The NCIOM Task Force on Implementing Evidence-Based Strategies in Public Health is working to develop recommendations to assist public health professionals in the identification and implementation of evidence-based practices within their communities to improve population health.

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This project is a collaborative effort with the North Carolina Division of Public Health and the North Carolina Center for Public Health Quality and is being supported by National Public Health Improvement Initiative funding from the Affordable Care Act. ... READ MORE

The NCIOM Suicide Prevention and Intervention Workgroup is working on developing recommendations to enhance the Division of Mental Health, Developmental Disabilities and Substance Abuse Services’ (DMHDDSAS) statewide suicide prevention and response system.

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The NCIOM Task Force on the Mental Health, Social, and Emotional Needs of Young Children and Their Families is working on 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.

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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.
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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.
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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).

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The dental health issues and problems addressed in this report 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.

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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 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.
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In 2003, there were more than 1.4 million uninsured North Carolinians. 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 Safety Net Task Force 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.
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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.
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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.
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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.
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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.
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The NCIOM Task Force on Covering the Uninsured focused its work on expanding health insurance coverage to the two groups most likely to lack coverage—small employers, low-income families—and to those with pre-existing health conditions. The recommendations concentrate in three areas: (1) subsidies and new insurance products aimed at making health insurance more affordable to small employers, (2) a Medicaid limited benefit package for low-income adults, and (3) a high-risk pool for people with pre-existing health problems. The Task Force tried to balance the need to provide health insurance to more uninsured with the necessity to restrain new health spending for employers, uninsured individuals and families, and government. Thus, many of the recommendations include limited benefit packages and/or cost sharing to ensure that, to the extent possible, uninsured individuals and families contribute toward the cost of their own care.
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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.
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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.
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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.
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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.

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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.
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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.
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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.
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The Task Force on the Co-Location of Different Populations in Adult Care Homes worked on developing short- and long-term solutions to issues within adult care homes related to the co-location of the frail elderly with individuals with behavioral problems due to mental illness, substance abuse problems, intellectual or other developmental disabilities, or other disabilities.

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The Task Force on Behavioral Health Services for the Military and Their Families worked on developing recommendations to ensure that the mental health, developmental disabilities and substance abuse services that are available to active, Reserve, and National Guard members of the military, veterans, and their families are adequate to meet the needs today and in the future. The Task Force focused on examining state services that can help address gaps in the availability of behavioral health services available through the military or Veterans Administration. Full Report | Executive Summary | Issue Brief | Chapters | NCMJ Behavioral Health Needs of Military Personnel and Their Families ... READ MORE

The Health Reform Quality Workgroup examined new federal guidelines for patient outcome quality measures and reporting requirements, identifying strategies to meet the new guidelines while building on existing state quality initiatives.

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The Health Reform Safety Net Workgroup reviewed new federal requirements for safety net providers, exploring the impact of health reform on North Carolina’s unmet health needs, and identifying opportunities for community-based collaborative networks of care.

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The Health Reform Medicaid Workgroup worked to identify implementation steps necessary to expand Medicaid coverage, including coordination of eligibility and enrollment between Medicaid and the Health Benefits Exchange: exploring various state Medicaid options, including home and community based services; and examine funding options under the Elder Justice Act.

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The Health Reform Fraud and Abuse Workgroup examined new program integrity provisions under Medicaid and Medicare, identifying ways to meet new federal requirements, and developing strategies to educate providers about new financial integrity and fraud and abuse reporting requirements.

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The Health Reform Overall Advisory Group coordinated the work of the eight health reform workgroups. Each workgroup is tasked with helping North Carolina explore the different options available to the state under specific parts of the Affordable Care Act. The Overall Advisory Group will also address cross-cutting issues that arise.

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The Health Reform Health Benefits Exchanges and Insurance Oversight Workgroup explored options to establish a health benefits exchange, providing guidance on insurance oversight and the consumer ombudsman program, and identifying steps needed to coordinate Medicaid and the Health Benefit Exchange.

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The Health Reform Prevention Workgroup identified funding opportunities for prevention and wellness opportunities that will help the state meet the goals of North Carolina’s Prevention Action Plan, and examined options to develop a wellness initiative for Medicaid recipients.

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The Health Reform Health Professional Workforce Workgroup looked at ways that North Carolina can strengthen and expand its current supply of health professionals to meet the expected increase in demand for services as more people gain insurance coverage.

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The Health Reform New Models of Care Workgroup explored new ways of delivering and financing care. The workgroup is considering the benefits and challenges of implementing various new models in North Carolina.

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