Newspapers / Philanthropy Journal of North … / Nov. 1, 1994, edition 1 / Page 6
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Philanthropy Journal of North Carolina November 1994 14 more counties to get Smart Start New partnerships The second phose of Smart Sfoit, Gov. Jim Hunt's program for eorly childhood education, wos lounched in EH Pioneer partnerships September with the announcement of 14 new statewide proiects. Shown obove ore the locations of the newest projects, along with the originol 12 Smort Start pilot programs. The new projects, which will split SI 4.8 million in stote funding, were selected from a pool of 74 community groups teptesenbng 76 of the stote's 100 counties. Coordinated by the nonprofit North Corolinn Portnership for Children, Smart Start aims to improve the lives of children and families by building publii/ptivate partnerships to address needs ranging from day core to heolth care to transportation. Here are some of the comments made at recent public hearings sponsored by the North Carolina Health Planning Commission. The hearings are part of the commis sion’s effoi'ts to come up with rec- ommendatiom for state health care reform legislation by 1995: “It is incorrect and unfair to hold teaching hospitals primarily responsible [for producing too many specialists]. To fix the distortion requires a major revolution in how we finance medical education.” Michael Simmons, dean, Medical School, University of North Carolina at Chapel Hill, “Even under fancy managed care Voices of health-care debate plans, there would he tiers of health care. The more money you have, the better health care you receive.,.We support single payer - the only plan that meets the goals that this commission set out. When is the commission going to seriously consider single payer?” Jan Sehradie, North Carolina Student Eural Health Coalition, Durham. “Fd hope you’d he very careful about who you believe and what you believe about statistics. 1 would hope you would proceed cautiously. I don’t believe North Carolina ought to take the lead as one of the states working with the federal goveim- ment until it becomes clear what that fed eral program will be,” William Laupus, for mer dean, School of Medicine, East Carolina University, Greenville. “We believe substance abuse services should be delivered in a one-tier system. The plan should provide a continuum of care from the most intensive to the halfway house...Managed care should not be used to reduce access to care. Outcome [studies] from substance abuse treatment centers should be required but should be looked at realistically,” Richard Eerring, director of operations, Mary Frances Center, Tarboro. “HMOS [health maintenance organiza tions] offer unique opportunities for patients to have better access to preventive care...We don’t believe we need legislation to force HMO’s to cover areas that are already our business to cover. What we would like to see from the state is support tor managed care,” Don Bradlej', executive director, Personal Care Plan, Blue Cross and Blue Shield of North Carolina, Durham. “I want to discuss rurality. It is my career challenge to overcome obstacles that rurality represents...As you look at health-care reform, please remember that raral North Carolina needs vour technical assistance,” Linda Watkins, area director, Tideland Mental- Health Center, Williamston. “Most insurance coverage for the men tally ill is done for a lesser percentage than other diseases. What Fm asking this group to do is remember that mental illness is a biologically-based brain disease. It’s not something our loved ones have done to themselves,” Sharon Barnes, president, ■Alliance for the Mentally Ill, Durham. Health Continued from page 3 “Our focus is on improving health status, not just reforming the medical care system,” says Deputy Director Pam Silberman. An example of this approach is the commission’s advisory commit tee on Community Health Districts. Each district would coordinate all health-related services in a geo graphic area with the goal of improving the health of the entire community. “That means a larger role for everyone who has anything to do with impacting on health status,” Silberman says. “You’d have groups that deal with teenage pregnancy, groups that deal with workplace safety - all working on improving the health status of people in a community.” The commission’s main chal lenge, members say, has been to analyze opinions on health-care delivery in the absence of a clear consensus about reform. “A lot of people have strong Interests in [reform] - some person al and others financial,” Silberman says. “We’ve tried to have the advi sory committees reflective of all special interests so that no one interest will dominate.” At public hearings this summer in Greenville, Raleigh and Durham, the commission heard opinions from insurance industry represen tatives, rural health-.care workers and medical school officials - among others. Issues ranged from who should pay for health-care coverage to how doctors should be trained. Ideas ran the gamut from subtle (support existing managed care networks) to sensational (stop paying for circum cisions). Molly Davenport, who coordi nates Pitt County Project Assist, went to the Greenville hearing to urge the commission to make smok ing cessation programs like hers part of basic health-care benefits. But she ended up talking more about her struggle to care for her 22-year-old son, who is a diabetic. “For these 22 years, decisions about where I work and where I go are made on the basis of, can I get health insurance for my son,” Davenport said. “Our family is being held hostage by what we can afford to do with medical insur ance.” Asheville physician Hal Lawrence traveled to the hearing in Raleigh to let the commission know that reproductive health services for women should be considered “primary care” and should be cov ered by insurance. It's SO simple... 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Philanthrol When asked about concerns that privately-practicing obstetricians and gynecoiogists provide iittie care to the poor, Lawrence said, “I have never turned away patients that come through my office based on their ability to pay.” At the Durham hearing, Rosemary Andrews expressed fears that coverage for the elderly will be eroded under health-care reform. “My personal interest is in bet ter coverage for prescription drug benefits,” said Andrews, a retiree. “What scares me to death is what Washington is doing...They’re say ing they’re not going to make employers pay [for health care] and will take money from Medicare.” In response to concerns from citizens and interest groups that too few people knew about the health-care hearings, the commis sion sought help from the North Carolina Health Access Coalition - a nonprofit education and advocacy group based in Raleigh. The coalition has been working to help get the word out about reform efforts to nonprofits throughout the state - a move that commission members say Eas increased attendance at recent pub lic hearings. In the next several weeks, the commission will continue to take public comment, analyze health care programs in other states and begin sifting through advisory com mittee options for reform. Once members have agreed on a select number of options, they will submit recommendations for a health-cq,re bill to state lawmakers. In September, the Benefits Committee proposed a benefits package that would cost between $11 billion and $19 billion annually if offered to all state residents. Although commission members are disappointed that the momen tum for health-care legislation in Washington has halted, they are committed to moving ahead with reform in North Carolina. “We need to do this anyway - need to switch over to prevention, support practitioners in rural areas, build a structure for univer sal access,” says Jones of Eastern Carolina University. “Even if [national] health-care reform never comes, we owe it to the citizens of North Carolina to do something.” To find out about future public hearings or for other information on the commission, call (919) 715- 4740. .’HERROSI & Company, Inc. Investment Counsel 3301 Woman's Club Drive, Suite 148 Raleigh, NC 27612 Phone (919) 571-7722 FAX (919) 571-7889
Philanthropy Journal of North Carolina (Raleigh, N.C.)
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Nov. 1, 1994, edition 1
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