As the health system shifts to new payment models, we know that financially vulnerable residents including the uninsured and underinsured will suffer disproportionately from a lack of access to care. That is why it is imperative in this time of transition to maintain the health care safety net system in the state. It is critical that federally qualified health centers, free and charitable clinics, rural health centers, public health departments, and other safety net providers have the capacity to pivot with new payment systems. The Trust has an interest in helping safety net organizations adapt to value-based care.

The current COVID-19 pandemic highlights existing disparities in our state, and we are seeing the impact of underfunding public health, which makes responding to the current crisis more difficult. Residents need reliable information, and human service organizations need guidance. Providing unbiased information, translating between local communities and state and federal agencies, and acting as a coordinator and strategic planner are all roles filled by public health departments. The Trust wants to strengthen public health in the state to support these important functions.

We are interested in proposals that strengthen the health care safety net in the state. This could include technical assistance to safety net providers on value-based care and Medicaid reform. We will also consider support for broad-based education efforts to inform the public and decision makers about the pressures faced by safety net clinics; applications to convene public health departments and other stakeholders to make recommendations on how to bolster local public health in North Carolina; and applications that support community-based evaluation, research, and planning that engages residents in the process.