The WNC Health Policy Initiative (HPI) Podcast

Sheila Jenkins of Macon County’s No Wrong Door for Support and Recovery joins us to discuss six years of work on filling critical gaps in mental health, substance use, and homelessness support.
From starting with a $12 bank account to managing 700 visits a month, Sheila breaks down their work building trust, navigating systemic barriers like rural transportation and housing shortages, and creating a compassionate, peer-led support system in Western North Carolina.
Some takeaways from the episode include: 
Getting the community together and avoiding duplication of services is key, especially when new funding structures or policies are introduced.
Basic hurdles, such as not having an ID or a physical address for direct deposit, can stall recovery and prevent people from accessing services.
Peer support specialists with lived experience play a critical role in creating an open door.
Local cross-sector collaboration, including schools, DAs, and law enforcement, can help divert individuals from prison into treatment.
Narrow grant parameters can be a significant barrier to meeting complex, local needs.
Listen in to hear our conversation! 

Marie Collins shares her experience navigating behavioral health systems across several counties in Western North Carolina over the past 10 years, highlighting several major policy opportunities, including: treating housing as part of mental health care and making it easier for providers to participate in Medicaid networks.
We also hear more about peer support specialists, the public mental health ecosystem, Housing First, yoga, and more. 
Marie is speaking from her professional and personal experience and is not speaking on behalf of Vaya Health.

Provider Mapping Tool for WNC
In our most recent Friday Forum, we heard about MAHEC's FindMyCareWNC tool- an interactive map that shows primary care, behavioral health, dental services, substance use treatment, reproductive health, WIC, etc across WNC . It can serve as a referral tool for providers and helps community leaders identify service gaps.
Maternal Health:
NC's Budget has a directed grant of $800,000 in non-recurring funds to MAHEC for Project CARA which expands access to evidence-based perinatal substance use disorder treatment and care coordination across western North Carolina.
The NC Maternal and Child Health Perinatal Strategic Plan also received $3,398 in recurring funds,
Perinatal Quality Collaborative of North Carolina did not receive continued funding
Planned Parenthood has regained access to federal funding for non-abortion services nationwide as of Saturday, July 4th, one year after Republicans cut its clinics off from Medicaid as part of HR1, aka “The One Big Beautiful Bill Act” in 2025.
Childcare Subsidy Floor
North Carolina's new budget invests $97 million each year in child care subsidies and sets a statewide minimum reimbursement rate for the first time. This helps ensure rural child care providers are paid more fairly for the care they provide. Listen to other childcare policy opportunities in Episode 9. Read about FFN care in WNC. 
Local Investment
The Western Carolina Medical Society (WCMS) received a $510,000 investment from UnitedHealthcare Community Plan of North Carolina to expand healthcare access for uninsured patients, strengthen medical interpreter services, and support clinician well-being across WNC.
Policy Update
Gov. Stein vetos ‘unauthorized camping’ homeless ban, HB 437
Cyclospora Updates
While links have been drawn in several states to this parasite found in lettuce distributed by Taylor Farms to certain Taco Bell chains, there has not been an established link to cases seen in WNC. 
Federal officials scaled back routine CDC surveillance for Cyclospora done through FoodNet in 2025. While states still report cases, national tracking is less comprehensive than it was before, slowing public health action.
Read NCDHHS updates here
 
The weekly 'WNC Health Policy Brief' will be paused, but stay tuned for more long form interviews. 

This week, on the WNC Health Policy Initiative Podcast, we discuss:
some of the biggest health implications after North Carolina's long-awaited state budget finally became law after more than a year without a full budget
Governor Josh Stein's Executive Order No. 39 creating the bipartisan Health Care Affordability Commission to address rising medical costs &
a recent federal court ruling on state efforts to restrict SNAP purchases of certain foods.

In this episode, we begin to explore the mental health and substance use landscape of Western North Carolina through the experience of clinician Lissa Carter, who has worked across recovery, community mental health, education, and clinical leadership roles in Buncombe County.
We learn about her experiences with our workforce shortages and insurance barriers, and care fragmentation, alongside regional strengths like harm reduction initiatives and training pipelines. It sets up a broader discussion on how policy shapes access, retention, and outcomes in mental health care.

According to the 2026 West Health-Gallup Affordability Index, Americans’ ability to afford healthcare has fallen to its lowest level since tracking began in 2021. Fewer than half of U.S. adults (49%) are considered “Cost Secure,” meaning they cannot consistently afford needed healthcare services and prescription medications.
Although CMS Medicare Pilot, WISeR, whose stated intention was to reduce fraud and unnecessary care, critics say it is causing treatment delays, added administrative burden, and inappropriate denials for Medicare patients.
According the chief medical examiner in NC, counties' with the highest average fentanyl death rates include Buncombe County at number 5 (22.9) and Burke County at number 8 (21.5) vs the state average of 12.5.
On June 24th, the General Assembly overrode the Governor's vetos of NC Senate Bills 227 and 558 (impacting targeted health initiatives) and 153 (impacting communities' ability to access care)
Federal health grants delayed (including 988 services, disease surveillance, and opioid treatment grants) while undergoing a review screening for language found to be unacceptable.
The NC Senate approved House Bill 437, which would prohibit local governments from allowing homeless encampments on public property, create stricter drug penalties near homeless service providers, and allow legal action against local governments that fail to enforce the ban; the measure now awaits further action after Senate passage.
June 24th featured a ROOTS Hub webinar by the NCDHHS where region leads introduced themselves (Impact Health for WNC) and introduced a new partnership with NCDIT for a health information exchange .
Elevance Health, which covers about 2 million people on Medicare, paid the government more than $342 million to address allegations that it overcharged the federal healthcare program for years.

coming soon 

In this episode, we learn about the Appalachian Sustainable Agriculture Project (ASAP)'s Produce Prescription Program and how it overlaps as a public health strategy to improve nutrition, increase access to healthy food, and support long-term health outcomes.
By connecting healthcare providers with local farmers and markets, the program helps participants access fresh fruits and vegetables while strengthening Western North Carolina's agricultural economy.
The conversation also places Produce Prescription programs within the broader "Food Is Medicine" movement, which a growing set of interventions that includes medically tailored meals and nutrition incentives like Double SNAP at Farmers' Markets, designed to address chronic disease through food. 
The Produce Prescription Program recently received $400,000 in renewed funding from Blue Cross NC to continue and expand programming into the next year, pointing also to evidence of healthy food access as a long term cost-savings strategy for health insurance providers.
Proposed House Bill 1154, 'Expand the FarmSHARE Food Hub Program' also points to state policy that also covers the intersection between healthy food access and support for rural agricultural economies by seeking to allocate some funding to Double EBT at farmers markers.  

Recorded on 6-15-26, learn about health policy updates impacting WNC, including:
An overview on how NC Medicaid stands following the OBBBA.
Read about NC's changes here
Comment period for CMS's June 3rd rules on medical frailty is open here. 
Will HB 2076, "The Innovations Waitlist Reduction Act" continue or die in a committee?
Healthcare committee endorsed SB 978 without cutting CEO pay cap and workforce protections
A resource on navigating federal student loans following the annulled SAVE plan for student loan repayment. 

Recorded on June 8th, we talk about:
Changes to the NC Health Plan, increases for retirees, decreases for others approved on June 1st
A virtual Annual 1115 Waiver Forum offers opportunity to ask questions about the future of HOP: 1-2 p.m., Wednesday, June 24, 2026
Does the Rate Payer Protection Act protect utility rates? While creating regulations for data centers, it seems to build in other increases to power bills. 
Some BrAIn Hub Summit takeaways on Artificial Intelligence & Health in WNC
Emergency Mental Health Policy Updates:
EMS funding to 10 counties in WNC through the RHT fund could support mental health emergency 
House Bill 307 "Iryna's Law" leads to jail overcrowding in Buncombe and other counties across the state, generating concerns about efficacy, escalation of upstream health challenges, & 
House Bill 1104 "Improve IVC Process and Enhance Public Safety" sent to Senate despite public health concerns 
First round of SunBucks, or 'summer EBT,' distributed in NC on June 1st to provide support to kids previously receiving school meals. Learn how to apply here.  Learn more about school meals here.  
Center for Healthcare Quality & Payment Reform (CHQPR) released a report showing 5 rural hospitals in NC at immediate risk of closing, and provides an analysis of root causes.