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News & Updates


It is safe to say that there aren’t many things that could have kept the Rural Counts advocacy team from attending The Insider’s Perspectives on Rural Healthcare in North

Carolina event in downtown Raleigh, Wednesday, October 23. Particularly after learning that there would be a panel featuring Senate Leader Phil Berger, Senate Minority Leader Dan Blue, and Dr. Roxie Wells, president of Cape Fear Valley Hoke Healthcare Hospital in Raeford, NC.

In all that we do, our mission remains at the forefront; need a refresher on our mission?  No worries, we’ve got you covered, “The NC Rural Center’s mission is to develop, 

promote, and implement sound economic strategies to improve the quality of life of rural North Carolinians. We serve the state’s 80 rural counties, with a special focus on individuals with low to moderate incomes and communities with limited resources.”  We not only understand the economic benefits that would result from greater access to quality, affordable health care, but also acknowledge the sheer human toll and suffering lack of access has on many of those we work with and for, rural North Carolinians.  

Event attendees were mostly lobbyists, legislators and healthcare system employees.  The atmosphere felt contradictory in the sense that it seemed tense yet eager. Conversations over wine and hors d’oeuvres quickly revealed that many were hoping for some sort of coverage gap announcement before nights end. In part because session has yet to adjourn and H655, the NC Healthcare for Working Families, the bipartisan policy proposal focused on closing the health insurance coverage gap has yet to receive a House floor vote despite passing out of the House Health committee twice. 

Wishful thinking would more accurately describe said anticipation, as there was no such announcement and both legislative leaders remained steadfast in their respective stances on Medicaid expansion. 

Dr. Wells undoubtedly stole the show as her passion for her community and patients was glaringly evident. So much so, at one point she directly addressed both senators, reminding them that although she appreciates the ideological banter often occurring on Jones Street, the need for affordable healthcare and hospital sustainability should be top priority.  Although healthcare is by far not a simple issue, the cornerstone premise is… making sure the sick can receive reasonably priced, valuable treatment, and for hospitals to be able to do so in a compassionate and fiscally responsible manner.

The conversation flowed rather smoothly from topic to topic, in part due to panel moderator, Colin Campbell, editor of The Insider.  Although there are many healthcare issues that could have been covered, the discussion centered around three questions to shape the panelistsexchange; the challenges facing rural health care, S681–the Rural Health Care Stabilization Act, and what was referred to as “the elephant in the room”– Medicaid expansion. Championed by panelist, Senator Berger, S681, (now entitled the Rural Health Care/Local Sales Tax Flexibility/Utility Account) seeks to aid rural hospitals by serving as a bridge loan program of sorts for rural hospitals at risk of closure due to financial shortfalls. 

Senator Berger described the bill as a tool for struggling hospitals to partner with larger facilities, and provide loans to eligible hospitals to hold them over.  The Republican leader admitted the plan isn’t a guaranteed cure. He described it as one of many approaches that are needed versus a magic bullet.  

Senator Blue listened intently but unabashedly shared his thoughts on S681 when, his notion focused on how S681 was written for just one hospital in particular, while the state really needs to be working towards a statewide solution instead of a siloed approach. He also spoke about how insufficient he finds the appropriation amount and that a better solution would be none other than Medicaid expansion. 

Dr. Wells admitted that she too has concerns about S681, and reiterated Senator Blue’s point about the need for a more statewide approach. During the week of October 28, S681 was merged into S537, Licensing & HHS Amends & Rural Health Stabilization, with its fiscal note being added to H200, the 2019 Storm Recovery Act. 

The mention of Medicaid expansion led to a rather interesting exchange between the two legislators. In response to Senator Blue’s suggestion to increase healthcare access, Berger retorted that investing billions of dollars into a broken system is not the viable option and expansion would only lead to current benefactors being hindered from seeing their healthcare providers. 

Deploying the use of an analogy to illustrate his position, Senator Blue spoke of how rural students aren’t penalized because their schools may be operating in the red, nor has it stopped the state from sending money for school improvement projects. Persistent in his stance, Senator Berger remarked as to how one can agree with Senator Blue’s statement and still oppose Medicaid expansion. 

A great event albeit absent of any earthshattering revelations, breaking news or major political paradigm shifts and then a moment in almost divine fashion happened.  As the event began to wind down, Dr. Wells’ closing comments reminded us all as to the heart of the matter and the awesome responsibility that our elected officials carry. “I depend on the General Assembly to help me take care of the populations they represent,” she stated. “I just want to take care of my patients.”

The impact of expanding Medicaid in Hoke County, where Dr. Wells practices medicine, would result in the creation of 78 jobs by 2022 and more than $11 million in county growth from 2020 to 2022. (Source: The Economic and Employment Benefits of Expanding Medicaid in North Carolina: A 2019 Update, 2019)  Furthermore, in addition to providing millions of NC residents with access to quality healthcare, if expansion occurred, NC would see an increase of more than 37,000 new jobs within the next three years.   

Closing the coverage gap is not the golden strategy to address all of our rural health concerns,  but we can’t discount the fact that it would significantly reduce the number of uninsured North Carolinians, which is a critical first step in addressing virtually any other rural health issue. The fact that 37 other states have done it, is not by accident. 



Then & Now: North Carolina’s Rural Broadband Success Story


Now: Access to broadband in rural communities is a conversation often plagued with associations of challenges or deficits, but Monday, October 14, we saw a huge development in the right direction for broadband access, as Governor Cooper signed House Bill 387 into law.  This legislation authorizes a $15 million investment each year for 10 years to maintain the Growing Rural Economies with Access to Technology (GREAT) broadband grant program.  On behalf of rural North Carolina, we are so grateful to the leaders and advocates who made this win happen.

If you’re curious as to how exactly we got here, we have to go back to 2017. Determined to find a solution for increased access to high speed, affordable broadband in rural NC, Senator Harry Brown and Representative Dean Arp developed a plan which was the genesis of the GREAT program, a statewide grant program that incentivizes eligible Internet Service Providers to deploy broadband in unserved areas. During its first year, the Department of Information Technology, the administrator of the GREAT program, received a $10 million nonrecurring appropriation from  the General Assembly, with the maximum amount a grantee can receive being $2 million. As a result of these most recent efforts, the program will receive $15 million annually for 10 consecutive years. The funding, however, is not the only change H387 will bring to the broadband program; initially, the program was only available for tier one counties but with the passage of H387, tier two counties will soon be in the race to increase broadband access in their communities.  

According to DIT’s 2019 Annual Report, 25 ISPs submitted applications, 21 of which were awarded grants. Based off of the awardees’ projected reach, DIT determined that “9,720 households, and 503 businesses, agricultural operations, and community anchor points will have access,” as a result of the deployment.

This critical win for our rural communities and their futures.  While we look forward to seeing what more can be done, let’s take a look at just how far we’ve come. 

Then: The internet has been around since the late 1960s, however broadband, a faster version of the internet, didn’t become widely known and utilized until roughly 1996.So how did the Rural Center get involved with the broadband access fight? In 2016, Rural Counts, the Rural Center’s advocacy program, was created under the leadership of Patrick Woodie, president, and then director of advocacy, John Coggin. Rural Counts was a direct result of their road trip to all 80 rural counties in our state.  From Clay to Currituck counties, broadband consistently came up in every conversation with local leaders and community members. The Rural Center proudly endorsed the creation of the GREAT program and has consistently worked with legislators, partners, and key stakeholders to move various broadband policy proposals through both chambers of the General Assembly.  This Long Session alone, we’ve seen policies aimed at permitting electric cooperatives the capacity to light dark fibers as a means to develop and expand broadband, and we’ve seen a statewide “dig once” policy implemented via executive order. 

When you really stop and think about it, broadband is a lot like rural NC: it is constantly evolving and innovating. At the Rural Center, we understand that although we have seen wonderful strides this year in the rural broadband access movement, there’s still much work to be done. We are committed to supporting efforts that seek to enhance the lives of those who live in rural areas as our ultimate goal is for sustainable, thriving rural communities for generations to come. 



2019 Conference Report Overview


Thursday, June 27, the House and Senate passed the conference report (CR).  A CR is the consolidation of provisions from both the House and Senate budgets into one unified budget. Yet, as many expected, Friday, June 28, Governor Cooper vetoed the CR. We not enter uncertain territory: the General Assembly may try to gather enough votes to override the governor’s veto, they could adjourn without adopting a budget (leaving last year’s budget in place), or they could return to the drawing board to draft a compromise budget.


We will keep you updated about continuing budget negotiations; in the meantime, below you’ll find a comparison of the House, Senate and CR budgets.





Conference Report


  • GREAT Program

$30 million 

($15M / $15M)

$30 million 

($15M / $15M)

$30 million 

($15M / $15M)

  • McDowell Technical Community College WiFi Connectivity Project



$25,000 NR


  • Coverage Gap Closed




  • Loan Repayment Program

$4.5 million 

($3.5M / $1M)

$3.2 million 

($2.1M / $1.1M)

$4.5 million ($3.5M/$1M)

  • Nurse-Family Partnership

$6.9 million 

($3.45M / $3.45M)

$5.6 million 

($3.8M / $1.8M)

$4.5 million ($3.5M/$1M)

  • Community Paramedicine Program


($70k / $70k)


($350k / $350k)



  • NC HealthConnex

$5 million


$5 million


$5 million ($2.5M/$2.5M)

  • Telehealth

$500,000 NR


$500,000 NR

  • Substance Abuse Services 

$10 million ($5M/$5M)

$10 million ($5M/$5M)

$10 million


  • Community Health Grants




  • Certificate of Need (CON) Protected





  • Advanced Teaching Roles Model

$1.5M ($500K/$1.5M)

$5 million 

($2M / $3M)

$5 million ($2M/$3M)

  • NC Career Coaches

$8.4 million 

($4.2M / $4.2M)

$5.6 million ($2.8M/$2.8M)

$9.8 million ($4.5M/$5.3M)

  • Hospitality Workforce Training





  • IT Workforce Training



$19 million


  • Workforce Development Credentialing

$24 million ($12M/$12M)

$19.5 million


$24 million ($12M/$12M)

  • Eastern Triad Workforce Development

$9 million ($4.5M/$4.5M)

$9 million ($4.5M/$4.5M)

$9 million ($4.5M/$4.5M)

Water & Sewer Infrastructure

  • Viable Utility Reserve

$17.5 million



$18 million ($9M/$9M)

  • Clean Water State Revolving Fund

$1.6 million-

 w/ $4.1M federal match


$829,000 NR

(w/ $4.1M federal match)

$1.6 million- w/ $4.1M federal match



  • Bicycle/Pedestrian Match Changes




  • Highway Fund

$4.7 billion 

($2.3B / $2.4B)

$4.7 billion ($2.3B/$2.4B)

$4.7 billion ($2.3B/$2.4B)

  • Highway Trust Fund

$3.24 billion 

($1.59B / $1.65B)

$3.24 billion


$3.24 billion


  • General Maintenance Reserve

$799 million 

($350.8 M / $448.2 M)

$667.3 million


$809.2 million


  • Resurfacing Projects

$1 billion

 ($510.9M / $515.9M)

$1.1 billion


$1.04 billion ($513.1M/$535.7M)

  • Bridge Projects

$547.9 million ($273.9M/$274M)

$547.5M ($273.7M/$273.8M)

$900K ($400K/$500K)


Additional Proposed Investments

– The transportation committee also seeks to create and Emergency Reserve fund, similar to the Rainy Day fund. 


     Senate: $3.5 million in 2019/2020 

     House: Nada 

     Conference Report: N/A


Additional Item 

$210.4 million cumulative allocated to the Savings Reserve fund (also known as the Rainy Day fund) 


     Senate: $210.4 million ($46.9M/$163.5M) 

     House: $258.6 million ($104.6M/$154M)

     Conference Report: $500 million ($40M/$460M)





Tiffany Gladney

Policy & Government Affairs Manager


2019 Senate Budget Overview


Friday, May 31, the Senate passed its version of the budget for the upcoming biennium (July 2019 – June 2021) and the grand total is $24 billion.  Follow the link for our analysis.



House Budget Highlights


House members of the NC General Assembly released their biennium budget Monday night. Out of the 285-page budget, here’s the highlights we found most relevant to the Rural Counts advocacy priorities developed by rural advocates across the state of North Carolina.

We have bolded provisions of particular interest, and given our take on several parts of the budget.


– $15 million recurring for 10 years for the Growing Rural Economies with Access to Technology (GREAT) Broadband Grant Program, the rural broadband grant initiative seeking to incentivize internet service providers to deploy high speed internet to unserved areas in NC. 

Our take: This grant program was the Rural Center’s top priority during the 2018 short session. We are pleased to see the GREAT program institutionalized and given an increase of funding from its $10 million pilot phase. Still, we wish the timeline had been sped up for implementation, with $30 million over the next 5 years rather than $15 over 10. There are also some technical improvements that could be made to the GREAT program, including increasing the minimum speed to 25:3 Mbps and eliminating a Tier 1 restriction on eligible areas.


– $2.1 million in 2019/ 2020 and $1.1 million in 2020/2021 for Rural Health Loan Repayment Program- Physicians and Dentists Specific via Office of Rural Health- *Amendment passed May 1 to add nurse practitioners and midwives*

– $3 million increase in 2019/2020 to The Nurse-Family Partnership and $1.8 million the following year to support first time parents. 

– $200,000 per fiscal year for Community Health Grants via Office of Rural Health

Community Health Grants Program: Rural specific Health centers that provide quality, affordable medical care to underserved communities. Maximum of $150,000 per recipient

– $4.8 million to the Southern Regional Area Health Education Center per year for surgery and family practice residencies in the area it serves.

– $100,000 to DHHS for opioid antagonists

– $75,000 of the antagonists goes to the NC Harm Reduction Coalition for distribution and $25,000 of the antagonists go the law enforcement.

Our take: We applaud the House for showing true leadership on rural health access issues. Programs like loan repayment, Community Health Grants, and AHECs, are vital in recruiting quality providers and offering quality care in rural communities. In order to optimize these investments, the General Assembly should close the health insurance coverage gap. Access is only truly accomplished when people have affordable health insurance to afford the care available in their communities.

Small Business

Our take: While there are numerous budget provisions that could have local or indirect impacts on small business development, we have found no evidence of strategic, long-term investments in cultivating a stronger small business climate in North Carolina. We remain committed to working with the members of the General Assembly to promote wise investments to help our existing businesses and encourage new ones to thrive.


– $11.7 million 2019/2020 and $11.9 million 2020/2021- Highway Fund

– $12 million- to make rural and urban highway improvements.

Statewide funding for rural or small urban highway improvements and related 7 transportation enhancements to public roads and public facilities, industrial access roads, railroad 8 infrastructure, and spot safety projects, including pedestrian walkways that enhance highway 9 safety. Projects funded pursuant to this subsection require prior approval by the Secretary of 10 Transportation.

– $20.9 million 2019/2020, $109.5 million 2020/2021- Department of Transportation Strategic Transportation Initiatives Program (STIP)

– $8.5 million recurring to bicycle and pedestrian improvements- additionally, the proposal allows for the use of state money to draw down federal funding. The state match is limited to municipalities of no more than 50,000 residents. Smaller towns of 25,000 or less could receive a 15 percent state match, and those up to 50,000 could receive a 10 percent match.

– Department of Transportation to conduct Economic Development Study. The purpose of such a study is that it would reveal potential economic development opportunities in rural communities.

Our take: We are thrilled that the budget includes a change in the state match requirements for bicycle and pedestrian projects. It is important for communities to have “skin in the game” on these projects, but the previous match level proved fiscally impossible for many smaller communities. The Rural Center has been working hard to right-size this match, and we applaud legislators for making this adjustment.

Education & Workforce

– $8 million to Community Colleges in 2019/2020 and $11.5 million in 2020/2021, to increase the money for short -term continuing education and workforce development leading to industry credentials.  The funds will be used to reduce the full time equivalency (FTE) disparity between workforce training and curriculum programs.

– Career Coaches funding will increase by $2.8 million/year resulting in a $5.6 million total appropriation

– The Needs Based Public School Capital Building Fund will decrease by $7,547,388 to reflect a decrease in the funds available from the Education Lottery.

– Changes to Advanced Teaching Roles compensation model

Our take: The Rural Center celebrates the General Assembly’s investment in Advanced Teaching Roles. This strategy will help create new career pathways for teachers, allowing them to grow in their teaching skills, develop leadership abilities, and importantly, stay in the classroom. Implementing this model statewide has the potential to attract more teachers to rural areas and keep them in our communities.

Rural Development

– An additional $4 million to The Parks & Recreation Trust Fund yearly, bringing the total appropriation to $20.2 million/year

– $4 million more per year for The Clean Water Management Trust Fund, generating a total appropriation of $18.3 million/year

– Community Development Block Grant Funding (CDBG), $48.3 million total

Neighborhood Revitalization- $10 million

Economic Development- $11 million

Infrastructure- $25.7 million

$100,000 – Town of Rowland (rural) for downtown revitalization.

Our take: Changes in CDBG allocations move funding back to housing, and away from water and sewer infrastructure, where they have been allocated for several years. While we strongly support more investment in rural housing, doing so at the loss of capacity for water and sewer projects, which vastly outnumber the resources we already have, is not the way to do it. If we ultimately allocate more funding to housing, we must find ways to keep water infrastructure funding stable (if not increased, as well).

Water and Sewer Infrastructure

$200,000 – Town of Four Oaks- rural

$500,000- Town of Maysville- rural

$500,000- Town of Midland- suburban

$100,000- Town of Wilson’s Mills- rural

$15 million- City of King- rural

Our take: Our rural water and sewer systems are in dire need of maintenance and renovation, and many are struggling to simply keep open. Any investment in water systems should be celebrated. Still, the current practice of funding worthy projects through legislative earmarks is not good public policy. Funding should be allocated via competitive, transparent processes where the best (and neediest) projects will rise to the top. These processes already exist and are administered by skilled staff. Let’s allow these excellent projects to be funded in better ways.

Agriculture & Natural Resources

– $2 million to NC State University a year in recurring funds to accelerate development of manufacturing biopharmaceuticals and matching grants

– $25,000 per Healthy Foods/Small Retailers via The Department of Agriculture and Consumer Services  to Increase access to healthier food options by reimbursing smaller retailers for offering healthier options

Disaster Relief

– $2.5 million- State Search and Rescue

– $1 million- Stream debris removal

-$ 10 million for housing, specifically homes ineligible for FEMA relief

– $13 million dollars to provide additional funding for gap assistance payments- working around the edges of FEMA funding

– $2 million for flood insurance pilot program

– $2 million for volunteer labor grants

– $26 million- Golden Leaf Foundation


Other Items of Interest

– $20 million- The Housing Finance Agency to assist the development of multifamily affordable housing through the Workforce Housing Loan Program.

– The budget extends the Historic Rehabilitation Tax Credit through January 2024.

Where do we go from here?

The House is currently moving the budget through the legislative process, and after a final vote by the House, this budget will be sent to the Senate.

Then, the Senate will create its own budget (not necessarily using the House version as a model). Once they pass their separate budget, a committee will be formed with House and Senate members to reconcile the two budgets.

That means that even though this is only the first of several “drafts” of the budget, it’s important for the provisions we like to make it through the House budget, where they can be considered by the conference committee from both chambers.

We encourage you to contact your House members about provisions you want to see (or don’t). Your voice matters in making sure the State of North Carolina invests in rural economic development!


2019 NRHA Recap


So I just returned from a four-day-long trip to the nation’s Capital where I had the privilege to participate in the National Rural Health Association’s annual advocacy event, Rural Health Policy Institute. Not only was I in DC while it was unseasonably warm but also happened to be there during President Trump’s State of the Union address.  But back to the matter at hand, let me tell you about my week.

Day one of the institute was chocked-full with political and public health heavy hitters.  Before 10 A.M. I had already heard remarks from Senator Doug Jones, D-AL, and Senator Tim Kaine, D-VA.  Yes, the-almost-VP-of-the-US Tim Kaine and yes, the Doug Jones from the hotly contested 2017 congressional race in Alabama against Roy Moore.

The issue on everybody’s minds and in most of the speakers’ talking points was, yep, you guessed it, Medicaid expansion. While speaking of a Medicaid expansion bill he plans to introduce next week with none other than 2020 presidential candidate, Senator Elizabeth Warren,  Jones stated, “ I am sick to death with excuses not to expand Medicaid, we have the data now [from other states] to show we can indeed afford expansion.”

Kaine presented a rather unconventional approach to the Medicaid expansion conversation that he aptly titled, Medicare X.  His concept would add a public insurance option for all working Americans on the Affordable Care Act (ACA) exchange.

Senator Tina Smith is also focused on quality, affordable healthcare access for rural Americans, specifically moms. She’s attempting to resurrect her bill with Senator Heidi Heitkamp, Rural Moms Act; policy intended to in part increase maternal and obstetrics services to expectant rural moms via telehealth.

Later in the day, Health and Human Services Secretary, Alex Azar outlined the three goals in his department as it pertains to rural; affordable care, accessible care and high quality care. He went on to say that these tasks can be achieved by focusing on sustainability, innovation and flexibility.

Although the day was jam packed with leaders and pioneers in the fight for equitable care in rural areas, the day winded down with Surgeon General Jerome Adams, who reassured the audience that his office is committed to ensuring all rural Americans have access to healthcare.

Day two was the day, Capitol Hill day! Our teams were determined based off of the state we represented. I was paired with two presidents from rural critical care hospitals, and various leaders of NC Rural Center partner organizations.  No pressure, right? We had various meetings throughout the day, with staffers from Senators Thom Tillis and Richard Burr’s offices as well as Congresswoman Alma Adams and Representative G.K. Butterfield. In said meetings, we discussed the need for telehealth, health innovation, broadband, and closing the coverage gap in rural areas and well as the dire straits many of our communities are in due to hospital closures.

Closing Day

The conference closed out with a focus on health disparities, chronic diseases staggeringly prevalent in rural locales and effective tactics for recruiting healthcare providers.  Esteemed speakers included: Dr. George Sigounas, East Carolina University Professor and HRSA Administrator, Cara James from the Office of Minority Health, CMS and Grace and Ted Koppel.

In Summation

My recent trip to DC was exciting, eventful and filled me with optimism. I’ll admit it, constantly hearing about the disparate trials facing rural America can get overwhelming but I left our Capital feeling optimistic as my legislative visits affirm that help, collaboration, and resources are on the way.  


As the Session Turns

Remember in October when the North Carolina General Assembly (NCGA) passed a historic appropriation totaling nearly $800 million in response to Hurricane Florence? And remember how legislators designated half of the appropriation then but put the rest in reserves so they could strategically assign allocations in November? Well, they kept their word.

Not only did the month of November conclude with unseasonably warm weather but also the passage of Senate Bill (SB) 823, the Hurricane Florence/Supplemental Act.  Or as I like to call it, the sequel to Senate Bill 2.

SB 823 is relatively simple compared to SB 2. The largest component of the nearly $300 million bill is $240 million for farmers whose land, crops and businesses were damaged.

What is the other $60 million going towards? I’ve pulled out some details for you below:

  • $10 million to help commercial fishermen and shellfish producers
  • $5 million for small business loans
  • $18.5 million to draw down federal matches
  • $1 million to refurbish courthouses that sustained damage
  • $1.5 million to repair and renovate school cafeterias, labs, etc.

To read SB 823 in its entirety, click here.

NCGA members also included language in the bill that would require Governor Cooper and his staff to submit a plan to them by March 1 as to how they can replenish the “Rainy Day” fund, which was the source of the majority of the disaster relief funds.  

Speaking of Governor Cooper, he has been hard at work lobbying DC for $8.8 billion in federal aid to help with North Carolina recovery efforts.

With a portion of the appropriations yet to still be assigned, sounds like a trilogy is in the making. Stay tuned for details as the special session advances.

2018 Midterm Recap

It’s two days after the 2018 midterm election and I’m sure we’re all still on the struggle bus from staying up late to watch the results come in. But there’s a lot to talk about, let’s just jump right in.  North Carolina showed up to the polls in historic numbers, more than we have for a nonpresidential race in nearly 30 years.

After eight years in solid control of the NC General Assembly (NCGA), the Republicans lost their supermajority in both the House and the Senate. This means that any vetoes from Governor Roy Cooper will not be able to be overturned by the legislature along partisan lines. However, the NCGA will remain widely red, with 66 republicans and 54 democrats in the house and 29 republicans and 21 democrats in the senate.

Concerning the hotly contested amendments, a majority of North Carolinians voted in favor of expanding crime victims’ rights, the right to hunt and fish, voter ID requirements and reducing the maximum state income tax to seven percent. In contrast, amendments to create a judicial vacancy commission and the allowance of legislative appointments to elections boards were voted down by 66.9% and 61.6% of North Carolina citizens.

What does this mean for rural North Carolina? There will be 15 new legislators when the legislature convenes in January. We will be working hard to help those new legislators – and all our leaders – understand both the challenges rural NC faces and some of the best ideas out there to move our whole state forward.

To learn more about the NC midterm election, check out this great breakdown from WTVD or visit the State Board of Elections site and explore the results both locally and federally. With that being said, we’ve got a lot of work to do in the 2019 long session. But for the rest of the week, we rest.

Here’s what you missed!

Historic Response for a Historic Crisis: The General Assembly’s Disaster Relief Fund

Monday, October 15, members of the North Carolina General Assembly (NCGA) reconvened for a special session to finalize disaster relief legislation aimed at helping communities rebuild and restore themselves in the aftermath of the destruction caused by Hurricane Florence.

This was the second time in less than a month that legislators gathered to Raleigh to address the many needs of their citizens who were affected by Florence. The first session focused primarily on compensation for school employees and how to best handle the missed school days for K-12 students. The total appropriation of that first session was $56 million.

I walked into the Legislative Building last Monday for the latest session filled with optimism, a priority list of disaster relief policies for rural North Carolina developed by the Rural Center and shared with both the General Assembly and the Governor’s office, and, of course, snacks (sadly, to my consternation, not enough snacks). As the day quickly turned to night, due to meeting delays and various questions from the committee, the resulting Senate Bill 2 was passed and has since passed both House and Senate floors and signed into law by Governor Cooper.

Some notable moments from the meeting included the State Budget Director, Charlie Perusse, stating that the economic impact of Florence was $12.7 billion. $12.7 billion. Yep, let that sink in… But also remember that even the $800 million appropriation from the GA won’t completely address the various needs of communities from across North Carolina’s declared disaster areas.

Senator Tommy Tucker also posed a question about the issue of Matthew funding and how much of it still hasn’t been dispensed. Representative John Bell clarified that due to the guidelines of Community Development Block Grant-Disaster Recovery (CDBG-DR) funding, monies assigned for Matthew recovery cannot be used for Florence relief as they come from different funding sources.

Okay, so let’s tackle MAJOR legislative takeaways:

  1. Because of the due diligence of the NCGA’s leadership, this appropriation bill will be funded through three sources, the “rainy day” reserve fund which had amassed $2 billion, $65 million from the state’s Highway Fund, and $25 million from the lottery. This is important to mention because it means the NCGA’s disaster relief response won’t result in any budgetary interruptions or cuts to current state programs/services nor will North Carolinians see any tax increases.
  2. The package totaled $800 million, and the first $400 million will be dispersed immediately. Once the legislature reconvenes in November, they will determine how to best spend the remaining monies.

Alright, alright, I know what you’re thinking, “What EXACTLY is in this bill that is plastered all over local news?” I realize that most of you are not policy managers, so legislation might not be near the top of your reading list. But don’t you worry, this policy manager has got you covered. 

  • $5 million towards mental health
  • $500,000 to NC Hospital Foundation to directly aid rural hospitals
  • $20 million for local government infrastructure
  • $5 million for small business recovery loans
  • $50 million for agricultural recovery
  • $23 million for disaster relief housing

Additional Highlights from

  • $65 million to draw down federal disaster recovery dollars that will go to victims of the storm, plus another $23 million for a homeowner repair and rehabilitation fund
  • $10 million to help develop new affordable housing
  • $65 million to draw down federal transportation funding
  • $2 million for mosquito spraying programs
  • $20 million to help local governments make repairs and replace vehicles or other equipment

As the new policy manager for the NC Rural Center, October 15 was the first of many long nights for me at the NCGA and as strange as it may seem, I found it exhilarating. I look forward to making real change for those at the core of what we do here at the Rural Center. Stay tuned, folks! I’m sure there’s way more to come.

Short Session in Short

The General Assembly convened in May (May 16) with a focus on revising the state budget for the upcoming state fiscal year (July 1, 2018 to June 30, 2019). The budget the legislature enacted was vetoed by Governor Cooper, but his veto was overridden. The General Assembly also enacted legislation to make multiple technical corrections to the budget bill and those corrections became law without the Governor’s signature in the final week before the legislature adjourned on June 29. The legislators are scheduled to return November 27, although the agenda for that session has not yet been established.

Budget Overview


The budget creates a new Growing Rural Economies with Access to Technology (GREAT) program to provide $10 million in grants for the development of broadband infrastructure in rural areas. Preference is to be accorded to economic tier one areas and the emphasis is to be placed on serving unserved and underserved areas. Communities will need to partner with private providers, and a match is required, although it is reduced for economically distressed areas.

We applaud the NC General Assembly, and in particular Senator Harry Brown and Representative Dean Arp, for championing this approach to expanding rural broadband infrastructure.

This type of grant program has been one of the top advocacy priorities for the Rural Center since the launch of our Rural Counts advocacy program. In fact, the only dollar amount cited in our original platform was $10 million for just this type of program. That suggestion was for a $10 million recurring annual allocation, but we believe that this initial funding will help the state test the model, make adjustments for maximum effectiveness, and prepare this pilot program to be scaled and institutionalized.


UNC Rockingham Health Care is slated to receive $500,000 to match funding for a primary care rural advancement program.

An appropriation of $4.8 million is provided for surgery and family practice residencies and facility improvements at the Southern Regional Area Health Education Center.

Language in the budget bill directs the Department of Health and Human Services to seek permission to set Medicaid coverage for family nurse practitioners to provide home visits for pregnant women and families with young children.

First responders in Anson, Moore, Richmond, and Scotland counties will be able to use $10,000 per county to purchase naloxone. Grants of $10,000, each, will go to sheriff’s departments in Ashe, Brunswick, Cleveland, Columbus, Rockingham, Rutherford, and Swain counties to fight opioid abuse.

Vaya Health will be granted $1.4 million to help construct a facility-based mental health crisis center in Wilkes County.

Appropriates $4 million to pay for inpatient behavioral health beds in Harnett County.

NC State’s Innovation in Manufacturing Biopharmaceuticals will add $2 million to draw down federal funding targeted to accelerating development of products.

Emergency Response/Disaster Relief

The budget includes a number of actions and appropriations related to the state’s continuing response to disasters and also creates a reserve to address future events. The legislature directed dollars to these items:

  • $14.5 million will be available to match federal funds for future disasters
  • $3.7 million will be used for landslide mapping
  • $250,000 goes to NC 2-1-1
  • $2.83 million will be used for flood warning and dam assessment
  • $2.3 million is directed to search and rescue (includes $100,000 specifically for equipment and training)
  • $700,000 will aid the Forest Service’s emergency response
  • $10 million goes to Golden LEAF for infrastructure grants
  • $24.99 million is for housing-related actions (such as elevation, mitigation, acquisition, relocation)
  • $700,000 is provided to aid Princeville and Fair Bluff in using and managing disaster recovery funding            

Rural Small Business / Downtown Development

Of the 46 grants totaling $3,084,100 targeted for downtown revitalization, $2,493,000 will go to 32 rural communities.

There are 12 additional state-assisted community development grants totaling $1.024 million.

The majority of those grants (10) will go to rural towns and counties providing a total of $744,000 to aid their activities.

Community facilities will receive separate funding with 15 local governments receiving grants that total $1,324,500. Of those grants, 12 will go to rural communities and provide $959,000.

EMS and volunteer fire departments that serve rural areas also received funding. A total of $185,000 was appropriated for EMS grants for Haywood, Jackson, and Rockingham counties, plus Lake Waccamaw.

Fire departments in 34 communities received grants that were provided by $1,125,807 in the state budget. The majority of the grants were small and went to rural communities.

The One NC Small Business Fund received a $1 million appropriation.

The Carolina Small Business Development Fund received a $2.5 million appropriation



State matching funds were provided for the Clean Water and Drinking Water state revolving loan funds. Both loan funds received additional funding to draw down additional federal dollars.

An additional $1 million was provided to draw down an extra $5 million in federal funding for the Clean Water State Revolving Fund. Plus, an additional $2.7 million provided to the Drinking Water State Revolving Fund will permit the state to add $14 million in additional federal funds. These funds provide loans for local governments to construct sewer and water infrastructure.

Additional infrastructure investments were provided through eight grants to specific systems. The grants totaled $2.327 million, and six of the grants, worth $2.235 million were designated for rural systems.

Economic Development

The Job Development Investment Grant (JDIG) program will have several additional provisions that may assist large economic development projects. The program will have $60.9 million available.

Funding for the other major economic development tools remains available – One NC Fund is expected to need $6.8 million and JMAC (Job Maintenance and Capital Development) is expected to require $7.1 million.

Two changes were made to the calculation of economic development tiers. The budget bills removed the exemption for small counties and phase-out of designation for counties that no longer qualify as tier one. (The small county adjustment automatically made any county with fewer than 12,000 residents a tier 1 county and any county with fewer than 50,000 citizens could not rank higher than tier 2. In addition, any county that had been a tier 1 county would automatically remain a tier 1 county for another year, even if the factors would have moved it to tier 2.)

The Department of Commerce also has been directed to examine the county development factors used for the tier system, and aid counties in improving their performance in areas in which the county lags behind the state performance values.


The Agricultural Development and Farmland Preservation Trust Fund received $14.7 million.

Carteret Community College will receive $75,000 to create the Shellfish Aquaculture Demonstration Center.

The Healthy Foods Small Retailer program received $250,000 funding for the second year of operations. This program increases the availability of fresh agricultural products in food deserts.


Public school teachers will receive a pay increase that averages 6.5%. Principals are to receive an increase that averages 6.9%. Teachers with 25 or more years of experience will get an additional $70/month.

The budget increases the percentage of lottery profits going to school capital projects. (The budget bill will increase the percentage that is devoted to school construction from the current 16.9% in effect this year to 40% by the 2028-2029 fiscal year.) This change will increase the Needs-Based Public School Capital Fund from $30 million this year to $117.3 million next year. The amount for the upcoming year includes $42.3 million that is a direct appropriation in this year’s budget. Administered by the Department of Public Instruction, preference for use of the money in the Needs-Based Public School Capital Fund is directed to counties in the economic development Tier 1, to counties with greater need and less ability to finance their needs, and to counties with high debt to tax revenue ratio. (All the tier 1 counties are rural.)

Funds for the UNC system operations increase by 1.9%. The university system also will receive $20 million to provide pay increases, but those dollars do not have to be used for across-the-board raises.

Community colleges operating funds increase 3.8%, including about $15 million for short-term workforce training. Community colleges also will receive $1.8 million (one-time funds) to offset declines in enrollment related to Hurricane Matthew. The budget includes $24 million for pay raises for personnel, but those dollars do not have to be used for across-the-board raises.

The budget expands the tuition reimbursement program for teacher assistants to 19 counties (18 of which are rural). Rural schools also will receive a significant portion of the $9.8 million provided in grants to schools and school programs. Among the grantees are school programs in Avery, Burke, Cherokee, Clay, Columbus, Edgecombe, Franklin, Graham, Halifax, Harnett, Johnston, Lee, Robeson, Swain, Transylvania, and Wayne.

Specialized community college programs will receive $14.9 million in the coming year. Community colleges in Carteret, Johnston, Richmond, Surry, Wilkes, and Yancey counties are among the recipients for these funds.

Other Budget Provisions of Interest

Raises for state employees will be allotted at 2% for most non-education (not teachers or college) employees. Corrections employees will get an average increase of 4%, and state troopers will be awarded an 8% increase.

State retirees and retired teachers are slated to receive a 1% bonus in the fall, but there is not COLA for state or local retirees.


Beyond the Budget

Very few public bills moved through this session, which truly was a “short session” of the legislature. Among the bills that would advance the Rural Counts priorities, two pieces of legislation were ratified.

  • Improving Rural Health (H 998) is a multi-part bill that seeks to improve access to medical and dental care in rural areas. The bill directs the Department of Health and Human Services (DHHS) to study incentives for medical education in rural areas and assist rural hospitals in becoming designated as teaching hospitals. It directs the Office of Rural Health to ensure the loan repayment program is targeted to benefit health care providers in rural areas in order to recruit and retain providers. Rural Health also is to identify the need for dentists in rural areas and improve access to dentists in rural areas.
  • Heroin and Opioid Prevention and Enforcement (HOPE) Act (S 616) amends laws related to controlled substances and expresses the legislature’s intention to appropriate funds for the 2019-2020 fiscal year for community-based substance use disorder treatment and recovery. The bill further states the General Assembly intends to provide funding for opioid antagonists for law enforcement and for Medicine Drop. As part of the bill, the Office of Rural Health is directed to oversee establishing a program for telepsychiatry.

Build NC Bond

In addition to those bills, the General Assembly passed the Build NC Bond Act of 2018. This act authorizes $3 billion in bonds for highways. About half of the funds are to aid projects that are Division Needs within the Strategic Transportation Investments category. The remainder of the funds must be used for Regional Impact Projects. The bonds will be repaid from the Highway Trust Fund and no more than $300 million in the bonds may be issued in any year. The bonds may not be used for non-highway projects or toll roads. Although specific projects have not been designated to receive the bond funds, the availability of money is expected to advance projects to aid rural areas prior to the original scheduled construction time.

Constitutional Amendments

In the final weeks of the session, the General Assembly adopted six constitutional amendments that will be on the ballot in November. The amendments propose to:

  • Provide that the maximum tax rate on incomes cannot exceed 7.0% (S 75) (the current constitutional limit is 10%)
  • Protect the right to hunt, fish, and harvest wildlife (S 677)
  • Require photo identification to vote (H 1092)
  • Provide a nonpartisan judicial merit commission to nominate and recommend nominees to fill judicial vacancies (S 814)
  • Establish a bipartisan Board of Ethics and Elections Enforcement (H 913)
  • Provide better protections and safeguards to victims of crime (H 551)

Two of these amendments – the nonpartisan judicial merit commission and the bipartisan Board of Ethics and Election Enforcement – were recently blocked by a panel of Superior Court judges. A special session of the General Assembly may be called to clarify the language of these amendments to meet the demands of that panel. Additional details about all of these proposed amendments may be better defined when the legislature re-convenes in late November, after the vote to decide which ones are enacted.