April 27, 2020
Dear House Select Committee on COVID-19:
We appreciate the opportunity to provide comments as your committee does the important work of responding to the COVID-19 pandemic in North Carolina. We write on behalf of the North Carolina AIDS Action Network, Duke Health Justice Clinic and the signed individuals and organizations on behalf of people living with HIV and advocates for HIV prevention in North Carolina.
We appreciate the leadership shown so far by state government leaders to address this pandemic. We are thankful that the NC House is seriously committed to social distancing and using technology to allow the state’s business to proceed without gathering in person. We also applaud the leadership of the executive branch in educating the public about the pandemic and implementing a stay at home order on March 30th.
Below are several recommendations the committee should consider when moving forward to address the COVID-19 pandemic.
Close the Medicaid Coverage Gap
The time for debating the benefits of closing the Medicaid coverage gap is over. Expanding Medicaid would bring health insurance to more than 500,000 hardworking North Carolinians, likely more now given job loss occurring every day due to the pandemic.
We have been longtime advocates for closing the coverage gap. It will provide full insurance to thousands of low-income individuals living with HIV, and increase access for low income individuals looking to access PrEP (Pre Exposure Prophylaxis) and other healthcare services to help them stay HIV-negative. Medicaid also will help our state combat the opioid epidemic and ever increasing rates of hepatitis C by connecting individuals to substance abuse treatment and helping cure hepatitis C.
North Carolina has spent years debating and discussing the merits of closing the coverage gap. Now is the time to put the partisan bickering aside. Closing the coverage gap is good for the economy, it is good for our rural hospitals, and it is good for the hundreds of thousands of residents who need health insurance now more than ever.
Extensive changes were made to North Carolina’s unemployment compensation system in 2013 that decreased the amount and duration of payments to unemployed persons. Those changes have placed North Carolina’s unemployment insurance program in the bottom ranks of states, leaving unemployed North Carolinians with inadequate protection, especially in a time of unprecedented unemployment. Earlier this month, it was reported that more than 510,000 new claims for unemployment had been filed in our state.
We are thankful for the immediate steps taken to increase access to unemployment now taken by Executive Order and by Congress in the Cares Act. However, more changes are needed to provide for the anticipated long term waves of COVID-19-related unemployment. We hope the General Assembly will make long term changes to increase the maximum weekly benefit; calculate benefits based on the worker’s highest quarters of earnings, rather than lowest; increase the maximum duration of state unemployment benefits to 26; and adopt a work sharing/short time option for employers. We hope the General Assembly will bring North Carolina’s unemployment compensation system back into step with other states.
Paid Sick Leave
If someone becomes sick and suspects they might have COVID-19, it is critical that they stay at home to recuperate and get better. This is particularly true of those who are vulnerable to adverse outcomes, such as seniors, people living with HIV, those who have conditions such as diabetes, heart disease, cancer,and those who are immune compromised. They need to take time off when they have been exposed to COVID-19 or have symptoms. Some, who are particularly vulnerable, may need to take time off to reduce their risk of infection. Unfortunately, many hardworking North Carolinians live paycheck to paycheck, and do not have the sick leave or resources to take time off work. The federal Families First Coronavirus Response Act provides for paid leave for many employees, but does not apply to companies with more than 500 employees, which effectively excludes low-wage workers in grocery, fast food, and other essential businesses that continue to operate. North Carolina should fill this gap and follow the lead of other states that provide the right to paid sick leave to all workers.
Syringe service programs were legalized by the General Assembly in 2016, and provide a vital role in stopping the spread of HIV & hepatitis. Not only are they critical for preventing the spread of infectious disease, but they also support the overall well being of people who use drugs through medical care, housing, overdose prevention and other vital social services. Many local programs are innovating to stay open and mobile during this time, and they should be treated as essential services.
No one knows the future course of the COVID-19 pandemic, but it is clear that there will be many waves that cannot be predicted with any certainty. Periods of social distancing may well be necessary during voting season and on Election Day 2020. All citizens should be able to participate in the November 2020 election safely, without risk of contracting COVID-19 disease. Those with elevated risks are particularly worried about having to choose between exercising their right to vote and their health.
We applaud the recent move by the NC Board of Elections to allow residents to register to vote online. We must take more steps to ensure that all North Carolinians can exercise their right to vote in November. All North Carolina voters should be provided with an absentee ballot request form, we should eliminate witness and notary requirements, and ensure free return mail postage for ballots.
Emergency Provisions for Remote Notarization & Witnessing
The risk of transmission of COVID-19 has interfered with the ability of citizens to execute legal documents such as Advance Directives, Powers of Attorney, Wills and other planning documents. Statutory requirements that witnesses and notaries be in the physical presence of the person signing such documents are at odds with social distancing and other disease prevention efforts, making it extremely difficult for people to complete end-of-life planning documents. This is particularly distressing for people who are at elevated risk of COVID-19 and wish to get their affairs in order. Barriers have been especially high for people in nursing homes, hospitals, hospice or other settings that are banning visitors as a COVID-19 precaution. We support legislation to permit remote witnessing and notarization on an emergency basis.
If you have questions or we can provide additional information, don’t hesitate to reach out to Lee Storrow at firstname.lastname@example.org or Allison Rice at email@example.com.
North Carolina AIDS Action Network
Duke Health Justice Clinic
Southern HIV/AIDS Strategy Initiative (SASI)
The Alliance of AIDS Services – Carolina
NARAL Pro-Choice North Carolina
The Frank Harr Foundation, HIV Elders Resource Outreach
Health Care Justice NC
Western North Carolina AIDS Project
Partners IN Caring
Heritage Directions LLC
Charlotte Transgender Healthcare Group
ACLU of North Carolina
Coalition for Health Care of NC
We Stand Up—Indivisible
Many Voices: A Black Church Movement for Gay and Transgender Justice
Kreative On Purpose
No Sad Story, INC
Lincoln Community Health Center
The Word Factory
Southern AIDS Coalition
Triad Health Project
Carolinas CARE Partnership
North Carolina Council of Churches
Mindy Oshrain, MD
Susan Orovitz, PhD
Antonio Del Toro
Juvencio Rocha Peralta
Maurice J. Carter
Francis M. Cox IV
Clyde A. Caudle Jr.
J.B. Sprague II
Denise Finck-Rothman, MD
David Margolis, MD
Barbara Johnston, MD
Mike and Jeff Robinson-Thomas