North Carolina Health and Human Services Secretary Dev Sangvai, and NCDHHS Deputy Secretary for Opportunity and Well-Being Michael Leighs, traveled to eastern North Carolina this week to meet with leadership and participate in discussions with the Dare County Department of Health and Human Services, Chowan County Department of Social Services (DSS) and ECU Health Chowan Hospital.
During this trip, Secretary Sangvai discussed the current state of North Carolina Medicaid amid state budget uncertainty, impacts of federal legislation H.R. 1 on the state’s Medicaid program, the Supplemental Nutrition Assistance Program (SNAP), and implementation of the Rural Health Transformation Program.
Dare County Health and Human Services
Secretary Sangvai began his trip the afternoon of Thursday, March 26, where he met with Social Services staff at the Dare County Department of Health and Human Services in Manteo, North Carolina. There, he spoke with staff members, highlighting the valued leadership of the county and their work to cultivate services that best meet the needs of the North Carolinians they serve.
During his visit, Dare County officials discussed the evolving needs of their community. Approximately 24% of permanent residents in Dare County are adults aged 65 and older. They discussed the ongoing challenges of serving an aging and growing population, particularly with the implementation of Medicaid and SNAP changes required by federal legislation H.R. 1.
Under the new federal legislation, Medicaid expansion and SNAP beneficiaries face expanded work requirements. In addition, the Medicaid expansion population will be subject to more frequent eligibility redeterminations. These changes create additional obstacles for rural populations and areas with unique geography such as Dare County to receive these essential benefits. In order to implement the federal changes, there will be increased administrative burden on county departments of health and human services across North Carolina.
Dare County Health and Human Services staff are continuously working to provide comprehensive care despite staff turnover and amidst challenges like limited access to health care, including mental health and substance use services. County staff expressed excitement for opportunities to improve automation with the integration of new technology that will improve the function of services.
Dare is one of the 11 counties that will go live in PATH NC in April 2026 for Intake and Assessments as well as Ongoing Case Management modules, meaning all 100 counties will now be live in PATH NC for Intake and Assessments. These 11 are the first counties in the state to onboard into PATH NC for Ongoing Case Management.
"County DSS agencies are vital to the areas they serve and ensure their neighbors and communities get the necessary services and resources they need to thrive," said Secretary Sangvai. "I am grateful to our county social services staff whose dedication is critical in our mission to improve the health and well-being of all North Carolinians."
Chowan County Department of Social Services
Following his visit in Dare County, Secretary Sangvai travelled to Edenton, North Carolina, on Friday, March 27, to meet with Chowan County DSS staff. During the visit, he spoke with county staff on NCDHHS’ priorities supporting children and families, and the potential for operational uncertainties in the coming years from federal policy changes to SNAP and Medicaid in H.R. 1.
Secretary Sangvai and county staff also discussed impacts to NC Medicaid if the NC General Assembly funding shortfall continues. The North Carolina General Assembly must allocate $319 million to fund this year’s NC Medicaid program. Without this funding, the program is projected to run out of money before the end of the fiscal year, putting health care access for more than 3 million North Carolinians at risk. Funding impacts at the state level are separate from those at the federal level.
Chowan County DSS staff also discussed challenges facing their community, including staff retention and training, and ongoing innovative solutions they have implemented successfully. Notably, Chowan County DSS offers flexible hours to help staff perform efficiently and encourages staff to collaborate with community stakeholders to develop resources for their clients. These efforts have helped stabilize and support the workload for county staff.
Secretary Sangvai also provided Chowan DSS updates on PATH NC, the modernized child welfare information system that equips DSS staff with real-time data and decision-making tools to better protect and serve the children and families in their counties. For smaller counties like Chowan, PATH NC allows staff balancing multiple responsibilities to access timely data and resources, identify trends and work seamlessly with neighboring counties through a centralized data system.
"We launched PATH NC with the goal to create better outcomes for children and families in North Carolina," said Secretary Sangvai. "Over the last year, PATH NC has successfully launched in a majority of North Carolina’s counties, and we are eager to continue our collaboration to build a stronger child welfare system across the state."
ECU Health Chowan Hospital
Secretary Sangvai concluded his trip Friday with a visit to ECU Health Chowan Hospital for a tour of their facilities and a roundtable discussion on the state of rural health care and the unique challenges facing rural hospitals.
During this stop, Secretary Sangvai toured the Emergency Department and Outpatient Services Center at ECU Health Chowan to see and learn more about how the ECU Health system addresses workforce and retention challenges and the successes they've achieved with patients in the community.
Throughout his conversations with staff at ECU Health Chowan Hospital, Secretary Sangvai highlighted the positive impacts of public health partnerships as well as the persistent need to strengthen and retain North Carolina’s rural workforce. NCDHHS has expanded loan repayment programs for nurses and mental health professionals who practice in rural communities.
Secretary Sangvai also discussed North Carolina’s participation in the Rural Health Transformation Program. North Carolina received $213M in RHTP funding to improve the health and well-being of more than 3 million people who live in rural communities in North Carolina.
"Our goal is to optimize the funding awarded by our federal partners to North Carolina to implement the Rural Health Transformation Program," said Secretary Sangvai. "We will continue to collaborate with counties and stakeholders as we work together to address the growing needs of the nearly 3 million residents living in rural areas. Together, we will strengthen and improve outcomes for our rural communities in support of a healthier North Carolina for all."