The Southern Highland Reader

(Hat tip: Ashvegas)

Trust for America’s Health (TFAH) and the Robert Wood Johnson Foundation (RWJF) released the seventh annual “Ready or Not? Protecting the Public’s Health from Diseases, Disasters, and Bioterrorism” report, which finds that the H1N1 flu outbreak has exposed serious underlying gaps in the nation’s ability to respond to public health emergencies and that the economic crisis is straining an already fragile public health system.

The report contains state-by-state health preparedness scores based on 10 key indicators to assess health emergency preparedness capabilities.

Twenty states scored six or less out of 10 key indicators of public health emergency preparedness.  Nearly two-thirds of states scored seven or less.  Eight states tied for the highest score of nine out of 10: Arkansas, Delaware, New York, North Carolina, North Dakota, Oklahoma, Texas, and Vermont. Montana had the lowest score at three out of 10.  The preparedness indicators are developed in consultation with leading public health experts based on data from publicly available sources or information provided by public officials.

Overall, the report found that the investments made in pandemic and public health preparedness over the past several years dramatically improved U.S. readiness for the H1N1 outbreak.  But it also found that decades of chronic underfunding meant that many core systems were not at-the-ready.  Some key infrastructure concerns were a lack of real-time coordinated disease surveillance and laboratory testing, outdated vaccine production capabilities, limited hospital surge capacity, and a shrinking public health workforce.  In addition, the report found that more than half of states experienced cuts to their public health funding and federal preparedness funds have been cut by 27 percent since fiscal year (FY) 2005, which puts improvements that have been made since the September 11, 2001 tragedies at risk.

See a synopsis of the report here.

GSMNP–Congressman Heath Shuler recently helped secure a $13 million down-payment from the federal government to help put an end to the nearly-seven-decade controversy over a road once planned along the north shore of Lake Fontana.

The payment, part of a larger, undisclosed sum, would compensate Swain County for the federal government’s choice not to build the road, which was promised in 1943.

National Parks Traveler writer Danny Bernstein gives a history of the controversy here.

Here’s an excerpt:

The North Shore Road issue was revived again in 2001 when former Congressman Charles Taylor, a Republican from western North Carolina, obtained $16 million for further construction of the North Shore Road. This set off a process that looked into the environmental impact of a 35-mile road. The National Park Service held public input forums in various locations around the Smokies and accepted comments from anyone in the U.S. on various ways to resolve the 1943 agreement. Thousands of pages were generated, reviewed, and discussed. Descendants of the original settlers were the only ones who wanted a road in the park. Almost all comments were against the road and for a financial settlement with Swain County, where Fontana Dam is located, one of the four parties to the original agreement.

In December 2007, the Department of the Interior made a decision that officially called for a yet-to-be-specified multi-million-dollar monetary settlement to Swain County instead of a road through one of the most pristine and untouched areas in the East. Though the park is now protected and the North Shore Road will never be built, Congress still has to approve the funds to settle the 1943 agreement.

STATEWIDE–When the state of North Carolina announced a new online reservation system for its state park campgrounds late last year, there was uncertainty about how the system would be received, and about how well it would work.

The Raleigh News and Observer reports that all is well. In fact, all is very well.

Over 1,300 reservations have been made for 2,000 available campsites for 2010, the paper reports.

An excerpt:

The new system was launched in July, making it easier for people to reserve spots up to 11 months in advance at any park. Reservations can be made for stays as short as one night or as long as two weeks.

The new system should eliminate what used to be long lines starting New Year’s Day at popular parks such as Kerr, Jordan and Falls lakes. Under the old system, about 2,000 campsites could only be reserved by paying in person at the park or taking the chance on the U.S. Postal Service. Visitors were permitted to reserve spots only up to a week in duration.

Read the story here.

STATEWIDE-The Raleigh News and Observer reports that the state of North Carolina will urge 78,000 state residents whose unemployment benefits recently expired to re-apply for extended benefits recently approved by congress.

An excerpt:

The N.C. Security Employment Commission is preparing to send out the letters this month as it begins administering the extension, which increases benefits by up to 20weeks. Congress boosted maximum jobless benefits five weeks ago from 79 weeks to 99 weeks in the midst of the nation’s most severe economic recession in decades.

Read the story here.

STATEWIDE–The Charlotte Observer reports that state health officials now say Lyme Disease can be contracted in North Carolina. For years, officials thought the tick-borne ilness was unlikely to be contracted here.

An excerpt:

Based on the new evidence, Dr. Megan Davies, state epidemiologist, said the state is now working to get the word to doctors, who for years were reluctant to even test patients for Lyme because it wasn’t considered much of a possibility.

“What we’re trying to communicate to physicians is that it’s possible to acquire Lyme in North Carolina, so don’t hold to an old belief,” Davies said, noting that she and others are meeting with infectious disease doctors at the state’s medical schools to get the word out.

Read the story here from the Observer.

STATEWIDE–Newly-elected Asheville city council member Cecil Bothwell defines himself as an atheist, and conservatives say that means that under North Carolina law he may not serve in a public office.

Here’s a blog post from the C-T’s Jordan Schrader that outlines the history of state laws that suggest as much.

An excerpt:

… the U.S. Constitution guarantees freedom of religion and bans religious tests for office, so a lawsuit against City Council would have little legal ground to stand on. But the clause remains in the state constitution, even after a major rewrite of the document in 1972.

Voters have to approve changes to the constitution, and that’s a fight few politicians would want to take on for little or no practical benefit.

Here’s a news story from the Asheville Citizen-Times.

STATEWIDE–A former North Carolina Department of Transportation official from the eastern end of the state was sentenced to over three years in prison yesterday for taking kickbacks from an excavation company.

Dalton Alligood Jr., a former district engineer for the DOT, received 10% in cash from contracts funneled to the company between 2004 and 2006.

Governor Beverly Perdue has stated her intention to be tougher on corruption at the DOT at all levels.

More on Alligood here from AP via the Charlotte Observer.

STATEWIDE–The North Carolina Utilities Commission has approved a 7 percent rate hike for Duke Energy customers.

The hike will increase Duke’s annual revenue by $315.2 million. Duke originally sought a $488 million increase in rates, but the Commission staff had argued that a $183 million increase for Duke would be sufficient. The final amount represents a compromise.

The rate hike will be phased in, with Duke customers seeing an initial 3.27% hike next month.The balance will come in January of 2011.

The hike is controversial, in part, because Duke plans to use part of the revenue to pay for its new Cliffside Steam Station, a large, coal-driven plant west of Charlotte. Cliffside is opposed energetically by environmentalists.

Read more here, from the Charlotte Business Journal.

REGIONAL–The governing board of MedWest Health System voted unanimously Tuesday to accept Carolinas HealthCare System’s recommendation and appoint Mike Poore as the chief executive officer for the affiliated hospitals of Haywood Regional Medical Center, Harris Regional Hospital and Swain County Hospital. The system will enter into a management agreement with Carolinas HealthCare System beginning in January, 2010.

Mike Poore

Poore, who was hired as CEO of Haywood Regional Medical Center in October 2008, will assume the new position effective January 1, 2010.

“I’m excited about the challenges of bringing these two organizations together to better serve all of our communities. By integrating the resources of WestCare, Haywood Regional and Carolinas HealthCare System we will greatly enhance the healthcare of our region,” states Mr. Poore.

“The new MedWest CEO will be very busy over the next few months working with the new organization and with Carolinas HealthCare System to develop a management action plan to be presented to the MedWest board. The transitional process will take approximately six months,” said Mark Clasby, chairman of the MedWest board.

Fred Alexander, board vice chairman, stated, “Mike Poore has the experience and expertise to lead this system as it grows and enhances healthcare in the area. He has the full backing and support of the board and we look forward to the work that needs to be done.”

“I would like to congratulate Mike Poore on his appointment to CEO of MedWest Health System. This system, with support of Carolinas HealthCare System, will ensure that quality healthcare continues to be delivered to the citizens of Western North Carolina for years to come. I am very proud of our strong, capable and compassionate WestCare staff and know they will remain committed to providing excellent patient care. I would ask the WestCare staff to give Mike the same level of commitment and dedication they have always provided,” Mark Leonard, CEO of WestCare Health System.

The MedWest Board of Directors is made up of 14 members and has equal representation from both Haywood Regional Medical Center and Harris Regional and Swain County Hospitals. Two physicians each from Haywood and WestCare will also serve on the board of directors.

Poore served as senior vice president and administrator for Wellstar Douglas and Wellstar Paulding hospitals and the Paulding Nursing Facility in Atlanta, Ga., from 2007 to 2009; and as vice president and administrator for Douglas Hospital from 2004 to 2007. He served as the administrative director of ancillary services and vice president of operations at DePaul Medical Center from 1998 to 2004. Prior to that he was an administrator of support services at Erlanger Health Systems and was an administrator at Stewart Webster Hospital in Richland, Ga.

“An organization will flourish when you develop ownership and pride among employees. I believe in giving employees the tools needed to do their job, removing any barriers, and then getting out of the way and letting them do their job,” Poore said.

He is originally from Mobile, Al. He earned a Bachelor of Science degree in Health Services Administration at Auburn University and a Master of Business Administration degree at the University of South Alabama. He is a Fellow of the American College of Healthcare Executives. He and his wife, Penny, have two sons and one daughter.

“I would like to thank the MedWest board for their hard work to ensure a strong system that can offer better service to all communities served by the newly integrated network,” said Michael C. Tarwater, CEO of Carolinas HealthCare System. “CHS looks forward to being actively involved in those communities, and responsive to community needs, once the new management agreement has taken effect.”

Mr. Clasby said the MedWest board’s goal is for the management agreement to become effective in January. The management services agreement will help to ensure access to broader resources, including sharing best practices in areas such as financial management, staff recruiting, safety and quality improvement, he said.

Haywood Regional Medical Center (www.haymed.org) was established in 1927. The current facility opened in 1979 and is licensed for 170 acute care beds. It is the third largest employer in Haywood County with more than 900 employees.

WestCare Health System (www.westcare.org) was formed in February 1997 when Harris Regional Hospital and Swain County Hospital combined to develop a full spectrum of health services. WestCare employs almost 1,200 full and part time employees and has a medical staff of more than 90 physicians representing 22 specialties.

Carolinas HealthCare System (www.carolinashealthcare.org) is the largest healthcare system in the Carolinas, with 29 affiliated hospitals in North Carolina and South Carolina.

REGIONAL–From Onvia, by way of the North Carolina Economics blog, here’s a nice interactive map of federal stimulus spending in North Carolina. Click on counties to read a summary of projects.

The short take:

• Jackson: 9 projects at a value of $3,811,725
• Swain:  12 projects at a value of $15,667,128
• Graham: 3 projects at a value of $1,260,556
• Cherokee: 9 projects at a value of $98,949,966
• Clay: 3 projects at a value of $25,806,709
• Macon: 6 projects at a value of $6,220,760

STATEWIDE–As I touched on here and here, North Carolina’s state health plan will soon be closely tied to the behavior of the people enrolled in the plan. The state will penalize those who are overweight, who smoke, and so forth, and will be among the first few states in the nation to do so.

Some in the media argue that tying behavior to health insurance costs is sensible, although Adam Linker at NC Policy Watch isn’t so sure.

He argues, among other things, that the use of any type of tobacco product will be treated the same as the use of cigarettes, despite varying health risks (he uses cigars as an example). Linker also points out what he sees as a fundamental unfairness of the plan: that low-wage state workers — who are statistically more likely to be in poor health than higher paid workers — are “punished” more severely, because the programs costs aren’t on a sliding scale.

“Imposing a penalty for smoking is one thing. Crippling family budgets for using tobacco is quite another,” Linker writes.

He also points out that the expense of the state plan for lower-paid workers is quite high.

Read more here at the NC Policy Watch blog.

Another story from the Asheville Citizen-Times here.

REGIONAL–Kay Byer, of Cullowhee, served as North Carolina’s Poet Laureate from 2005 until 2009.

Here, Brian Brodeur, poet and author of the blog How a Poem Happens, interviews Byer. They talk at some length about Byer’s poem “Precious Little”.

From the poem:

I seethed while my student poets,
all of them women, sat waiting for someone
to challenge his vision of literature,

belligerent canon
where warring tribes battle it out
in their epics and blood-spattered novels.
“Miss Welty,” I countered, “stayed

clear of the battlefield, if you recall.
She sat down every day at the same desk
and made language raise the world up
from the grave of our common amnesia.”

An excerpt from the interview:

Byer: “The fiction writer, made much younger and more successful in the poem, actually said that war was the story, expressing his regret that he had never experienced war first-hand. I countered with Eudora Welty’s never having been to war, yet being one of our greatest American writers. My students were appalled by his attitude, and over the next few weeks, we kept spiraling back to this incident in our discussion. The poem began out of my initial irritation and growing frustration at not having spoken more forcefully and eloquently that day.”

Read the post here.

BRYSON CITY–The Smoky Mountain Times’ Lee Zion reports that an $84,300 grant from the federal government will purchase “urban” rescue equipment to be shared by the seven westernmost North Carolina counties and the Qualla Boundary.

An excerpt:

[When the money arrives], Swain County will use it to purchase a truck to haul a search-and-rescue equipment trailer. The trailer will be used by several counties, said David Breedlove, the county’s Emergency Management Agency director.

North Carolina Urban Rescue Task Force 1 is based in Swain County. The task force is staffed by rescue personnel from the seven western counties and the Eastern Band of Cherokee Indians, he said.

“The grants came about after 9-11 to help with buildings coming down, or bridges or tunnels – any big structure that you need equipment to lift up heavy things, like girders of buildings. Similar with bridges and things like that,” King said.

Read Zion’s story here

STATEWIDE–Former NC state senator Cal Cunningham, a Democrat, has rejoined the race to unseat current senator Richard Burr in next year’s election.

From Congressional Quarterly:

In what appears to be a case of right news, wrong timing for the Democratic Senatorial Campaign Committee, word began to leak out Tuesday that Democratic former North Carolina state Sen. Cal Cunningham has decided to reverse an earlier decision and will challenge incumbent Republican Richard M. Burr in 2010.

The decision is a victory for the DSCC, which has been working to get Cunningham to reconsider the contest after he passed on the race in mid-November. The only problem is that the news leaked out on the same day that North Carolina Secretary of State Elaine Marshall, who is also competing in the Democratic primary, was holding a funeral for her husband, who died last week at age 77.

Read the piece here.

SYLVA–One of the most harrowing crimes committed in western North Carolina during the first half of the 20th century is the alleged murder in 1913 of two-year-old Roberta Putnam by her grandmother, Nancy Kerley, known as Nance Dude. Released from prison after 15 years hard labor, Nance Dude lived out her life rejected by her family. But as she never admitted her guilt or testified in court, her side of the story was never heard. In his acclaimed play, Gary Carden imagines what she might have said, combining folklore, some compelling historical evidence, and a playwright’s storytelling art.The much-performed play is now available as a DVD, featuring a performance by Elizabeth Westall.

Friday, December 4, City Lights Bookstore in Sylva will host a reception and discussion to celebrate the release.

The evening at City Lights will feature copies of the DVD for sale as well as refreshments and conversation with the playwright. The focus of the discussion will be not only on the play but also more generally on the subject of preserving and celebrating the folklore and heritage of the region. Pam Duncan, Rob Neufeld, and Michael Beadle will join in the discussion, as well.

STATEWIDE–Some four dozen new North Carolina laws become active on December 1, including the tightening of probation regulations, new rules about license plate readability and harsher rules for sex offenders.

The state is also shortening some prison sentences to alleviate prison overcrowding.

The tightening of probation regulations came about after the murder of UNC student body president Eve Carson last year, writes Barry Smith for enctoday.com. One of the suspects arrested in her killing was on probation, but because his probation officer did not have access to his juvenile records, his restrictions were light. New regulations give the state’s 2,000 probation officers greater access to such records.

Other new laws require greater control and labeling of venomous reptile pets, restrict fancy decorations on license plates that render them unreadable and make Salvia divinorum, an herbaceous perennial in the mint family sometimes known as “Seer’s Sage”, a controlled substance.

Read a rundown on the new laws from enctoday.com here.

UPDATE: The post below details a schedule for a decision on whether to seek criminal charges against former NC Governor Mike Easley. Since it was written the prosecutor has changed his tune, saying he is consulting with federal investigators and his decision could take many additional months. Story here.

STATEWIDE–The lead from Associated Press writer Gary Robertson:

REGIONAL–The Artful Parent posts here about a new exhibit on display at the North Carolina Arboretum in Asheville: Building Small: American Folk Art Houses and Structures.

An excerpt from the Artful Parent:

These folk art houses are from the collection of Steven Burke and Randy Campbell, the largest such collection in the country. According to the exhibit attendant this is the first (and probably only) time this collection will be exhibited.

Here’s a promo at the Arboretum website.

Building Small: American Folk Art Houses and Structures

STATEWIDE–Twenty North Carolina legislators have filed a complaint against Blue Cross and Blue Shield concerning its anti-health reform campaign in the Tar Heel state, and, as detailed in this story from the Associated Press’s Gary Robertson, state Attorney General Roy Cooper’s office has launched an investigation.

Robertson’s lead:

State lawmakers and attorneys are scrutinizing Blue Cross and Blue Shield of North Carolina for its attempt to influence the national health care debate through direct mail and possibly illegal automated phone calls.

At issue is whether BCBSNC, which operates as a “unique not-for-profit corporation”, has enjoyed tax-protected status in North Carolina and handles an enormous slice of the health insurance market in the state should be conducting campaigns to influence public policy.

BCBSNC has mounted an aggressive statewide campaign against health reform in recent weeks.

Of the 20 policymakers who filed the complaint, only one, Madison County’s Ray Rapp, is from the mountains.

Read Robertson’s story in the Washington Post here.

Read coverage from the Progessive Pulse here.

CHAPEL HILL–Sylva native and Smoky Mountain High product Cetera DeGraffenreid, now a junior guard at North Carolina, is ACC player of the week.

From UNC:

DeGraffenreid played one of the best all-around games of her career against Coastal Carolina, scoring 20 points and adding eight assists, eight steals and six rebounds in 29 minutes of action. The eight steals tied a career-high for the junior from Cullowhee, N.C. DeGraffenreid followed that performance with a 22-point, four-rebound, three-assist outing against UNLV on Sunday. The guard was a perfect 10-for-10 from the foul line against the Rebels, with several coming down the stretch to secure the win.

Read more here

Cetera DeGraffenreid