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Helene: North Carolina death toll 88, 100 estimated missing | North Carolina

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www.thecentersquare.com – By Alan Wooten | The Center Square – 2024-10-10 16:21:00

SUMMARY: Hurricane Helene has caused devastating impacts in North Carolina, resulting in at least 88 deaths and over 100 people unaccounted for. U.S. Rep. Virginia Foxx expressed sadness over the devastation in the Appalachian Mountains, which experienced unprecedented rainfall. The hurricane has claimed 230 lives across six southeastern states, ranking among the deadliest storms in recent history. Reports indicate 628 road closures statewide, complicating search and rescue efforts. North Carolina Governor Roy Cooper has allocated $273 million in aid, amid concerns for residents lacking heat as temperatures drop. Community support from agencies and volunteers has been crucial during the recovery process.

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The post Helene: North Carolina death toll 88, 100 estimated missing | North Carolina appeared first on www.thecentersquare.com

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How civics class could stage a comeback in NC schools

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carolinapublicpress.org – Sarah Michels – 2025-08-20 07:57:00


North Carolina’s civic education faces challenges due to inconsistent, uninspiring curricula, but some teachers like Eric Shock and Nicole Clarke engage students through real-world activities, such as contacting legislators or meeting local officials. Action civics, emphasizing hands-on projects, shows promise in states like Tennessee and Indiana, improving civic knowledge and engagement. However, North Carolina’s legislative support is limited; a pre-registration law for youth voting was repealed, and proposed bills on civics exams and voter registration face political hurdles. Experts advocate for project-based learning and professional development over standardized testing. Community programs like citizen academies and Braver Angels foster civic understanding and respectful political dialogue beyond classrooms.

When Southeast Middle School social studies teacher Eric Shock’s eighth-graders walked into class one day last semester, they noticed a piece of paper on the board. It was a bill being considered by the North Carolina General Assembly that would ban cellphones in schools. 

His students weren’t happy. 

“Of course, all the kids are like, ‘No, we need to have cellphones,’” Shock recalled. 

So, he gave them the email addresses of the representatives behind the proposed legislation. If students wanted to share their opposition to the ban, they could reach out directly. They’d get class credit for civic engagement, and just maybe, have their input considered by state leaders. 

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While the students’ lobbying effort ultimately failed — Gov. Josh Stein signed the cellphone ban into law last month — Shock considered it an educational success. Now, his Rowan County eighth-graders knew how their government worked, and how they could use their voice within it. 

A few years ago in Vance County, Clarke Elementary School social studies teacher Nicole Clarke wanted to spice up what she saw as an unexciting curriculum. 

So one day, she invited Henderson’s mayor, city council and the school district superintendent to the school for Resource Day. Her third graders got the chance to talk to their local leaders, and the now-fifth graders still talk about the experience to this day, she said. 

When North Carolina Association of Educators Vice President Bryan Proffitt taught social studies, he started one class by playing a breakup song. He then asked students to write about a time when they ended some kind of relationship, why they made that choice, how the person responded and what the consequences were. 

Then, he pulled up the Declaration of Independence. After all, it’s just a breakup letter, Proffitt said. 

“What I often hear from students is that civics is interesting when it connects to their lives,” said Wake Forest University School of Medicine researcher Parissa Ballard. “Civics can feel far away, but it actually isn’t. I’ve seen many talented civics teachers who find ways to connect students’ interests and concerns to historical and modern politics.”

Shock, Clarke and Proffitt may count themselves among those teachers. But the problem is, for many of North Carolina’s students, civics class isn’t interesting. It’s not interactive, and it doesn’t effectively motivate them to be informed, engaged citizens. 

It doesn’t have to be this way. With intentional policymaker investment, school support and teacher effort, civic education can be a powerful tool for building the next generation of active citizens. 

Brunswick County voter Amanda Stepka leaves the polls in Shallotte on Election Day, Nov. 5, 2024. Jane Winik Sartwell / Carolina Public Press

This article is the third in Civics Unlearned, a three-part investigative series from Carolina Public Press. This article suggests ways to bolster retention of what’s learned in civics class to promote engagement, both within and beyond North Carolina’s formal education system.

The first article showed that deprioritized and inconsistent civic education in North Carolina classrooms has likely hindered it from effectively spurring civic engagement evenly across the state. The second article explored how conflicting priorities and inconsistent delivery have hamstrung quality civic education.

Looking at other states’ answer sheets for civics class

To learn civics, you have to do it. 

That’s the theory behind action civics, an approach to civics class that has students identify a community issue they care about while teachers guide them toward the information and public officials they need to devise and implement a public policy solution, Ballard said.

Ballard and her team are conducting research into action civics. They hypothesize that action civics will promote civic engagement, like students taking action in their community, having more civic discussions and feeling a greater sense of belonging. 

Voting in Rocky Mount 2018
Shaniquah Ford of Nash County looks over a sample ballot with her sons, Ka’Son Whitaker, 11, and Kalil Whitaker, 9, at the Braswell Library in Rocky Mount before going in to vote on Nov. 7, 2018. Calvin Adkins / Carolina Public Press

In Tennessee, action civics is already producing results. In 2012, the state legislature passed a law requiring students to pass a project-based civic assessment once in grades 4-8 and another time in high school. 

Cleveland Middle School eighth-grade social studies teacher Ed Fickley has been involved with the Tennessee Center for Civic Learning and Engagement for about 20 years. He’s seen the impact of action civics firsthand. 

“The more engaged they are in something, the more hands on they are with something, they’re going to learn and integrate more deeply,” he said. 

In recent years, Fickley’s district piloted a Project Citizen program, which requires students to identify a public policy issue in their community, research potential solutions, find who in government is responsible for that issue and present proposals in front of elected officials. 

The program also includes a media literacy component to teach students how to distinguish between facts and opinions. 

According to Georgetown University research, students who participated in Project Citizen not only demonstrated significantly higher civic knowledge than their peers who took a traditional civics class, but developed a stronger civic disposition — high-schoolers were more inclined to stay informed about government and politics, commit to voting, trust in government and media and feel capable of organizing people to solve a community problem. 

A curriculum used by many schools across the U.S., including Tennessee and Indiana, also resulted in stronger civic habits, according to Georgetown research. 

The We The People curriculum goes over the founding of the United States, and culminates in a simulated legislative hearing over an academic question. For example, one Indiana middle school class asked why the founding fathers thought that freedom of speech was important, and whether they believed there are times where freedom of speech can be limited, said Tim Kalgreen, director of civic education at the Indiana Bar Association. 

In addition to the We the People curriculum, Indiana passed a law in 2021 requiring a standalone middle school civics course, Kalgreen said. 

“It’s catching students younger,” he said. “It’s getting them interested younger. It’s making sure that they get the knowledge younger, which allows their teachers, as they get later into their education, to really build on stronger concepts, or more in depth concepts, more nuanced concepts.” 

When Independent High School junior and student advisory council member April Alonso of Mecklenburg County spoke to North Carolina Superintendent of Public Instruction Mo Green a few months ago, he talked about bringing project-based civics to the state. 

It could be volunteering or public speaking or a voter registration drive — anything that gets students actually engaging in their community, Alonso said. 

Green’s recently released 2025-2030 strategic plan at least pays lip service to this goal. It states a goal of increasing the number of schools implementing “high-quality character, service-learning and civic programs that reinforce durable skills.” 

Legislation on the wrong track? 

Without state-level buy-in from the legislative and executive branches, it’s unlikely that civic education will change much. 

In 2009, North Carolina invested in civic education by passing a law requiring county boards of election to go into schools and offer pre-registration to 16- and 17-year-olds. But it didn’t last. 

In 2013, the pre-registration law was repealed, and when courts ruled that 16-year-olds could pre-register in 2016, the educational piece fell through the cracks. 

Counties with a pre-registration law had a nine percentage point higher youth voter turnout than other counties in 2020, according to a Center for Information & Research on Civic Learning report

And yet, there are no signs of the law making a comeback. 

Rep. Cynthia Ball, D-Wake, said no argument against pre-registration makes sense. She thinks it is political — Republican lawmakers assumed that by promoting youth voter turnout, they would be boosting Democratic numbers. 

However, a Democracy NC analysis found that of about 60,000 young voters eligible to vote in 2012 after pre-registering, a third were Democrats, a third were Republicans and a third were unaffiliated voters. 

Jamie Osteen takes a photo as her son Nolan, a first-time voter, puts his ballot in the scanner to be counted at Upward Elementary School in Henderson County on Election Day. Colby Rabon / Carolina Public Press
Jamie Osteen takes a photo as her son Nolan, a first-time voter, puts his ballot in the scanner to be counted at Upward Elementary School in Henderson County on Election Day in November 2020. Colby Rabon / Carolina Public Press

Still, lawmakers have made similar moves this session. A proposed bill that would have added extra hoops to register voters at voter registration drives lost momentum once research found that voter registration drives actually yielded bipartisan results, Ball said. 

Rumors suggest that a recently removed provision of this session’s election omnibus bill that would ban county boards of election from “encouraging or promoting voter turnout in any election” may make a return, she added. 

That would cut off pre-registration educational efforts at the knees. 

The legislature is also considering a bill that would mandate a civics exam for all public high school students. The questions would be taken from the official naturalization test immigrants must pass to become citizens. 

Testing is a tricky topic. 

UNC Charlotte political science professor Jason Giersch’s research found a correlation between testing and youth voter turnout, but he said that tests are limited in what they can actually measure. 

“It’s not just about knowing the facts, but it’s about adopting behaviors and sort of adopting a mindset of what it means to be a citizen and how to participate in democracy, and it’s really hard to capture that in tests,” he said. 

North Carolina used to have a required end-of-grade civics test, but the legislature removed it in 2011 as part of the backlash against too much standardized testing. Instead, in 2019, the state mandated a high school civics class 

In Morganton, Burke Middle College civics teacher Timothy Barnsback is adamant that it needs to stay that way. With testing, teachers lose flexibility because they feel pressure to teach to the test, he said. 

“It would keep me from teaching my students the concepts that they need to learn in realistic ways, rather than just that rote memorization,” Barnsback said. 

Tim Barnsback talks with his civics students in his classroom at Burke Middle College high school in Morganton. Provided / Tim Kalgreen

Civics class is different from other tested subjects; it’s “a living entity” constantly changing with the world and the news cycle, he added. 

Instead of adding more testing, state lawmakers should invest in professional development for teachers, particularly on navigating civics in a nonpartisan, project-based, meaningful manner, Fickley said. 

In Wentworth, Rockingham Early College High School social studies teacher Valencia Abbott said professional development sessions are where she picks up ideas on how to make her class more interactive and engaging, but there’s not always enough time or money to support it.

More generally, if teachers were paid at a professional level, Abbott believes most would naturally rise to a higher level of professionalism. 

“I think that that is part of it, but that’s not going to be fixed anytime soon,” she said. 

Beyond the class

In late June, hundreds of coastal North Carolinians converged upon the state legislature for days on end. 

They spent their time trying to get the attention of lawmakers who originally supported a bill to ban shrimp trawling within a half mile of the coast; the bill would negatively impact their livelihoods, and they wanted legislators to vote against it. 

Rep. Ball received more than 1,000 emails about the issue. She met with a group of shrimpers who presented her with information supporting their side of the issue. 

“You couldn’t run away from that, no matter what side of the issue you were on,” Ball said. 

Ultimately, their effort seems to have worked. The bill died in the state House. 

The Legislative Building in Raleigh. Sarah Michels / Carolina Public Press

Most bills don’t get the same show of opposition, Ball said. That’s partly due to legislative rules that allow legislation to move and change quickly without much public input, but also because most people just don’t understand how the legislative process works, she said. 

Ball thinks having more training videos on the process or free workshops on the legislature would be helpful. 

Several groups around the state are already trying that, on a local level. They’re called citizen academies, and they involve local governments holding annual programs that show citizens how their government operates behind the scenes, from the budget process to passing ordinances. 

Graduates of the programs act as ambassadors, in a way, said UNC School of Government professor Ricardo Morse, who wrote a citizens academy handbook with best practices. 

“People walk away from those programs with a very positive view of their local government, because they sort of get to look under the hood,” he said. 

Cary 101 is one of North Carolina’s citizen academies. It’s run once a year with about 25 residents, and many participants end up on boards or even city council, said Ryan Eades, who oversees the program. 

Cary also has a newer, weeklong public service academy for high school students to learn much of the same information and skills. Afterwards, several of the students have shown up to council meetings and reached out to their council members about community issues, director of learning and organizational development Allison Hutchins said. 

YMCA Youth & Government also tries to catch students at a younger age. The program allows students to become part of a local delegation that participates in a mock legislative process. 

2024 North Carolina Youth Governor Drew DiMeglio said he found a passion for politics within the program that set him on a path of public service. 

“Before participating in Youth and Government, I felt unequipped and unprepared to be an active and engaged citizen,” he said. “I was motivated by news cycles, and was not inclined to research and dig deep into topics. Since participating, I am a much better equipped citizen.”

Central North Carolinian Janice shares her thoughts on U.S. foreign policy with her peers as part of a debate hosted by Braver Angels, an organization bringing together people from both political aisles to discuss political issues in a respectful, civil manner, at Holy Infant Church in Durham on Aug. 11. Sarah Michels / Carolina Public Press

Braver Angels is another organization working to fill in the gaps of uneven civic education. It brings together people from both sides of the aisle to hang out, discuss political issues in a civil manner and hopefully, build community and trust. 

Lisa Wells, the Democratic leader of the Braver Angels Alliance of the Sandhills, said she started the local group after four years of “bicker central” with her husband, who is a Republican. She attended an online national Braver Angels debate, and thought the model was balanced and respectful. 

Two years later, the Sandhills group is growing. Josh Lowery, the group’s Republican leader, said it’s improved individual relationships between Moore County residents, which ideally will build trust and unity throughout the community. 

“It’s opened up avenues of like, we can have disagreements, but we are still people,” he said. “We can work together and move things forward.” 

On a recent Tuesday evening, a central North Carolina Braver Angels group of about 20 older North Carolinians gathered in a room at Holy Infant Catholic Church in Durham to debate whether the U.S. should focus more on its domestic priorities or global leadership. 

It wasn’t your typical debate, with raised voices and gotcha moments; the moderators were going for a “different vibe” — “the kind of vibe where we listen deeply and respect everyone in the room,” Jim Paisner told participants. 

Anyone could make a speech from either side of the debate, and then the other participants could direct a question to them through the chair, Paisner. At times, it seemed like the debate might get tense; but each time, the tension dissipated with a thoughtful question or moment of shared laughter. 

At the end of two hours, nobody had won. But everyone left understanding each other, and their government, a bit better. 

This article first appeared on Carolina Public Press and is republished here under a Creative Commons Attribution-NoDerivatives 4.0 International License.

North Carolina’s civic education faces challenges: many students find it unengaging and inconsistent. Teachers like Eric Shock and Nicole Clarke use interactive methods, such as contacting legislators or inviting local officials, to connect students with real-world politics. Research supports “action civics,” where students tackle community issues, boosting engagement and civic knowledge, as seen in Tennessee’s Project Citizen. However, North Carolina’s legislative support is limited; past initiatives like youth pre-registration were repealed, and proposed civics exams risk reducing teaching flexibility. Beyond schools, programs like citizen academies and Braver Angels foster civic understanding and respectful political dialogue, aiming to build informed, active citizens.

The post How civics class could stage a comeback in NC schools appeared first on carolinapublicpress.org



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

This article presents a broadly progressive perspective on civic education, highlighting the importance of inclusive, participatory, and project-based learning approaches that encourage youth engagement in democracy. It voices concern about legislative moves perceived as hindering voter participation and civic education, such as the repeal of pre-registration laws and proposed restrictions on voter mobilization efforts, framing these as politically motivated barriers often associated with Republican lawmakers. At the same time, the article promotes bipartisan civic engagement through organizations like Braver Angels and includes voices from both Democratic and Republican leaders in such initiatives. The emphasis on expanding civic education, opposing barriers to youth voting, and the call for better teacher support aligns more closely with center-left values focused on expanding democratic participation and education equity, while maintaining a fairly balanced and inclusive tone.

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Erin: Coastal flooding at high tides forecast in Carolinas, Virginia | North Carolina

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www.thecentersquare.com – By Alan Wooten | The Center Square – (The Center Square – ) 2025-08-20 07:40:00


Hurricane Erin, a Category 2 storm with 100 mph winds, is generating high tide storm surges of 1-3 feet from South Carolina to Virginia, and 2-4 feet on North Carolina’s Outer Banks. The storm, located 645 miles southeast of Cape Hatteras, has a vast wind field with hurricane-force winds extending 90 miles from its center. Rainfall is expected to be light, with most damage from storm surge causing flooding and water over dunes and the key N.C. 12 highway. Mandatory evacuations are in place for parts of the Outer Banks, with emergency declarations in Hyde and Dare counties. The hurricane’s path moves northward, affecting tides and flooding risks along the coast through Thursday and into Maine by Friday. Recent rescues from rip currents have been high, and the storm’s near miss is a relief amid ongoing recovery from deadly Hurricane Helene last year.

(The Center Square) – High tide peak storm surges from Hurricane Erin are forecast from 1 to 3 feet between South Carolina and Virginia, and 2 to 4 feet on the Outer Banks of North Carolina.

Erin at 8 a.m. Wednesday was Category 2 at 100 mph maximum sustained winds and moving 13 mph to the north-northwest, having started to make the turn away from the mainland as expected. The National Hurricane Center, an arm of the National Oceanic and Atmospheric Administration, said the storm’s center was 645 miles south-southeast of Cape Hatteras, and 900 miles west-southwest of Bermuda.

Veteran meteorologists have marveled at the size of the storm.

Hurricane force winds (74 mph or greater) extend outward 90 miles from the center, and tropical storm force winds (39 mph or greater) extend 265 miles from the center. Rain for the Carolina coast is just 1 to 2 inches Wednesday and into Thursday, with damage coming more from storm surge than rain or wind.

The next high tides on the Outer Banks are 6:18 p.m. Wednesday, and Thursday at 6:45 a.m. and 7:10 p.m. Erin has already sent Atlantic Ocean water over dunes and N.C. 12, the famed 148-mile roadway linking peninsulas and islands of the Outer Banks.

Mandatory evacuations have been issued for Ocracoke Island in Hyde County and Hatteras Island in Dare County. Each county has declared an emergency.

Storm surge warnings were in effect from Cape Lookout to Duck; a tropical storm warning was in effect from Beaufort Inlet to the Virginia border inclusive of the Pamlico and Albemarle sounds; and a tropical storm watch was in effect from the North Carolina-Virginia border to Chincoteague, Va.

The Wednesday evening high tide for coastal South Carolina, including Charleston, and southern North Carolina is being closely watched for flooding. Early Thursday evening is the expected time of coastal flooding from the southern Delmarva Peninsula and southern Chesapeake Bay down to eastern North Carolina.

The storm’s projected path through the weekend skirts parallel to moving more away from the Atlantic Seaboard. Thursday’s pass is by the Carolinas and Virginia, and Friday the storm will be moving by Maine.

Coastal rescues from rip currents in North Carolina, according to published reports, have numbered between 75 and 100 over Monday and Tuesday.

As often happens with hurricanes, water began to run over N.C. 12 on Tuesday. The highway begins at U.S. 70 at the community of Sea Level and runs to a point just north of Corolla and south of the Currituck Banks North Carolina National Estuarine Research Reserve. Two ferries, Hatteras Island to Ocracoke Island and Cedar Island to Ocracoke Island, are part of the route.

The storm’s landfall miss of the state is particularly welcome in light of Hurricane Helene. Recovery from that storm is in its 47th week. Helene killed 107 in the state, 236 across seven states in the South, and caused an estimated $60 billion in damage to North Carolina.

The post Erin: Coastal flooding at high tides forecast in Carolinas, Virginia | North Carolina appeared first on www.thecentersquare.com



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Centrist

The article provides a straightforward report on Hurricane Erin, including storm forecasts, evacuation orders, and impact assessments. It strictly focuses on factual information from official sources, such as the National Hurricane Center and local emergency declarations, without expressing opinions or framing the content to favor any particular political ideology. The language is neutral and informative, adhering to objective reporting standards. While it references the impact of a previous storm for context, it does so only to highlight the potential severity of the current situation, without commentary or political framing. Overall, the content reports on the actions of governmental agencies and the meteorological facts without promoting an ideological stance, maintaining a centrist bias through purely factual coverage.

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Buncombe to send letter to NCDHHS flagging concerns about Mission’s quest for Level I trauma center • Asheville Watchdog

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avlwatchdog.org – ANDREW R. JONES – 2025-08-20 07:10:00


Buncombe County commissioners unanimously sent a letter to North Carolina’s Department of Health expressing concerns about Mission Hospital’s application to become a Level I trauma center, despite missing the state’s feedback deadline. The letter, partly based on a critical assessment by Reclaim Healthcare WNC, highlighted issues including staffing shortages, patient safety failures, and high costs linked to HCA-owned hospitals. Since HCA’s 2019 acquisition, Mission has faced staff exodus, lawsuits, and federal sanctions. Mission defends its efforts toward Level I accreditation. The hospital’s application remains undisclosed. NCDHHS and the American College of Surgeons will visit Mission in September to review the application.

Four days after Buncombe County missed a state-imposed deadline to provide feedback about Mission Hospital’s application to become a Level I trauma center, commissioners voted unanimously Tuesday to send a letter detailing an array of concerns to North Carolina’s department of health.

“The decision on this application will have far-reaching consequences for patient safety, access, system reliability, and affordability in western North Carolina,” Board of Commissioners Chair Amanda Edwards wrote in the letter on behalf of the board. “At present, it appears that Mission Hospital has not demonstrated the staffing stability, operational reliability, or patient safety culture required for Level I trauma designation. Our purpose is not to oppose or endorse, but to ensure that OEMS [Office of Emergency Management Services] has all pertinent information to make a well-informed decision.”

The vote at the commission’s biweekly meeting came just hours after Asheville Watchdog reported that the hospital had applied to become a Level I trauma center, which would be the only one of its kind in western North Carolina. In its report, The Watchdog detailed how the North Carolina Department of Health and Human Services had contacted County Manager Avril Pinder on July 15 and given the county until Aug. 15 to share any concerns it had about the hospital’s application, but it had not done so.

Commissioner Drew Ball brought the letter, which he told The Watchdog was drafted after its report, for a vote at Tuesday’s meeting. He told his colleagues that NCDHHS had informed him that it would consider the document despite missing the deadline.

NCDHHS told The Watchdog earlier Tuesday that it was determining whether it would take the letter into consideration.

Responding to the draft letter, Mission Health spokesperson Nancy Lindell issued a statement to The Watchdog.

“Mission Hospital is actively undergoing the process to become an American College of Surgeons (ACS)-verified Level I Trauma Center,” Lindell said. “Our multi-year journey toward this important step reflects our longstanding commitment to ensuring patients in our region have access to the highest level of trauma care – right here at home.”

“The significant resources that HCA Healthcare has invested in our trauma and physician residency programs have allowed Mission Hospital to further strengthen this vital care to pursue this accreditation. We look forward to continuing to provide exceptional care, recruiting additional skilled medical professionals that a Level I trauma center can draw and advancing our role as a trusted regional resource for trauma services.”

Letter draws from Reclaim Healthcare WNC document

In some sections of the letter, the county used identical language from a critical assessment of Mission’s application written by Reclaim Healthcare WNC, a group of doctors, patient advocates and politicians calling for HCA to end its ownership of the Mission Health system. 

Reclaim provided the assessment to Ball on Aug. 10 after he sent an email in mid-July to Democratic state Sen. Julie Mayfield, who heads Reclaim, asking her to share “thoughts or ideas on shared advocacy on behalf of patients and hospital staff.” Ball was vacationing when he received Reclaim’s assessment and did not share it with Pinder until Aug. 18, three days after the state’s deadline.

Since HCA purchased Mission for $1.5 billion in 2019, the hospital has faced an exodus of physicians and nurses and has been sued by the state attorney general. It’s also been placed in immediate jeopardy, the harshest federal sanction a healthcare facility can face, following deficiencies in care in its emergency and oncology departments. In February, a patient died after calling for assistance from an emergency department bathroom for 29 minutes and getting no response as several Mission staffers passed by the door with a call light flashing above.

Edwards, the commission chair, referenced those issues in the letter to NCDHHS.

“Trauma activations necessarily draw upon emergency department staff,” she wrote. “Many of Mission’s most serious problems over the last two years, including severe staffing shortages, excessive patient-to-nurse ratios, and unsafe delays in treatment, have occurred in the ER. Due to a series of incidents occurring between April 2022 and November 2023, the Centers for Medicare & Medicaid Services cited the hospital with ‘immediate jeopardy’ findings after patient deaths were linked to understaffing and delayed care.

‘This raises fundamental doubts’

“Mission has experienced significant turnover among nurses, physicians, and specialists. The North Carolina Attorney General’s lawsuit against HCA alleges that Mission has not consistently operated at even its current Level II designation. This raises fundamental doubts about whether the hospital can meet the higher, more rigorous standards of Level I care, which depend on immediate, coordinated response across the ER and specialty teams.”

The letter also raised concerns about patient costs should Mission receive the Level I designation.

Buncombe County Commissioner Drew Ball brought the letter to a vote Tuesday and told his colleagues that the North Carolina Department of Health and Human Services had told him that it would consider the document despite the county missing its deadline to provide feedback. Earlier in the day, NCDHHS told Asheville Watchdog that it was determining whether it would take the letter into consideration. // Screenshot from Buncombe County Government Facebook page

“Independent studies show that HCA trauma centers charge dramatically higher ‘activation’ and inpatient fees than nonprofit hospitals,” the letter stated. “For example, a 2023 national study found a median trauma activation fee of $9,500; at HCA hospitals, the median was $30,000 – three times higher.” 

The letter stated that once HCA sites receive a trauma designation, the number of cases classified as trauma at each dramatically increases, which leads to much greater costs for patients.

Mission’s application has not been made public, a point that commissioners highlighted in their letter. 

“Because the hospital’s application has not been made available, we cannot evaluate what HCA is committing to do differently; this is an important question that must be answered clearly,” Edwards said in the letter.

The Watchdog requested the application from Mission and the American College of Surgeons, to whom the application was submitted. 

The group declined to provide the application and Mission did not respond to the request. 

Commissioner Jennifer Horton asked Ball during the regular meeting on Tuesday if missing the deadline would have any impact on the county’s ability to have a say in Mission’s application. 

“I did call DHHS and spoke to staff there and let them know that we did not have a lot of opportunities to discuss this publicly as a body and asked if they would honor our comments,” Ball said, adding that NCDHHS said they would.

Commissioners met Aug. 5 for a briefing and regular meeting – three weeks after Pinder received the NCDHHS request for concerns and 10 days before the state’s deadline. 

Trauma care is essentially a subset of emergency care. Trauma patients typically are admitted into a hospital through its emergency department, but they require more specialized, extensive treatment than a typical ER can muster.

As a Level I trauma center, Mission would have to commit to teaching and research in trauma management care for patients who have used multiple drugs. It would also be required to provide mental health screening for patients with traumatic injuries, and handle a minimum of 1,200 trauma cases a year — or at least 240 involving extreme trauma injuries — and at least 200 trauma patients under the age of 15. 

NCDHHS representatives and members of the American College of Surgeons will visit Mission in late September to consider its application.


Asheville Watchdog welcomes thoughtful reader comments on this story, which has been republished on our Facebook page. Please submit your comments there.


Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Andrew R. Jones is a Watchdog investigative reporter. Email arjones@avlwatchdog.org. The Watchdog’s reporting is made possible by donations from the community. To show your support for this vital public service go to avlwatchdog.org/support-our-publication/.

Original article

The post Buncombe to send letter to NCDHHS flagging concerns about Mission’s quest for Level I trauma center • Asheville Watchdog appeared first on avlwatchdog.org



Note: The following A.I. based commentary is not part of the original article, reproduced above, but is offered in the hopes that it will promote greater media literacy and critical thinking, by making any potential bias more visible to the reader –Staff Editor.

Political Bias Rating: Center-Left

This content leans center-left as it focuses on healthcare accountability, patient safety, and criticism of a large healthcare corporation owned by HCA Healthcare. It highlights concerns raised by a group including doctors, patient advocates, and politicians, along with government oversight and regulatory actions. The emphasis on improving public health infrastructure, protecting patient rights, and challenging corporate healthcare practices aligns with center-left priorities without being strongly partisan or ideological.

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