March 10, 2020

The Joint Legislative Oversight Committee on Health and Human Services met this morning at the North Carolina General Assembly.  Secretary of the N.C. Department of Health and Human Services, Mandy Cohen, first provided an update on the department’s response to the COVID-19 virus.

North Carolina currently has 7 confirmed cases of the COVID-19 virus. The Governor and NCDHHS are coordinating preparedness efforts through the Novel Coronavirus (COVID-19) Task Force by developing response plans, identifying and testing people under investigation, and implementing control measures. The state is in the process of securing more testing supplies from the CDC, and is also developing a new testing mechanism to allow for more people to be tested. Shortly after Secretary Cohen addressed the committee, Governor Roy Cooper held a press conference to declare N.C. a state of emergency. Declaring a state of emergency allows for the state to have increased flexibility to respond, expedited supplies, and the ability to draw down federal funding.

Secretary Cohen also updated the committee on NCDHHS’s budget pressures under the continuing resolution that the state is operating on. Secretary Cohen emphasized the need for the right budget to be in place in order for the department to successfully function and protect the health and safety of North Carolinians.

Next, the committee received an update from the North Carolina Institute of Medicine’s Risk-Appropriate Perinatal System of Care Task Force. In 2018 the General Assembly directed the task force to recommend actionable steps that can be taken in North Carolina to best ensure that pregnant women receive quality prenatal care and that mothers and newborns are cared for in a facility that can meet their specific clinical needs. The task force recommended updates and changes with regards to birthing facilities, expanding access to health care for uninsured residents of NC, quality improvement, and increased support for pregnant and postpartum women and their families.

Lastly, the committee heard from several health care professionals on the benefits of expanding telehealth services in NC. Ben Money with NCDHHS presented on the department’s goals for telehealth in the state, along with an update on telehealth activities. The committee also heard from Atrium Health on school-based telehealth initiatives.

Dr. Brad Kolls, Associate Professor of Neurology and Vice Chair of Informatics and Teleneurology at Duke, presented on the value of Duke’s Telestroke Network in the state. The Duke Telestroke Network began in 2013, and the Duke Telehealth Office was created in 2015. Telehealth at Duke improves access of care, reduces travel and facility traffic, produces greater efficiency of care delivery, and allows for more appropriate use of subspecialty care, all with no loss of care quality.

The Duke Telestroke Network’s goal is to collaborate with community hospitals to improve stroke care throughout the state by improving care locally at each partner center through direct and immediate access to stroke experts, expediting access to tertiary care when appropriate, and providing education and training to local providers. The Duke Telestroke Network consists of eight community partners across the state.

Dr. Kolls and the other presenters emphasized that a large barrier to providing telehealth is reimbursement for services. North Carolina does not currently require for insurers to cover and reimburse telehealth services consistently. Dr. Kolls stated that, while some business models can work around the current reimbursement system, deferring care costs to community hospitals is not sustainable.