By Greg Barnes

The public utility for Wilmington and New Hanover County will spend about $46 million to filter out potentially carcinogenic “forever chemicals” from drinking water for an estimated 200,000 people.

In neighboring Brunswick County, bids totaling $137 million have been approved for a similar filtration system to remove per- and polyfluoroalkyl substances known as PFAS to be completed within the next two years.

In Cumberland County, officials have approved spending $10 million to run public water lines to two schools and homes whose wells have been contaminated with the substances, much of which is the result of contamination emanating from the smokestacks at the Chemours Fayetteville Works plant on the border of Bladen County.

And in the small Chatham County town of Pittsboro, officials are eyeing a $42 million filtration system for the removal of PFAS and perhaps an even more troubling chemical, a likely carcinogen known as 1,4 dioxane. The money would also expand the town’s water treatment plant.

If these projects move forward, ratepayers — and not the companies that contaminated the water supplies — will be footing the bills. Brunswick County recently announced in January that it is raising rates to offset filtration costs and expansion of its water treatment plant. Lawsuits have been filed in New Hanover and Brunswick counties in an effort to recoup the money.

Some of the state’s lawmakers want to make the polluters pay.

Ten bills introduced

A bill introduced in the General Assembly by Rep. Deb Butler (D-Wilmington) would put the onus of cleanup on the backs of the industries that caused the contamination in the first place.

House Bill 444 is among 10 that have been filed since March 22 that aim to reduce or eliminate PFAS in North Carolina — and, in the case of Butler’s bill — hold the polluters responsible. One of the bills, introduced by Rep. Pricey Harrison (D-Greensboro), would go so far as to ban the manufacture, sale and distribution of PFAS in the state.

Most of the bills were filed with overwhelming support from Democrats – but including a handful of Republican co-sponsors – have been introduced in previous legislative sessions, and all of them, Butler and Harrison agree, have zero chance of being approved this time around.

They blame politics.

“Let’s just face it,” Butler said. “DuPont, Chemours and all these other big industrial manufacturers pay a lot of money to politicians … They pay the max to an awful lot of very influential Republicans. And I don’t understand it because, honestly, clean water should not be a partisan issue. It really, really should not. But everything is these days. It is tragic, really.”

Harrison agreed that partisan politics is a big part of the problem, but she said it goes even deeper than that.

“First of all, in terms of doing something more aggressive, I think it’s a couple of things,” Harrison said. “One, it’s probably the problem is so huge and unwieldy that where do we even get started? Isn’t this something that maybe EPA should be tackling, you know, do we actually have the manpower and the wherewithal to manage that in our state? How’s it going to affect commerce? We just don’t have a history of being very aggressive with exposure to toxic chemicals.” 

Republican PFAS funding

Butler and Harrison didn’t mention a bill introduced in April by Sen. Mike Lee (R-Wilmington) and other Republicans that would allocate $15 million to the North Carolina Policy Collaboratory, which is housed at the University of North Carolina – Chapel Hill.

A branch of the collaboratory — the PFAS Testing Network — has been using more than $5 million in state funding to test all of the municipal water systems in North Carolina for PFAS contamination. In July, it released findings showing that nearly half of the public utilities tested had detectable levels of PFAS in their drinking water. Another round of testing continues.

Senate Bill 544 would allow the PFAS Testing Network to expand its analysis and statewide water and air testing of PFAS. It would also provide additional funding for toxicology work in laboratory animals, research on PFAS levels in citizens and their potential health effects, and development of technologies to reduce PFAS exposure.

According to the bill, at least $10 million would be directed to UNC for the development of technologies that use water filtration or other chemical or physical methods to remove or reduce GenX and other PFAS from water supplies. The bill has bipartisan support. 

Lee said UNC has developed technology that can filter out up to 100 percent of PFAS from drinking water. He said the researchers are trying to bring the technology to scale.

Conventional filtration systems in water treatment plants and homes now only remove a portion of total PFAS, and the resin that removes the contaminants breaks down over time, according to UNC. University researchers made a resin specifically designed to filter PFAS molecules.

Lee said he has been working “really hard” on getting the bill passed.

“I’m willing to go to the mat as much as I can,” he said.

Butler and Harrison said in later emails that they didn’t mention Lee’s bill because they didn’t know about it. Both said they typically don’t read Senate bills until they make it to the House. Lee said the same about House bills.

Nevertheless, Butler said, she prefers that funding be allocated to the state Department of Environmental Quality, “our watchdog who has been systematically underfunded by this leadership, and the collaboratory.” Harrison called the DEQ “woefully underfunded.”

Big problem, small response

North Carolina is said to have the third-worst PFAS contamination problems of any state in the country. Yet at least nine other states have set maximum contaminant levels for certain types of the more prevalent PFAS in public drinking water. North Carolina has set only a health advisory for one type of PFAS, called GenX.

A bill introduced in the House by state Rep. Ashton Wheeler Clemmons (D-Greensboro) would, at a minimum, set maximum contaminant levels for PFAS, 1,4 dioxane and hexavalent chromium, which is associated with coal ash. But again, the bill only has Democratic co-sponsors and without Republican support in a Republican-controlled General Assembly, there is little chance of the bill’s passage. 

Clemmons’ proposed legislation, House Bill 521, would have to successfully complete its trip through committees and pass a vote in one of the legislature’s chambers by May 13 or else be dead for the rest of the biennial General Assembly session. The bill, filed April 8, was sent to the House Rules Committee, where it stands little chance of escaping. A companion bill filed March 31 by state Sen. Sydney Batch (D-Apex) was referred to the Senate’s rules committee.

Republicans have another PFAS-related bill that Butler and Harrison agree has a good chance of passing. Lee has introduced Senate Bill 327, which would require mandatory inventory reporting of aqueous firefighting foam and track its use. Ted Davis (R-Wilmington) has filed a companion bill in the House.

The foam, which is used largely for training purposes at airports, fire stations and military bases, contains PFAS that has contaminated drinking water sources. Drinking water for the town of Maysville near the coast is believed to have been contaminated by foam used by firefighters and an alternate water source had to be found. Military bases in the state have also been contaminated with PFAS from the foam, as has an area at Piedmont Triad International Airport.

Lee said there are cases in which firefighting foam has and should be used in real emergencies. He wants the state to keep track of where and how much is used.

But environmental advocates argue that there are already substitutes for the foam that work just as well and don’t contain PFAS. In December, Congress agreed to phase out firefighting foams containing PFAS at military installations by 2024. 

Little Republican support

Butler said only two Republicans — Frank Iler and Charles Miller, both of Brunswick County, downriver from Chemours — have signed onto any of the PFAS-related bills filed by Democrats. Iler and Miller support Butler’s bill to make polluters pay for cleanup. Both have a vested interest, providing clean drinking water and keeping their constituents happy by avoiding a rate increase on their water bills.

Lee said that he also favors making polluters pay and that a bill he sponsored in 2018 had a provision to do so.

“So I certainly believe that those who pollute should pay for the cleanup,” he said. “What I’m really concerned about is not just that but the amount of PFAS in the environment, generally. It’s ubiquitous. It’s everywhere.”

Democratic lawmakers do have support from the top — Gov. Roy Cooper has pledged $8 million in his proposed budget to help mitigate PFAS and other emerging contaminants.

Chemours response

After spinning off from DuPont in 2015, the Chemours Fayetteville Works chemical plant is now responsible for much of the PFAS contamination in the lower Cape Fear River and in private wells surrounding the Bladen County plant. The plant had been discharging PFAS into the river since the early 1980s. Although Chemours has been prohibited since 2017 from discharging its wastewater, PFAS still show up downstream, mostly in runoff, groundwater seepage and from river sediment. 

If signed into law, Harrison’s bill to ban the manufacture, use and distribution of PFAS could place extreme hardship on the Chemours plant, which employs more than 500 workers and contractors. Among the plant’s primary functions is to produce GenX, the PFAS substance used in everything from nonstick pans to wiring and components for computers, automobiles and airplanes.

Lisa Randall, a spokeswoman for Chemours, said the company continually reviews all proposed legislation that would impact its operations and the communities where it operates. Randall said some of the pending PFAS legislation in the General Assembly would have a profound negative effect on North Carolina and the country. 

If approved, the bills would deny “North Carolina hospitals access to critical respiratory applications, and prevent our Fayetteville Works employees from supporting the supply chain to produce chlorine bleach, desperately needed during the current pandemic,” Randall wrote in an email to NC Health News.

“North Carolina workers could no longer support the large battery industry, which is the key to growing solar and wind energy, as well as the electric vehicle markets the U.S. is relying on to help fight climate change,” Randall said. “Companies would no longer be able to manufacture or repair anything that involved wiring or computer components. North Carolina’s military bases would risk not being able to receive many replacement parts for their jets, helicopters or vehicles. Data centers in our state may not be able to cool equipment or get replacement parts to maintain those server farms.”

Butler, a primary sponsor of the bill to ban PFAS, said Chemours is missing the point.

“Human health is being negatively affected by these forever chemicals,” she wrote in response to Chemours. “Regardless of the usefulness of some of these applications, it is past time to transition from them by using the categorizations identified by researchers. 

“Some PFAS applications are nonessential and should be abandoned immediately. The second category is those products that are substitutable and an aggressive plan for alternatives should be developed. Only those applications that are essential for human health and safety should be available in a limited and heavily regulated manner.  It doesn’t matter how useful or profitable a product is if it is a hazard to human health.”

PFAS have been associated with many human diseases. In large enough concentrations, scientists say they may cause cancers of the thyroid, liver, testicles and kidneys. They are believed to suppress the immune system, raise cholesterol levels and cause low birth weight. Recent studies have found that PFAS may make people more vulnerable to the coronavirus and less responsive to COVID-19 vaccines. 

The EPA now says there are an estimated 9,000 different types of PFAS, more than 600 of which are currently being used. PFAS are referred to as “forever chemicals” because they accumulate in the human body and don’t break down in the environment.

The post There are harmful chemicals in North Carolina’s waterways. Will lawmakers address the problem? appeared first on North Carolina Health News.

By Anne Blythe

North Carolina children are not eligible to vote for the state lawmakers who debated what age they could marry and go to court, but those adults made big decisions this summer that have an impact on when they can be thrust into grown-up circumstances.

Lawmakers raised the age at which a child can marry in North Carolina to 16. They also adopted legislation that says a child must be at least 8 years old to be sent into a court system that sometimes puts them in a position of trying to respond maturely to a judge’s questions from a seat in which their tiny legs dangle above the floor.

Both laws have been the subject of much debate for several years.

Gov. Roy Cooper signed “An Act To Amend The Lawful Age of Marriage to Sixteen Years Of Age or Older And To Provide A Maximum Four-Year Age Difference for a Sixteen or Seventeen-Year-Old To Marry,” or Senate Bill 35, into law on Aug. 26.

Four days later, Cooper signed changes to the juvenile justice act, or Senate Bill 207, which sets December as the month in which North Carolina no longer will prosecute 6- and 7-year-olds in juvenile court. Though lawmakers debated setting 10 as the minimum age at which children can be prosecuted for crimes, they decided in late August to add a provision that allows for the prosecution of 8- and 9-year-olds who are either repeat offenders or accused of the more violent crimes.

A law years in the making

Rep. Marcia Morey, a Democrat from Durham and a former district court judge who presided over juvenile proceedings, introduced a bill in the state House of Representatives in 2019 to raise the minimum age for prosecution. It never made it to the chamber floors for a vote.

In December, the North Carolina Task Force For Racial Equity recommended raising the age of juvenile court jurisdiction to 12.

Morey worked again this year with lawmakers from both sides of the aisle in the House of Representatives and the Senate to raise the age.

During committee meetings, advocates argued that new research in neuroscience has shown that the brains of children are not developed enough for them to assist in their defense in a judicial system that can be complicated even for adults.

Judges and others shared stories of children in their courtrooms being asked to make significant life choices.

Imagine a kindergartner or first-grader who just had a sixth birthday, perhaps still struggling to remember their address or the phone number of a parent or caregiver, responding to questions that could have a big impact on what happens to them.

Judge Jay Corpening, New Hanover County’s chief district court judge, an advocate of raising the age and a member of a Juvenile Jurisdiction Advisory Committee, has asked rhetorically whether children who believe in Santa Claus, the Easter Bunny, the Tooth Fairy can have any meaningful aid in their defense. 

He has responded with his own, “no.”

Tethers to needed help

Many have described the juvenile justice system as one that over the years has been a place in which children in need of mental health care or family support aid can find a tether to counseling, social workers and other services.

That’s what some lawmakers, prosecutors and law enforcement representatives argued as they pushed for the provision that allows for the prosecution of 8-year-olds.

Others argue that children who are exposed to life’s adversities — such as parents with substance abuse or domestic violence issues — should not be thrust into the court system to gain such community supports. 

Research in the past two decades has found that children exposed to such “adverse childhood experiences,” turn out to have worse mental and even physical health outcomes as they grow into adults. 

Morey argues that children who commit crimes at such young ages with brains far from fully developed cannot really have criminal intent, a necessary legal element to win convictions in many cases. 

Jim Woodall, the district attorney for Orange and Chatham counties, supported raising the age for juvenile jurisdiction. Nonetheless, he says he has difficulty buying into the argument that children at such a young age are not capable of intent.

“When I was 9 or 10 years old, I know I intended to do things,” Woodall said. “To me, where the difference is, it’s not about intent, it’s about understanding the consequences of taking an action. You might intend to hurt somebody, but you might not understand the consequences of doing that.”

Woodall was not one of the prosecutors who pushed for the provision for 8-year-olds to fall within juvenile jurisdiction for some offenses.

Morey, who had hoped to see the juvenile jurisdiction floor raised to higher than 10, says she’ll continue to advocate for change in sessions to come.

“It was a first step,” Morey said.

Hoping for more steps

That’s what many are saying about North Carolina’s new marriage law, too. It’s a step in the right direction if only a baby step.

The governor noted as much when he signed the bill.

“This legislation is an important step toward ending child marriage in North Carolina and instituting more protections for children,” Cooper said in a statement announcing his signing. “While it falls short of raising the age of marriage to 18, it will make our state a safer place for children.”

Until the governor added his signature to the law, North Carolina was one of 13 states that allowed children younger than 16 to get married, according to a map provided by Unchained at Last, an organization pushing all states to raise the minimum age to 18.

Fraidy Reiss, who tells her own story of being 19 and forced into an arranged marriage by her family to a man who turned out to be violent, formed the organization to fight for others who might be in forced or child marriages.

A study by the organization found that between 2000 and 2018, at least 232,473 children were married. They estimate that even more were wed, but records were not available.

Ninety-six percent of the marriages were 16- and 17-year-old children, the study found, and North Carolina’s updated law would not necessarily prohibit them. For marriages in which gender data were available, more than 86 percent of the marriages were minor girls.

While some might think the child marriages are two teens eager to get a romantic start to a lifetime together, that’s not what Drew Reisinger, register of deeds in Buncombe County, found.

“There often are egregious differences in age,” he said during a telephone interview on Wednesday.

One such case that Reisinger has talked about more than once as lawmakers debated child marriage was when a 17-year-old girl and 49-year-old man came to him in search of a marriage license after the state in which they lived refused to grant them one, where it was against the law.

‘We’re no longer the worst’

Reisenger refused, sending them out the door, knowing full-well they might go to a different county in North Carolina and obtain the license they tried to get from him.

“I felt comfortable doing that,” Reisenger said. “I didn’t want to aid them in breaking the law.”

The North Carolina Register of Deeds Association helped put together a bipartisan effort to raise the age in North Carolina this legislative session. The association was pushing for the marriage age to be raised to 18.

During the early part of the year, Reisenger said, there appeared to be momentum among lawmakers to raise the age to 18, the same age that Unchained at Last and others lobbying against child marriage are advocating for in all 50 states.

Only six states, according to Unchained at Last, prohibit marriage before age 18 with no exceptions.

Then the North Carolina effort to do just that hit a roadblock in the late spring when some lawmakers started to push for exceptions to the age limit.

Supporters of allowing people younger than 18 to enter a marriage contract argue that such unions should be OK if assessed and approved by parents or the courts, and in some cases both, then such unions are OK.

Critics of such vetting, point out that girls in such unions could be forced into marriages they should not be in, and often end up in abusive relationships, drop out of school and fall into poverty, another example of the adverse experiences that set these young women up for health problems for the rest of their lives. 

Some weddings, in which the girl is pushed into a marriage because she’s pregnant, cover up statutory rape, critics also point out.

While the North Carolina law is a “step in the right direction,” Reisinger said, he and others hope there will be legislative sessions ahead where child marriage critics can lead the lawmakers to take even more steps to protect children from such unions.

“We’re no longer the worst,” Reisinger said. “That’s not really a motto a state wants to have, but that’s where we are.”

The post North Carolina raises the age for when children can marry and go to court appeared first on North Carolina Health News.

By Mark Darrough, for Carolina Public Press

Before a new batch of 25 FEMA-contracted ambulances arrived in North Carolina in early February, overworked crews at Forsyth County Emergency Services had weathered a rising number of calls amid the winter surge of the omicron variant. 

Like many other EMS agencies across the state, the pandemic heightened demand for their services, but heavy workloads and the ensuing burnout had led to a shortage of qualified paramedics and emergency medical technicians to fully staff Forsyth County’s fleet of ambulances. 

Assistant Chief Bryan Gallimore said his EMS division has in recent months operated with 20-30 vacancies — of an EMS workforce typically 100 strong — while call volume increased by roughly 11% from 2020-21. On top of that, the overall level of medical care required to treat patients has gone up, according to Gallimore.

“Our crews essentially come in at the beginning of their shift, and they run calls until they go home,” Gallimore said. “(There’s) very little time for anything else — for documentation and inventory. We’re running calls around the clock.”

Increased calls and more complex medical situations from COVID-19 put pressure on already short-staffed EMS teams across the state. Federal assistance in the form of 50 ambulances from the Federal Emergency Management Agency helped ease the burden in 25 counties since September, and counties are finding ways to bolster the staffing pipeline.

Staffing shortage and federal help

Staff shortages from heavy workloads and burnout through the pandemic, compounded by quarantines of paramedics and EMTs exposed to the virus, strained the system in Forsyth, according to Gallimore.

At the same time, the emergency medical science program at Forsyth Technical Community College — the county’s traditional pipeline of new EMS employees — was disrupted by training delays because of lockdown procedures, resulting in smaller graduation numbers.

In response to the county’s application to the state, Forsyth EMS received four of the contracted ambulances with two EMS staff members per crew. One ambulance was added to the night shift, one to the day shift and two for the peak load time of 1 p.m.-1 a.m. 

For Gallimore and other strained EMS crews around the state, the federal ambulances gave them sorely needed breathing room.

“(The FEMA ambulances) help ease the workload of our staff, but they also shorten call response,” he said. “With more ambulances, we get to calls quicker.”

The additional crews also mean less assistance is required from neighboring counties’ EMS crews, each struggling with its own capacity constraints, to help “keep their ambulances at those borders,” according to Gallimore.

Each county typically plans for a 2.4% increase in annual call volume based on normal population growth, according to Kimberly Clement, who oversees health care preparedness at the N.C. Office of Emergency Medical Services. But from November to December, as omicron cases skyrocketed, call volume among EMS agencies statewide spiked 10.1%.  

Several days before North Carolina’s omicron surge peaked in late January — when more than 8,700 new reported cases dwarfed any of the pandemic’s previous peaks — DHHS announced it had applied for another 25 ambulances due to “daily records of hospitalizations throughout January.” The vast majority of those requiring hospitalization were unvaccinated, according to Department of Health and Human Services Secretary Kody Kinsley.

On Feb. 1, NCDHHS announced that its FEMA request for 25 additional ambulances had been approved.

“Our hospitals continue to deal with near-record levels of patients, and this federal support is one of many levers we are using to meet demand,” Susan Kansagra, senior deputy director for the N.C. Division of Public Health, stated in a press release.

The first batch of 25 FEMA ambulances arrived in late September to only nine counties. Two of the approved counties, Mecklenburg and New Hanover, received the lion’s share with a combined nine vehicles and their crews.

North Carolina first submitted a resource request to FEMA on Sept. 10 to assist the nine EMS agencies “experiencing greatly increased calls for service during the COVID-19 pandemic,” according to DHHS. 

Data gathered from counties’ request forms submitted to the state shows critically understaffed EMS crews among the 31 applicants. On average, 12 EMS vacancies were reported per county, representing about 20% of the 1,800 total positions budgeted for the 31 counties. According to the data, 170 daytime EMS units were staffed, although total capacity called for 220 units.

Clement said the 25 approved counties experienced higher call volume and staff shortages than statewide averages. 

The FEMA ambulances are scheduled to stay in their respective counties through March 2, according to a DHHS spokesperson, whereupon the department will decide whether to request another extension. As of Tuesday, no additional ambulances had been requested.

Shrinking EMS programs and educational partnerships

Coastal Brunswick County “has not experienced the staffing shortages as severely as other EMS agencies around the state and nation,” said county spokesperson Meagan Kascsak. 

Although the county led the state in population growth from 2010-19, EMS crews were considerably less strained than other EMS agencies across the state. Calls per month only increased by 3.7% from 2020-21 — nearly 3 percentage points less than the statewide average of 6.5%. 

The vacancies that do exist in Brunswick are rooted in the same obstacle hampering Forsyth EMS: a shrinking pipeline of emergency medical service students. 

“One of the biggest problems with filling (EMS) vacancies is that we have seen declining enrollment numbers in college paramedic programs over the past two years,” Kascsak said.

“Some of this is due to concerns about the COVID-19 pandemic or because some educational programs may have fewer clinical opportunities available for students to complete their programs.”

In response, Brunswick and Forsyth officials partnered with community colleges to boost enrollment and offer clinical training opportunities for paramedic programs. 

Gallimore believes lagging enrollment will not become a stronger trend in the foreseeable future, in part because Forsyth Tech has incentivized students to join its two-year emergency medical science program. He believes these efforts, along with a planned EMT academy in the summer or fall, “can bolster this workforce.”

“We’ve seen a large number of students enroll at the college; the pipeline of new employees is opening up a little bit,” Gallimore said. “So, I think it’s going to be a slow fix, but it will right itself over time.”

Enrollment jumped from 43 students in 2020 to 72 students in 2021, according to communications director Devin Purgason.

“We saw the dire needs in our own county for staffing and knew that we had to do whatever we could to fill in the gap,” Purgason said. “That’s why we worked creatively to fund these incentives, largely through funding from our Forsyth Tech Foundation.”

The program grew in enrollment in 2021, he said, because of targeted marketing efforts in collaboration with Forsyth EMS. The campaign highlighted incentives for potential students, including free tuition, a $500 signing stipend, books, fees, uniforms and a $2,000 “program completion stipend.” 

“We have a responsibility to our community to train competent, really great workers for EMS and EMT,” Purgason said. “And so it’s something that we’ve really taken to heart.”

Carolina Public Press is an independent, in-depth and investigative nonprofit news service for North Carolina.

The post ‘Running calls around the clock’: FEMA ambulances assist depleted EMS crews appeared first on North Carolina Health News.

By Taylor Knopf

When two sheriff’s deputies showed up at the hospital room of John Noel’s husband, Chris, he thought he was being arrested. No one had told him they were coming. 

The deputies handcuffed Chris and escorted him to the back seat of a patrol car, according to Noel. Driving away from the hospital, Chris asked the officers if they were taking him to prison. They ignored his questions. 

(NC Health News verified Chris’ identity and chose not to identify him by his real name due to the ongoing stigma of mental illness and involuntary commitment.)

The officers were taking Chris from the emergency department at Duke Regional Hospital in Durham to Holly Hill Hospital, a psychiatric facility in Raleigh under an involuntary commitment order. 

Meanwhile, Noel was at home and had no idea. Had he known about the order, Noel says he would’ve tried to prevent it or driven Chris to Holly Hill himself.

Involuntary commitments are ordered by a judge when a person is determined to be a danger to themselves or others. In most North Carolina counties, a commitment order triggers a call to law enforcement to transport the patient to a hospital to be evaluated or to an available psychiatric bed. The nearest opening could be located at a hospital several hours away.

Amid local and national conversations about “defunding the police,” this practice is getting a new look. Even law enforcement officials are asking if some of the roles assigned to them — such as transporting mental health patients and responding to mental health crises — should be done by professionals with a different set of skills. 

Increasingly, sheriffs across North Carolina appear to be agreeing with mental health advocates on this point. 

Transporting psychiatric patients

More and more patients have found themselves handcuffed in the back of a police car over the last several years. NC Health News reported a 91 percent increase in involuntary commitment petitions over the decade prior to the pandemic, far outpacing population growth in the state. 

North Carolina counties are required by state law to provide secure transportation for psychiatric patients under an involuntary commitment order. In most counties, sheriffs’ departments are tasked with this job. 

But many sheriffs say they do not want this responsibility anymore.

In March, the NC Sheriffs’ Association released an updated report on “law enforcement professionalism” in response to the national protests and conversations about the responsibilities of law enforcement that erupted after the death of George Floyd. 

Among the list of changes and requests, the sheriffs ask state lawmakers to pass legislation removing their role of transporting patients under involuntary commitment. The sheriffs said that mental health professionals should be transporting these patients and they also ask for more state funding for substance use and mental health treatment.

“I believe that it is the general feeling of the law-enforcement community that persons with mental health needs should more appropriately receive the services that they need from mental health professionals and mental health facilities rather than from law-enforcement officers or the county jail,” Eddie Caldwell, general counsel to the NC Sheriffs’ Association, told NC Health News in an email.

Caldwell has previously explained how transporting patients under involuntary commitment orders strains those sheriffs’ departments with fewer resources, especially when they have to drive patients hours across the state. 

The request from the sheriffs’ association could be a pivotal point for North Carolina’s involuntary commitment process, which advocates say currently compounds the trauma for many patients by involving law enforcement. However, there’s a concern that county officials may shift transit responsibilities from deputies to contracted security companies that have less oversight than government agencies.

‘Felt like a prisoner’

One night in February, Noel and Chris were getting ready for bed at their home in Durham when Noel said his husband suddenly seemed to be in a “parallel universe.” He was restating claims from a past psychotic episode and trying to leave the house carrying a backpack full of mustard to fix a problem at a six-figure job he no longer had, Noel recalled.

Noel said they needed to go to the emergency room, and Chris — who was recently diagnosed with type 1 Bipolar disorder — didn’t argue and went willingly. 

What Noel didn’t expect was five days to pass before he heard Chris’ voice, calling from Holly Hill. Noel claims that no one at Duke Regional or Holly Hill would confirm where his husband was during the five-day interval. 

Chris described how confused he was when officers handcuffed him and put him in the back of a cruiser. He said he felt like a prisoner and asked Noel, “why did you put me here?”

“It really just broke my heart that he went through that,” Noel told NC Health News later. “I was both angry and crying at the same time. I just felt like I had failed him somehow.”

In 2019, counties were tasked with rethinking how they transported patients like Noel’s husband after a state law went into effect aimed at reforming parts of the involuntary commitment process. County leaders met and most submitted updated transportation plans to the state health department. 

NC Health News reviewed those plans and previously reported that most counties chose to continue using local law enforcement for patient transportation. A very small number opted to contract with private security companies or local EMS to transport patients. 

Opting for private security guards

Mental health advocates are concerned that as counties and behavioral health management groups look for alternatives to police transports that more will default to contracting with G4S, a private security company already used by a couple of counties. The state of Virginia recently awarded G4S a $7 million contract to transport nearly half of its mental health patients under involuntary commitment instead of law enforcement.

“Having off duty police officers or security guards transporting is not what is meant by an alternative to police transport,” said Cherene Allen-Caraco, director of Charlotte-based Promise Resource Network, a mental health services agency run by people with lived experiences of mental illness, incarceration, homelessness and substance use. 

Allen-Caraco advocates for non-coercive, non-restrictive mental health treatment and support. She doesn’t want to see more patients transported by private security officers, who she said receive little pay or training for the role. She also pointed to an incident last year in Charlotte when a G4S security guard was charged with sexual assault of a minor after allegedly raping a 14-year-old girl he was transporting to the hospital under an involuntary commitment. 

G4S has been transporting mental health patients since 2012, according to a spokesperson for Allied Universal, which acquired G4S last year. 

“Allied Universal employees entrusted with this role go through enhanced training focused on healthcare essentials, de-escalation, safe driving and safety near or around stairs. Additionally, Allied Universal has a certified Mental Health First Aid Trainer on staff to train all new hires in this role. Allied Universal employees also receive training from third parties and client-specific training on working with individuals with autism and other conditions,” a spokesperson wrote in an email to NC Health News. 

A number of North Carolina counties’ updated transportation plans included a clause with an option to use a contractor like G4S in the future. Other plans had details about using officers of the same gender as the patient when possible or officers in plain clothes rather than full uniform. 

A handful of plans went so far as to lump together prisoners and mental health patients in their transportation plans. And in some cases, the transportation of incarcerated people and psychiatric patients looks very similar.  

Criminalizing mental health

Nine years ago, sheriff deputies loaded Susan Silver’s daughter, Anne, into a prisoner transport van and drove her from an emergency department in Wilmington to a psychiatric bed two hours away in Greenville. It was the same kind of vehicle Silver would see sitting outside the courthouse each weekday. 

(NC Health News verified Anne’s identity and chose not to identify her by her real name due to the ongoing stigma of mental illness and involuntary commitment.)

Silver recalls watching her then-25-year-old daughter shuffle out of the hospital to the van with her wrists and ankles shackled together and attached to a chain around her belly.

“This, of course, in full view of everybody in the department and in the hallways and everywhere else, and with a deputy on either side of her like she was a criminal,” Silver said. 

Inside the van, Anne sat on a wooden bench in the middle compartment closest to the front of the vehicle. She couldn’t see outside. Silver remembers her daughter being locked inside the van in the parking lot for close to an hour as the deputies waited on a second male patient they needed to drive to Greenville too.

“I was pretty nearly hysterical,” Silver recalled. “I’m shouting at someone to let her out and give her some air, and they’re telling me that they’re not doing any such thing because this is policy.”

On the drive, the second patient urinated onto the metal floor of the van, and the fluids squished back and forth between the two caged compartments. Anne told her mother that she sat with her legs on the bench to avoid getting wet.

“Mom, don’t ever let me do that again,” Anne said when they finally spoke in Greenville. That incident prompted Silver to complain to the New Hanover County sheriff, saying her daughter was treated like a “dangerous criminal.” 

“People like my daughter suffer long-lasting consequences from that kind of trauma,” she said. When Silver adopted Anne as a young child, she already had a history of trauma as well as an intellectual disability and emotional and behavioral health issues.

Some time later, Anne needed another ride to a psychiatric hospital and New Hanover deputies showed up in a regular patrol vehicle without the handcuffs. There were magazines and a blanket in the back seat. Silver said she thanked the sheriff for the improved treatment. 

However, some psychiatric patients in New Hanover County are still transported in vans with caged compartments inside, according to the sheriff’s department. The kind of vehicle the patients are put in depends on logistical factors, including their age, availability of staff and vehicles, and how many patients need to be transported from one hospital to another at the same time. 

Advocates have cautioned against the use of vehicles with caged compartments to transport mental health patients for safety reasons after two South Carolina women drowned inside a law enforcement van swept away by floodwaters during Hurricane Florence. The officers driving the van managed to escape.

In New Hanover, the transport vehicles have no markings on them that would distinguish them as law enforcement vehicles, according to Doug Price, a major with the New Hanover Sheriff’s Office. He said his officers dress down when transporting patients and only use handcuffs when necessary.

‘Strain on the squad’

Though law enforcement have been transporting psychiatric patients for decades, some patients are still caught off guard when the deputies arrive at their home or hospital room. 

“I can say from experience that when they go to the hospital voluntarily and they get put on [involuntary commitment] papers, sometimes the hospital staff might not tell them that they’re getting placed somewhere,” explained Christopher Miles, head of the transportation unit at New Hanover Sheriff’s Office.

“So sometimes it’s a shock to them when they see us come in, but once we speak to them and tell them the situation, from my experience, they tend to relax,” Miles said. 

Price added that his officers receive more push back from family members of patients who want to drive their loved one themselves, something allowed under NC law. Getting an exception to drive a loved one can be tricky, as hospitals tend to be risk averse and prefer law enforcement officers to transport patients.

In New Hanover County, the sheriff’s department has a dedicated transportation unit that’s responsible for taking incarcerated people to court, doctor’s appointments and between prisons. The unit also drives mental health patients under involuntary commitment.

Not all counties have that luxury. 

“There’s 100 counties in North Carolina and some of the smaller agencies don’t have as robust of a transportation unit and it becomes a strain for them,” Price said. 

“When I first started, you would carry your IVC patient to the hospital and you would sit with that IVC patient sometimes for four, five, six, seven hours and then you would carry him somewhere else, so it was a strain on the squad,” he said. 

Over time, New Hanover deputies were asked to transport more patients further distances across the state so the department made a change to address the rising demand. Now, one frequent placement for patients from Wilmington is Old Vineyard Behavioral Health Services three and a half hours away in Winston-Salem, Price explained. His department recently met with local hospital officials to ask if patients could be placed closer to the county.

‘Warm receiving atmosphere’

The presence of law enforcement doesn’t help a person in a mental health crisis, whether they’re in the hospital or experiencing a crisis in the community, according to Mecklenburg Sheriff Gary McFadden.

“The uniform presence is threatening, no matter what we do. And the car you’re coming in is threatening also. It escalates the situation,” McFadden said. “Khaki pants with a polo shirt that says something else on it — you’ll be fine.”

McFadden added that the hours and hours of transporting patients under involuntary commitment are stressful for his officers and the patients.

“It’s that warm pick up …,” he said, pausing. “If we could change anything, it could even be the car that they travel in or how they travel. They travel with an officer with a gun and a badge and they’re in a caged area in the back of these vehicles. Why can’t we take a look at how we can give them better transportation to the next facility?”

Law enforcement doesn’t need to respond to every situation, especially to non-violent incidents involving people with mental health issues, McFadden explained while sitting on the porch of Promise Resource Network’s new peer-run respite after its launch event last year. McFadden supports using mobile mental health response crisis teams and peer support inventions, offered by trained people with their own experiences of mental illness, substance use or homelessness.

“A warm receiving atmosphere helps soothe these people. An organization like this, we can learn from,” McFadden said, gesturing to the new space available in Charlotte as an alternative to hospitalization for people in mental health distress. “These are people who have been through this. They are the consumers of what we’re talking about.” 

Wrong role for law enforcement

While zigzagging down a dark street in Greensboro in 2018, Marcus Deon Smith encountered police officers and asked for help. With blue lights blinking around him, Smith appeared distressed and disoriented as officers shined flashlights in his face and tried to usher him into the back of a police cruiser. 

In a video captured by police, 38-year-old Smith told the officers that he wanted to go to the hospital and that he was not resisting them. Smith appeared more distressed inside the vehicle so the officers used a controversial, but legal, “hogtie” restraint on him which triggered a heart attack. Smith died before reaching the hospital. 

The medical examiner ruled Smith’s death a homicide, and his family recently reached a $2.57 million settlement agreement in their wrongful death lawsuit against the Greensboro Police Department. However, the officers involved were not disciplined. The mayor and then-police chief said the officers didn’t do anything wrong and acted as they were supposed to, according to a report by The Assembly. 

In response to Smith’s death and the following conversation in Greensboro, two North Carolina-based researchers wrote a model law that municipalities could adopt to better respond to people in mental health crises. 

“[Smith] needed help from someone who understood his lived experience and who could de-escalate his behavioral health crisis humanely. He needed a person-centered behavioral health crisis response team,” argue Taleed El-Sabawi and Jennifer Carroll, authors of the model law.

Their model could be used as a legal framework to start a program such as Crisis Assistance Helping Out On The Streets — better known as CAHOOTS — where mobile response teams made up of a medic and a mental health crisis worker respond to 911 calls related to mental illness, homelessness and substance use. Each CAHOOTS team member has more than 500 hours of training. 

The program was established over 30 years ago in two Oregon cities and has since been replicated in other states. In 2019, the CAHOOTS teams in Oregon responded to more than 24,000 calls and only requested police backup 250 times. The program in Oregon estimates that it saves the local government $8 million on public safety and $14 million on ambulance and emergency room treatment annually.

Studies have shown that people with mental illness are more likely to be injured by law enforcement during an encounter and that people who have psychotic episodes have more interactions with law enforcement as a result of their mental illness than others. People with untreated mental illness are 16 times more likely to be killed by police, according to a study by the Treatment Advocacy Center.

In their academic paper, “A model for defunding: An evidence-based statute for behavioral health crisis response,” El-Sabawi and Carroll explain how Crisis Intervention Training (CIT) for officers — a favored program aimed at helping them better understand mental illness — isn’t actually working. 

The core of the program is a 40-hour training in the signs of mental illness and crisis de-escalation techniques. Since the training was born in the late 1980s, more than 3,000 law enforcement agencies have adopted it. 

“Little evidence exists to show that the CIT approach is effective at reducing incidents of police use of force (or even simply reducing incidents of excessive police use of force) during behavioral-health-related calls,” El-Sabawi and Carroll argue. 

They conclude that officers lack training, institutional support, infrastructure, culture and public image to respond to mental health calls effectively. They say the program is asking law enforcement “to be something that they are not.”  

“Therefore, first responders to behavioral-health-related calls for service should not be law enforcement,” they argue. “First responders should consist of a different set of service professionals entirely.”

Not going back

Patients and their family members are often shocked and traumatized when officers arrive at their home or their hospital room to transport them to the hospital, often in restraints. 

“This is a person who’s in a crisis already, and they’re just making it worse,” Noel said, recalling the effects of the process on his husband. “I think this is a broken process here and it needs to be fixed.

“The hospitals aren’t happy with it. The sheriffs aren’t happy with it. The patients aren’t happy with it. The families of the patients are not happy.”

In Mecklenburg County, assistant public defender Bob Ward represents patients under involuntary commitment almost daily and says his clients often describe the additional trauma they feel due to law enforcement involvement in the process. 

“It does get in the way of them fully embracing the treatment,” Ward explained. “They are angry. They are anxious. They feel belittled. They feel dehumanized. They say ‘I’ve done nothing wrong, but I felt like I was being treated like a criminal.’”

Noel said his husband is doing better right now. Chris got a new job, and his medications and treatment appear to be working. But Noel said he lives “in dreaded fear” of what he’ll do if Chris has another severe psychotic episode. 

“Because I cannot turn to the emergency room,” he said. “I will not do that again.”

Noel and his husband aren’t alone. Many family members and psychiatric patients say they will not return to the emergency room for psychiatric care in the future after similar experiences. 

Studies show that this type of forced treatment deters people from seeking help in the future and increases the risk of suicide. A survey of about 450 people who have gone through coerced psychiatric hospitalizations, created by people who had been subjected to involuntary commitments, found that 53 percent said they attempted suicide after their hospital stay and 78 percent said they had post-traumatic stress symptoms from the experience. 

The majority said they would hesitate to or not tell their mental health provider about suicidal crises in the future. 

This story was supported by a grant from the Fund for Investigative Journalism. 

The post Sheriffs want to turn transport of psych patients over to mental health workers appeared first on North Carolina Health News.

By Greg Barnes

CityView Today

North Carolina environmental groups are outraged over the Chemours chemical corporation’s plans to expand its Fayetteville Works plant in Bladen County.

Chemours announced in a statement Tuesday that it will hold two public information sessions on plans to expand its manufacturing capabilities at the plant, which sits just over the Cumberland County line. 

The planned expansion would “support an increase in domestic production in the semiconductor, transportation, clean energy, consumer electronics, and communications industries,” according to the statement.

Little more is known about the expansion plans because the company said it will not provide interviews before the public sessions.

Chemours has been under a consent order since 2019 to clean up decades of per- and polyfluoroalkyl contamination — also known as PFAS or forever chemicals — that have been emitted from the plant into the air and the Cape Fear River. The contamination has affected thousands of people from Cumberland County to the coast. Many will no longer drink the tap water from their homes without filtration.

“Chemours’ decision to propose this plan when so many still lack safe drinking water due to its reckless handling of toxic chemicals shows where its priorities lie,” Geoff Gisler, a senior attorney for the Southern Environmental Law Center, said in an email.

Chemours is expected to provide more details of its expansion plans at the two public sessions. The first one is set for 5 to 7 p.m. on Sept. 20 in the Bladen Community College auditorium in Dublin. The second is scheduled for the same time the next day at the Leland Cultural Arts Center. 

At least until then, Chemours will remain mum on specific details of its proposed expansion, company spokeswoman Lisa Randall said in an email. 

So people won’t know whether Chemours plans to produce more PFAS at the plant, although production of semiconductors and electronic components typically contain the forever chemicals. People also won’t know how many jobs will be created and the average wage of those jobs, or how Chemours plans to keep surrounding areas safe from pollutants.

Sharon Martin, a spokeswoman for the state Department of Environmental Quality, said Chemours has not submitted applications related to its proposed expansion to the DEQ.

“DEQ remains focused on the immediate need to address the PFAS contamination from Chemours and its impacts to North Carolinians throughout the Cape Fear River basin and the continuing efforts to reduce or eliminate environmental impacts from the facility’s ongoing operations,” Martin said. “DEQ’s priority is protecting our communities and the drinking water sources North Carolinians rely on.

“Chemours must meet all of its obligations to clean up the PFAS contamination impacting thousands of residents in at least eight counties and provide them with alternate water. DEQ will continue to hold Chemours accountable for the cleanup and for preventing future impacts to North Carolinians.  DEQ will continue to use all available authority, including the Consent Order, ongoing actions by the EPA, and advances in the science and understanding of PFAS to do so.”

Dawn Hughes, manager of the Fayetteville Works plant, said in the Chemours’ statement that the informational sessions will give company representatives an opportunity to meet with residents, discuss their plans, gather information and “create a greater understanding of how this investment will positively impact the local economy and North Carolina’s manufacturing industry.”

That statement and Chemours’ expansion plans infuriate leaders of environmental advocacy groups downstream of the plant. Because of PFAS from Chemours, Cumberland, Brunswick and New Hanover counties are spending — or are planning to spend — millions of dollars to provide safe drinking water to their residents.

Studies have shown a link between GenX and other forever chemicals with liver and kidney disease, high cholesterol, low birth weight, several types of cancers and other illnesses. Studies by N.C. State University have found that some types of PFAS in the blood of residents in Cumberland and New Hanover counties far exceed the levels found in the U.S. as a whole.

“Chemours claims they’re good neighbors; we think the neighborly thing to do after contaminating the drinking water for 510,000 and counting would be to shut the plant down; instead they have the audacity, or more accurately, the depravity to try to make even more money off of poisoning us?!,” Dana Sargent, executive director of Cape Fear River Watch, said in an email. “Hughes can save this deceitful commentary for her shareholders; her neighbors are smart enough to know the only thing Chemours cares about is their bottom line.” 

Cape Fear River Watch is urging people to sign up to attend the public sessions.

Cumberland County has earmarked $21 million to provide public water to residents near the plant. The county has filed a lawsuit against Chemours after the company is said to have stopped cooperating with PFAS cleanup negotiations.

County spokesman Brian Haney said the county’s Board of Commissioners has allocated $258,600 in the fiscal 2023 adopted budget to move forward with the first phase of the Gray’s Creek Water Project. That phase would extend water into the Gray’s Creek Water and Sewer District to serve two elementary schools and residents along the route. Haney said the county is seeking additional funding to complete the first phase.

Meanwhile, thousands of residents have joined their own lawsuits against Chemours.

Emily Donovan, co-founder of the advocacy group Clean Cape Fear, said Chemours has not done anything to combat PFAS contamination that is not required of it under the 2019 consent order, “yet they continue to make misleading public statements about how they are acting responsibly.”

“Nope. No more,” Donovan said in an email. “We believe releasing even tiny amounts of PFAS can be deadly over a lifetime. We’ve had enough. Chemours, and their predecessor DuPont, spent 40 years saturating our air, soil, water and food supply. We are done being poisoned by this company. We are going to fight this with everything we’ve got.”

In its statement, Chemours again noted that it has reduced air emissions of PFAS compounds from the plant by more than 99 percent and reduced PFAS emissions into the Cape Fear River by 97 percent.

But millions of gallons of GenX and other PFAS contaminants lie under the plant and some of it continues to seep into the river. Chemours is in the process of building a deep and long barrier wall at the river to contain the contamination.

That’s far from good enough for Beth Markesino, leader of North Carolina Stop GenX in our Water.

“Our communities desperately want these chemicals removed from their water, bodies, and land,” Markesino said. “Allowing Chemours to expand its facility would allow them to further pollute our community. Chemours Fayetteville Works Plant instead should be declared a superfund site, requiring a long-term response to cleaning up their use of hazardous material and contamination.”

Greg Barnes is an investigative reporter for CityView TODAY. He can be reached at gregbarnes401@gmail.com. Have a news tip? Email news@CityViewTODAY.com.

The post Chemours expansion plans infuriate environmentalists appeared first on North Carolina Health News.

By Will Atwater

A thousand residents living in the Cape Fear region have PFAS in their bloodstream, according to the long-awaited results of a blood-sampling study performed by local researchers. 

On Oct. 18, researchers from NC State University announced the results of a multi-year study that involved analyzing blood samples of 1,020 participants across three communities in the Cape Fear Region for GenX. Roughly, half of the participants in the GenX Exposure Study live in the lower Cape Fear region (New Hanover and Brunswick Counties), while the other participants reside in the upper Cape Fear Basin (Fayetteville and Pittsboro), according to the report which was published online and presented via webinar. 

One important distinction among study participants is that Fayetteville participants receive their drinking water from wells, while the other participants rely on municipal water for their water supply. 

These results come even as North Carolina Attorney General Josh Stein has seven pending lawsuits against per – and polyfluoroalkyl substances (PFAS) manufacturers. Six of the lawsuits target aqueous film forming foam (AFFF) manufacturers and one targets the Chemours Fayetteville Works Industrial site which was the source of contamination in the lower Cape Fear. 

The new study findings bolster Stein’s argument that PFAS manufacturers are harming North Carolina citizens. And with action by the EPA Administrator Michael Regan, whose agency established the Strategic Roadmap, an approach to address PFAS contamination, it feels like people who are pushing back against PFAS contamination might be going on the offensive against industry instead of always playing catch-up, as they have for years.

The origin of ‘forever chemicals’

In the last several weeks, PFAS headlines have been a constant fixture in state and national news. 

Since 2017, when GenX, a class of PFAS, were discovered in the Cape Fear River Basin downstream of Chemours Fayetteville Works site, the toxic compounds have been one of the most discussed environmental issues in North Carolina and beyond. 

Starting in the 1940s, PFAS — also referred to as “forever chemicals,” due to their persistence in the environment and the human body — have been used in the manufacturing of oil and water-resistant products, as well as products that resist heat and reduce friction.There are more than 12,000 different PFAS compounds used in products such as non-stick cookware, cosmetics, cleaning products, water-resistant clothing and textiles, and firefighting foam, along with firefighting turnout gear.

What’s more, researchers have found evidence that suggests a link between PFAS exposure and weaker antibody responses against infections in adults and children, elevated cholesterol levels, decreased infant and fetal growth, and kidney cancer in adults.

Some key findings from the study are that while there were GenX compounds found in previous water samples in these communities, there were no GenX compounds present in the blood samples, said Jane Hoppin, NCSU epidemiologist and lead study researcher. GenX is the PFAS that was manufactured most widely at Fayetteville Works in recent years and that has been found in the Cape Fear River.

“The fact that we can’t measure Gen X in people’s bodies today means that we can’t measure it in you today,” Hoppin told NC Health News in 2021. “It doesn’t mean that you haven’t been exposed in the past.”

What Hoppin and her team have been able to determine from all their testing is that GenX doesn’t stick around in human bodies for as long as older chemicals in the same class. But she said that doesn’t mean GenX’s passage through those bodies is benign. Like alcohol, which is ingested and then passes through the body quickly, Hoppin said GenX exposure could lead to health problems over time.

Additionally, PFOS, PFOA, PFHxS and PFNA, also referred to as legacy compounds, “which are found in most people in the U.S.,” according to Hoppin, were present across all samples at a rate higher than the national average.

The report also said the sources of PFAS in the Cape Fear River Basin were from textile and furniture manufacturing, sludge from wastewater treatment plants used as fertilizer, the use of firefighting foam at airports and the Fayetteville Works facility. 

Mounting a case against PFAS

Last month, North Carolina Attorney General Josh Stein filed two new lawsuits against the manufacturers of aqueous film forming foam (AFFF), a fire suppressant that contains PFAS compounds. According to the press release, the companies named in the suits are DuPont, Chemours and 3M. One suit “relates to contamination at the Piedmont-Triad International Airport.” The other suits target “contamination at Marine Corps Base Camp Lejeune and Marine Corps Air Station New River,” according to the press release issued at the time.

Stein’s seven pending PFAS-related lawsuits signal an aggressive stance toward manufacturers who, he says, prioritize profits above all else.

“In our filing with the court, we allege that these companies that made firefighting foam knew well how dangerous it was to our first responders and our natural resources,” he said. “But they continued to sell this product to line their pockets at the expense of our health and our drinking water. It’s wrong and unlawful, so I’m taking them to court and will fight to make sure they clean up the mess they made.”

Stein’s aggressive stance against corporate AFFF manufacturers seems to fall in line with EPA Administrator Michael Regan’s 2021 Strategic Roadmap “to confront PFAS contamination nationwide,” according to the press release.

“For far too long, families across America – especially those in underserved communities – have suffered from PFAS in their water, their air, or in the land their children play on,” Regan said. “This comprehensive, national PFAS strategy will deliver protections to people who are hurting, by advancing bold and concrete actions that address the full lifecycle of these chemicals.”

Stein talks PFAS

Stein said his previous experience suing other industries, such as opioid manufacturers, has informed his approach to the PFAS litigation. 

“Companies knew or should have known that the products they were manufacturing and selling were dangerous, and then engaged in misrepresentations or failing to warn purchasers about the risks,” he said. “They need to be held accountable for what they did.”

He said that the point of lawsuits against opioid manufacturers, for instance, is to make companies pay to clean up the messes they’ve made. 

“Whether it’s pollution, or whether it’s the damage to people suffering with drug addiction, we also want to change the way [the companies] do business, so that it doesn’t happen again,” Stein said. That’s part of his impetus behind suing companies making the firefighting foams, too.

At this point, the original four PFAS cases have been brought into the national multinational district litigation in U.S. District Court before a federal judge. 

“There’s actually going to be an important trial next summer called a bellwether trial,” Stein said. “How that case goes will be very impactful into how my litigation against these manufacturers goes. And then the two most recent cases I just filed — the one in Greensboro and the one at Camp Lejeune — will very likely be pulled into that same multidistrict litigation.”

The first case Stein’s office filed against DuPont and Chemours for discharging GenX into the Cape Fear River is at the North Carolina Supreme Court on a litigation issue. He said that trial is on hold until these issues get resolved, but they were resolved in his office’s favor in a lower court.

Stein’s office worked to negotiate a 2018 consent order between Chemours and the state, where Chemours agreed to stop all discharges and emissions of PFAS, to remediate contamination in the groundwater, and to control future air emissions and reduce them by over 99 percent.

The consent order, which was updated in 2019, also forced the company to provide alternative drinking water to the homes of affected people and also pay a $12 million penalty. 

“The private sector needs to be transparent about what it’s doing and responsible in the decisions it makes in order to minimize the risk to the public,” he said, ”but the public sector needs to put in place clear rules that ensure the health and safety of people.”

Along those lines, the EPA is getting ready to establish standards for GenX and other PFAS in drinking water that will signal to municipal water managers what are permissible levels. 

“I think the federal government can really help us whether it’s setting standards for water and air … or when it comes to clothing and textiles,” he said. “There are agencies out there that, I think, can play an important role setting standards,” he said. 

The post PFAS evidence piling up, putting polluters on notice appeared first on North Carolina Health News.

By Anne Blythe

Few would fault Bill Milner if he decided it was time to slip out of his scrubs and retire from dentistry, then go off and travel the world.

At age 73, he has been tending to teeth in North Carolina for nearly half a century. He has been honored by his peers. In January, the American Dental Association Board of Trustees bestowed upon him the 2023 ADA Humanitarian Award.

Yet if you check in with Milner, he talks excitedly about his vision for expanding the mobile dentistry nonprofit he started 23 years ago.

With portable dental chairs and equipment in vans, teams of dentists, hygienists and assistants from Access Dental Care fan out across a 33-county area from Morehead City to Murphy to offer oral health care to special needs populations.

Some of their patients are immunocompromised. Some have behavioral challenges. Others are older people with mobility challenges who need dentists and hygienists to come to them.

Milner, who is passionate about public health, spent the early part of his career caring for children in clinics he helped set up through the Randolph County public health department and the state health department’s oral health division.

Those experiences led him to see the other side of the age spectrum and how many elderly people, especially those in nursing homes, could use better and more consistent oral health care.

Milner had a bit of an epiphany in the late 1970s while traveling in England, where he saw that dentistry was part of nursing home care. Furthermore, dentists there in private practice made house calls to fit older patients with dentures.

He returned to North Carolina and began to build a business model that would work here. That’s when Access Dental Care, based in Asheboro, started setting up mobile clinics.

Lessons from Great Britain

What started in just 12 facilities has grown to providing care to 150 facilities in 33 counties across the state — from the mountains to the coast.

Access Dental also helps people in their homes.

The idea is that oral health care should not be an afterthought, especially for seniors who often get little dental coverage through Medicare.

A Kaiser Family Foundation issue brief written in 2019 found that 47 percent of Medicare beneficiaries had no dental coverage. Although some Medicare recipients have Advantage Plans with additional coverage, premiums and copayments often are out of financial reach, making dental care unaffordable.

That same study showed that 47 percent of Medicaid beneficiaries did not visit a dentist that year. When broken down by race and ethnicity, the data showed that 68 percent of Black Medicare beneficiaries did not see a dentist that year, and 61 percent of Hispanic beneficiaries were in the same boat.

Bridging coverage gaps

Milner believes that some of those disparities can be bridged by bringing dental services to the people rather than expecting them to get to clinics and care provided in university settings that often can be difficult to navigate.

Last year, the New Hanover County board of commissioners agreed to spend hundreds of thousands of dollars to set up a joint program with Access Dental Care. The target is county residents who are 55 and older and with incomes at or below 200 percent of the federal poverty level — a group that could include as many as 20,000 residents.

Lack of oral health care can have significant consequences for overall health. Some might find it difficult to eat and chew solid foods, creating nutritional problems that can lead to larger troubles. Periodontal disease often is linked to systemic health problems such as heart disease, diabetes, kidney problems and cancer.

“They wanted a mobile program,” Milner said recently. “It has been an incredible experience. Now we are serving folks in the community who have not had a chance to get care before.”

Building a model for others

Programs such as the one set up in New Hanover County show why Milner was selected for the 2023 ADA Humanitarian Award.

“He has spent his 40-plus years in organized dentistry working toward oral health equity, providing care to those most in need,” ADA President George R. Shepley said at the time. “Patients with disabilities, those in nursing homes and even patients with infectious diseases like HIV/AIDS are receiving care that might not always be available otherwise. 

“Dr. Milner and his staff’s dedication is epitomized by the fact they are being proactive about meeting the needs of seniors and those with special health needs, while at the same time inspiring early-career dentists and dental students in North Carolina to follow his lead.”

Inspiring early-career dentists is one of the reasons that Milner has no plans to retire yet.

If given a magic wand, Milner said he would wave it with a vision for the next 10 years that includes setting up more training opportunities through Access Dental Care that bring dental students through rotations in the mobile clinics. Eventually, he would like to see the North Carolina dental schools include training for special needs populations and mobile dentistry.

“I want to establish a specific residency program and give them just a little taste while they are in school,” Milner said.

Wanting to help special needs populations can often bring on a warm and fuzzy rush, Milner said. But then dental students begin to realize some of the difficulties that come with serving such needs.

It can take a special skill set, Milner said, and a unique understanding of what each individual needs just to get them to open their mouth long enough for a cleaning, extraction or other care.

What Milner finds rewarding, though, is that the dental profession and others are talking more about caring for the elderly and special needs populations.

He’s even gotten into the manufacturing of the mobile equipment for dental clinics on wheels like his.

“We’re not out to conquer the world,” Milner said of his team. “All we’re trying to do is care for the good folks of North Carolina.”

The post Taking dental care to the people in need appeared first on North Carolina Health News.

By Will Atwater

On Friday, three large chemical manufacturers agreed to contribute $1.19 billion to a fund to settle lawsuits brought by water utilities across the country that allege that the companies contaminated drinking water supplies with per- and polyfluorinated chemicals, or PFAS.

This announcement comes as lawsuits — filed by state governments, environmental advocacy groups, water utilities and others — accusing Chemours, DuPont and Corteva of poisoning the environment and causing illness among people with long-term exposure to PFAS are piling up.

Seven years after the Wilmington Star-News first published the announcement about the presence of GenX compounds in Cape Fear River deposited there by DuPont spinoff Chemours, the settlement agreement was met with skepticism by many in the environmental community.

“I am extremely concerned about this, as lawyers are going to make a ton of money off the backs of contaminated communities — and giant chemical corporations are getting out easy,” said Dana Sargent, executive director of Cape Fear River Watch, a Wilmington-based environmental advocacy group.

Cape Fear River Watch sued Chemours in 2018 for discharging the chemical GenX into the Cape Fear River. The action led to a consent order among Cape Fear River Watch, Chemours and the North Carolina Department of Environmental Quality.

The order required Chemours, among other things, to develop and execute a PFAS remediation plan for contaminated air, soil and water for the affected lower Cape Fear River Basin communities. 

This area includes New Hanover, Brunswick, Columbus and Pender counties. Like many critics, Sargent believes the pledged funds represent a small fraction of what’s required to address the nationwide problem.

“This settlement comes nowhere near the amount needed to cover the devastation they have caused. It is clear they’re coming out on top; their stocks have gone up as their shareholders see this as their liability issues being behind them,” Sargent said. “I am grateful that, to my knowledge, lower Cape Fear utilities are not participating in this settlement.”

Since the 1940s, PFAS — referred to as “forever chemicals” for their persistence in the environment and the human body — have been used in the manufacturing of oil and water-resistant products, as well as products that resist heat and reduce friction. 

More than 12,000 PFAS compounds are almost ubiquitous in nonstick cookware, cosmetics, cleaning products, dental floss, water-resistant clothing and textiles, and in some firefighting foams and firefighting turnout gear.

While there is no definitive evidence about PFAS posing health risks to humans, there is mounting research that suggests links between extended exposure to forever chemicals and weaker antibody responses against infections in adults and children, elevated cholesterol levels, decreased infant and fetal growth, and kidney and testicular cancer in adults.

Who’s eligible?

Settlement funds are only available to municipal water systems with detectable levels of PFAS and systems required to monitor for PFAS per “EPA monitoring rules or other applicable laws,” according to the news release. 

Water systems not eligible include those managed by state and federal governments and small systems that currently have no PFAS detected and are not required to be monitored. Also, water utilities in the Cape Fear River Basin are ineligible unless they request to opt in, the release says.

In response to the recently announced settlement, the Cape Fear Public Utility Authority, which would be allowed to opt in based on the guidelines outlined in the agreement, posted a response on its website that states, in part:

“Unfortunately, CFPUA has not been provided with the terms of the agreement and we do not know what compensation CFPUA should expect if it were to participate. Our utility’s financial losses and future financial commitments to address our upstream neighbor’s pollution are substantial, and any settlement must substantially address these damages. 

“Litigation will continue until the polluter provides solutions that meet our community needs. CFPUA must consider the best interests of the Authority and the community it serves.”

In 2019, CFPUA, which provides drinking water to more than 200,000 customers in the Wilmington area, started construction on a $43 million granular activated carbon filtration system (now operational) at its Sweeney Water Treatment Plant to remove GenX and other PFAS compounds from the drinking water supply. 

CFPUA anticipates spending “$3.7 million for Fiscal Year 2023 [and] $5 million in subsequent years,” according to the utility’s 2022 annual report. 

The millions of dollars spent by CFPUA and the ongoing financial burden required to maintain the system are examples of why critics argue that the settlement amount falls short of what’s needed.

“Chemours, DuPont and Corteva’s recent $1.19 billion agreement will not cover the installation of reverse osmosis filters to all 101 water providers in North Carolina, let alone the over 150,000 public water systems in the U.S.,” said Beth Kline-Markesino, founder of North Carolina Stop GenX in Our Water, a grassroots advocacy organization based in Wilmington. 

A closer look at the agreement

The following are key points outlined in the agreement, according to the release:

• Chemours will contribute 50 percent (about $592 million), DuPont about $400 million and Corteva about $193 million. The court ordered the money to be deposited in a fund and made available within 10 business days of being approved by the court.

• If the agreement is finalized in 2023, a final ruling will be delivered by the U.S. District Court for the District of South Carolina. Then, those wishing to join the settlement will have a certain amount of time to do so. If not enough water systems join the settlement, the chemical companies can decide to opt out of the agreement. 

• If an agreement can’t be reached with plaintiffs, the chemical companies have vowed to defend themselves in court against pending litigation.

Though many environmental advocates argue that the best way to address the issue of PFAS contamination is for manufacturers to stop producing the chemicals, there was a sliver of optimism coming from the North Carolina Attorney General’s office after first hearing about the settlement agreement. Attorney General Josh Stein has filed several lawsuits against Chemours.

“Our office is pleased to see Chemours/DuPont/Corteva beginning to take some responsibility for their actions,” said Laura Brewer, Stein’s communications director. 

“We look forward to reviewing the details of the proposed settlement. Based on initial reports, this proposed settlement does not address all of the issues in A.G. Stein’s lawsuit,” she said. “A.G. Stein’s case against these companies continues, and he will continue his work to ensure that the water North Carolinians drink is clean and safe.”

The post Critics skeptical as chemical companies agree to $1.19 billion PFAS settlement appeared first on North Carolina Health News.

By Thomas Goldsmith

Enduring threads of North Carolina’s past — such as bygone industries and separate public schools for whites, Blacks and Native Americans — still affect older state residents, as harmful holdovers and even, in some cases, as positive forces.

Interviews with residents of small counties showed that the forces affecting the lives of North Carolina’s 1.8 million residents who are 65 and older often date to decades past.

The interviews were conducted as budget writers at the state General Assembly seemed to ignore calls to boost funding for lower-profile — but vital — agencies such as NC Adult Protective Services. Instead, lawmakers focused on proposals that would cut personal and business income taxes and increase support for private-school vouchers that would cost nearly $500 million annually by 2030. 

Meanwhile, older residents in Robeson County recalled the experience of learning in separate public school systems for white, Black and Native American students. 

“We were not furnished books,” Geraldine Lowry, 78, said of her primary education in schools attended by Lumbee students under the divided county system. 

“They wouldn’t let us have a lot of books, and, when they came, they were the ones that the other schools would throw away,” she said. 

Lowry was talking with members of the Lumbee Elders women’s group that meets regularly in the Pembroke headquarters of North Carolina’s Lumbee tribe, who number about 55,000 people in Hoke, Robeson, Scotland and Cumberland counties. 

“We did the best we could with what we had,” she added. 

Making do

As illustration, Lowry recalled the way Lumbee and Black children learned to play baseball with a rock wrapped in tobacco twine. 

After seeing tribe members save up to help the schools stock books and supplies as she learned, Lowry went to college and enjoyed a long career as a Robeson County teacher. She’s seen her own children and grandchildren head off to colleges that would have been closed to her as a high school senior. 

Lumbee Elders member Earlena Lowery, 80, also graduated from Robeson County’s Normal schools for Lumbee students, then moved on to earn master’s and doctoral degrees — far from home, she said.

“The mentors, the older teachers with experience, their recommendations were: ‘To the West, go to schools in the West,’” she said in August during a telephone follow-up to the Lumbee Elders gathering. 

“Not your East Carolinas and those other schools. No, it was Appalachian, Western Carolina or Peabody [Vanderbilt University’s school of education]. You couldn’t go to those other [North Carolina] colleges because of who you were.” 

Have the Lumbee people who were students of the segregated decades before the 1970s, felt disadvantaged by the experience as the years have worn on? 

Perhaps, but not necessarily, Lowery said. She recalled dedicated teachers, saying that many among her peers have gone on to successful careers in business, education and the ministry. 

“It’s just like today,” she said. “You’ve got barriers, and you’ve got to be strong enough to work through them. There were probably students that, I won’t say were held back, but students who didn’t work through the barriers like some of us do.”

Life without a diploma 

Today, almost a quarter (23.6 percent) of Robeson County adults over the age of 25 lack a high school diploma, compared with the state average of 13.7 percent who did not complete high school. The county also lags when it comes to higher education, with only 12.6 percent of adults over 25 holding bachelor’s degrees, compared with a state rate of 29 percent. 

Mary Locklear, another attendee at the Elders meeting, said only one word, “Proud!” when asked her feelings about growing up as a member of the Lumbee tribe. But her life’s choices were limited, she said, when she left the schools segregated by ethnic background before 10th grade to labor alongside her family on a tenant farm.

“We had to work,” Locklear said. ”We worked on this other man’s farm. It was seven of us, working in tobacco, cotton, cucumbers — you name it — hoeing tobacco and all that good stuff.” 

Another barrier, she said, was her father’s failure to provide for the large family. “I never knew my daddy to work,” Locklear said. “He run the road and [was] drunk all the time. 

“I never seen him cut a piece of wood to keep us young’uns warm nor nothin’. We had to do it.” 

Alcohol misuse continues to be an issue in Robeson County. Between 2009 and 2021, the data show, more than 900 deaths of North Carolina residents in Robeson were listed as  attributable to alcohol, which works out to a per capita rate that is much higher than in larger counties such as Wake, Mecklenburg and New Hanover. In 2021, Robeson County had a alcohol death rate of 105 per 100,000 population. Only two other counties in the state — Jones and Pamlico — had higher rates.

Buffeted by global winds of change

Changes detectable for decades can arise through international trade developments and by decisions of state departments from the Division of Health and Human Services to the Marine Fisheries Commission. 

Robeson and Hertford counties have felt the impact of departing plants and companies that had been mainstays of employment in communities, said E. Frank Stephenson, 83, a Hertford County resident, historian and former Chowan University official. Stephenson has chronicled instances such as the collapse of the herring fisheries that were central to northeastern North Carolina, in part through decisions by the state. 

The state herring trade reached a peak of 20 million pounds in 1969, but it dwindled first because of foreign competition for the bony fish, then because of overfishing and the fisheries commission’s efforts to manage the catch. The community events, extra income and household barrels of salted herring have become endangered species. 

“People depended on herring fishing for food,” Stephenson said. “During the spring when the herring came up here, people would catch them and salt them down. That was to have them just in case during the year you had a bad crop year in a rural area.” 

Another business development that hurt the incomes and community of lower-income residents came with the shutdowns in 1970 of large Hertford County factories devoted to making baskets of gum-tree wood. Stephenson called the basket-making Riverside Manufacturing Company a “lifeblood” for its hundreds of employees. His daughter Caroline Stephenson, 52, runs a local nonprofit and has worked with Frank Stephenson on his books. 

“It really got bigger and up and running in the ’30s and ’40s after the war,” Caroline Stephenson said of Riverside Manufacturing during a joint interview in Murfreesboro. “It enabled a lot of African Americans to basically stop sharecropping and move into town and to become homeowners.

“It created this, I wouldn’t say Black middle class, but it certainly got people off of the farm and away from dire, extreme poverty — which is sharecropping.”

Leaving, only to return

Another way out has involved simply leaving home and extended family, a route chosen by Rosa McMillan, 64, a project analyst who retired from New York City’s famed Memorial Sloan Kettering Cancer Center and recently returned to Hertford County. At the Murfreesboro Nutrition Center, she reminisced about working as a sharecropper from the late ’60s to the early ’70s while living with her grandmother after the deaths of her mother, father and great-grandmother. 

“We grew up on a dirt road,” she said. “I worked in the fields from the time I was eight until I was 16 — tobacco fields, cotton fields, cornfields. We was up in the morning, and we was on the back of somebody’s truck going to their fields.” 

But that wasn’t all it took to keep the household going, as McMillan’s grandmother raised and dealt in pigs, chickens and bootleg whiskey.

“My grandmother sold liquor here in Hertford County. That’s how we was raised,” McMillan said.

People visited the large farmhouse with no air conditioning in summer or heat in the winter every day of the week to have a drink and listen to soul-music performers such as James Brown and Marvin Gaye on a jukebox that was called a piccolo for its small size.

McMillan recalled: “They came and said, ‘Miss Mary, could I have a pint?’ ‘Miss Mary, could I have a shot?’ and they’d get a shot and they’d sit there drinking.” 

McMillan left Hertford County as soon as she could, but she still values what she learned in the big house set back from a dirt road. 

“We went to school in the morning and came home at night,” McMillan said. “It was a hard life, but it was a good life. [My grandmother] told us that if you want something you’re going to have to work for it, because nobody’s gonna give it to you.” 

Older people like McMillan and Berna Stephens, who have enjoyed success after years as working professionals in other states, still deal with remnants of old stresses and biases now that they’ve returned to Hertford County. 

After years working with the U.S. Census Bureau near Baltimore, Maryland, Stephens, 76, serves as a town council member in Murfreesboro. She sometimes deals with screeds from people who move out to avoid paying property taxes within town borders. 

But with a family reunion coming up, she’s been visited by memories of an incident that touched her deeply even though it happened in the ’30s, before she was born. 

Her maternal grandfather had lent money to a church fund, putting up his farm as surety. 

But, according to Stephens’ family lore, fellow parishioners didn’t follow up on their promises to pitch in on loan payments, so her grandfather lost the farm, with no help or understanding from an all-white legal establishment, she said. 

North Carolina had more than 12,000 Black operators of entire farms in 1930 and more than 900 “Indian” operators in the same year, according to the U.S. Department of Agriculture’s Census of Agriculture Historical Archive, Black farmers once operated 25 percent of the state’s farms; that share had dropped to three percent as of 2017. The most recent Census of Agriculture report showed that Black operators in Hertford County owned nine farms. In Robeson, the number was 42. 

There’s no way to calculate how much the loss of each farm cost the displaced owners in family wealth, self-esteem or future prospects. 

“You think you get over things until that subject comes up again and you think about the effect it may have had,” Stephens said. 

A lack of money for transportation, which better-off families could have provided, meant that one of Stephens’ aunts had to bypass an early road to what her family believed would be better prospects.

“She was 16, and that probably kept her from going to college,” she said. “She had a scholarship, but she couldn’t go.”

Correction: Initially a photograph of Frank Stephenson misidentified him as Frank Sullivan.

The post Old North Carolina policies, patterns keep hold on some seniors’ lives appeared first on North Carolina Health News.

By Anne Blythe

As Tropical Storm Ophelia showered the North Carolina Piedmont with a windy drizzle Saturday, dozens of people at High Point University gathered inside the Congdon Hall auditorium for an unusual ceremony.

After several years of planning, campus leaders and guests were ready to break ground for the new Workman School of Dental Medicine. The weather wasn’t cooperating, so they headed indoors, where 10 gleaming shovels on a table awaited them near a shallow dirt-filled pit on the patterned carpet.

“I’m not sure we’ve ever done a groundbreaking in another building,” President Nido Qubein told the crowd before turning the soil. “This is a big step. A really, really big step. You can do a lot of things at a university, but when you start talking about dental medicine, you are talking about something big.”

The indoor groundbreaking was not the only extraordinary part of what was happening at the High Point campus.

The new dental school, scheduled to open to 60 students in the fall of 2024, will be one of only three such academic programs in North Carolina — and the only one at a private institution. UNC Chapel Hill and East Carolina University house the state’s two public dentistry schools. 

The UNC dental school was established in 1950, the first in the state. Sixty-one years later, ECU enrolled its first students in a state-funded dental program created to address a shortage of dentists in rural North Carolina. In the lead-up, there had been much debate among dentists and others about whether the state needed a second dental school, even though at the time, North Carolina had one of the lowest per capita rates of dentists in the nation.

Not just ‘another dental school’

Planning for the third dental school, at High Point University, has been in the works for nearly a decade and a half. The Great Recession sidelined the project for a while, but momentum picked up again several years ago.

Scott de Rossi, founding dean and professor of the High Point dental school, was dean of the UNC dental school when he first was approached about the new project. Initially, he was reticent.

“I had no interest in creating ‘another dental school,'” de Rossi recalled in a phone interview with NC Health News.

While dean of the UNC dental school, de Rossi and some of his younger colleagues tried to “do some innovative things,” he said. But entrenched bureaucracies and the slow-turning wheels of government funding for long-established public university programs often made cutting-edge change difficult, he added.

So when de Rossi found out High Point University was willing to entertain the development of a different kind of academic model, he drafted a business plan.

Then the opportunity to build a program from the ground up lured him away from his deanship at UNC after four years on the job and into uncharted territory in High Point in January 2021.

Trying a new model

One of the drivers of the new model is the development of High Point University satellite dental practices throughout the Triad. 

The city of High Point straddles four counties — Guilford, Randolph, Davidson and Forsyth — all of which are considered dental health professional shortage areas, according to the Rural Health Information Hub.

For several decades, North Carolina has ranked in the bottom 25 across the country for the number of dentists per 10,000 people in the state.

In 2001, according to a report compiled by the Cecil G. Sheps Center for Health Services Research at UNC Chapel Hill, the state was ranked 47th in the country with only 4.2 dentists for every 10,000 residents. There was a bit of improvement by 2013, when North Carolina was 44th in the country with 4.8 dentists per 10,000. The numbers climbed to a ranking of 37 in 2017, and by last year the state was 24th in the country with 5.6 dentists per 10,000 people, slightly lower than the national average of 6.1 for every 10,000 residents.

Most of the dentists who practice in North Carolina, who were not educated at one of the state’s two dental schools, are from Texas, South Carolina, Virginia, New York and the nation’s capital, the Sheps Center report found. Dentists who leave North Carolina head to Virginia, South Carolina, Texas and Florida, the report said.

The state added 586 dentists between 2017 and 2021, but they were hanging their shingles mostly in urban counties. Sixty percent, or 351, went to five counties — Durham, Guilford, Mecklenburg, Pitt and Wake. Another 20 percent, or 119 dentists, were added to the rosters in Brunswick, Moore, New Hanover, Orange and Union counties. Only 116 dentists went to the other 90 counties.

Forty-five percent of the population growth from 2017 to 2021 was in Durham, Guilford, Mecklenburg, Pitt and Wake counties, according to the Sheps Center. Those same counties account for nearly a third of the state’s overall population of almost 10.7 million people.

Care in the community

There are five dental practices in High Point University Health, an LLC owned and operated by the university, according to de Rossi. The goal is to have 30 practices in the network within a 60- to 65-mile radius of High Point, helping to address shortages in some of the areas that don’t have a wealth of oral health care providers for the size of the population.

In addition to serving counties in need of more dentists, the satellite offices will provide opportunities for HPU dental students to get hands-on experience as part of their clinical rotations during their years at school. Additionally, some of the revenue from those businesses will go to the dental school to help offset costs.

A $32 million gift from the Rick and Angie Workman Foundation also will go a long way to helping with building and operational costs.

Rick Workman, founder of Heartland Dental, a network with more than 1,650 offices across the country, was in High Point on Saturday for the groundbreaking. He recalled his first meeting with Qubein and how drawn he was to the didactic philosophy the president had for the dental school he wanted to build.

“Some of us of a certain age have memories of our education in dentistry — and I know it’s come a long, long way since then — but back in the day, it wasn’t very humanistic, and we weren’t really valued as people,” said Workman, a 1980 graduate of the Southern Illinois University dental school. “It seemed like sometimes, maybe it was just for me, that the things you needed to learn was kept a mystery. … I understand it’s supposed to be difficult, but it doesn’t have to have psychological trauma with it.”

Workman talked about training dentists to have community leadership skills, compassion and understanding of the science and technology needed to run a modern dental practice.

“They need to know that while they have to learn the sciences, and they have to learn the technical clinical skills, that to learn that leadership and interpersonal communication, how to lead a team, your staff, how to interact with patients, how to be a valued member of your community, is very important to yourself, very important to the dental profession,” Workman said.

Workman told the crowd gathered for the groundbreaking that he never dreamed coming out of dental school that he would be in the position he is today to be able to contribute to the development of a new dental school.

“When I entered dentistry, it was 98 percent male, 98 percent white,” Workman said. “My class had the highest percentage of women in the United States, 15 percent. That was seven. Two of them were named Luanne.”

“But by the late ’80s, one could begin to see that tuitions were coming up, women were rapidly advancing as a percentage of the population, it was becoming much more diverse,” Workman added. “And you could see, I felt, that how it had always been done — that dentists graduate, put out a shingle, spend 30 to 40 years of their life in one community, in one office — that might not be how it’s going to be for the next 40 years.”

High-tech simulators

The Workman School of Dental Medicine will be housed in a 77,000-square-foot building with labs that have mannequin and haptic-augmented reality simulation, which has been described as something similar to a flight simulator that can replicate the feel of a real tooth and its pulp.

In some of the more established dental schools, students practice their skills on patients, often not hearing from the practitioners overseeing them until after they’re done with a procedure. At some schools, students practice on plastic teeth placed inside a fake mouth, which might not reflect distinctions they encounter when working on someone in the chair.

The haptic simulators, de Rossi said, will give High Point University dental students feedback in real time as they try procedures virtually before testing their skills on people. 

State-of-the-art technology and innovation were common refrains at the groundbreaking ceremony, which happened nearly a month after the Commission on Dental Accreditation gave the Workman school its initial accreditation, a longer than anticipated process because of a pandemic backlog.

Annual tuition and fees will be $85,000 to $89,000, lower than some other private schools and less than the 2021-22 national private tuition average of $92,850. It will be higher than the public school in-state average of $55,000. Although 60 students will be selected from the 1,000-plus applicants for the inaugural year, the school eventually could accept as many as 80 students in each class, according to de Rossi. 

The admissions process is touted as one that won’t require standardized tests or prerequisite courses. There also won’t be application fees, although an Acuity Insights assessment will be necessary, and applicants will have to pay its associated cost.

While the new campus building is going up, the school will be in the former chamber of commerce building, which was purchased by the university in 2022. Construction is scheduled to be completed in 2025.

De Rossi, who received his dental degree from the University of Pennsylvania dental school,  described the weekend ceremony in High Point as “a momentous occasion.”

“We are here for a groundbreaking, but I would like for you to reflect on the word,” de Rossi told the crowd, pointing out that the word is defined in the Cambridge Dictionary as “innovation or innovative and likely to have an effect on how things are done in the future.”

“The Workman School of Dental Medicine will be groundbreaking with its innovative care curriculum, its novel admission processes, its unprecedented oral health networks distributed across the Triad, across the state, delivering care to the citizens of North Carolina, ensuring our students receive pre-eminent clinical and didactic education in authentic environments,” de Rossi said. “We will be relentless in our pursuit of integrating medicine and dentistry to improve health outcomes. And with a state-of-the-art, 77,000-square-foot building, we will discover, develop and deliver better health.”

The post High Point University closer to welcoming students to the only private dental school in North Carolina appeared first on North Carolina Health News.