North Carolina

Medicaid patients and county workers brace for the end of the COVID public health emergency

Published

2 years ago

August 10, 2022

Medicaid patients and county workers brace for the end of the COVID public health emergency

By Clarissa Donnelly-DeRoven

When the pandemic hit, Rachel bought sick with COVID-19. Like thousands and thousands of others throughout the nation, the agricultural japanese North Carolina resident misplaced her job. Although it was a blow to her revenue, it meant she was eligible for one thing she hadn’t been earlier than: Medicaid, the federal and state-funded insurance coverage program for low-income individuals.

Rachel’s two sons are autistic and already acquired protection by means of this system, so she was considerably conversant in the method. She’d additionally had Medicaid when she was pregnant. And as an individual with bipolar dysfunction, she’d skilled how useful dependable insurance coverage protection might be in conserving her situation beneath management.

(NC Well being Information selected to not determine Rachel together with her full identify because of the ongoing stigma of psychological sickness.)

Finally, as a number of the financial impacts of the pandemic started to wane, Rachel bought a brand new job at a small nonprofit. The one problem was that the place didn’t supply medical insurance. Below regular circumstances, that in all probability would’ve been an enormous deal — perhaps even a deal breaker.

Nonetheless, when the federal authorities declared COVID-19 a public well being emergency in 2020, a part of that declaration included a requirement that prohibited states from terminating practically anybody’s Medicaid protection, no matter adjustments to their revenue.

That federal coverage change meant Rachel may preserve receiving protection though she now made an excessive amount of cash to qualify for this system beneath regular circumstances. In North Carolina, which is considered one of 12 states that hasn’t expanded Medicaid eligibility, Rachel would lose her protection if her annual family revenue exceeded $30,630, the higher restrict for a household of three. It’s the equal of 1 individual working full time at an hourly wage of $14.73.

The requirement of the general public well being emergency that everybody’s protection proceed led Medicaid enrollment numbers to swell nationwide. In North Carolina, the variety of individuals enrolled in Medicaid grew from 2.1 million in February 2020 to 2.8 million in July 2022 — a rise of practically 30 p.c.

However as soon as the federal public well being emergency ends, scheduled now for October, the protection requirement may even finish. That’ll imply 1000’s of individuals will, as soon as once more, discover themselves with out medical insurance. It additionally signifies that the county Medicaid staff, who’re chargeable for enrolling and terminating individuals from this system, will discover themselves with massively inflated workloads.

Nonetheless reviewing, not terminating

Per federal legislation, county or state Medicaid staff (relying on how this system is run on the state degree) obtain and assessment revenue paperwork on a yearly foundation from everyone on the state’s Medicaid program. The employees decide if every individual has a low sufficient revenue that they’re nonetheless eligible for protection, or in the event that they make an excessive amount of and must be faraway from the rolls.

These within the area name this course of — interchangeably — a case assessment, renewal, recertification or redetermination. All through the pandemic, county Medicaid staff in North Carolina stored doing case opinions every month, however they didn’t finish individuals’s protection even when they have been discovered to not be eligible.

Whereas the state noticed an general improve in Medicaid enrollment of about 30 p.c, county by county enrollment diversified considerably, in response to an NC Well being Information evaluation of state Medicaid enrollment knowledge.

Coastal Currituck County, for instance, noticed its Medicaid enrollment improve by 43 p.c between February 2020 and April 2022 — the best improve within the state.

There are 16 staff on the county social service division who can do case opinions, in response to Samantha Hurd, the director of Currituck’s DSS workplace. Relying on how sophisticated the case is, doing a case assessment can take a couple of minutes or just a few hours.

No matter whether or not Medicaid is expanded or not, state and county officers have suggestions for a way individuals with Medicaid can finest navigate the case assessment course of.

Be certain that your tackle and cellphone quantity are up to date with the county and with the insurance coverage firm — Wholesome Blue, WellCare, AmeriHealth Caritas, UnitedHealthcare, Carolina Full — that manages your plan if in case you have managed care.
When it’s time to your yearly case assessment, don’t panic! It is best to obtain a letter out of your county DSS workplace explaining what they want from you. In the event you’re on a managed care plan you’ll obtain info from that group as effectively.
If the general public well being emergency ends in October, the county will start reviewing instances in November. Which means in case you have been first enrolled in Medicaid in October, for instance, you’d nonetheless be coated by this system for a 12 months and you’ll proceed to make use of your protection throughout this era.
In the event you’re discovered to be ineligible, you might have a proper to enchantment that call. Pals, household or advocates from authorized assist organizations might help you navigate the method.
In the event you’re discovered to be ineligible and also you assume that call is appropriate, there are different choices obtainable to you for protection. At healthcare.gov you possibly can search for plans that suit your wants and see in case you qualify for federal subsidies (right here’s a calculator) by means of the Reasonably priced Care Act. These might help make personal insurance coverage protection extra inexpensive.]

“Each consumer goes to be on a distinct assessment cycle, relying upon after they utilized for Medicaid and when that Medicaid was permitted,” Hurd defined.

Throughout an interview in July, Hurd, and lots of different county DSS administrators, expressed concern that the state could require all of the pandemic-era Medicaid instances to be reviewed inside a particular timeframe, resembling 90 days, slightly than on their regular yearly cycle.

However Dave Richard, the deputy director of NC Medicaid on the state well being division, defined that county staff can proceed to assessment instances on their regular yearlong cycle because of a provision — which could be discovered beneath part 9D.5. — within the 2022 state price range invoice. Gov. Roy Cooper signed the price range into legislation on July 11.

As a result of the county staff in Currituck have continued conducting their opinions as regular, Hurd stated she’s not apprehensive in regards to the work piling up, or how they’ll handle.

Workforce and know-how points

Not all county staff really feel the identical. Some are involved in regards to the emotional toll terminating individuals’s Medicaid advantages may have on county staff.

“Initially, these will not be simply case numbers. These are households. These are the grandmother on the market who’s taken on her grandchildren, the mother and pa who’re each working and simply attempting to make ends meet and nonetheless want help,” stated Renee Smith, who works with Medicaid and different public advantages on the Johnston County Division of Social Companies, which noticed a couple of 34 p.c improve in Medicaid enrollment.

“It’s gonna be a course of and we’re simply gonna should take that at some point at a time,” Smith stated. “We have to do what’s in the very best curiosity of the consumer whereas caring for our staff and conserving them from burning out. That’s crucial as a result of if we don’t have the staff right here to do the job, then the purchasers aren’t gonna get taken care of.”

County staff may even want a refresher course on the insurance policies and guidelines, as terminating individuals from Medicaid hasn’t been a part of their workflow for greater than two years, Smith defined.

Employees turnover has additionally confirmed to be an actual problem for a lot of county DSS workplaces, particularly over the previous few years throughout what’s come to be often called the “nice resignation.”

Karen Calhoun, the director of human providers at Cabarrus County’s DSS workplace, stated the workplace has seen large turnover in workers for the reason that begin of the pandemic, a lot in order that many individuals within the workplace have by no means truly achieved a termination. “We now have employed workers during the last two years that don’t know what that ordinary tradition of seeing individuals in individual is,” she stated.

Cabarrus additionally skilled a couple of 34 p.c improve in Medicaid enrollment over the course of the pandemic.

Dave Richard, deputy secretary for Medicaid on the N.C. Division of Well being and Human Companies, updates the Joint Legislative Oversight Committee on Feb. 11, 2020, on Medicaid transformation. Picture credit score: Anne Blythe

“Even when there was a big quantity of recent cash that got here in from counties or states to rent extra individuals to do that work,” stated Richard, from the state well being division, “The employees simply aren’t there — and that is sophisticated work.”

“We’re very apprehensive in regards to the workforce points, primarily, when this adjustments. We’re doing the whole lot we are able to to attempt to improve a number of the know-how points to make it simpler for people to get by means of it, however the fact is, it’s simply going to be an elevated workload,” he stated.

A few of these technological enhancements embrace updates to the NCFAST system, which counties, suppliers and the state use for a lot of completely different social service administrative processes.

The state well being division is engaged on updates to the system that will enable it to do case opinions electronically.

“NCFAST will run all of its digital matches for revenue, and many others. on a case, and if it is ready to make an eligibility willpower based mostly on these matches, it’ll course of that redetermination routinely with out the county DSS having to the touch the case,” Richard stated. “Proper now, the county DSS has to the touch the case as much as 3 times to assessment and begin the subsequent steps.”

The state has carried out this facet of the NCFAST system in a few counties and has discovered that as much as 40 p.c of case opinions could be accomplished this manner. The aim is to have the software program rolled out statewide by Dec. 1.

The function of growth

Whereas updates to NCFAST and extra coaching seminars may assist counties stability this work, many argue there’s one clear strategy to keep away from disruptions to each county staff and sufferers.

“Frankly, one of the essential issues we may do truly to ease the burden on counties can be to move Medicaid growth,” Richard stated. “There’s such a big variety of individuals which are at present on the roles that will wind up not having to be disenrolled as a result of they’d be eligible for growth.”

Whereas growth would imply that extra individuals can be on Medicaid, it will additionally imply the state would get extra money from the federal authorities to pay for these extra prices. Moreover, the state may move a few of these funds alongside to the counties to cope with their added workload.

The way in which the present Medicaid system works is the federal authorities pays about 68 p.c of the price of Medicaid, whereas North Carolina pays for the remainder. However for these newly coated by means of growth, the federal authorities pays 90 p.c. To cowl its 10 p.c of the tab, some specialists have proposed that North Carolina improve evaluation prices on hospitals, which might usher in extra money to the state.

“We’d use a portion of these {dollars} to help counties as a result of we knew there can be extra workload,” Richard stated. “The query that individuals ask is, may this system deal with these extra individuals on this system? Nicely, we’ve got.

“We will deal with it,” he stated. “If we’re going to increase, increasing sooner slightly than later is smart since you keep away from having to go to individuals saying, ‘Oh, you don’t have insurance coverage,’ however then three months later, return to that very same group of individuals saying, ‘Oh, effectively you now have it as a result of we’ve expanded.’”

For Rachel, the japanese North Carolina resident who acquired Medicaid advantages beneath the general public well being emergency, it’s not possible to overstate how useful it’s been. Along with getting correct look after her bipolar dysfunction, it’s additionally meant she’s been capable of see medical doctors to handle her fibromyalgia and that she may attend a number of follow-up appointments after a hysterectomy that she acquired to deal with endometriosis.

For years, she’d discovered learn how to handle these persistent situations with out insurance coverage, however “not in very wholesome methods,” she stated. She took numerous Motrin. She spent hours on the cellphone calling pharmacies to see which one provided the most cost effective out-of-pocket worth for her drugs. She requested her physician to forgo a number of the actually costly blood work that they wished to run on her, and so forth.

With Medicaid, she goes to see her specialists when she wants them, and so they can run the total gamut of checks. Now Rachel worries what is going to occur in October.

“Final month I used to be again to feeling the identical method I felt in 2019 after I was within the protection hole and didn’t have insurance coverage,” she stated. “It was again to these sleepless nights, these crying nights.”

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by Clarissa Donnelly-DeRoven, North Carolina Well being Information
August 10, 2022

<h1>Medicaid sufferers and county staff brace for the top of the COVID public well being emergency</h1> by Clarissa Donnelly-DeRoven, North Carolina Well being Information August 10, 2022 <h4 id=”h-by-clarissa-donnelly-deroven”><sturdy>By Clarissa Donnelly-DeRoven</sturdy></h4> When the pandemic hit, Rachel bought sick with COVID-19. Like thousands and thousands of others throughout the nation, the agricultural japanese North Carolina resident misplaced her job. Although it was a blow to her revenue, it meant she was eligible for one thing she hadn’t been earlier than: Medicaid, the federal and state-funded insurance coverage program for low-income individuals.  Rachel’s two sons are autistic and already acquired protection by means of this system, so she was considerably conversant in the method. She’d additionally had Medicaid when she was pregnant. And as an individual with bipolar dysfunction, she’d skilled how useful dependable insurance coverage protection might be in conserving her situation beneath management. (NC Well being Information selected to not determine Rachel together with her full identify because of the ongoing stigma of psychological sickness.) Finally, as a number of the financial impacts of the pandemic started to wane, Rachel bought a brand new job at a small nonprofit. The one problem was that the place didn’t supply medical insurance. Below regular circumstances, that in all probability would’ve been an enormous deal — perhaps even a deal breaker.  <determine class=”wp-block-image aligncenter size-full”><a href=”https://www.northcarolinahealthnews.org/donate/”><img src=”https://www.northcarolinahealthnews.org/wp-content/uploads/2021/04/COVID-Donate-Advert-NEW-April-2021.png” alt=”” class=”wp-image-33559″ /></a></determine> Nonetheless, when the federal authorities declared COVID-19 a public well being emergency in 2020, a part of that declaration included a requirement that<a href=”https://eohhs.ri.gov/initiatives/medicaid-and-end-covid-19-public-health-emergency”> prohibited states</a> from terminating practically anybody’s Medicaid protection, no matter adjustments to their revenue.  That federal coverage change meant Rachel may preserve receiving protection though she now made an excessive amount of cash to qualify for this system beneath regular circumstances. In North Carolina, which is considered one of 12 states that<a href=”https://www.northcarolinahealthnews.org/2022/06/03/will-nc-medicaid-expansion-ride-tailwinds-or-lean-into-new-headwinds/”> hasn’t expanded Medicaid</a> eligibility, Rachel would lose her protection if her annual family revenue<a href=”https://www.advantages.gov/profit/1390″> exceeded $30,630</a>, the higher restrict for a household of three. It’s the equal of 1 individual working full time at an hourly wage of $14.73. The requirement of the general public well being emergency that everybody’s protection proceed led Medicaid enrollment numbers to swell nationwide. In North Carolina, the <a href=”https://medicaid.ncdhhs.gov/experiences/dashboards#enroll”>variety of individuals enrolled in Medicaid</a> grew from 2.1 million in February 2020 to 2.8 million in July 2022 — a rise of practically 30 p.c.  However as soon as the <a href=”https://aspr.hhs.gov/authorized/PHE/Pages/covid19-15jul2022.aspx”>federal public well being emergency</a> ends, scheduled now for October, the protection requirement may even finish. That’ll imply 1000’s of individuals will, as soon as once more, discover themselves with out medical insurance. It additionally signifies that the county Medicaid staff, who’re chargeable for enrolling and terminating individuals from this system, will discover themselves with massively inflated workloads. <h4><sturdy>Nonetheless reviewing, not terminating</sturdy></h4> Per federal legislation, county or state Medicaid staff (relying on how this system is run on the state degree) obtain and assessment revenue paperwork on a yearly foundation from everyone on the state’s Medicaid program. The employees decide if every individual has a low sufficient revenue that they’re nonetheless eligible for protection, or in the event that they make an excessive amount of and must be faraway from the rolls.  These within the area name this course of — interchangeably — a case assessment, renewal, recertification or redetermination. All through the pandemic, county Medicaid staff in North Carolina stored doing case opinions every month, however they didn’t finish individuals’s protection even when they have been discovered to not be eligible.  Whereas the state noticed an general improve in Medicaid enrollment of about 30 p.c, county by county enrollment diversified considerably, in response to an NC Well being Information evaluation of state Medicaid enrollment knowledge. Coastal Currituck County, for instance, noticed its Medicaid enrollment improve by 43 p.c between February 2020 and April 2022 — the best improve within the state.  There are 16 staff on the county social service division who can do case opinions, in response to Samantha Hurd, the director of Currituck’s DSS workplace. Relying on how sophisticated the case is, doing a case assessment can take a couple of minutes or just a few hours. <div class=”wp-block-group has-white-color has-primary-background-color has-text-color has-background”> <sturdy>No matter whether or not Medicaid is expanded or not, state and county officers have suggestions for a way individuals with Medicaid can finest navigate the case assessment course of. </sturdy> <ol> <li>Be certain that your tackle and cellphone quantity are up to date with the county and with the insurance coverage firm —  Wholesome Blue, WellCare, AmeriHealth Caritas, UnitedHealthcare, Carolina Full —  that manages your plan if in case you have managed care.</li> <li>When it’s time to your yearly case assessment, don’t panic! It is best to obtain a letter out of your county DSS workplace explaining what they want from you. In the event you’re on a managed care plan you’ll obtain info from that group as effectively.</li> <li>If the general public well being emergency ends in October, the county will start reviewing instances in November. Which means in case you have been first enrolled in Medicaid in October, for instance, you’d nonetheless be coated by this system for a 12 months and you’ll proceed to make use of your protection throughout this era. </li> <li>In the event you’re discovered to be ineligible, you might have a proper to enchantment that call. Pals, household or <a href=”https://disabilityrightsnc.org/assets/how-to-appeal-denial-of-medicaid/”>advocates from authorized assist organizations</a> might help you navigate the method. </li> <li>In the event you’re discovered to be ineligible and also you assume that call is appropriate, there are different choices obtainable to you for protection. At <a href=”https://www.healthcare.gov/”>healthcare.gov</a> you possibly can search for plans that suit your wants and see in case you qualify for federal subsidies <a href=”https://www.kff.org/interactive/subsidy-calculator/”>(right here’s a calculator)</a> by means of the Reasonably priced Care Act. These might help make personal insurance coverage protection extra inexpensive.]</li> </ol></div> “Each consumer goes to be on a distinct assessment cycle, relying upon after they utilized for Medicaid and when that Medicaid was permitted,” Hurd defined.  Throughout an interview in July, Hurd, and lots of different county DSS administrators, expressed concern that the state could require all of the pandemic-era Medicaid instances to be reviewed inside a particular timeframe, resembling 90 days, slightly than on their regular yearly cycle.  However Dave Richard, the deputy director of NC Medicaid on the state well being division, defined that county staff can proceed to assessment instances on their regular yearlong cycle because of a provision — which could be discovered beneath part 9D.5. — within the <a href=”https://www.ncleg.gov/Classes/2021/Payments/Home/PDF/H103v4.pdf”>2022 state price range invoice</a>. Gov. Roy Cooper signed the price range into legislation on July 11.  As a result of the county staff in Currituck have continued conducting their opinions as regular, Hurd stated she’s not apprehensive in regards to the work piling up, or how they’ll handle.  <h4><sturdy>Workforce and know-how points</sturdy></h4> Not all county staff really feel the identical. Some are involved in regards to the emotional toll terminating individuals’s Medicaid advantages may have on county staff.  “Initially, these will not be simply case numbers. These are households. These are the grandmother on the market who’s taken on her grandchildren, the mother and pa who’re each working and simply attempting to make ends meet and nonetheless want help,” stated Renee Smith, who works with Medicaid and different public advantages on the Johnston County Division of Social Companies, which noticed a couple of 34 p.c improve in Medicaid enrollment.  “It is gonna be a course of and we’re simply gonna should take that at some point at a time,” Smith stated. “We have to do what’s in the very best curiosity of the consumer whereas caring for our staff and conserving them from burning out. That is crucial as a result of if we do not have the staff right here to do the job, then the purchasers aren’t gonna get taken care of.” County staff may even want a refresher course on the insurance policies and guidelines, as terminating individuals from Medicaid hasn’t been a part of their workflow for greater than two years, Smith defined. Employees turnover has additionally confirmed to be an actual problem for a lot of county DSS workplaces, particularly over the previous few years throughout what’s come to be often called the <a href=”https://www.npr.org/2021/06/24/1007914455/as-the-pandemic-recedes-millions-of-workers-are-saying-i-quit”>“nice resignation.” </a> Karen Calhoun, the director of human providers at Cabarrus County’s DSS workplace, stated the workplace has seen large turnover in workers for the reason that begin of the pandemic, a lot in order that many individuals within the workplace have by no means truly achieved a termination. “We now have employed workers during the last two years that do not know what that ordinary tradition of seeing individuals in individual is,” she stated.  Cabarrus additionally skilled a couple of 34 p.c improve in Medicaid enrollment over the course of the pandemic.  <determine class=”wp-block-image aligncenter size-full”><img src=”https://www.northcarolinahealthnews.org/wp-content/uploads/2020/02/DAVERICHARDDHHS-scaled-e1581461544140.jpg” alt=”Man carrying darkish swimsuit and yellow tie speaks at a podium. He’s DHHS official Dave Richard and he is speaking about Medicaid transformation.” class=”wp-image-26512″ /><figcaption>Dave Richard, deputy secretary for Medicaid on the N.C. Division of Well being and Human Companies, updates the Joint Legislative Oversight Committee on Feb. 11, 2020, on Medicaid transformation. Picture credit score: Anne Blythe</figcaption></determine> “Even when there was a big quantity of recent cash that got here in from counties or states to rent extra individuals to do that work,” stated Richard, from the state well being division, “The employees simply aren’t there — and that is sophisticated work.” “We’re very apprehensive in regards to the workforce points, primarily, when this adjustments. We’re doing the whole lot we are able to to attempt to improve a number of the know-how points to make it simpler for people to get by means of it, however the fact is, it is simply going to be an elevated workload,” he stated.  A few of these technological enhancements embrace updates to the NCFAST system, which counties, suppliers and the state use for a lot of completely different social service administrative processes. The state well being division is engaged on updates to the system that will enable it to do case opinions electronically.  “NCFAST will run all of its digital matches for revenue, and many others. on a case, and if it is ready to make an eligibility willpower based mostly on these matches, it’ll course of that redetermination routinely with out the county DSS having to the touch the case,” Richard stated. “Proper now, the county DSS has to the touch the case as much as 3 times to assessment and begin the subsequent steps.” The state has carried out this facet of the NCFAST system in a few counties and has discovered that as much as 40 p.c of case opinions could be accomplished this manner. The aim is to have the software program rolled out statewide by Dec. 1.  <h4><sturdy>The function of growth</sturdy></h4> Whereas updates to NCFAST and extra coaching seminars may assist counties stability this work, many argue there’s one clear strategy to keep away from disruptions to each county staff and sufferers. “Frankly, one of the essential issues we may do truly to ease the burden on counties can be to move Medicaid growth,” Richard stated. “There’s such a big variety of individuals which are at present on the roles that will wind up not having to be disenrolled as a result of they’d be eligible for growth.” Whereas growth would imply that extra individuals can be on Medicaid, it will additionally imply the state would get extra money from the federal authorities to pay for these extra prices. Moreover, the state may move a few of these funds alongside to the counties to cope with their added workload.  The way in which the present Medicaid system works is the federal authorities pays about 68 p.c of the price of Medicaid, whereas North Carolina pays for the remainder. However for these newly coated by means of growth, the federal authorities pays 90 p.c. To cowl its 10 p.c of the tab, some specialists have proposed that North Carolina <a href=”https://www.northcarolinahealthnews.org/2021/03/18/medicaid-expansion-incentives-pandemic-relief-bill/”>improve evaluation prices on hospitals</a>, which might usher in extra money to the state.  <div class=”wp-block-group has-secondary-background-color has-background”> </div> “We’d use a portion of these {dollars} to help counties as a result of we knew there can be extra workload,” Richard stated. “The query that individuals ask is, may this system deal with these extra individuals on this system? Nicely, we’ve got. “We will deal with it,” he stated. “If we’ll increase, increasing sooner slightly than later is smart since you keep away from having to go to individuals saying, ‘Oh, you do not have insurance coverage,’ however then three months later, return to that very same group of individuals saying, ‘Oh, effectively you now have it as a result of we have expanded.’” For Rachel, the japanese North Carolina resident who acquired Medicaid advantages beneath the general public well being emergency, it’s not possible to overstate how useful it’s been. Along with getting correct look after her bipolar dysfunction, it’s additionally meant she’s been capable of see medical doctors to handle her fibromyalgia and that she may attend a number of follow-up appointments after a hysterectomy that she acquired to deal with endometriosis. For years, she’d discovered learn how to handle these persistent situations with out insurance coverage, however “not in very wholesome methods,” she stated. She took numerous Motrin. She spent hours on the cellphone calling pharmacies to see which one provided the most cost effective out-of-pocket worth for her drugs. She requested her physician to forgo a number of the actually costly blood work that they wished to run on her, and so forth.  With Medicaid, she goes to see her specialists when she wants them, and so they can run the total gamut of checks. Now Rachel worries what is going to occur in October.  “Final month I used to be again to feeling the identical method I felt in 2019 after I was within the protection hole and did not have insurance coverage,” she stated. “It was again to these sleepless nights, these crying nights.” This <a goal=”_blank” href=”https://www.northcarolinahealthnews.org/2022/08/10/medicaid-patients-and-county-workers-brace-for-the-end-of-the-covid-public-health-emergency/”>article</a> first appeared on <a goal=”_blank” href=”https://www.northcarolinahealthnews.org”>North Carolina Well being Information</a> and is republished right here beneath a Inventive Commons license.<img src=”https://i0.wp.com/www.northcarolinahealthnews.org/wp-content/uploads/2021/10/cropped-favicon02.jpg?match=150percent2C150&ssl=1″ type=”width:1em;peak:1em;margin-left:10px;”><img id=”republication-tracker-tool-source” src=”https://www.northcarolinahealthnews.org/?republication-pixel=true&submit=40762&ga=UA-28368570-1″ type=”width:1px;peak:1px;”>

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North Carolina

Feds approve Cooper plan to relieve up to $4B in NC medical debt, as Harris weighs in

Published

2 hours ago

July 29, 2024

Press Room

Feds approve Cooper plan to relieve up to B in NC medical debt, as Harris weighs in

A plan unveiled at the beginning of this month by Democratic Gov. Roy Cooper to leverage Medicaid funds to help North Carolinians struggling with medical debt has been approved by the federal government.

On Friday, the U.S. Centers for Medicare and Medicaid Services (CMS) approved a plan that has the potential to relieve $4 billion in existing hospital medical debt for people in the state, according to a news release. In order for the plan to take effect, hospitals would need to sign on.

“Unlike most other debts, medical debt is not intentional because people don’t choose to get seriously ill or have an accident,” Cooper said, according to the news release.

“Medical debts are often beyond people’s ability to pay, ruining their credit, keeping them from getting credit cards, loans and jobs and sometimes driving them into bankruptcy. That’s why we’re working with hospitals and federal partners to help relieve the burden of medical debt for North Carolina families,” he said.

Vice President Kamala Harris — who appears set to become the Democratic presidential nominee for the November election, and has been considering Cooper as a possible running mate — has been “coordinating” with state officials on the medical debt plan, The Washington Post reported.

“No one should be denied access to economic opportunity simply because they experienced a medical emergency,” Harris said in a statement sent as part of a news release Monday.

“Yet today, more than 100 million Americans struggle with medical debt — making it more difficult for them to be approved for a car loan, a home loan, or a small-business loan, which makes it more difficult for them to just get by, much less get ahead.”

“I applaud North Carolina for setting an example that other states can follow by advancing a plan that has the potential to relieve $4 billion in medical debt for two million individuals and families. This critical step also strengthens financial assistance for emergency medical procedures moving forward,” Harris said.

Vice President Kamala Harris, joined by N.C. Gov. Roy Cooper, speaks while visiting Durham’s historic Black Wall Street district on Friday March 1, 2024.

Harris wrote that over $650 million in medical debt had been forgiven through the American Rescue Plan, which was passed under the Biden administration.

The News & Observer has contacted several hospitals and the North Carolina Healthcare Association, which represents hospitals, regarding their stances on the plan.

UNC Health “continues to have discussions with state and federal officials,” UNC Health spokesperson Alan Wolf said in an email.

“We support efforts to reduce medical debt and we expect to receive more details on the approved plan soon,” he said.

Medical debt relief provided

According to Cooper’s news release, hospitals that opt in to the plan must implement the following to be eligible for enhanced payments offered under the plan:

For those on Medicaid, relieve all unpaid medical debt dating back to Jan. 1, 2014.
Relieve all unpaid medical debt that has become virtually impossible to collect dating back to Jan. 1, 2014, for people not enrolled in Medicaid whose income is at or below at least 350% of the federal poverty level (FPL) or whose total debt exceeds 5% of their annual income. A family of two at 350% of the FPL makes about $71,000 a year.
Provide discounts on medical bills for people at or below 300% FPL.
Automatically enroll people into financial assistance, known as charity care.
Not sell medical debt of people making below 300% FPL to debt collectors.
Not report debt covered by policies laid out in the plan to a credit reporting agency.

Patients of participating hospitals will not need to take any actions to benefit from medical debt relief, according to the news release.

Plan to leverage Medicaid funds

When the state expanded Medicaid in December, it implemented a mechanism that allowed hospitals to receive higher federal reimbursements in return for paying the state’s share of costs under the expansion bill.

The federal government covers 90% of Medicaid coverage costs for the expansion population, while the state covers 10%. This funding mechanism was called the Healthcare Access and Stabilization Program.

The medical debt relief plan further leverages federal funds by providing higher HASP payments to hospitals that choose to implement the plan.

Hospitals often only collect a small fraction of the medical debt they are owed, Cooper said during a press conference announcing the plan on July 1.

However, large debts that remain on the books can prevent people from buying a home or getting a credit card and sometimes can lead people into homelessness and bankruptcy, he said.

North Carolina has one of the highest percentages — 13.4% — of adults with medical debt, according to KFF, a health policy organization. About 20 million people — or nearly 1 in 12 adults — owe a combined total of at least $220 billion in medical debt in the United States, KFF says.

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North Carolina

Officials warn against swimming in French Broad River due to dangerous bacteria

Published

10 hours ago

July 29, 2024

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Officials warn against swimming in French Broad River due to dangerous bacteria

NORTH CAROLINA (WTVD) — A North Carolina river is deemed ‘too dirty’ to swim in.

People are advised to refrain from swimming in the French Broad River near Asheville for 24 to 48 hours, or until the water is less muddy.

Samples showed high levels of bacteria, including e-coli from recirculating water. According to officials, it’s because of the recent heavy rains.

“What we recommend for folks to do is…find somewhere else to go swim,” Anna Alsobrook, the watershed science and policy manager at MountainTrue, said. “We’ve seen everything from ear infections to GI issues (to) sinus infections.”

Officials are also telling people to avoid ingesting any water until the quality level improves, which could be in a matter of days.

French Broad River flows from North Carolina into Tennessee.

SEE ALSO | NC farmer losing crop because of unsafe levels of chemicals in water

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North Carolina

4-generation N.C. winery aims for visitors to leave ‘feeling like a part of our family’

Published

17 hours ago

July 28, 2024

Press Room

4-generation N.C. winery aims for visitors to leave ‘feeling like a part of our family’

Part of the reason for publishing these travel pieces is to help spread the word about quality wineries worth visiting to those who do hit the road and explore.

The other part is to find good stories up and down the East Coast of individuals and families who are operating wineries and/or cideries.

A story on Parker-Binns Vineyard in Mill Spring, North Carolina, around 85 miles west of Charlotte and 45 miles southeast of Ashville in the foothills of the Blue Ridge Mountains. It operates on 40 acres.

Dan McLaughlin, a member of North Carolina Fine Wines and a familiar figure in the state’s wine industry, noted in an email that “if Jimmy Buffet had a vineyard, it would be like Parker-Binns. It has four generations there (on the weekends, the great-grandson of the owner is there helping his dad in the vineyard.) They have a restaurant that is very relaxed and great food at reasonable prices. … Their vibe is very chill, but classy. Everything is spa-like in perfection. Just a place to enjoy the view and enjoy excellent wines. James Suckling gave them five 90+ scores this past year.”

Parker-Binns Vineyard is open noon to 6 p.m. Wednesday and Thursday and noon to 7 p.m. Friday through Sunday.

Prices for its canned ciders and bottled wines are in the $20s, with a few exceptions. You can see the full list at this link, although the 2021 Loco Lulu Red should be mentioned because $1 of every bottle sold goes to the local pet adoption organization.

The Relish Kitchen is open noon to 5:30 on Thursday and noon to 6:30 on Friday through Sunday. Here’s a link to the menu.

Parker-Binns Vineyard in western North Carolina opened in 2010. Several wines including this one, feature Lulu (their 4-legged greeter) on the label.Parker-Binns Vineyard

There’s a full section on the history of the place, founded by Karen and Bob Binns.

Per the website:

After spending twenty-five years in the food and beverage industry on the Jersey Shore, we headed to South Florida where we purchased raw land, north of the Everglades, just east of the Great Cypress Swamp. After months of clearing jungle-like conditions, we planted a tree farm and established a plant nursery. After twenty years of a very successful business, the Government approached us to acquire the land for a project to restore and save the Everglades. The timing was right, it was a good reason to sell, and we thought we could retire!!

After only a couple of years of retirement, we were bored and needed inspiration. With our background in the food and beverage industry, we decided that we wanted to be part of the emerging East Coast wine industry. We searched up and down the region and finally found what we felt was the perfect parcel, 10 acres in the Tryon Foothills of the Blue Ridge Mountains.

Polk County, North Carolina had a rich history of growing and selling grapes in the late 1800’s. Now with the area having over 20 vineyards and 3 wineries, we knew this was the place to begin. And begin we did…clearing the trees and thickets, preparing the soil and planting over 4000 grape vines. Although we were familiar with this, we made an outstanding discovery … we’re 31 years older (ouch!) and yet another adventure begins!!!

The business, which opened in 2010, eventually welcomed daughter Kelly Binns and grandson Cory Lillberg and his family.

Justin Taylor makes wine for Parker-Binns Vineyard as well as Marked Tree Vineyard down the road in Hendersonville.

Karen died in April. Her obituary includes this line: “Leave a mark, dance like no one’s watching, and love hardest.” She said it, and lived it.”

Thanks to Lillberg for responding to PennLive’s questions with answers that cover plenty of ground for the latest in the “Grape Escape ‘24″ series.

Q, I want to include the history of how Bob and Karen wound up starting the winery. Pretty fascinating. Just because of our proximity, what did the two do while they were on the Jersey Shore early in their careers? And when did the winery open?

A, They spent their time on the Jersey Shore operating “The Fairview,” a rock ‘n’ roll bar that my grandfather owned and operated from Memorial Day to Labor Day each year from 1957-90. My grandmother wasn’t in the picture until 1979 when they started managing that business as a team. Eventually, they would live in South Florida year-round once they sold the business in 1990. They met and worked together first at my grandfather’s restaurant and bar in Fort Lauderdale called “Maggie Mae’s.”

The view from the tasting room at Parker-Binns Vineyard in Mill Spring, North Carolina.Parker-Binns Vineyard

Once they sold that business, they then started their next adventure, which was growing a plant and tree nursery in the Fort Lauderdale area. They operated “B.J Binns Plants and Trees” for over 20 years. They grew tropical hardwoods, palms, shrubs, hedges and flowering bushes on over 100 acres of South Florida farmland. The tree farm has since been viewed as the birth of their passion for agriculture. Fast forward to 2006 when they sold the tree farm and began looking for their next adventure. At the ripe age of 73, the old man decided that he would plant a small vineyard as a passion project to leave the heat of Florida for the summer. After finding the 10-acre lot in North Carolina’s Polk County, he and my grandmother cleared the land, dug the holes, pounded the posts, planted the vines, and took care of them until their first fruit came in 2011. They had intended on selling most of the fruit to the Biltmore estate as our neighborhood vineyards had already been supplementing The Biltmore’s estate vineyard in Asheville for years. Upon finding out the Biltmore house was not looking for more contracts, a decision had to be made. Drop the fruit or make wine? Ultimately, they decided to each make their own wine in order to figure out who had the better mind for winemaking. Admittedly, my grandmother kicked my grandfather’s @$$ and she became the winemaker while he tended to the vines. Fast forward to today and the vineyard and winery have grown to 40 acres of estate and are officially our “hobby out of control” as my late grandmother would say. Their passion for what they started is what made this business successful from the beginning even without the intent.

Q, Four generations working at the winery now? What roles do everyone play there?

A, We do have 4 generations working the farm and in many capacities. Bob Binns, Kelly Binns, myself, and my soon-to-be 10-year-old son Hunter Lillberg round out the four generations respectively. At nearly 90 years young, my grandfather is more of an overseer these days. However, he does still make appearances in the tasting room regularly as well as being our resident flower man. He makes sure to get himself out to water, feed and maintain our rose and English gardens with some regularity during the growing season. While his body may be slowing down a bit, his cognitive prowess is as strong as ever. Kelly is our tasting room manager and bookkeeper. She also books our music schedule for the year as well as being an integral piece of executing our many events over the calendar year. As for myself, I have assumed the responsibilities of vineyard manager, winemaker (alongside Justin Taylor), and server (on the weekends). Essentially, I have assumed all of my grandparents’ primary responsibilities. My son, Hunter, helps on every level and in every arena that this business possesses. He is hard-working, motivated and eager to help always. He has given tours to families, helps out on the weekend with appropriate taskings around the tasting room and has also started learning operations in the vineyard and winery. As the only one of us to grow up in this business, I envision him becoming the best of all of us with an already evident passion for what we do as an estate vineyard and wine producer.

Q, For someone who has never visited, how would you describe the vibe there?

A. For someone who has never visited, I would simply say that anyone who walks in our doors leaves feeling like a part of our family. We extend an unrivaled level of customer service and care in an aesthetically stunning environment that defies pretension and a “snooty” atmosphere. Wine should be fun, and we try VERY hard to harness that fun, light-hearted approach to wine, with a family-centric experience like vineyards of the Old World.

Q, Are you sourcing your own vineyard (s) or others in the area? What are some of the grapes that thrive down there?

A, We are currently producing fruit on 10 acres of vineyard with another 3 acres coming online over the next 2 seasons at the estate. We will certainly bring grapes in from other local facilities around North Carolina as needed in a pinch, usually in lieu of a cold event in the vineyard. We grow 10 different varities including Chardonnay, Muscat, Petit Manseng and Vidal Blanc for white varieties. Our reds include Merlot, Cab Franc, Chambourcin, Malbec, Tannat and Petit Verdot. To keep things simple, I would say that the Petit Manseng and Merlot are my favorite white/red performers in the vineyard and winery respectively. Our 2021 Merlot won the “Best Red” category in our 2024 state competition.

Q, Wines mostly dry? Looks like a wide mix of red and white still wines? Anything new on the horizon?

A, We are currently producing a wine portfolio that is mostly dry. However, we do have a tier of off-dry labels that feature a mild sweetness and approachability as well as some dessert-style wines made from both our fruit and that of other local growers. Our blackberries are sourced from a family operation in the Henderson County area. We also produce a line-up of 4 seasonal hard ciders! The fruit for that project comes from the same neighborhood in Henderson county. From A-Z, we like to think anyone can find a wine or drink they enjoy in our tasting room. Our newest project we are working on is a Piquette that we intend on serving on tap at the tasting room. It is a low-alcohol, lightly carbonated, Muscat-derived sparkling wine that we hope appeals to a future generation of “consumption-conscious” patrons.

Q, For those traveling into town, is that list you have on the website up to date?

A, Our website is up to date for those who would like to order wine online or stop in for a tasting. www.Parkerbinnsvineyard.com

Q, Is Relish the restaurant? Open Thursday through Sunday?

Q, Relish is open Thursday-Sunday during our busy season (Apr-Oct) and Fri-Sun the other half of the year. They were a successful food truck in the Lake Lure area for many years and we joined forces in the winter of 2022. They have brought an incredible menu to bolster an already breathtaking winery experience.

Q, Finally, tell me about the Hippie Bash in September. How long have you been doing that?

A, With my grandmother passing in April of this year, we decided to “rebrand” our harvest festival into a celebration of our deeply missed matriarch. She was a hippie at heart, and it was glaringly obvious to anyone who met her. We will be celebrating her with the inaugural event this year on Sept. 14 and every year forward. We will celebrate her legacy and the harvest that she cared so deeply for with music all day, yard games, food trucks, Relish restaurant, event-specific tie-dye shirts and local craft vendors to help us make the day extra special. 12-7p.

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