PAGE 2
YOU AND YOUR
HEALTH
by Pat Patterson
North Carolina has a
shortage of physicians, in
both rural and well-populated
areas. Statistics show that 21
counties in the state have
only one general practitioner
for every 6000 persons.
Relief for this problem is
coming from at least one
source - the North Carolina
Medical Care Commission
(MCC). Through the MCC,
the state provides a
scholarship program designed
to send students through
their medical training and out
into needy areas.
Approximately 400
applications have recently
been received for this
program for the September
school term.
The MCC has also received
$100,000 from the General
Assembly as a pilot incentive
program for doctors. In
addition to that, $734,000
has been appropriated from
the General Assembly toward
the loan program. Of this
amount, approximately
$460,000 will go to students
already in the program and
$450,000 for new students.
According to Mrs. Janet M.
Proctor, head of the loan
program for the MCC,
interviews for students
interested in health related
fields are conducted
year-round, but the bulk of
them are interviewed from
January to May.
Since 1945, when the MCC
program was begun,
approximately 2000 students
have been approved for loans.
More than 1500 of these
students have been approved
since July 1, 1965.
For those interested in
medicine, osteopathy,
dentistry and optometry, the
scholarship will pay up to
$2,000 for each academic
year and a maximum of
$8,000 for four academic
years. Nurses may receive
$500 in their second and
third years in hospital
schools; $1,000 in the second
year of an associate degree or
for each full academic year in
a baccalaureate program.
These medical loans are
granted with the
understanding that students
will repay them by practicing
in communities with 10.000
persons or less depending on
the ratio of practitioners to
the population and other
characteristics of the
community. Nurses can
practice anywhere except in
physician’s offices, private
duty practice, research,
federal facilities and
industrial and summer camp
nursing.
Students in the MCC
program are required to be
residents of North Carolina,
but they do not have to take
their training in this state.
However, 61 percent are
enroUe‘ti in in-state four year
or professional programs, 15
percent in hospital schools
(in- and out-of-state), 12
percent in in-state technical
schools or community
coUeaes anrf ahnut 12 percent
in out-of-state four year or
professional programs.
Should a student decide to
drop out of the program,
leave the state or not practice
in his field, he must repay the
MCC loan. Mrs. Proctor said,
“The current rate of interest
in a pay back loan is seven
percent; however, we plan to
bring interest rates more in
hne with the market rate,
MCC loans are not intended
for general loans.”
Though dentists and
physicians comprise the most
crucial shortage area, the
majority of the students are
enrolled in the nursing
program. Currently, there are
165 . nurses in practice
repaying their loans and there
are 156 potentially available
as manpower. There are also
197 physicians and 108
dentists potentially available
to doctor-hungry counties.
Of the 400 new applicants,
35 are enrolled as dentists, 69
as physicians, 166 as nurses
and the remainder in other
health related fields. These
other fields include chnical
psychology, dental hygiene,
dietetics, medical record
hbrary science, medical
recreation, medical social
work, medical sociology,
medical technology, nurse
anesthesia, occupational
therapy, optometry,
pharmacy, physical therapy
and public health (physicians
only).
by
Jacqueline M. RansdeU
The concept of caring for
the mentally handicapped at
the community level where
the problem begins, and not
placing the responsibility on
the state institutions alofte,
has been in existence for
about ten years.
It was in 1963 that
Congress passed the
Community Mental Health
Centers Act which made
available federal funds to
supplement state and local
monies to build and support
community mental health
centers.
That same year, the N.C.
Department of Mental Health
was created and given a
mandate to provide services
to meet the needs of the
mentally ill, the alcohoUc, the
drug abuser, and the mentally
retarded citizens of our state.
Over the years the thrust
of mental health
programming has focused on
the community. The logic
behind community
responsibility for the-
mentally handicapped is
sound; 1) the provision of
community-based treatment
and rehabilitation resources
reduces the necessity for
hospitalization in many
instances, and 2) the
avaUabUity of aftercare
facihties in the community
fosters a speedier return of
hospitalized patients to their
homes and families.
Particularly in the area of
community care for its
mentally retarded citizens has
North Carolina advanced in
recent years. The
estabhshment of day care
programs, special education
classes for educable &nd
trainable youngsters in the
public school system.
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outreach
Human Resources in Action
in North Carolina
half-way houses and small
group homes for adult
retardates, sheltered
workshops, diagnostic
evaluation clinics, foster
homes, and many other
resources are just a few
examples of alternatives to
institutional care which are
becoming more readily
available within the
communities of our state.
The 1973 General
Assembly appropriafted more
money for new programming
to the Department of Mental
Health than ever before.
Much of this money is
designated for expanded
programs for the mentally
retarded at the community
level.
The legislature
appropriated funds providing
for an increased subsidy to
trainable and severely
retarded children enrolled in
day care centers across the
state - from $40 per month to
$80 per month per child.
These funds can also be used
for children above the
trainable level if they are
multiply-handicapped.
Because these funds were
appropriated, many day care
centers across the state that
would have had to close their
doors because of lack of
funds can continue to provide
needed services for our
handicapped citizens.
Funds were also
appropriated for the
establishment of small group
homes to serve adults and for
sheltered workshops.
In addition, the
Department of Mental Health
received funds which will be
used to implement the first
stage of Caswell Center’s plan
to develop communl'v
services for the mentally
retarded in the eastern region.
This includes monies for the
establishment of child day
care centers, and day activity
for adults.
In addition, the
Department of Mental Health
has been authorized to use
community demonstration,
funds to develop three more
early childhood intervention
programs at the community
level - programs similar to the
outstanding P.A.C.T. (Parents
and Children Together)
program in Gastonia. These
programs will provide help
for developmentally disabled
(mentally retarded)
pre-school children and their
families.
All of these programs will
go a long way towards
providing more
comprehensive community
care for the mentally retarded
in North Carolina.
In addition, aU of the
f ederal funds provided
through the Developmental
Disabilities Services Act
(DDSA) are used to provide
alternatives to institutional
ization for the mentally
retarded at the community
level with the majority of
funds earmarked for day care
and sheltered workshop
programs. A portion, of the
funds, however, goes to local
public school systems to
establish classes for trainable
mentally retarded children
and some is used for
programs for homebound
retarded youngsters.
The concept of providing
respite care for the retarded -
providing day and overnight
care so as to give the parents
and family members of
retarded individuals an
opportunity for a few days’
rest - is growing in North
Carolina. All four of the
state’s mental retardation
centers offer respite care.
According to Don Taylor,
deputy commissioner for
children’s services with the
division of mental
retardation, Department of
Mental Health, there are a
number of problems in the
area of community services
for the retarded which need
attention.
First, he says, there are not
nearly enough community
programs to meet the needs
of our retarded citizens.
However, the funds recently
appropriated by the General
Assembly will do much to
ease this situation.
Second, there is the
problem of quality control in
our day care centers. Many
do not have sufficient
supervision, standards, or
training and staff
development programs.
Third, community-based
services for the retarded need
to be better coordinated and
the roles of various programs
and their relationship to one
another need to be clearly
defined. However, we must
be careful to guard against
“over-definement” so that
services are not fragmented
and that gaps between
services are not created.
Fourth, attitudes on the
part of the community and
the families of our retarded
citizens need to be improved.
We need to strive for more
acceptance of the retarded
and their problems
particularly in regard to the
establishment of small group
homes for retarded adults in
local communities.
Fifth, there is a need for
one person or agency to be
responsible to following up
on the retarded who are
returned to their
communities from the state
retardation centers, to see
that adequate and
appropriate protective
services are being provided.
In commenting on
community services for the
mentally retarded, Dr. Ann
Wolfe, deputy commissioner
for mental retardation
services with the Department
of Mental Health, said,
“People have a right to
receive needed services in
their community, and this
includes the mentally
retarded.
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