NC Cases: 222,969
Cases Hospitalized: 1,028
NC Deaths: 3,693
Positive Tests: 7 day average was 6.4%
NC DSS/Benchmarks Webinar
Lisa Cauley presented on the Thursday October 8th webinar for Benchmarks. Highlights from the webinar include:
Lisa has been promoted to a new position as the Senior Director for Adult and Child Services. She will continue as interim Deputy Director for Child Welfare Services for a couple of months until a replacement is found.
NC DSS is ramping up work on FFPSA with the looming Oct 1, 2021 deadline quickly approaching. They have begun estimating the loss of IV-E dollars in the first year when the 2 week limit goes into place for any residential placement outside of a QRTP, placement for youth at risk of sex trafficking, pregnant teens, and youth 18 and older who are aging out of care.
Currently there are 750 children in DSS custody in Children's Homes (these are NON Medicaid behavioral health facilities) and 200 in Medicaid-funded residential treatment facilities such as Level III, IV and PRTFs. The IV-E/county/state costs for the Children's Homes is $4000 per month. For the children in residential behavioral health placements, IV-E contributes $600 a month for eligible children's room and board and Medicaid covers the treatment costs.
Based on these numbers, NC DSS roughly estimates a $3 million dollar IV-E loss the first year.
Concerns were raised that the number seemed low. Ms. Cauley noted that it is only for 9 months of the fiscal year (Oct 2021 - June 2022) AND for children who are placed in residential settings prior to Oct 2021 that are IV-E eligible will be able to continue to draw down the IV-E dollars after the first 2 weeks if the placement is not disrupted.
At this point, NC DSS is planning to use the FFPSA Transition Act money to offset these losses as they realize they don't have alternative placements for all the youth currently in residential placements. They are still working to refine the loss estimates to determine if an additional legislative asks for state dollars will be needed in addition to the Transition Act funds.
NC DSS realizes that there is a great deal of misunderstanding across the counties about FFPSA, particularly around the placement of youth in Children's Homes. Some counties have disrupted placements in the Children's Homes because they believe they have to remove the children now or they will begin losing IV-E dollars.
Counties also don't have a strong understanding that the IV-E loss of funds will only be for the youth who are not IV-E eligible as they counties already cover the IV-E costs for non IV-E eligible youths in residential placements. Lisa noted that they had started, and would continue to do a lot of education with the counties around the fiscal dynamics of FFPSA.
NC DSS has started to look closely now is the potential use of Qualified Residential Treatment Programs (QRTPs). What Ms. Cauley noted is that they are particularly interested in finding agencies that provide a complete continuum of care that includes foster, TFC, non-Medicaid funded residential and QRTPs. They are just in the beginning phases of thinking through the QRTP and recognize that since it falls under the Medicaid IMD rules that limits them to 16 beds or less that it will be a fiscal challenge to appropriately fund them so they can meet all the QRTP statute requirements.
They are really trying to ramp up kinship opportunities in North Carolina and are hopeful that the work that Children's Home Society is doing with "Caring for our Own" program will be a key catalyst in that change. This program is focused on increasing kinship licensure much more quickly across the state and addresses needed waivers many kinship families need to attain licensure status. NC DSS is looking at drawing down IV-E funds to assist to the financial needs of kinship placement prior to kinship family being licensures. This is part of a larger effort they are making in rethinking about how to achieve better outcomes for families.
CDC says airborne transmission plays a role in coronavirus spread in a long-awaited update after a website error last month
The Centers for Disease Control and Prevention acknowledged Monday that people can sometimes become infected with the novel coronavirus through airborne transmission, especially in enclosed spaces with inadequate ventilation.
The long-awaited update to the agency Web page explaining how the virus spreads represents an official acknowledgment of growing evidence that under certain conditions, people farther than six feet apart can become infected by tiny droplets and particles that float in the air for minutes and hours, and that they play a role in the pandemic.
The update follows an embarrassing incident last month when the agency removed a draft that had not gone through proper review and was posted in error. The draft's wording included a reference to aerosols - tiny droplets that can stay in the air, potentially traveling a significant distance. Officials said the draft was removed because they feared the language could be misinterpreted as suggesting that airborne transmission is the main way the virus spreads.
That is not the case. The CDC says the main way the virus spreads is through close contact with virus-containing droplets - large and small - that are emitted when someone coughs, sneezes, sings, talks or breathes. When people are in proximity, within six feet, they are exposed to the whole spectrum of spray that can cause infection.
Now, the CDC is saying infection can also spread through exposure to smaller virus-containing droplets and particles that can remain suspended in the air over long distances and time.
"There is evidence that under certain conditions, people with COVID-19 seem to have infected others who were more than six feet away," the updated Web page states. "These transmissions occurred within enclosed spaces that had inadequate ventilation. Sometimes the infected person was breathing heavily, for example while singing or exercising."
"Under these circumstances," the Web page says, "scientists believe that the amount of infectious smaller droplet and particles produced by the people with COVID-19 became concentrated enough to spread the virus to other people. The people who were infected were in the same space during the same time or shortly after the person with COVID-19 had left."
In a statement, the agency said it "continues to believe, based on current science, that people are more likely to become infected the longer and closer they are to a person with COVID-19."
The CDC added: "Today's update acknowledges the existence of some published reports showing limited, uncommon circumstances where people with COVID-19 infected others who were more than 6 feet away or shortly after the COVID-19-positive person left an area." The agency said transmission took place in "poorly ventilated and enclosed spaces that often involved activities that caused heavier breathing, like singing or exercise. Such environments and activities may contribute to the buildup of virus-carrying particles."
The agency said its recommendations for avoiding the virus remain the same.
People can protect themselves by staying at least six feet away from others, wearing a mask that covers their nose and mouth, washing their hands frequently, cleaning touched surfaces often and staying home when sick, the CDC said. People should also avoid crowded indoor spaces and ensure indoor spaces are properly ventilated by bringing in outdoor air as much as possible, the agency said.
To improve indoor airflow in public buildings, experts at the Yale School of Public Health recommend switching off sensor-based ventilation to more constantly flush air. Open windows for fresh breezes, they said. And reverse ceiling fan blades, which can draw air up, away from a room's occupants.
Vaccine Planning
NEWS RELEASE, 10/05/20
The N.C. Institute of Medicine is convening a COVID-19 Vaccine Advisory Committee to provide feedback to the N.C. Department of Health and Human Services on its COVID-19 Vaccination Plan. The Advisory Committee is composed of stakeholders including public health experts, health care providers, advocacy organization leaders and representatives of essential workers and at-risk populations. North Carolina is required to develop and submit a COVID-19 Vaccination Plan to the federal government in mid-October in anticipation of vaccine doses becoming available.
The purpose of the Advisory Committee is to provide expert guidance on the development of the plan, support its successful operationalizing, and increase public awareness about vaccination activities, especially prioritized and historically marginalized populations. Committee members are reviewing the plan with a focus on ensuring a sound base of science, equity, and operational feasibility. The initial focus of the committee's work is to inform the development of an allocation framework for vaccine distribution, based on federal guidance, as states will receive limited supplies at the start. The committee has met three times and will continue to meet, as needed.
Tracing App
Zachery Eanes, THE NEWS & OBSERVER, 10/07/20
In the two weeks since it was launched, North Carolina's COVID-19 exposure app, SlowCOVIDNC, has been downloaded more than 100,000 times. But Sam Gibbs, the deputy secretary for technology and operations at the N.C. Department of Health and Human Services, said the app shouldn't necessarily be judged by the absolute number of North Carolinians who download it. That's because the state, he said, is being very specific about who it is marketing the app to. Rather than invest in widespread and expensive marketing to all residents in the state, DHHS is targeting the app toward specific populations.
For example, a large majority of people who have downloaded SlowCOVIDNC are students in the UNC System, community colleges or private universities in the state. "It is not an overall number (of downloads) we are looking for - we are trying to get concentrations in places that" are at high risk, Gibbs said in a phone interview.
Like many states, North Carolina is using technology created by Apple and Google to create its COVID-19 exposure app. Virginia became the first state to launch one in August, and by September more than 500,000 people had downloaded it, according to WVTF, a public radio station in Roanoke, Virginia. Virginia took a more blanket marketing approach than North Carolina's targeted one, Gibbs said. As North Carolina's schools try to return to on-campus instruction next semester, the app could become an important tool, Gibbs added, noting Eastern Carolina University plans to use it heavily. North Carolina launched its app on Sept. 22, making it available for free in the Google Play Store and Apple's App Store, The News & Observer previously reported.
The app uses Bluetooth technology to share anonymous ID numbers with other phones nearby. Bluetooth signal strength is recorded on your phone to estimate the distance between phones, so it can track when exposure to another phone meets the definition of close contact - six feet or closer for at least 15 minutes. If you become COVID-19 positive, and report it to the app via a PIN provided by your local health department, SlowCOVIDNC will tell others if they were exposed a certain number days ago.
COVID Research
Hannah Towey, UNC MEDIA HUB, 10/07/20
The University of North Carolina at Chapel Hill is one of 89 testing sites for Moderna's phase 3 clinical trial for a COVID-19 vaccine. Because of its quick response and extensive research, UNC-CH has become among the most cited universities in the U.S. for coronavirus expertise. With pressure from the federal government to distribute a vaccine before election day, Moderna and eight other COVID-19 vaccine developers released a pledge in early September reaffirming their commitment to "high ethical standards and sound scientific principles."
Even still, 78% of Americans worry the vaccine approval process is being driven more by politics than science. In a rare bipartisan sentiment, 72% of Republicans and 82% of Democrats expressed such worries, according to a survey from STAT and the Harris Poll. Despite concerns of a rushed approval process, thousands of volunteers across the nation have stepped up as patients for the COVID-19 vaccine trials. After multiple medical examinations, participants receive either the vaccine or a placebo. In the weeks that follow, any symptoms are monitored through an E-diary mobile application and follow-up appointments as patients continue with daily lives.
Rental Assistance
Travis Fain, WRAL NEWS
Gov. Roy Cooper's administration expects to have a rent and utility assistance program that the governor announced in late August up and running next week. The state is "in the process of finalizing all the pieces," and the nonprofits and local governments that will help run the program are getting training this week, according to Haley Pfeiffer Haynes, spokeswoman for the state Office of Recovery and Resiliency, which will oversee the program. As announced, the program will use $175 million to help people avoid eviction and help homeless people find housing. Asked why it's taken until now to get the program launched, Pfeiffer Haynes said there were a lot of steps.
Officials had to write eligibility policies, decide what documentation would be required, what rules landlords will face if they accept funding and recruit community partners in all 100 counties, she said. The rules laid out had to fit the regulations for two separate federal programs that the money will be drawn from. "We have been working quite feverishly," Pfeiffer Haynes said in an email.
Rent assistance is one of the state's biggest needs in an economy waylaid by closures linked to the coronavirus pandemic. Requests for rental assistance dominate calls into the United Way's 211 help line, totaling more than 55 percent of those calls since April. The next two highest categories of calls are people seeking information about shelters and low-cost housing, according to figures from 211.
Economic relief talks are back on, Trump asserts, two days after he cut them off
President Trump said Thursday that economic relief talks are back on, two days after he abruptly declared them over and ordered his deputies to stop negotiating with House Speaker Nancy Pelosi (D-Calif.).
"Well I shut down talks two days ago because they weren't working out. Now they are starting to work out, we're starting to have some very productive talks," Trump said in an interview on Fox Business Network. He said he believes Pelosi "wants it to happen, because it's so good for our country, we really need it."
Pelosi and Treasury Secretary Steven Mnuchin have begun negotiating over a bill to rescue airlines, with United and American furloughing more than 30,000 workers after federal payroll support measures expired last week. Pelosi has not indicated publicly that other issues beyond airline aid are on the table right now, after Trump pulled the plug Tuesday on talks on a comprehensive relief bill with a pricetag between $1.6 trillion and $2.2 trillion.
But Trump said Thursday that other issues were also being discussed, including a new round of $1,200 stimulus checks. The labor market remains weak, with another 840,000 Americans filing for unemployment claims last week, more than six months after the coronavirus pandemic began in the United States.
"We're talking about airlines and we're talking about a bigger deal than airlines. We're talking about a deal with $1,200 per person, we're talking about other things," Trump said. "But it's not anybody's fault, they were trying to get things, and we were trying to get things and it wasn't going anywhere, I shut it down. I don't want to play games. And then we reopened, and I see the markets are doing well but I think we have a really good chance of doing something."
It remains highly uncertain that any deal can be reached, on airlines or anything else. Talks have been on again and off again for months, but ultimately Congress and the administration have been unable to strike a deal since the spring when they passed around $3 trillion in aid.
Multiple programs approved at that time have since expired, including enhanced unemployment insurance for individuals. It's not clear whether congressional Democrats would be willing to support a deal that just helped airlines, although Pelosi sounded out some lawmakers at a meeting Wednesday night, with some sounding open to entertaining the idea because of the jobs at stake.
The Cares Act from March included a Payroll Support Program for airlines that expired Oct. 1. Democrats have been pushing an approximately $25 billion bill to renew the program.
Trump began backtracking within hours Tuesday after his announcement that he was ending talks and asking Senate Majority Leader Mitch McConnell (R-Ky.) to focus on filling the Supreme Court vacancy instead. A number of Republicans in tough re-election races immediately criticized Trump's move and urged him to re-engage.
Opioid Grants
Liora Engel-Smith, NC HEALTH NEWS, 10/02/20
With the help of funds from the federal Health Resources and Services Administration, four rural North Carolina agencies - two in the east and two in the west - are poised to take a more comprehensive approach to the opioid crisis. The mney they received will help them evaluate gaps in services and tailoring programming to match those needs.
UNC Nash will use the $200,000 grant to study the needs of residents in Bailey Township - a rural opioid addiction hotspot about 33 minutes west of Rocky Mount. The township is home to drug houses and few recovery resources, she said. The 18-month project at Nash will use the results of their study to tailor programming to fit the community's needs.
More than 300 miles to the west, an organization in a mountain county is hoping for a similar transformation in rural Transylvania County. The Appalachian county does not have its own syringe exchange program and residents often have to travel out-of-county to receive addiction treatment, said Kristen Gentry, program director of CARE Coalition of Transylvania County. In the rural county with few resources, grant funding has emerged as the way forward to address some community needs, particularly when it comes to opioid and methamphetamine misuse.
Another awardee, a health center in Robeson County, will use an almost $500,000-grant to bolster its offerings for mothers with opioid addiction and their babies. Meridian Behavioral Health Services in Jackson County was awarded $200,000.
Teen Struggles
Rupen Fofaria, EDUCATION NC, 10/07/20
On Tuesday, the State Board of Education heard about increasing rates of attempted suicide, depression, and other mental health risk factors among the state's high school students. The data are from the latest youth risk behavior survey, taken in 2019 before the COVID-19 pandemic. The state has conducted the survey every other year since 1993. The Board discussed the 2019 results on the first day of a two-day strategic planning meeting. The presentation came amid renewed attention to youth suicide, which is the second-leading cause of death among teenagers nationally.
In North Carolina, the sampling showed high school students are at greater risk of self-harm, suicidal ideation, depression, and bullying. "I think we rightly and often say we care most about those who have the least, which is our children," State Board Vice-Chair Alan Duncan said. "We want to say that's who we are. But these numbers would suggest it's not who we are. And as a state, it's not what we're doing." Board member Jill Camnitz said she is worried these trends might have worsened since the survey was conducted last year. "I can't help but think about what these numbers would look like if we could sample those same kids right now," Camnitz said, referring to students' struggles during COVID-19.
High school students in the survey reported more suicide attempts and suicidal ideation. In the year before taking the survey, 19% of students seriously considered attempting suicide, they said, and 10% attempted it. That former number had dropped slightly from 2013 to 2017, before a 3% increase in 2019. LGBTQ students are about three times as likely to have suicidal ideation or attempt suicide, the survey showed. Among this group, 44% said they seriously considered attempting suicide and 22% actually attempted it.
AND ON A HAPPY NOTE YOU CAN STILL GET DEEP FRIED TWINKIES!
Fair Food
Drew Jackson, THE NEWS & OBSERVER, 10/07/20
While the North Carolina State Fair is canceled this year due to the COVID-19 pandemic, there will be something of a fair food festival in its place. Every day from Oct. 15-25, the N.C. State Fairgrounds in Raleigh will open up for fair-goers needing their fix of deep-fried bliss. Vendor will be open from 10 a.m. to 8:30 p.m. daily, with all orders served to-go. Fair organizers said gatherings will not be allowed at the fairgrounds and that all social distancing and mask orders apply.
"We just know that everyone misses their fair food," said Sarah Ray, spokesperson for the North Carolina State Fair. "We've had so many calls about how much everyone is bummed the fair can't happen this year." Since Memorial Day, the fairgrounds has hosted a series of drive-thru fair food events, where a handful of vendors served up a rotating menu of sweet treats and deep fried favorites. It turned out to be the sugar rush some needed, Ray said. The state fair typically features dozens of food vendors, collectively frying, grilling and candy-coating a wide spectrum of culinary wonders.
