Union County March 2023

Union County has an interesting challenge: The outskirts of the Charlotte metropolitan area sit on the western side of the county, and as one travels east the landscape grows increasingly rural. Communities and crossroads to the east face significant challenges, but they have difficulty securing grants and funding because the wealth to the west skews the county’s overall per capita income upward. On paper, Union is a Tier 3 county, but that designation doesn’t reflect the lived experience of many residents: 1 in 5 people in Monroe, NC, live below the poverty line.

Over dinner hosted by South Piedmont Community College in Monroe, the Blue Cross NC team engaged in a lively discussion of how the county has built support systems that work around the imbalance in prosperity. The discussion brought together representatives from across sectors: Government leadership, education, social services, law enforcement and philanthropy.

Project Manager Dr. Maria Lander for Our Future in UNiSON talked about her organization’s work to get more students across the county on a higher education pathway. Only 9% of Union County high school students participate in Career & College Promise programs, and the percentage of high school seniors completing college financial aid applications is below the state average.

As with students in many communities, mental health needs and substance use present some of the most significant barriers to educational attainment. Director of Social Services in Union County Ashely Lantz explained that a collaboration with the school system helps students without insurance get access to mental health care. She added that these kids have care … but their parents don’t.

“As a manufacturer,” chimed in Goulston Technologies President and COO Fred Edwards, “we have those parents. Anti-depressants have become the #1 prescribed pharmaceutical in our employee health care plan.”

The second stop in Union County gave the Blue Cross NC team an opportunity to see first-hand one of the sites where the community has banded together to improve the health and well-being of residents facing financial insecurity.

Community Health Services of Union County is one of the 70 free clinics in the NC Association of Free & Charitable Clinics. Clinic Executive Director Cindy Cole proudly shared that her organization has been serving the community for 40 years. Most of the staff have been around for more than 10 years. This longevity reflects a sincere commitment to the clinic’s mission and to Union County’s people and communities. In 2022, the clinic delivered an astounding 19,000 services to more than 4,000 patients.

“That’s a lot of work coming out of a little space!” said Blue Cross NC Senior Vice President for Government Markets Fran Gary.

After touring the facility and meeting members of the remarkable staff, the team sat down for a presentation from the CEO of the NC Association of Free & Charitable Clinics April Cook.

The Association’s free clinics serve more than 82,000 patients across 85 counties, including 63 rural counties. More than 80% of these patients are employed, but they don’t earn enough to lift them above the eligibility threshold (250% of the poverty level or less). The Association is exploring options for satellite clinics or mobile busses to get care into the 15 counties that are currently unserved.

While it’s not possible to put a price tag on the quality-of-life improvements that this work brings to the patients served, it is possible to quantify the economic impact this work has had: Every dollar invested in the state’s free clinics yielded more than $5 worth of services. In total, North Carolina’s free clinics prevented more than $369 million in medical costs.

To have an even greater impact, the Association has recently moved toward a regionalized structure. This makes it easier to leverage resources and it allows larger, more established clinics to support smaller ones. One of the Association’s major priorities moving forward is to expand access to dental, behavioral and primary care.

Dr. Gwendolyn Perkins, Medical Director of Community Health Services of Union County, has been with the team more or less from the beginning, and she continues to serve patients even after retiring from her private practice. When asked what drives her long-term commitment, she reflected, “What modern medicine can do for people is magic … it’s just magic. But not everyone can afford that magic.”