training of primary care physicians, physician assistants and nurse practitioners might be the best short-term solution to rural workforce issues. HOSA and middle and high school programs offering students exposure to healthcare were also considered good longer-term solutions to increasing the rural healthcare workforce. There seemed to be consensus that this policy priority would be a worthy third priority if the list extended to 3 priorities.

August 15, 2022, 3:00 to 5:00 pm, Work Group Meeting

Co-Leads: Anshita Chaturvedi, Randy Jordan, and Mark Snuggs

Work Group Members & Others Present: Alice Pollard, Alice Salthouse, Brian Toomey, Charlene Green, Chris Shank, Christopher Ray Vann, Don Holloman, Elizabeth Hudgins, Gregg Griggs, Karen Gliarmis, Kathy Dail, Katye Griffin, Kristen Spaduzzi, Savannah Junkins, and Shaunna Herrman

Discussion:

• Received presentation from Karen Gliarmis (Substitution for Stephanie Nantz). 
• Reviewed 14 proposed policies and advanced 4 of 14 policies for strategic planning; 8 policies were deferred/not selected as priorities and 2 policies were removed. Refer to proposed policies tagged Primary Care Clinicians below. 
  • Advanced:
    • Expand Medicaid to support financial viability of primary care providers serving low-income patients (8 votes)
    • Support increased funding for provider loan repayment programs that incentivize primary care providers to practice in medically underserved areas (4 votes)
    • Develop long-term solutions to healthcare workforce challenges with a particular emphasis on increasing the number of North Carolina health care providers from historically marginalized populations (3 votes)
    • Expand medical school training and learning experiences focused on the skills necessary to practice successfully in rural areas (1 vote)
  • Deferred: (All of the following received 0 votes)
    • Assess recruitment strategies used by colleges and universities that focus on rural needs
    • Ensure highspeed Internet access to support access to telehealth, electronic health records and controlled substance reporting system sites 
    • Grow NCCARE360 by adding more health systems, payers, providers 
    • Increase patient access and provide for adequate compensation for consultations with specialists 
    • Increase requirement for number of rural health clinical rotations for physician assistants (PAs) and Advanced Practice Nurses (APNs) 
    • Increase telehealth primary care initiatives in rural areas 
    • Increase the number of residency positions in rural areas 
    • Support pipeline programs in rural areas to encourage high school and college students to pursue careers in medicine and primary care 
  • Removed: (All of the following received 0 votes)
    • Invest in rural economies
    • Review and optimize middle and high school career and tutoring programs to augment math and science skills

Priorities

The NC SHIP priorities were integrated into the existing Comprehensive Suicide Prevention Advisory Council (CSPAC). The CSPAC convenes suicide prevention professionals (Division of Mental Health/ Developmental Disabilities and Substance Abuse Services [DMH/DD/SAS], Department of Public Instruction [DPI]), loss survivors, attempt survivors, people who have accessed mental health, substance use, and intellectual and developmental disabilities (MH/SU/IDD) services, veterans, and special populations including Black, Latino/Hispanic, those that identify as person of color (POC) and LGBTQ+ youth to guide action plan components and implementation of strategies.

The North Carolina Suicide Prevention Action Plan (NC SPAP) acknowledges that suicide prevention is complex, and the plan is structured to implement comprehensive strategies in the following focus areas to reduce injury and death by suicide. Refer to the NC Suicide Prevention Action Plan for additional information about this plan, data and justification, strategies, and related actions. The policies included below are the focus areas for the NC SPAP. 

1. Create a coordinated infrastructure
2. Reduce access to lethal means
3. Increase community awareness and prevention
4. Identify populations at risk
5. Provide crisis intervention with a specific focus on people with increased risk
6. Provide access to and delivery of suicide care
7. Measure our impact and revise strategies based on results

Action Plan

The North Carolina Suicide Prevention Action Plan is available at https://injuryfreenc.dph.ncdhhs.gov/preventionResources/docs/CSP-ActionPlanFinal.pdf.

Meeting Notes

August 8, 2023, Comprehensive Suicide Prevention Advisory Council (CSPAC)

• Updates on priorities:

May 10, 2023,  Comprehensive Suicide Prevention Advisory Council (CSPAC)

• Updates on prioritized policies:

February 8, 2023,  Comprehensive Suicide Prevention Advisory Council (CSPAC)

• Updates on prioritized policies:

​​​December 19, 2022,  Comprehensive Suicide Prevention Advisory Council (CSPAC)

• Updates on prioritized policies:

November 2022

• NC Comprehensive Suicide Prevention Advisory Council (CSPAC) meeting held.

September 19, 2022

• Published Suicide Prevention Action Plan. The North Carolina Suicide Prevention Action Plan is focused on specific actions to be taken in North Carolina over the next four years to reduce injury and death by suicide. For additional information refer to the press release. 

August 10, 2022, 10:00 to 11:30 am, Comprehensive Suicide Advisory Prevention Council Meeting

Co-Leads: Catherine English, Anne Geissinger, Sue Pilgreen, and Glorina Stallworth

Discussion:

• Discussed the proposed policy initiatives from the NC SHIP for Indicator 19: Suicide Rate, and then prioritized 6 of the 13 policies. The prioritized policies were then ranked as follows, with number 1 being most important.

1. Implement policies targeted to decrease access to lethal means
2. Increase programs that provide mental health services and support for LGBTQ youth
3. Increase programs that provide mental health services and support for military veterans
4. Create trauma-informed schools with access to mental health providers
5. Modernization of data systems
6. Expand rapid access to crisis services, including implementing the national 988 number  

• Reviewed work currently being done by the Division of Public Health to assist with identifying where to focus efforts throughout the year.

Priorities

The Life Expectancy Work Group identified the following priorities for action planning. Work group members engaged in discussions and review of best practices related to falls prevention, brain health and dementia, and radon. The Life Expectancy Work Group acknowledges that many factors have and will impact Life Expectancy as an indicator that are not addressed by these three policy areas. Some key factors include maternal and infant mortality, substance misuse, chronic disease prevention and management and the COVID-19 pandemic. The work group suggests using some related secondary population level indicators to measure whether North Carolinians are better off.

Falls Prevention

• Foster partnerships to increase awareness of fall risk factors
• Advance access to fall prevention interventions
• Cultivate strategic partnerships with traditional and nontraditional agencies and organizations addressing falls

Brain Health and Dementia Care

• Educate individuals, caregivers, and healthcare providers about cognitive decline risk factors, including potential hearing loss, screening, and evidence-based interventions to support brain health
• Increase use of screening and diagnostic assessment to identify early signs of cognitive decline risk factors and dementia to reduce risk, slow decline and manage symptoms
• Improve access to and use of clinical and community services for people with Alzheimer’s disease and related dementias (ADRD)

Radon Testing and Mitigation

• Support the North Carolina Housing Finance Agency and other organizations by increasing grant funds to support the installation of radon mitigation systems among homeowners financially eligible
• Improve access to free radon test kits and education, particularly to historically marginalized populations
• Require public schools to test and mitigate for high levels of radon

Action Plan

Falls Prevention

• Priority: Foster partnerships to increase awareness of fall risk factors
  • Strategies:
    • Promote effective referral pathways to all health care providers, rehab care providers, evidence-based falls prevention programs
    • Ensure all counties have access to community-based falls prevention programs
    • Expansion of PACE to counties with high hospitalization, ED visits and deaths from falls
    • Expansion of Community Paramedic Programs in high falls risk counties in NC
• Priority: Advance access to fall prevention intervention
  • Strategies:
    • Universal Falls Screening: Implement a systematic and comprehensive falls screening program for all older adults to identify individuals at risk of falling. This can involve the use of standardized assessment tools and protocols.
    • Collaboration and Coordination: Foster collaboration and coordination among healthcare providers, community organizations, and caregivers involved in fall prevention. Encourage information sharing, referrals, and joint efforts to provide comprehensive care and support for older adults.
    • Adopt a multidisciplinary approach that involves healthcare professionals from different disciplines, such as geriatricians, physical therapists, occupational therapists, audiologist, pharmacists, and others. This ensures a holistic assessment and the implementation of appropriate interventions tailored to individual needs.
    • Education and Training: Provide education and training programs for healthcare providers, caregivers, community volunteers, and older adults themselves. These programs can include falls prevention strategies, home safety assessments, exercise programs, medication management, and balance training.
    • Accessible Interventions: Ensure that fall prevention interventions are accessible and available to older adults. Promote the integration of falls prevention services into primary care settings, community centers, senior housing facilities, and home care services.
• Priority: Cultivate strategic partnerships with traditional and nontraditional agencies and organizations addressing falls
  • ​​​​​​​Strategies:
    • ​​​​​​​Cultivate strategic partnerships with traditional and nontraditional agencies and organizations addressing falls

Brain Health and Dementia Care

• To be added.

Radon Testing and Mitigation

• ​​​​​​​To be added.

Meeting Notes

May 9, 2023, 10:00 to 12:00 pm, Work Group Meeting

Co-Leads: Heather Carter, Amy Lanou, and Martha Zimmerman

Attendees: Brandie Garner, Ellen Schneider, Jennifer Teague, Phillip Gibson

Presenters: Scott Herrick and Kathy Dowd

Discussion:

• Reviewed the purpose of the NC SHIP Community Council is to advance the policy agenda for the Healthy North Carolina 2030 (HNC 2030) population indicators. The Life Expectancy indicator result is “All people in North Carolina have long and healthy lives.”
• Reviewed updated policy recommendations:
  • Educate individuals, caregivers, and healthcare providers about cognitive decline risk factors, screening, and evidence-based interventions to support brain health.
  • Increase use of screening and diagnostic assessment to identify early signs of cognitive decline risk factors and dementia to stop or slow decline and manage symptoms.
  • Improve access to and use of clinical and community services for people with Alzheimer’s disease and related dementias (ADRD).
• Received presentation on Alzheimer’s Disease from Scott Herrick, State Director of Public Policy, Alzheimer’s Association.
• Received presentation on Hearing Loss and Dementia from Kathy Dowd, AuD, Executive Director, The Audiology Project.
• Discussed  potential tasks for a strategy to educate and disseminate information on hearing assessments/ hearing loss.

February 27, 2023, 10:00 to 12:00 pm, Work Group Meeting

Co-Leads: Heather Carter, Amy Lanou, and Martha Zimmerman

Work Group Members Present: Divya Venkataganesan, Ellen Schneider, Heather Burkhardt, Jenni Danai, Mark Hensley

Presenter: Vicki Mercer

Discussion:

• Reviewed recommendations and action planning related to the radon policies discussed at the previous work group meeting.
  • Support North Carolina Housing Finance Agency and other organizations by increasing grant funds to support the installation of radon mitigation systems for community buildings and among homeowners financially eligible
  • Improve access to free radon test kits, particularly to historically marginalized populations
  • Additional policy for the work group’s consideration: Require public schools to test and mitigate for high levels of radon
• Received presentation on falls prevention from Dr. Vicki Mercer, PT, PhD, University of North Carolina at Chapel Hill.
• Discussed revisions to the policy recommendations from the NC SHIP for falls prevention and potential strategies for action planning.
  • Foster partnerships to increase awareness of fall risk factors
  • Advance access to fall prevention interventions
  • Cultivate strategic partnerships with traditional and nontraditional agencies and organizations addressing falls
• Reviewed the next meeting is scheduled for Tuesday, May 9, 2023, from 10:00 am to 12:00 pm. The focus will be on Dementia Care and Prevention.

November 8, 2022, 10:00 to 12:00 pm, Work Group Meeting

Co-Leads: Heather Carter, Amy Lanou, and Martha Zimmerman

Work Group Members Present: Brandie Garner, Divya Venkataganesan, Ellen Schneider, Jenni Danai, Jennifer Teague, Phillip Gibson, Heather Burkhardt

Discussion:

• Received presentation about radon from Phillip Gibson, NC Radon Program Coordinator with the Division of Health Service Regulation, with the North Carolina Department of Health and Human Services.
• Discussed revisions to the policy recommendations from the NC SHIP for radon.
• Decided to not prioritize the proposed policies related to data infrastructure and metrics. The work group’s priority areas include falls prevention, dementia care and brain health, and radon.
• Reviewed the next meeting discussion topics. The next meetings are scheduled for:
  • February 14, 2023, from 10:00 am to 12:00 pm–Focus on Falls Prevention
  • May 9, 2023, from 10:00 am to 12:00 pm– Focus on Dementia Care and Brain Health

August 16, 2022, 10:00 to 12:00 pm, Work Group Meeting

Co-Leads: Heather Carter, Amy Lanou, and Martha Zimmerman

Work Group Members Present: Ellen Schneider and Jeff Jones

Discussion:

• Prioritized policies from the NC SHIP for Indicator 21: Life Expectancy related to falls prevention, dementia care, and radon. Began revising the falls prevention and dementia care policies.
• Discussed decision-makers and key influencers that should be invited to join in the work group.
• Determined additional information was needed on the policies about radon and data infrastructure/ metrics. Planned to discuss both further at next work group meeting on November 8, 2022.  

Policies to Support HNC 2030

Refer to pages 29 to 32 in the 2023 NC SHIP report: Table 2 provides  a summary of the policies identified by the 2022-2023 NC SHIP Community Council to support HNC 2030 and does not constitute an endorsement by NC DHHS/DPH. Many of the policies were originally suggested in HNC 2030: A Path Toward Health, and others were added by the NC SHIP Community Council members and community stakeholders July-September 2021 (pp. 8-9). Some of the policies are also those included in the Robert Wood Johnson Foundation County Health Rankings & Roadmaps Evidence Library of “What Works for Health” - https://www.countyhealthrankings.org/take-action-to-improve-health/whatworks-for-health. NC DHHS/DPH welcomes the opportunity to work with its partners and the community to prioritize policies and programs that have the greatest potential for “Turning the Curve” on the HNC 2030 indicators.