Publications

North Carolina Rural Health Action Plan: A Report of the NCIOM Task Force on Rural Health (2014)

Rural North Carolina faces unique obstacles that must be addressed to improve health outcomes. The North Carolina Institute of Medicine (NCIOM), in collaboration with the Office of Rural Health and Community Care (ORHCC) in the North Carolina Department of Health and Human Services, the Kate B. Reynolds Charitable Trust, and other partners, convened the NCIOM Task Force on Rural Health to develop a comprehensive, coordinated rural health action plan. The effort was funded through the Trust. The action plan highlights the underlying causes of health disparities in rural areas and identifies six key strategies at the state and local levels to address those problems.

Medical Orders for Scope of Treatment: Implementation in North Carolina (2013)

The Medical Orders for Scope of Treatment (MOST) document is a standardized form that patients can use to designate treatment preferences which can be used as medical orders across healthcare facilities. The legislation (2007) that enabled the MOST form requested that the NCIOM study the implementation of the form. This study includes key informant interviews and a web-based survey of hospital-based care managers and administrators of nursing homes, adult care comes, and assisted living facilities. This report summarizes the findings of that study.

2013 Update to the Primary Care and Specialty Supply Task Force (2013)

This update to the Primary Care and Specialty Supply Task Force provides information on progress made towards implementing the recommendations in Task Force's report, Providers in Demand: North Carolina’s Primary Care and Specialty Supply.

Promoting Healthy Weight for Young Children: A Blueprint for Preventing Early Childhood Obesity in North Carolina (2013)

The North Carolina Pediatric Nutrition Surveillance System, which collects data on low-income children ages 0-5 years, shows that the obesity epidemic affects even the youngest individuals in the state. Roughly 3 out of every 10 young low-income children ages 2-4 years are either overweight or obese in North Carolina. Children who are obese by age 6 years or overweight by age 12 years have greater than a 50 percent likelihood of becoming obese adults. According to a 2013 report by the Trust for America’s Health, almost a third of adult North Carolinians are obese. More than 70 experts and stakeholders from across the state worked as part of the NCIOM Task Force on Early Childhood Obesity Prevention (ECOP), which was a collaborative effort between the BCBSNC Foundation, the North Carolina Partnership for Children (NCPC), and the NCIOM. The report issued recommendations that would bring together parents, child care providers, health professionals and the community to promote healthy eating and physical activity in children. The recommended strategies focus on improving the treatment and preventing early childhood obesity through health care providers, encouraging healthy activities in child care settings, leveraging community resources to promote healthy eating and exercise and expanding the collection of physical activity and nutrition data.

Shaping Policy for a Healthier State for 30 Years: 30th Anniversary Report (2013)

Throughout its 30-year history, the NCIOM has played a major role in shaping policies to improve the health of North Carolinians. The work of the NCIOM, individual task force members, and partnering organizations has led to positive changes in public and private health policies and the availability and delivery of health care services. These changes have improved health care access and quality of care for millions of North Carolinians. This publication looks at the history and accomplishments of the NCIOM over the past 30 years.

The North Carolina Oral Health Action Plan for Children Enrolled in Medicaid and NC Health Choice (2013)

In the fall of 2012, the Centers for Medicare and Medicaid Services (CMS) launched an oral health initiative aimed at increasing the percentage of children enrolled in Medicaid or Child Health Insurance Programs (CHIP) who receive preventive dental services and dental sealants. CMS oversees Medicaid and CHIP in all states. CMS launched this oral health initiative in response to low utilization rates for preventive dental services across the country. In North Carolina, children with family incomes below 200% of the federal poverty level qualify for health care coverage, including dental services, through Medicaid or NC Health Choice, North Carolina’s State Child Health Insurance Program.4-6 The North Carolina Institute of Medicine Task Force on Children’s Preventive Oral Health Services was convened to help the Division of Medical Assistance (DMA) develop a dental action plan to improve access to preventive oral health services for children enrolled in Medicaid and NC Health Choice, as required by CMS. The Task Force is a collaboration between DMA, the Blue Cross and Blue Shield of North Carolina Foundation (BCBSNCF), the Oral Health Section within the North Carolina Division of Public Health, and the Office of Rural Health and Community Care. This report summarizes the findings of the Task Force and their recommendations to increase utilization of oral health services by children enrolled in Medicaid and NC Health Choice.

Examining the Impact of the Patient Protection and Affordable Care Act in North Carolina (2013)

This is the final report of the NCIOM Health Reform Workgroups. The groups met from 2010-2012 and included more than 250 members from across the state. The workgroups issued recommendations in eight areas impacted by the Patient Protection and Affordable Care Act including:Health Benefit Exchange, Medicaid, Safety Net, Health Professional Workforce, Prevention, Quality, New Models of Care, and Fraud, Abuse, and Overutilization.

2012 North Carolina Child Health Report Card (2012)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

2012 Update to the NCIOM Task Force on Adolescent Health Report (2012)

This update to the NCIOM Task Force on Adolescent Health provides information on progress made towards implementing the recommendations in Report of the NCIOM Task Force on Adolescent Health: Healthy Foundations for Healthy Youth.

2012 Update to the NCIOM Task Force on Chronic Kidney Disease Report (2012)

This update to the NCIOM Task Force on Chronic Kidney Disease provides information on progress made towards implementing the recommendations in the NCIOM Task Force on Chornic Kidney Disease Report, Addressing Chronic Kidney Disease in North Carolina.

Improving North Carolina's Health: Applying Evidence for Success (2012)

The Division of Public Health and local health departments can help improve the health and well-being of North Carolinians by increasing efforts to provide evidence-based programs, policies, and clinical interventions. The NCIOM Task Force on Implementing Evidence-Based Strategies in Public Health was charged with developing recommendations to assist public health professionals in the identification and implementation of evidence-based strategies within their communities to improve population health. Funding support for the Task Force was provided by the Centers for Disease Control and Prevention’s National Public Health Improvement Initiative. This report summarizes the findings of the Task Force and their recommendations on how to increase the use of EBSs in public health.

Growing Up Well: Supporting Young Children's Social-Emotional Development and Mental Health in North Carolina (2012)

Young children’s social-emotional development and mental health influence every critical developmental task of the first five years whether physical, cognitive, linguistic, or social-emotional. The NCIOM’s Task Force on the Mental Health, Social, and Emotional Needs of Young Children and Their Families was charged with examining the current mental health needs of young children and developing recommendations to ensure that there are systems and services in place to meet the mental, social, and emotional health needs of young children, ages 0-5, and their families. This report summarizes the findings of the Task Force and their recommendations to enhance North Carolina's early childhood systems that support the social-emotional development and mental health of young children.

Suicide Prevention and Intervention Plan: A Report of the NCIOM Task Force on Suicide Prevention and Intervention (2012)

Suicide is a devastating problem that has major emotional consequences for the family and friends of people who die by suicide, and physical and psychological consequences for those who survive suicide attempts. Death by suicide is one of the top ten leading causes of death for people ages 5-64 in North Carolina. Each year more than 1,000 North Carolinians die from suicide, more than 6,000 people are hospitalized due to self-inflicted injuries and more than 8,000 are treated in emergency departments. This report summarizes the findings of the NCIOM’s Task Force on Suicide Prevention and Intervention and the Task Force’s recommendations to enhance the Division of Mental Health, Developmental Disabilities and Substance Abuse Services’ (DMHDDSAS) statewide suicide prevention and response system.

Examining the Impact of the Patient Protection and Affordable Care Act in North Carolina: Draft Final Report Pending U.S. Supreme Court Decision (2012)

The Affordable Care Act (ACA) is arguably the most comprehensive health legislation ever enacted. The Secretary of the United States Department of Health and Human Services has responsibility to oversee the implementation of many of the provisions of the ACA. However, states, health care professionals, and businesses have responsibility to implement other sections of the law. The ACA offers the potential to improve health care access, quality, and population health, while reducing escalating health care costs, but it creates new challenges for the state, families, businesses, health care professionals, and organizations. In order to implement the new law, the North Carolina Department of Insurance (NCDOI) and the North Carolina Department of Health and Human Services (NCDHHS) asked the North Carolina Institute of Medicine (NCIOM) to convene workgroups to examine the new law and gather stakeholder input to ensure that the decisions the state makes in implementing the ACA serve the best interest of the state as a whole.

2011 Child Health Report Card (2011)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

Healthy North Carolina 2020 Technical Report (2011)

The Healthy North Carolina 2020 publication released in January, Healthy North Carolina 2020: A Better State of Health, highlights the 40 objectives, briefly describes the rationale for their selection, and includes key health disparities, as well as strategies to address the objectives. The purpose of the companion publication, entitled Healthy North Carolina 2020 Technical Report, is to provide additional background information for each of the 13 focus areas and more information about why each of the 40 objectives was selected and how targets were set. To provide an online source for additional information, the evidence-based strategy tables from the report released in January have also been included in the technical report.

Honoring Their Service: A Report of the North Carolina Institute of Medicine Task Force on Behavioral Health Services for the Military and Their Families (2011)

Our military personnel and their families are heroes who risk their lives in their mission to protect our freedom. There is a strong commitment to ensuring they have the resources they need to complete the mission and return home safely, but a safe return home does not always ensure that they have the services and support they need. The two most common health issues diagnosed in service members of the wars in Iraq and Afghanistan who seek care at the US Department of Veterans Affairs (VA) are musculoskeletal and mental health problems. While excellent systems exist to treat the physical wounds, treating behavioral health problems is often complicated by barriers including stigma, lack of behavioral health providers, and lack of coordination between federal, state, and local systems of health care. This report summarizes the findings of the NCIOM’s Task Force on Behavioral Health Services for the Military and Their Families and the Task Force’s recommendations to improve the provision of services and supports to meet the behavioral health needs of service members in the state when federal resources are not available.

NCMJ Behavioral Health Needs of Military Personnel and Their Families

Based on the Task Force recommendations, the North Carolina General Assembly passed Session Law 2011-185. It was signed into law by the Governor on June 20, 2011.

Implementation of the Patient Protection and Affordable Care Act in North Carolina (2011)

The Affordable Care Act (ACA) is arguably the most comprehensive health legislation ever enacted. The Secretary of the United States Department of Health and Human Services has responsibility to oversee the implementation of many of the provisions of the ACA. However, states, health care professionals, and businesses have responsibility to implement other sections of the law. The ACA offers the potential to improve health care access, quality, and population health, while reducing escalating health care costs, but it creates new challenges for the state, families, businesses, health care professionals, and organizations. In order to implement the new law, the North Carolina Department of Insurance (NCDOI) and the North Carolina Department of Health and Human Services (NCDHHS) asked the North Carolina Institute of Medicine (NCIOM) to convene workgroups to examine the new law and gather stakeholder input to ensure that the decisions the state makes in implementing the ACA serve the best interest of the state as a whole.

Healthy North Carolina 2020: A Better State of Health (2011)

The Healthy North Carolina 2020 project was a collaborative effort of the NCIOM, Governor’s Task Force for Healthy Carolinians; the Division of Public Health, North Carolina Department of Health and Human Services (NC DHHS); the Office of Healthy Carolinians and Health Education, NC DHHS; and the State Center for Health Statistics, NC DHHS. The goal of the Healthy North Carolina (HNC) 2020 project was to develop the state’s 2020 health objectives. This work began in late 2009 and culminated with the release of the 2020 objectives in January 2011.

The publication released in January, Healthy North Carolina 2020: A Better State of Health, highlights the 40 objectives, briefly describes the rationale for their selection, and includes key health disparities, as well as strategies to address the objectives.

Short- and Long-Term Solutions for Co-Location in Adult and Family Care Homes: a Report of the NCIOM Task Force on the Co-Location of Different Populations in Adult Care Homes (2011)

Although most people think of North Carolina’s adult and family care homes (ACH) as residences for the frail elderly, more than 60% of residents have a mental illness, intellectual or developmental disabilities, or an Alzheimer disease/dementia diagnosis. The placement of individuals with mental illnesses, substance abuse problems, intellectual and developmental disabilities, and other disabilitiesa that may result in serious behavioral problems can pose a threat to the health and safety of other residents, as well as to the staff of ACHs.This report presents the findings of the NCIOM's Task Force on the Co-Location of Different Populations in Adult Care Homes and the Task Forces' recommendations, which provide a roadmap to both addressing the challenges associated with co-location in ACHs and to increasing the options available to individuals with disabilities, which would reduce co-location in ACHs in the long-run

Just What Did the Doctor Order? Addressing Low Health Literacy in North Carolina: 2010 Update (2010)

In 2007, the NCIOM released a report entitled Just What Did the Doctor Order? Addressing Low Health Literacy in North Carolina which presented the findings and recommendations of the Task Force on Health Literacy. This 2010 update includes information about the progress, or lack thereof, in implementing the 14 Task Force recommendations. In total, progress has been made in implementing 11 (79%) of all the recommendations. No action has been taken to implement 3 of the recommendations.

2010 Child Health Report Card (2010)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

Prevention Action Steps (2010)

The Prevention Action Steps provide a list of actions or "steps" individuals and different groups can take to make improvements in health. Each document contains recommendations, modified for particular audiences, excerpted from the NCIOM's Prevention for the Health of North Carolina: Prevention Action Plan. Downloadable PDFs of Prevention Action Steps are available for individuals, communities, schools, employers, health care providers, and hospitals.

Healthy Foundations for Healthy Youth: A Report of the NCIOM Task Force on Adolescent Health (2009)

During adolescence, new health behaviors emerge and many health habits that affect life outcomes are established. Unfortunately, data show that many North Carolina youths engage in behaviors that compromise their health. The NCIOM's Task Force on Adolescent Health studied this issue and developed a 10-year plan to improve the health and well-being of North Carolina’s adolescents. This report presents the findings of their work and recommendations to improve the health and well-being of youth in North Carolina over the next decade.

2009 Child Health Report Card (2009)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

Prevention for the Health of North Carolina: Prevention Action Plan (2009)

The burden of chronic disease in North Carolina signifies a need to make dramatic improvements in population health. Investing in prevention can reduce this heavy burden by saving lives, reducing disability, and, in some cases, by reducing health care costs. The NCIOM’s Prevention Task Force studied the leading causes of death and disability in the state and developed evidence-based recommendations to address the preventable risk factors underlying these leading causes. This report presents the findings of the Task Force’s work and recommendations to improve population health in North Carolina over the several years.

Successful Transitions for People with Developmental Disabilities: A Report of the NCIOM Task Force on Transitions for People with Developmental Disabilities (2009)

There are approximately 150,000 people living with developmental disabilities in North Carolina. Many of these individuals will need assistance as they transition from one setting to another, for example, when adolescents with developmental disabilities age out of the school system, or when older individuals lose the support of older family members. The NCIOM Task Force on Transitions for People with Developmental Disabilities studied these issues and made recommendations to ensure that people with intellectual and developmental disabilities receive the kinds of coordinated services and supports they need to help them through life transitions.

Expanding Access to Health Care in North Carolina: A Report of the NCIOM Health Access Study Group (2009)

The lack of health insurance coverage is the foremost barrier to accessing health care services. Nearly one-fifth of the non-elderly population in North Carolina, more than 1.5 million people, lacked health insurance coverage in 2006-2007. The NCIOM Health Access Study Group studied ways to expand access to appropriate and affordable health care in North Carolina. This report presents their findings and recommendations.

Prevention for the Health of North Carolina: An Interim Report of the NCIOM Task Force on Prevention (2009)

Interim Report of the NCIOM Task Force on Prevention was released after the first eight months of meeting. During that time, the Task Force examined ways to reduce the use of tobacco and prevent exposure to secondhand smoke; reduce obesity through improved nutrition and increased physical activity; prevent STDs, HIV, and unintended pregnancies; and prevent substance abuse and addiction. The interim report covers these topics.

Building a Recovery-Oriented System of Care: a Report of the NCIOM Task Force on Substance Abuse Services (2009)

Substance abuse carries huge direct and indirect costs to society. In 2005-2006 in North Carolina, more than 700,000 people age 12 or older (8.5%) reported being addicted to alcohol, drugs, or both. The prevention, diagnosis, and treatment of substance abuse is difficult for several reasons. The NCIOM Task Force on Substance Abuse looked at how to improve the statewide substance abuse delivery system. This report presents their findings and recommendations.

2008 Child Health Report Card (2008)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

Shaping Policy for a Healthier State for 25 Years: 25th Anniversary Report (2008)

Throughout its 25-year history, the NCIOM has played a major role in shaping policies to improve the health of North Carolinians. The work of the NCIOM, individual task force members, and partnering organizations has led to positive changes in public and private health policies and the availability and delivery of health care services. These changes have improved health care access and quality of care for millions of North Carolinians. This publication looks at the history and accomplishments of the NCIOM over the past 25 years.

2008 Update to the NCIOM Safety Net Task Force Report (2008)

This update to the NCIOM Safety Net Task Force provides information on progress made towards implementing the recommendations in the NCIOM Safety Net Task Force report.

2008 Update to the NCIOM Task Force on Covering the Uninsured Report (2008)

This update to the NCIOM Task Force on Covering the Uninsured provides information on progress made towards implementing the recommendations in the Expanding Health Insurance Coverage to More North Carolinians report.

Addressing Chronic Kidney Disease in North Carolina (2008)

Chronic kidney disease (CKD) is a health condition that encompasses various levels of kidney damage ranging from a decline in function to kidney failure. There are just under one million people with CKD in North Carolina not including those with kidney failure. The growing prevalence of chronic kidney disease can be characterized as a public health threat. The NCIOM Task Force on Chronic Kidney Disease explored ways to educate the public and health care providers about CKD and developed a plan for prevention, early screening, diagnosis, and treatment of chronic kidney disease and its complications for the state’s population. The findings and recommendations of the Task Force are presented in this report.

Health Care Services for the Uninsured and Other Underserved Populations: a Technical Assistance Manual to Help Communities Create or Expand Health Care Saftey Net Services (2008)

This manual was written to help community groups interested in developing or expanding health care services for the uninsured and other underserved populations. It was developed by the NC Safety Net Advisory Council (NC SNAC)with the support of the Blue Cross and Blue Shield of North Carolina Foundation. NC SNAC grew out of a NC IOM task force that examined the availability and financial stability of safety net organizations across the state.

2007 Update to the Report of the NCIOM Task Force on the Nursing Workforce (2007)

This update provides information on progress made towards implementing the recommendations in the Task Force on the North Carolina Nursing Workforce Report.

2007 Child Health Report Card (2007)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

Just What Did the Doctor Order? Addressing Low Health Literacy in North Carolina (2007)

Health information can be very technical and hard to understand. Most of us have had trouble understanding our doctor’s instructions at one time or another. Studies have shown 40-80% of the medical information patients receive is forgotten immediately. Nearly half of the information they do remember is incorrect. Health literacy is the degree to which individuals have the capacity to obtain and understand the basic health information and services needed to make appropriate health decisions. The NCIOM Task Force on Health Literacy studied ways to improve the health literacy of North Carolinians. This report presents their findings and recommendations.

Providers in Demand: North Carolina’s Primary Care and Specialty Supply (2007)

The NCIOM Primary Care and Specialty Supply Task Force on was convened in 2006 to analyze current and projected trends in provider supply and to examine whether the existing production of physicians, NPs, PAs, and CNMs will address the state’s growing healthcare needs. The Task Force examined trends in provider supply including: (1) types of providers (by specialty) likely to be needed to address future healthcare needs; (2) areas of the state that experience persistent shortages; and (3) underrepresentation of certain ethnic and racial minorities in specified health professions. The goal of the Task Force’s work was to develop public and private policy options to ensure North Carolinians have access to the providers they need.

Stockpiling Solutions: North Carolina’s Ethical Guidelines for an Influenza Pandemic (2007)

The H1N1 influenza of 2009 heightened the public’s awareness of the dangers of a flu pandemic. Along with the public health threat, a flu pandemic presents ethical challenges as well. The Task Force on Ethics and Pandemic Influenza Planning was convened in 2006 to weigh different ethical considerations in developing an ethical framework to help guide public and private decision making during a pandemic including the need to ensure accountability, equitable treatment among similarly situated individuals, proportionality of actions, and inclusiveness and timeliness in decision making. The ethical framework developed by the Task Force is detailed in the report.

2007 Update to the Report of the NCIOM Task Force on Long-Term Care (2007)

This update provides information on progress made towards implementing the recommendations in the Task Force on the Long-Term Care Report.

2006 Child Health Report Card (2006)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

Expanding Health Insurance Coverage to More North Carolianians: A Report of the NCIOM Task Force on Covering the Uninsured (2006)

More than 1.3 million nonelderly people in North Carolina, or more than one-sixth of the state’s population, were uninsured during 2004. The NCIOM Task Force on Covering the Uninsured studied ways to expand access to appropriate and affordable health care in North Carolina. This report presents their findings and recommendations.

2005 Child Health Report Card (2005)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

2005 North Carolina Oral Health Summit Access to Dental Care (2005)

2005 North Carolina Oral Health Summit proceedings and action plan.

New Directions for North Carolina: A Report of the NCIOM Task Force on Child Abuse Prevention (2005)

Child maltreatment is a devastating social problem that affects the lives of millions of children in the United States each year. In North Carolina, a child is mistreated every 15 minutes by a parent or caretaker. Effects of maltreatment on the social, cognitive, and emotional development of children can be far-reaching and, in many cases, irreparable. Despite the enormous social and economic costs of child maltreatment in North Carolina, child maltreatment prevention has received little attention or resources from state policy makers. The NCIOM Task Force on Child Abuse Prevention studied this issue and developed a strategic plan to address child abuse prevention. This report presents their findings and recommendations.

Evidence-Based Approaches to Worksite Wellness and Employee Health Promotion and Disease Prevention (2005)

The NCIOM, in partnership with the Center for Health Improvement (Sacramento), recommend that the North Carolina Teachers’ and State Employees’ Comprehensive Major Medical Plan, as part of its NC HealthSmart Program, develop an initiative to promote worksite wellness activities for the benefit of Plan members. The characteristics of the initiative are detailed in the report.

North Carolina Safety Net Task Force Report (2005)

In 2003 there were more than 1.4 million uninsured North Carolinians, and this number is increasing rapidly. The lack of insurance coverage affects the uninsured person and his or her family, and also has an impact on health care institutions that have a mission to serve the uninsured. The NCIOM Task Force on Healthcare Safety Net explored ways to strengthen and expand the existing safety net to better meet the healthcare needs of the uninsured. This report presents their findings and recommendations.

2004 Update to the Report of the NCIOM Latino Health Task Force (2004)

This update provides information on progress made towards implementing the recommendations in the Latino Health Task Force Report.

2004 Child Health Report Card (2004)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

Task Force on the North Carolina Nursing Workforce Report (2004)

The NCIOM Task Force on the Nursing Workforce examined the need for nurses, their requisite skills and qualifications, the capacity of the state’s educational institutions to produce adequate numbers of qualified nurses, barriers to career advancement, and the workplace environments within which nursing is practiced. On the basis of these deliberations, the Task Force has concluded that, without some intervention, North Carolina is likely to experience a severe shortage of nursing personnel (in addition to the current shortage of nursing assistants— especially in long-term care) in the coming decade due to the combination of an aging population and an aging nursing workforce. The Task Force’s work focused on four primary areas: 1) nursing faculty recruitment and retention; 2) the capacity, quality, and accessibility of nursing education programs, 3) transitions from school-to-work, and 4) the work environments within which North Carolina nurses practice. This report presents their findings and recommendations.

2003 Child Health Report Card (2003)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

NC Health Choice: A Report of the NCIOM Task Force on the NC Health Choice Program (2003)

In 2003 the Secretary of the North Carolina Department of Health and Human Services asked the NCIOM to convene a task force to study options to ensure the long-term financial viability of the NC Health Choice program given the fiscal constraints of the state budget. The Task Force was asked to explore different options, including changes in enrollment, benefits, utilization, and professional reimbursement rates. The NC General Assembly specifically charged the Task Force with examining health professional reimbursement rates under this program. This report presents the findings and recommendations of the NCIOM Task Force on the NC Health Choice Program. The report is divided into six sections: overview of the NC Health Choice, program evaluation, program financing, program expenditures, recommendations and summary of fiscal and cost effectiveness implications.

NC Latino Health: A Report of the NCIOM Latino Health Task Force (2003)

The NCIOM Latino Health Task Force reviewed the major health and health care problems facing the NC Latino community, and identified public and private sector initiatives that can be undertaken to address these concerns. In addition to recommendations about expanding the availability of bilingual and bicultural providers, the Task Force made recommendations to expand the availability of primary, behavioral health, and dental resources; remove barriers that deter families from applying for Medicaid, NC Health Choice, and other publicly funded programs; provide meaningful workers' compensation for migrant and seasonal farmworkers; develop leadership within the Latino community to address health issues; address the problems of health literacy, including the lack of understanding of the US health system; and ensure that the state has adequate data to monitor health disparities and health access of the Latinos living and working in the state.

Community Alternatives Program for Disabled Adults (CAP/DA): 2003 (2003)

The North Carolina General Assembly directed the NCIOM to study the CAP/DA program, and to recommend ways to improve the administration of the program. This report begins with an overview of the CAP/DA program, and then presents the analysis of the legislatures’ questions.

Choosing a Nursing Home: A North Carolina Consumer Guide (2003)

This report explains how to interpret quality measure statistics of nursing homes in order to assist consumers. This report was prepared in collaboration with Medical Review of North Carolina and the members of the NC Quality Standards Work Group formed by the Division of Facility Services of the NC Department of Health and Human Services.

Consumers Guide to Health Insurance and Health Programs in North Carolina (2003)

This Consumer's Guide was written to help everyone navigate the health system, whether it involves understanding their private health insurance coverage, identifying available public programs, or finding community health centers in their area.

2003 Update to the NCIOM Task Force on Dental Care Access Report (2003)

This update to the NCIOM Task Force on Dental Care Access Report provides information on progress made towards implementing the recommendations in that report.

2002 Child Health Report Card (2002)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

2001 Child Health Report Card (2001)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

Consumers Guide to Health Plan Selection (2001)

Last Updated in 2001: This is an Internet guide to managed care plans in North Carolina.

2001 Update to the NCIOM Task Force on Dental Care Access Report (2001)

This update to the NCIOM Task Force on Dental Care Access Report provides information on progress made towards implementing the recommendations in that report.

Long-Term Care Plan for North Carolina: A Report of the NCIOM Task Force on Long-Term Care (2001)

The NCIOM Task Force on Long-Term Care examined long-term care issues for both older adults and people with physical or cognitive disabilities. However, most of the focus was on the long-term care delivery and financing systems for older adults and people of other ages with acquired physical and cognitive disabilities (i.e., those disabilities that occurred after childhood).The findings and recommendations of the Task Force are presented in this report.

2000 Child Health Report Card (2000)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

Interim Legislative Report from the NCIOM Task Force on Long-Term Care (2000)

This interim report captures the work of the NCIOM Task Force on Long-Term Care from November of 1999 to June of 2000.

Comprehensive Child Health Plan: 2000-2005 (2000)

The NCIOM Comprehensive Child Health Task Force conducted a thorough examination of a broad spectrum of issues affecting the health status and health care available to North Carolina’s infants, young children and adolescents. The chapters of this report summarize the problems that currently exist, the range of current programs addressing these issues and the gaps that exist in terms of coverage and the effectiveness of existing programs. In addition, the Task Force identified additional efforts that are needed to ensure that all children reach their maximum health and developmental potential. This report presents the findings and recommendations of the Task Force.

1999 Child Health Report Card (1999)

North Carolina Institute of Medicine Action for Children North Carolina

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

North Carolina Programs Serving Young Children and Their Families (1999)

Last Updated in 1999: This book was written to help families and service providers understand some of the basic program rules for the programs available to serve young children and their families.

Report of the NCIOM Task Force on Dental Care Access (1999)

The dental health issues and problems addressed in this report by the NCIOM Task Force on Dental Care Access are multifaceted and complex, requiring multiple strategies and actions by both the public and private sectors. Increasing Medicaid reimbursement rates is a necessary, but not sufficient, response to the problem of inadequate access to dental services. North Carolina needs to simultaneously increase the supply of dentists and dental hygienists; build a capacity among safety-net providers to address the dental care needs of low-income, Medicaid-eligible and special needs populations; and educate these groups about the importance of on-going comprehensive dental care. In addition, more emphasis must be placed on dental education and prevention strategies, to prevent costly and painful dental disease, especially among children. The 23 recommendations in this report, if acted upon, would go a great distance toward the goal of assuring adequate preventive and curative dental health care for those groups within our state’s population who presently suffer the consequences of inadequate access to dental care.

1998 Child Health Report Card (1998)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

Final Report of the NCIOM Task Force on Child Health Insurance to the Secretary of the North Carolina Department of Health and Human Services (1997)

In June 1997, the Secretary of the North Carolina Department of Health and Human Services, the Honorable H. David Bruton, charged the NCIOM and the Division of Women's and Children's Health to form a Task Force on Child Health Insurance. The Task Force, chaired by Dr. Gordon H. DeFriese, President of the Institute of Medicine, included representatives of organizations and constituencies around the state having an interest in child health issues. This report presented the major policy choices facing the state in enacting child health insurance coverage. The information provided in this report enabled policy makers to make expeditious and educated decisions on how to implement the provisions of the Child Health Insurance Program.

1997 Child Health Report Card (1997)

The purpose of this annual publication is to heighten awareness of the health of our children by summarizing data on important child health indicators. The NCIOM and Action for Children North Carolina produce the Report Card to assist health administrators, legislators, and child and family advocates in their efforts to improve the health and safety of children statewide.

The Form, Variety and Use of Community Health Assessments: An Analysis of North Carolina Studies (1997)

In 1996, the North Carolina Hospital Foundation, with the financial assistance of The Duke Endowment, undertook a review of community health assessments across the state of North Carolina. The Foundation and Endowment took this initiative to determine whether, in facilitating collaboration and partnerships among various community healthcare entities and organizations, these assessment efforts might result in improvements in the health status of North Carolinians.

How Well Does North Carolina Protect Enrollees in HMOs? (1997)

This research is a summary of a larger analysis of the adequacy of North Carolina’s consumer protections in the managed care market. This issue of how well the state of North Carolina protects consumers in managed care is especially relevant given the rapid increase in the numbers of individuals who receive health care through a managed care program. Almost one million North Carolinians were enrolled in full-service HMOs by the end of 1996. By the end of 1995, nearly three-quarters of the insured population in the United States received their medical care from some type of managed care organization. This research was funded in part by a grant from the Robert Wood Johnson Foundation Reforming States Initiative.

Universal Access at an Affordable Cost: Ensuring Health Care Services for all North Carolinians (1993)

In 1991, the NCIOM convened the Health Access Forum to reach a consensus on how to address inadequate access to health care for the uninsured and underinsured in North Carolina. The Forum’s proposal outlines a fundamental restructuring of the health delivery system that includes: universal access to basic health services; controlling costs by encouraging competition among organized delivery systems which integrate financing and delivery of care in ways that promote quality and minimize costs; specific reforms and cost reduction measures in such areas as conflict of interests, medical malpractice and defensive medicine; greater equity by using tax-based financing (based on ability to pay) in lieu of premiums.

Infant Mortality in North Carolina: An Inventory of Programs with Recommendations (1991)

The NCIOM in coordination with Arthur C. Christakos, MD, compiled an inventory of the programs designed to reduce infant mortality in North Carolina and to make recommendations specifically in the area of education that could conceivably improve infant mortality rates in this state. This report describes that inventory followed by a comparison of mortality rates in North Carolina counties with recommendations for educational efforts which may have some positive effect on the infant mortality rates throughout the state.

Strategic Plan to Assist the Medically Indigent of North Carolina (1989)

This strategic plan was developed by the NCIOM Task Force on Indigent Care to stimulate thinking and discussion on the problem of medical indigency in North Carolina. This report concentrates on the development of a long-range plan for assisting the medically indigent and entails basic principles regarding individual and social responsibility for health care and recommendations based on these principles. The plan is designed to address the issue of obtaining adequate health care at an affordable cost.

Issues and Options in Developing a System of Case-Managed Home and Community Care for North Carolina’s Older Adults (1989)

This paper outlines issues, options and principles associated with implementing a coordinated, case-managed system of community-based long-term care in North Carolina. The principles identified in it serve as the foundation for more specific recommendations for developing a program of case-managed home and community care. This paper has been prepared by the NCIOM with the assistance of the Center for Aging Research and Educational Services.

Case Management and Care Coordination in North Carolina: Preliminary Recommendations (1988)

This report, prepared by the Center for Aging Research and Educational Services at the University of North Carolina-Chapel Hill, represents the leading principles and program recommendations which are believed to underlie the development of a coordinated, case managed system of long-term care for the elderly in North Carolina. The principles were developed by examining the experiences of other states and are reflective of the collective opinions of key individuals spread throughout North Carolina’s long-term care network.

Improving the Odds: Healthy Mothers and Babies for North Carolina (1988)

This report, funded through the Kate B. Reynolds Health Care Trust, is designed as a blue print to begin the process to assure that in time children born in North Carolina will be as likely to be healthy and productive as they are in any advanced civilization on Earth. The plan created by NCIOM is designed to assure that women know how to improve the odds that their babies will be healthy, that needed services are in place, that caregivers have the latest information on how to improve the changes for positive pregnancy outcomes and that women who need the services can find, get to and pay for the services they need.

Report of the Task Force to Reduce Infant Mortality and Morbidity: Phase 1 Identification of the Major Factors (1987)

The Kate B. Reynolds Health Care Trust and the NCIOM developed plans and priorities for lowering infant mortality and morbidity in North Carolina. The subsequent task force created to address these issues allotted a subcommittee to draw upon available data to describe the principal factors associated with infant mortality and morbidity and to identify the gaps in knowledge and/or data collection systems for Phase 1 of the Task Force’s plan. Recommendations are made to improve this knowledge through improved data collection systems.