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Raleigh, NC –  – The North Carolina Community Health Center Association (NCCHCA) recognizes and applauds the critical role of its member community health centers (CHCs) in the state’s response to the COVID-19 pandemic and, as such, supports their efforts to protect CHC staff and the communities they serve through vaccination against the disease caused by the COVID-19 virus.

Vaccination against COVID-19 has been proven to dramatically reduce the risk of severe illness, hospitalization or death from the virus. Since January of this year, North Carolina’s CHCs have been key partners in delivering vaccines both to their patients, many of who represent vulnerable, underserved populations, and to their communities as a whole.  NC CHCs have delivered over a quarter of a million vaccines to date. Clinical data has shown the COVID-19 vaccines to be extraordinarily safe and effective, and the best tool to end the pandemic. With the FDA’s full approval of the Pfizer vaccine on Monday, August 23, consumers can be even more confident about the efficacy and safety of the vaccine.

NCCHCA supports member CHC policies that encourage all employees to be vaccinated against COVID-19, and regularly test those not yet vaccinated, but also acknowledges that each CHC is unique and each organization maintains the autonomy to evaluate and determine the appropriate strategy for ensuring the safety and health of their staff and patients. Additionally, NCCHCA also supports CHCs’ efforts to provide easily accessible, free vaccines to all in their community who desire them, and to be a trusted partner in educating community members on the importance of COVID-19 vaccination.

“Our job at NCCHCA is to act as a support system for our member community health centers and provide them with tools and resources so they can carry out their missions,” stated Chris Shank, CEO and President of NCCHCA. Shank continued, “Through continuous discussions, we are working with our members to aid them in developing vaccine strategies tailored to their individual staff and patient circumstance. Some of our members, along with the NCCHCA, have mandated staff COVID-19 vaccinations and testing requirements for unvaccinated staff while other members are continuing to evaluate their future plans. I am incredibly proud of the way our members have responded to the pandemic and continue to take actions that are in the best interest of their communities.”

Reuben Blackwell, chair of the NCCHCA board and chief executive officer of OIC of Rocky Mount, a NCCHCA CHC member added, “I am deeply worried about the effects of the virus that results from COVID-19 on North Carolina’s most vulnerable folks who also happen to be Community Health Center patients and staff. I hope that, like I did, staff will protect themselves as well as their communities by getting this safe, effective, and free vaccine to protect against this virus.”

Alvine Kapitako

In late 2019, the novel coronavirus (Sars coronavirus 2) started to gradually spread from Wuhan, China to the rest of the world. Before we knew it, the world was locked up and a global pandemic declared as more and more people were infected with the deadly virus every second of the day. The numbers of those who died were equally devastating. Slowly but surely every corner of the world felt the impact of this dreadful disease. With a number of vaccines in sight now, scientists and public health professionals are hopeful that life will eventually get back to normal with fewer hospitalizations and deaths, as a result. But, what did the pandemic teach us about humanity? Resilience? Yes, certainly. Telehealth, sometimes called telemedicine was definitely one of the lessons. During the pandemic, telehealth whether at Community Health Centers (CHCs) or hospitals was seen as an alternative to in-person health care service provision-all in an effort to curb the then ravaging pandemic.

Telehealth is defined as  “the use of electronic information and telecommunication technologies to provide care when a patient and doctor are not in the same place at the same time”.  Now that life is slowly getting back to normal, one of the biggest questions perhaps on everyone’s lips is whether telehealth will receive the same attention it did post COVID-19 pandemic.

Before the pandemic, there weren’t many providers using telehealth, said Dr. Eugenie Komives, a family physician who is also affiliated with the Wellcare Health Plan. Before the pandemic, Komives was exposed to telehealth but nothing compared to how much they used it when COVID hit. During the pandemic, the manner in which providers and patients viewed telehealth changed, primarily because of the need to provide services through telehealth to avoid possibly spreading the virus.

“I think we’ve learned that you’re able to provide safe care for a large number of conditions to patients who are either high risk or come into an office during a pandemic just having difficulty whether they’re literally afraid to come in and in doing so I think we’ve crossed over that digital divide around the use of telehealth and virtual healthcare and really looking forward to seeing how this continues to play out,” said Komives during a panel discussion of the North Carolina Community Health Center Association (NCCHCA)’s virtual Primary Care Conference in April 2021.

CHCs had to adapt to prevent the spread of COVID-19 within their settings. Changing the look of patient-provider interactions by modifying physical spaces, moving some appointments to telehealth and training staff and patients to use tele-devices are some of the changes CHCs had to implement, said Margaret Covington, the CEO of Stedman-Wade Health Services.

“The initial impression I had for telemedicine is that it’s a very underutilized tool for physician practices, said Dr. Michael Ogden of Healthy Blue NC. He said the uptake of telehealth was not immediate and before the COVID-19 pandemic “I felt like we were practicing fax machine medicine in the iPhone era”.

Also sharing his experience with the use of telehealth, Dr. George Cheely of the AmeriHealth Caritas insurance plan in North Carolina said that before the pandemic, there was potential for telehealth. However, it was viewed more as a modality that was often focused on night and weekend adjunct urgent care delivery often for people who could not afford to pay out of pocket for the services.

“I got a glimpse of positive and hopeful experiences working with neurology colleagues at Duke to help them expand their telestroke programs. It really gave me insight into how access to constrained services.  Some specialists could really be expanded statewide to deliver high quality care for stroke patients and I think that the pandemic has really built on that concept of expanding access,” he said.

Telehealth is now seen as a tool to break down barriers to access where people might have to drive to primary care more easily.  “People who are working shifts can step out on lunch and get their visit instead of missing work to get to visit a doctor,” said Dr. Cheely. Behavioral health, in particular, proved to be effective with telehealth, noted Dr. Cheely. “I think we’ve also really seen that where behavioral health providers may have had a 20 or 30 percent no show rate pre-telehealth with the deployment of telehealth those have dropped to almost 0.  Telehealth is an important way to augment access, provided it’s coordinated closely with primary care,” said Dr. Cheely.

But, as we know, telehealth is not entirely new. It has been around much longer than we probably had a formal definition of it. Dr. Michelle Bucknar of United Health Care shared her initial experience with telehealth. “My first experience with telehealth was actually in the mid to late 90s”, she told the panel. She had just finished her medical residency and moved to Kansas City. “The University of Kansas actually had school-based telehealth…” she related. Being “old school”, the idea of attending to patients without seeing them was not her idea of practicing pediatrics.

Looking at the use of telehealth beyond COVID-19.

“I really wasn’t in favor of the school-based telehealth clinics but at that time, I was also working at a pediatrics academic center that was mostly evolving into a telehealth program and by the time I moved to North Carolina they had a robust telehealth program predominantly the specialty visits,” she related. This early experience was very helpful during the pandemic, she notes. “I feel like I’ve come full circle and I embrace telehealth. I think the important thing is to not disrupt that primary care relationship.  Even though I’ve come a long way, I want to preserve that primary care relationship and because of that I really want primary care to offer these services and I think COVID has really pushed us forward. While COVID is just awful and has really disrupted our lives, I think there are some good that’s going to come out of that and I hope telehealth is one of those,” said Dr. Cheely.

The future of telehealth

Dr. Ogden believes that telehealth is an underused adjunct to a face-to-face relationship of providing healthcare.  “The balance of using that platform to be an augmenting factor in that relationship is really where I see the future of telemedicine being in North Carolina and beyond. I do think telemedicine is an important modality and from a [Blue Cross Blue Shield North Carolina’s Medicaid Insurance Program] Healthy Blue perspective we would want to preserve that modality of access as an adjunct and not a replacement for the primary care relationship,” said Dr. Ogden.

While telehealth has proved effective during the pandemic, concerns raised during the panel discussion are the challenges of access and affordability.  For example, not everyone owns a cellphone or broadband connection in America, which can make video telehealth visits harder if not impossible to accomplish.

“Anything we can do to lower the barriers to having that access will be a big advantage as long as it results and benefits to the patient,” said Dr.Ogden.  Additionally, confidentiality and protecting patient information is important, noted Dr. Ogden.  Looking at the future of telehealth would also require being clear on what is not telehealth, said Dr. Ogden.  “Telephone only consultations as a definition of telemedicine probably ought to be softened a little bit. I don’t think it’s the same thing as a telehealth visit unfortunately and right now it’s covered at a certain percentage but that’s one of those things that we feel is probably not the same thing and shouldn’t be covered at the same rate as a telehealth visit,” Dr. Ogden said. Another challenge is finding ways to prevent financial exploitation of telehealth claims, the panelists noted.

“To prevent fraud we would need to watch the data over time and ensure that when we see deviations from the norm we ask the questions rather than make assumptions,” Dr. Ogden said.  Blue Cross and Blue Shield of North Carolina announced in April that it would keep its pandemic telehealth policies through 2021. The use of telehealth by Blue Cross’ 3.9 million members grew by more than 7,500 in 2020, according to a report published by The News & Observer. Read more about it here: https://www.newsobserver.com/news/local/article251718023.html.

For Immediate Release. Contact: Leslie Wolcott, Communications & Emergency Preparedness. Wolcottl@ncchca.org

NCCHCA’s member Community Health Centers (CHCs) are grateful for the announcement this week from the Biden Administration of an important investment in Community Health Centers. This investment, in CHCs across the United States, is intended to increase access to and confidence in the COVID19 vaccine. You can see the North Carolina awards here. NCCHCA expects the funds to be available within the next month. Additional funding announcements for NC’s 3 CHC look-alikes have not yet been made, but are expected.

NC CHCs are extremely thankful that the federal funding opportunity will support a variety of current and anticipated future health center needs related to COVID-19 and, in some cases, cover unreimbursed costs health centers incurred since the pandemic first hit the U.S. dating back to January 31, 2020. Support is also available for basic primary and preventive services not only to maintain current health center services, but also to address “recovery and stabilization” activities in anticipation of serving pent-up demand for different services that people have been postponing due to the pandemic.

During the pandemic, which has now stretched over a year, North Carolina’s Community Health Centers have continued to deliver excellent and affordable primary and other health care services to every patient who needs them, regardless of ability to pay. Beyond that, they have worked to re-engineer both physical spaces and patient flows to protect the health of staff, patients, and the surrounding community. They’ve conducted hundreds of thousands of COVID19 tests, delivered care via telehealth to those who were not comfortable attending in person, and now they are on the front lines of vaccinating America’s most vulnerable populations.

While this funding is generous and much needed, it is specific to COVID19 response and vaccine administration. Community Health Centers in North Carolina continue to fulfill their mission of comprehensive care to hundreds of thousands of patients, with 42% being uninsured. North Carolina is yet to join 38 other states in the expansion of Medicaid, and NC CHCs stand in the breech to provide care and promote our communities’ overall wellness. One of the ways that CHCs benefit patients—by providing discounted medications thanks to a program called 340B—is under threat by those who would pickpocket the savings that health centers now invest in providing more services to patients. Without access to affordable medications, it is challenging for patients to control chronic conditions or recover from illnesses.

North Carolina’s Community Health Centers will, as they always have, squeeze every last penny out of this federal funding to vaccinate the underserved and historically marginalized populations where they have long existed as trusted community partners. They will deliver vaccines safely, efficiently, and with the kindness that they have displayed across the state for many years.

But North Carolina’s Community Health Centers ask the public and elected officials to remember: Our charge is much larger than Covid response. It includes vulnerable and underserved populations with diabetes, heart disease, cancers, and many other chronic and acute needs. These will continue to exist in North Carolina long after COVID is under control. Federal support for COVID relief is just one piece in the puzzle of long-term sustainable funding for CHCs. NC CHCs will continue to care for all their patients, regardless of insurance status or ability to pay, and strive to be ready for the next health emergency, the next pandemic, or the next hurricane as an essential part of NC’s health care safety net.

For more information, contact:
Elaine A. Ellis
VP, Communication and Marketing
North Carolina Medical Society
(919) 272-4027 (cell)
eellis@ncmedsoc.org

 

FOR IMMEDIATE RELEASE

RALEIGH — As a broad group of organizations representing your community’s physicians, physician assistants, health clinics, hospitals and local health departments, we strongly encourage everyone currently eligible to get a COVID-19 vaccine to do so as soon as possible. Getting vaccinated with one of the three authorized vaccines is crucial to stemming the severity of the illness caused by the COVID-19 virus and the spread of its more transmissible variants. In addition to the 3 ‘W’s – wearing a mask, waiting six feet apart and washing your hands – getting a vaccine will help end this pandemic.

Everyone Will Have a Chance to be Vaccinated

As vaccine supply slowly increases, a growing variety of providers are administering vaccines including at vaccination clinics set up by health departments, health systems and the state, pharmacies, and, increasingly, your doctor’s office. Please take just a minute to check the state’s website as well as the Centers for Disease Control and Prevention (CDC) vaccine finder to find a place near you offering the vaccine. These websites will help you determine your eligibility and to set up an appointment.

“We urge you to get a vaccine as soon as you’re eligible, keeping in mind our refrain that ‘those who would fare worst if they acquire the COVID-19 virus, should be vaccinated first,’” said North Carolina Medical Society President Philip Brown, Jr., MD. “Now with three effective vaccines, it won’t be long until it will be your turn to get your shot.”

To protect those most at risk of acquiring the virus and of serious illness, the state has established vaccine eligibility priorities. As supply limitations ease in the coming weeks, everyone will have the opportunity to receive a vaccine as we fight this virus together.

“We have three vaccines that are all safe, effective, and allow you to do the things you love and see the ones you love without getting sick,” said Mike Zelek, MPH, Chatham County Public Health Director and President of the North Carolina Public Health Association. “If you haven’t yet gotten your vaccine or signed up to get it when it is your turn, now is the time.”

All the Current Vaccines Are Effective

All three vaccines currently available have been shown to be effective in mitigating the severity of the illness caused by COVID-19, which not only means protecting yourself and your loved ones, but also ensuring our health system is not overwhelmed. While there are some differences between the vaccines – for instance, the Pfizer and Moderna vaccines require two doses while the Johnson & Johnson vaccine requires just one  – if a vaccine is available to you, please take it regardless of brand. Being vaccinated is the most important thing, not which vaccine you receive since they all offer protection.

“We all want to get back to close to normal as soon as possible.  This is our shot to do just that,” said Jessica L. Triche, MD, FAAFP, President of the NC Academy of Family Physicians.  “Please sign up as soon as you are eligible and take your shot regardless of the brand you receive.”

As the Centers for Disease Control and Prevention (CDC) makes clear, millions of people in the United States have received the authorized COVID-19 vaccines, and these vaccines have undergone the most intensive safety monitoring in U.S. history. This monitoring includes using both established and new safety monitoring systems to make sure that COVID-19 vaccines are safe and effective.

“If you are wondering about which vaccine is the best for you, I’ll keep it simple, with all three vaccines being safe and effective, the best vaccine for you is the one available to you at your appointment,” said Stacie Saunders, MPH, Buncombe County Public Health Director and President of the North Carolina Association of Local Health Directors.

Remember, these vaccines cannot give you COVID-19.

“NCCHCA and its members are glad to act as trusted community partners in the delivery of all available vaccines,” said Chris Shank, NCCHCA President and CEO. “Getting COVID-19 vaccinations into the arms of all North Carolinians, no matter their income or insurance status, is critical to the mission of North Carolina’s Community Health Centers.”

Getting a COVID-19 vaccine, along with following the 3 ‘W’s public health protocols we all know so well, will bring us one step closer to regaining more certainty for the future and more control over our lives once again.

 

About the North Carolina Medical Society: The North Carolina Medical Society is the oldest professional member organization in North Carolina, representing physicians and physician assistants who practice in the state. Founded in 1849, the Society seeks to provide leadership in medicine by uniting, serving and representing physicians and their health care teams to enhance the health of North Carolinians. 

About the North Carolina Academy of Family Physicians: The North Carolina Academy of Family Physicians, Inc. (NCAFP) is a non-profit professional association headquartered in Raleigh representing over 4,200 family physicians, family medicine residents and medical students across North Carolina.  The NCAFP is a constituent chapter of the American Academy of Family Physicians, based in Leawood, Kansas. 

About the North Carolina Healthcare Association: Founded in 1918, North Carolina Healthcare Association (NCHA) is the united voice of the North Carolina healthcare community. Representing more than 130 hospitals, health systems, physician groups and other healthcare organizations, NCHA works with our members to improve the health of North Carolina communities by advocating for sound public policies and collaborative partnerships and by providing insights, services, support and education to expand access to high quality, efficient, affordable and integrated health care for all North Carolinians.

About the North Carolina Community Health Center Association: The North Carolina Community Health Center Association was formed in 1978 by the leadership of community health centers. NCCHCA is comprised of membership from 42 Community Health Center organizations. NCCHCA is singularly focused on the success of health centers.

About the North Carolina Association of Local Health Directors: The mission of NCALHD is to promote health, prevent disease, and protect the environment in order to ensure the public’s health in North Carolina through leadership, vision, advocacy, and commitment to the principles of public health practice in our local communities and throughout the state.

About the North Carolina Public Health Association: NCPHA is an association of individuals and organizations working to improve the public’s health through political advocacy, public awareness, professional development, and the interface between research and practice.

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Contact Leslie Wolcott, NCCHCA

White House Announcement

To Promote Equity, White House Announces Phased Plan to Allocate Vaccines Directly to FQHCs
Declaring that equity is part of a core national strategy to address the COVID-19 pandemic, the White House Coronavirus Task Force announced a program to directly allocate a limited supply of COVID-19 vaccine to select Community Health Centers (CHCs) starting next week. While the program is starting small, with only 25 CHCs in the first week, the initiative will increase access to vaccines to over 250 health centers nationwide within the coming weeks. After that, as supply increases, HRSA and CDC will support vaccination in additional health centers with a goal of eventually distributing 1 million doses each week through this program.

While no NC CHCs are yet included in the earliest part of the rollout, NCCHCA is encouraged by the White House’s message that they value equity in vaccine delivery and CHCs’ critical role in executing that vision. However, we know this will come in stages, and we are excited to continue working with the North Carolina Department of Health and Human Services as they execute their plan to allocate vaccines to providers across NC with a focus on equity as well.

“Community Health Centers are grateful for the White House initiative but know that the urgency of COVID-19 means we must continue working diligently with all partners, especially NCDHHS, to get as many vaccines in arms as quickly as possible, especially to NC’s underserved populations,” said LaShun Huntley, NCCHCA Board Chair and CEO of United Health Centers in Winston Salem, NC.

To learn more about the national health center COVID vaccine program, please visit this link. 

House Relief Bill and Other Announcements

Congress also working to improve support for health centers. The National Association of Community Health Centers writes that “A stimulus package being prepared by the House Committee on Energy and Commerce recommends $7.6 billion for health centers for a number of uses including to plan, prepare for, promote, distribute, administer, and track COVID-19 vaccines and boost efforts to conduct mobile testing or vaccinations in hard-to-reach communities. The proposed funding could also be used to support workforce needs, conduct COVID-19 testing, the purchase of equipment and supplies, and an expansion of health care services and infrastructure. It also grants much-needed flexibility for health centers to cover the costs related to addressing the pandemic starting from the date of the Public Health Emergency declaration on January 31, 2020.”

Other announcements around the massive effort to vaccinate Americans against COVID19 include direct shipments to chain pharmacies and increased shipments to states. NCCHCA is excited about all the ways the nation is tackling this huge challenge, and member Community Health Centers will continue to do what they do best: act as trusted partners to underserved communities, providing primary and other health care services while also being on the front lines of testing and vaccination efforts. This work, though, takes remarkable levels of staffing under great pressure. It also requires resources like additional community locations, PPE, and partnerships with local EMS and law enforcement to manage traffic at these events. Any additional resources allocated to Community Health Centers will be immediately put to best use to address these challenges during the pandemic.

Thursday, February 4, 2021

This week the NC Community Health Center Association (NCCHCA) submitted a report to a state legislative committee detailing how its member community health center (CHC) organizations have gone above and beyond to respond to the COVID-19 pandemic.

With an investment of $12.425m by the NC General Assembly of federal CARES Act funds, CHCs were able to absorb new costs to meet their communities’ COVID-related needs head on. These funds helped CHCs fully adopt telehealth and renovate in-person facilities to promote social distancing and infection control. And most importantly, these funds helped maintain health care capacity and staffing throughout the harshest periods of the pandemic thus far, ensuring that patients could continue accessing primary health care services regardless of insurance status or ability to pay.

Since the pandemic began, NC community health centers have conducted well over 150,000 COVID-19 tests. Funds allocated by the state legislature have helped make that possible, as CHCs were able to absorb the costs of supplies and personal protective equipment (PPE), temporarily increase staff capacity, and acquire mobile medical units to provide services in community-based locations throughout the state.

Check out this infographic for more highlights of innovative ways that CHCs, also known as federally qualified health centers (FQHCs), have risen to the challenge thanks to funds allocated by the state legislature.

Looking ahead, NCCHCA and members look forward to continuing to partner with state lawmakers to care for our communities throughout the pandemic and see to it that every North Carolinian who wants a COVID-19 vaccine can receive it. NCCHCA welcomes additional investments into Community Health Centers to allow us to continue and enhance the work that the NC General Assembly has wisely supported thus far.

 

About the North Carolina Community Health Center Association

Representing the state’s community health centers since 1978, NCCHCA today comprises 42 community health center member organizations, including 39 federally qualified health center (FQHC) grantees and 3 FQHC look-alike organizations, all of which are commonly referred to as community health centers (CHCs). All FQHC and FQHC look-alikes in North Carolina are members of NCCHCA. With funding from the Health Resources and Services Administration (HRSA), NCCHCA is North Carolina’s state Primary Care Association (PCA) and Health Center Controlled Network (HCCN), representing FQHCs to state and federal officials and providing training and technical assistance on clinical, operational, financial, administrative, and governance issues.

North Carolina’s community health centers provide whole-person primary medical care, as well as integrated services—such as dental, behavioral health, pharmacy, substance use disorder, and enabling services—to North Carolinians without regard to their ability to pay. By mission and statute, community health centers provide care in medically underserved communities and to medically underserved populations.

 

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