Access to Care

Perspective  
Nearly three million people in North Carolina live in places deemed health professional shortage areas.  And in 2021, the state ranked 25^th in access to primary care and 26^th in access to mental health providers - with significant, and increasing, gaps between rural and non-rural areas. Further, estimates now show the state will be short as many as 21,000 nurses within a decade.

For North Carolina to be a place where everyone has the opportunity to be as healthy as possible, we must develop and invest in solutions bolstering the health care workforce, focusing on training, recruitment, composition, and deployment. It is also essential that we prioritize efforts in communities where a lack of workforce has had the most significant impact in terms of health outcomes and economic opportunity.

Approach  
Our approach centers on identifying and spreading models that address workforce shortages and distribution as well as supporting policy analysis that contributes to the ongoing evolution of the health care system. Specifically, our current focus is directed toward:

• Addressing shortages, maldistribution, and diversity in the workforce comprised of those who diagnosis and treat (physicians, physician assistants, and advanced practice nurses).
• Addressing shortages, maldistribution, and diversity in the nursing workforce.
• Increasing and improving training, employment opportunities, and career ladders for community health workers, peer support specialists, and others expanding access.
• Supporting changes to the practice and payment environment in order to make oral health care more affordable and accessible for everyone.
• Investing in diverse multi-sector partnerships that increase the capacity and amplify the voice of community.

Examples of our Work in this Area

• In 2024, we released a funding opportunity to expand access to mental health services and resources for youth through models that leverage a trained workforce that goes beyond specialty trained mental health care clinical and professional roles. As a result, more than $4.5M is supporting a selection of grantees from across the state.

• The NC Medical Society’s Community Practitioner Program, funded by a recent $2.25 million foundation grant, supports recruitment of providers by increasing preceptorships and loan repayment in primary care, behavioral health services, and maternal and women’s health in rural and other health care shortage areas.
• A $720,000 grant is supporting the NC Center on the Workforce for Health, a forum for collaboration among health employers, workers, educators, regulators, policymakers, and others to identify and address challenges and opportunities to improve the health workforce.
• We are working with partners to identify and highlight what works in nursing apprenticeship programs offered in partnership between health care and academic institutions.
• We take a comprehensive approach to making oral health care more affordable and accessible by supporting a network of organizations working to achieve systems-level change, integrate care into community settings, and strengthen safety-net access points.