Asheville – Lucy Lawrence, MSW Ph.D., provided the Buncombe County Commissioners with an update on the Health and Human Services Board, which she chairs. “We have been working on advocacy around a variety of issues,” she said. The first issue she highlighted was working to get the General Assembly to raise the cap on heating bill payments for seniors. The maximum grant, which had been $600, will now be $1,000. Payments are made by the county to the utilities on behalf of named, qualified individuals.
Another issue was the 2022 Dobbs decision. The manner in which the decision was received made planning very difficult for Planned Parenthood South Atlantic. They operate the Asheville abortion clinic, which is the only legal one in Western North Carolina. Anticipating state restrictions, there at first were worries about whether there would be enough staffing for compliance. Then, with Buncombe County District Attorney Todd Williams being very vocal about his stance that he would not prosecute a woman exercising her abortion rights, an additional level of complexity—to comply or not comply—was thrown into the mix.
Then, unexpectedly, Planned Parenthood’s clinic on McDowell Street first had to add staff to accommodate an influx of clientele from neighboring states that had beaten North Carolina to the punch with bans. In North Carolina, Senate Bill 20 added three in-person doctor visit requirements and changed the fetus’ legal abortion age. In just 13 days, the bill was introduced, ratified, and vetoed, and the veto was overridden.
With all this commotion, Planned Parenthood still had to deliver its many other services, like providing birth control and hormone treatments for people who have changed their gender. Nonetheless, leadership at the abortion agency risked doing what many other high-ranking officers in the state were and compounded the uncertainty with lawsuits.
In April 2023, a majority serving on the BCHHS board approved sending a statement condemning the Dobbs decision to members of the local delegation. As the law now stands, fetuses more than 12 weeks old must be aborted at a hospital.
The third advocacy issue was harm reduction. To this end, the county launched an “equitable access” pilot project. Lawrence said the program “provides smoking supplies to intravenous drug users to reduce their risk from needles.”
The board was handling all this in the milieu of major challenges. First and foremost was the pandemic. As businesses struggled with social distancing guidelines, HHS had to administer tests and vaccinations as well. This required staffing up and retrenching in the midst of epidemic levels of personnel calling out and calling it quits. The department had to stay up-to-date with the latest findings, guidelines, and interpretations, too, because HHS was considered the go-to for answers.
With the worst of the pandemic apparently over, staff still hasn’t had a chance to decompress. Lawrence said, “Our economic resources and staff have been stretched as moratoria and other forms of financial assistance are rolled back to pre-pandemic levels, and social work struggles with the pandemic-related social, economic, and mental health stressors that continue.”
Another major change was that the state approved Medicaid expansion. In the first five months of its rollout, the state boasted that 450,000 North Carolinians had gained coverage. As of this month, 13,057 people are enrolled in Buncombe County. That’s 13,057 people with applications to process, and several with questions in need of navigation. Many will also need services for which HHS serves as a junction box, not the least of which is free family planning.
The third major challenge was “lack of foster care placement options.” Interim HHS Director Colleen Bridger fielded a question from Commissioner Terri Wells, saying, “You’ve seen the coverage in the media about the issue,” but what wasn’t seen was the way staff is responding, “to an ever-growing need with an ever-shrinking pot of resources.”
Bridger said they’re trying to set up a system where “fewer kids go into foster care so we can intervene earlier and keep kids with their families, which is where they do best. But if the worst-case scenario happens, and we do have to take custody and we do have to remove them from the home, that we’re placing them in homes where they have a safe, stable, nurturing environment while we work with their family to address the issues that caused them to have to be removed in the first place.”
She closed with, “I’ve only been here a couple of months, and I’m amazed at the work that they do.”