This summer, 5 million tourists flock to North Carolina’s Outer Banks, home to 38,000 year-round residents. However, healthcare access is critically limited. A single 21-bed hospital in Nags Head lacks resources, often requiring helicopter evacuations. Remote islands like Ocracoke rely on long, weather-dependent ferry rides for emergency care, causing delays of up to six hours for EMS response. Seasonal population spikes strain services further, especially with many retirees who have chronic conditions. Staffing shortages, high housing costs, and funding cuts exacerbate mental health and substance abuse issues. Locals face barriers to consistent care and long waits for mental health services.
by Jane Winik Sartwell, Carolina Public Press May 19, 2025
This summer, 5 million tourists will descend on 200 miles of remote North Carolina coastline. The Outer Banks are idyllic — and popular. But for both those visitors and the area’s 38,000 year-round residents, the vacation paradise has one serious problem: health care access.
Dare County Emergency Management Services evacuates about one person a day by helicopter. In the summer, that number can reach four or five.
Outer Banks Health Hospital in Nags Head, with its 21 beds, is the region’s lone hospital, and its capabilities and equipment are limited. The hospital evacuates another 15 to 30 people per month.
On the island of Ocracoke in nearby Hyde County, for example, a ride in a helicopter or ferry is required to reach any kind of specialty, intensive or emergency care. Travel time to the mainland in a ferry can reach three hours, and that’s if weather permits.
Some parts of the Outer Banks are more well-connected, but even there, travel times, and staffing shortages keep people from getting the care they need.
In an emergency, these limitations can result in life-threatening crises. It can take up to six hours for EMS services to respond to a call.
“We’re a rural area that deals with nonrural problems because of the amount of visitors we have,” Dare County EMS chief Jennie Collins told Carolina Public Press. “The population swells from 38,000 to 300,000 in the summer. Everyone that’s coming on vacation brings their problems with them.”
Tropical weather systems and storm surges create a further threat. The region’s singular artery, Highway 12, can flood, leaving residents completely cut off. Traveling over bridges in high winds poses its own dangers. And for a number of populated islands like Ocracoke, no road connects them to the rest of the world.
In the event of a storm surge, Hatteras residents rely on emergency ferries to transport them to beaches farther north, Roanoke Island or to the mainland.
The last time that happened was nearly 10 years ago, noted Sheila Davies, director of Dare County Health Department. But Atlantic hurricanes are getting more and more severe, due in part to warming ocean temperatures.
The area is popular with retirees, many of whom have cardiovascular diseases, lung cancer or other conditions that can cause moments of acute emergency.
Medical calls from people over 50 are the most common form of emergency calls to Dare County EMS, said Collins.
“A lot of times, someone’s doctor back home will say, ‘you need to go on vacation and rest and relax,’” Collins said. “So those people will come to the Outer Banks. And then they want to go for a walk on the beach. Well, that’s very much like a stress test.” And if it doesn’t go well, help is rarely at hand.
Qualified medical professionals don’t tend to move to the Outer Banks. The seasonal economy makes year-round practice financially difficult. The geographic isolation stunts career growth. Housing costs have skyrocketed due to vacation rentals, making it nearly impossible for physicians and nurses to afford living where they would practice.
For locals, this means that treating chronic conditions like diabetes and hypertension is rife with challenges. Dentists as well are few and far between.
The Outer Banks is defined in different ways, but the heart of the island system spans four counties: Currituck, Dare, Hyde and Carteret. Additional island communities farther south along the coast are less isolated. The health department of each plays a key role for folks living on or visiting the Outer Banks. They coordinate emergency responses, collect data on what services are most urgently needed and treat the uninsured.
But under the administration of President DonaldTrump, $230 million in health funding for North Carolina is gone. One of the programs most dramatically gutted dealt with behavioral health for vulnerable populations. That funding cut is felt sorely on the local level.
“Services to Ocracoke are limited, mainly based on manpower and geography,” Gibbs said. “In fact, these services to the mainland are limited now based on manpower and funding.”
And what’s more, Outer Banks locals are plagued with rising instances of mental health problems and substance abuse.
“There is a certain amount of anxiety here all the time,” said Kathy Cooper, of the Outer Banks chapter of the National Alliance on Mental Illness. “Lives depend on how the tourist season goes. The rest of the year depends on May through September. Can they earn enough money this summer to get us through the winter?”
For the region’s youth, the situation can be dire.
“For kids growing up here, the only thing they want to do is get the hell off this rock,” Cooper continued. “There’s nothing here for youth. If you don’t surf or fish, you have a problem. And that problem usually ends up being substance abuse.”
On Ocracoke, alcoholism and substance abuse are of grave concern to the locals, Hyde County health director Luana Gibbs told CPP.
The hospital in Nags Head, Outer Banks Health, has no mental health beds. If someone is sent to the hospital under involuntary commitment, they have to find an open bed elsewhere in the state. And that could be as far as Asheville.
This gloom and anxiety factor disproportionately affects those working to keep the tourism economy afloat, and those service industry jobs don’t typically offer health insurance.
“We are seeing a growing number of mental health issues related to working in tourist related jobs such as restaurant and hospitality jobs,” said Linda Leiser, an administrator at Dare Community Clinic. “The American health care system is broken and puts the uninsured and underinsured at greater risk.”
A dearth of psychiatrists and licensed counselors at the clinic leaves some with a six-month wait to get an appointment.
Six months is a long time to wait for a suffering person on an isolated barrier island.
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
The article presents a factual account of the healthcare challenges faced by the Outer Banks, particularly focusing on the difficulties caused by geographic isolation and limited medical resources. It highlights the negative impacts of funding cuts under the Trump administration, including the reduction in behavioral health services, which may subtly suggest criticism of the former president’s policies. The article frames these issues as local struggles exacerbated by national-level policy decisions, leaning toward a critique of the healthcare system without an overt ideological stance. However, its focus on the consequences of these cuts and reliance on government services implies a Center-Left perspective on healthcare policy.
When will Helene-damaged Broadmoor Golf Course be ready for play? FernLeaf Charter School back in business in previously flooded location? • Asheville Watchdog
The Broadmoor Golf Course near Asheville Regional Airport, owned by the airport and leased to DreamCatcher Hotels, suffered over $10 million in flood damage from Tropical Storm Helene. DreamCatcher is rebuilding the course, clubhouse, and maintenance buildings using insurance and company funds, aiming to reopen in spring 2026. Meanwhile, FernLeaf Community Charter School in Fletcher, flooded by Helene, reopened its elementary Creek Campus after nearly a year with new modular buildings. Despite challenges, including ongoing construction and flooding risks, the school rebuilt on its original site with community support and flood insurance, celebrating resilience and continued education.
Today’s round of questions, my smart-aleck replies and the real answers:
Question: The Broadmoor Golf Course near the airport suffered catastrophic damage during the floods of Helene. Only the driving range has been able to operate. But now there is great activity that looks like the course is being rebuilt. I think the property belongs to the airport, and it is contracted out for management. Who is paying for this work, and when might the course be ready again for play?
My answer: I do miss playing this course, mainly because it’s not often I get a chance to hit a wayward shot onto an interstate, in this case I-26. Usually my drives are confined to the woods or a simple two-lane road.
Real answer: In short, a lot is going on at Broadmoor, which is located off Airport Road about a mile from Asheville Regional. The airport does own the property, but it leases the golf course to a company, DreamCatcher Hotels, which operates the golf course and plans to build a hotel on the property.
Zeke Cooper, president and CEO of DreamCatcher, told me his company has a 50-year lease, and it is committed to site improvements.
“As always planned, we are developing a hotel on the property, which we plan to start site work on later this year,” Cooper said via email.
Tropical Storm Helene inundated the Broadmoor Golf Links course, causing over $10 million in damage. // Photo provided by DreamCatcher Hotels
Helene, which struck our area Sept. 27, inundated the golf course and clubhouse. The French Broad River is close by, and the property is, as the name implies, relatively flat.
“The golf course lost over 1,000 trees and had 12-18 inches of silt covering 60-70 percent of the course,” Cooper said. “The first step was to remove all of the tree debris and remove the silt.”
The company finished that in April, and golf course reconstruction started shortly thereafter.
“The clubhouse had two feet of water on the first floor, with the basement completely submerged,” Cooper said. “The maintenance and irrigation buildings were submerged, resulting in total losses of the buildings and all equipment within them. It was a mess!”
Fortunately, they did have flood insurance. Cooper said total damage exceeded $10 million.
“So a lot of the work is being paid for with insurance funds, as well as our own money,” Cooper said. “We do not have an opening date yet, but expect to reopen in spring of 2026.”
For the golfers out there, Cooper gave a detailed breakdown of all the work they’re doing:
On the golf course: Stripping all greens surfaces, adding in new greens mix and reseeding with bent grass. All greens are completed and currently growing in. The 11th green was completely destroyed, as well as some tee boxes. Those have been rebuilt and are growing in.
All of the fairways and tees have been stripped of silt, regraded and tilled. All of these areas are currently growing in with Bermuda grass.
All of the bunkers were stripped, regraded and rebuilt with new drainage and sand. Sod was used around every greens complex and all bunkers, with the work completed about a month ago.
Tropical Storm Helene left behind 12 to 18 inches of silt on the Broadmoor Golf Links course in the Fletcher area. Workers had it removed by April, and the company that operates the course is rebuilding. // Photo provided by DreamCatcher Hotels
The irrigation electrical system was destroyed, and has now been replaced. New irrigation pumps have been operational the last couple of months. Workers also had to clean out and replace drainage systems, along with lots of bank restabilization.
Driving range: “We were able to open the driving range in a temporary capacity while work was being undertaken on the course,” Cooper said. “We closed the range on Aug. 11, in order to fix damage from the flood. It is currently under construction and we hope to reopen it in the next three to four months. No timetable, yet, as it’s weather dependent this late in the season.”
Clubhouse, maintenance buildings: The company gutted, cleaned and rebuilt the clubhouse. “We are close to hopefully reopening the clubhouse and restaurant in the next two months,” Cooper said. “We are working on finalizing some construction items for a full Certificate of Occupancy, as well as waiting on furniture, fixtures and equipment.”
The maintenance and irrigation buildings are completed and in use, Cooper added.
Question: What is going on with the FernLeaf Community Charter School in Fletcher? I’ve seen they’re putting back in mobile classrooms in the area that flooded, and it looks like it’s close to reopening. I thought they moved all the students to their location further south that sits on top of a hill?
My answer: I suspect all of the new mobile classrooms are actually barges. Pretty ingenious, really.
Real answer: Back in April I wrote about FernLleaf, the flooding at its location off Howard Gap Road in Fletcher, and the school’s plans to rebuild. Helene’s floodwaters filled the buildings with up to six feet of water and swept some of them off their foundations, Nicole Rule, communications, marketing and events coordinator for the school, said then.
On Monday she had some happy news about FernLeaf’s “second act.”
FernLeaf Community Charter School, which sustained major damage at its “Creek Campus” elementary school location in Fletcher, has reopened with new modular buildings. // Photo by Nicole Rule of FernLeaf Charter School.
“On Aug. 13, FernLeaf Community Charter School in Fletcher reopened its Creek Campus — 321 days after Hurricane Helene’s catastrophic flooding swept our main buildings off their foundations and left the campus under several feet of water,” Rule said via email. “In that time, over 430 elementary students and their teachers relocated to our Wilderness Campus (previously home to middle and high schoolers), where they continued learning without missing a beat.”
Rule said, “Community partners, including general contractor Beverly Grant and even the Carolina Panthers Charities (with a $20,000 grant), rallied to help us rebuild.
“While one building is still under construction due to this summer’s unrelenting rain, the reopening marks a milestone for our students, families, and the broader Fletcher/Asheville community,” Rule said. That building should be ready by the end of September.
Michael Luplow, FernLeaf’s executive director, said the school’s “journey has been a powerful demonstration of what we can achieve when we come together.”
“We are immensely grateful for the unwavering support of our students, families, staff, and the broader community,” Luplow said in the press release. “The re-opening of the Creek Campus is not just about a new set of buildings; it is a celebration of our collective spirit and our enduring mission to provide an innovative, inspiring education to our students.”
By the way, FernLeaf did rebuild on the same footprint, which is close to Cane Creek. But this is all approved.
“Since Fern Leaf had previously been constructed in a manner that met our current elevation requirements, they are permitted to go back in at the same elevation,” Town of Fletcher Planning Director Eric Rufa told me in April. “I have encouraged them to go higher, but current circumstances with regard to grade and ADA requirements may hinder that.”
The school did have flood insurance.
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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 content presents factual information about local community issues, such as flood damage and rebuilding efforts at a golf course and a charter school, without expressing partisan opinions or advocating for a particular political ideology. The tone is neutral and focused on reporting details relevant to the community, reflecting a balanced and nonpartisan approach.
SUMMARY: Brooke Johnson, 29, became the first woman to skateboard across the U.S., completing a nearly four-month, 3,000-mile journey from Santa Monica, California, to Virginia Beach. Motivated by a promise to her late stepfather, Roger, who suffered a spinal cord injury and encouraged her to skate across the country, Brooke fulfilled her goal while raising over $54,000 for spinal cord research. Despite emotional and physical challenges, she felt Roger’s support throughout. At the finish line, she wore a necklace containing his ashes, symbolizing their shared journey. Brooke plans to rest before deciding her next adventure. Donations continue via “Brooke Does Everything.”
Brooke Johnson traveled by skateboard from California to Virginia Beach over 118 days to raise over $50000 for spinal cord injury …
www.thecentersquare.com – By Alan Wooten | The Center Square – (The Center Square – ) 2025-08-18 08:01:00
Hurricane Erin, which rapidly intensified from Category 1 to Category 5 over the weekend with winds near 160 mph, weakened slightly to Category 4 on Monday while remaining offshore. At 8 a.m., it was about 115 miles north-northeast of Grand Turk and 890 miles south-southeast of Cape Hatteras, moving northwest at 13 mph. Dare County declared an emergency, ordering evacuations for Hatteras Island and the Outer Banks, where NC 12 is at risk of flooding and damage. While Erin is expected to miss U.S. landfall, North Carolina’s coast remains within its wind field amid ongoing recovery from Hurricane Helene.
(The Center Square) – Erin, once a Category 5 hurricane over the weekend that more than doubled wind speed to nearly 160 mph, on Monday morning remained on a path to miss landfall of the United States though not without forcing evacuations in North Carolina.
At 8 a.m., the Category 4 hurricane was just east of the southeastern Bahamas, the National Weather Center said, about 115 miles north-northeast of the Grand Turk Islands, and about 890 miles south-southeast of Cape Hatteras. Erin was moving northwest at 13 mph, forecast to be going north by Wednesday morning while parallel to the Florida panhandle.
Erin had 75 mph maximum winds Friday at 11 a.m., a Category 1, and 24 hours later was near 160 mph and Category 5. It has since gone to a Category 3 before gaining more intensity.
On the Saffir-Simpson Hurricane Wind Scale, Category 1 is 74-95 mph, Category 2 is 96-110, Category 3 is major and 111-129 mph, Category 4 is 130-156 mph, and Category 5 is greater than 157 mph. While the most-often characterization of Atlantic basin cyclones, the scale is without context on storm surge – a key factor in damage at landfall.
Dare County on Sunday declared an emergency with evacuations ordered for Hatteras Island and the Outer Banks. N.C. 12, the famed 148-mile roadway linking peninsulas and islands of the Outer Banks, is likely to go under water and parts could wash away – as often happens with hurricanes.
NC12 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.
Nearly all of North Carolina’s 301-mile coastline is within the outer wind field projection from the National Oceanic and Atmospheric Administration’s National Hurricane Center. The greatest speed, however, is 20 mph.
Erin’s rapid intensity is among the greatest on record, and particularly so for prior to Sept. 1. Hurricane force winds (74 mph) extend 60 miles from its center.
By midnight Thursday into Friday, the storm is expected to be past a point parallel to the Virginia-North Carolina border and gaining speed away from the coast.
The storm’s 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.
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 content provided is a straightforward news report on Hurricane Erin, focusing on meteorological facts, evacuation orders, and recent hurricane impacts in North Carolina. It presents detailed information about the storm’s strength, projected path, and historical context without expressing any opinion or advocating for a particular political viewpoint. The language is neutral and factual, offering updates from official sources and avoiding ideological framing. Thus, it reports on the situation without contributing any discernible political bias or ideological stance.
