Resilience in the wake of Hurricane Helene

Reflecting on Hurricane Helene, the deadliest and costliest hurricane in North Carolina's history, recovery efforts are expected to span years. Amid the devastation, stories of resilience shine through. Karen Wallace-Meigs, Executive Director of the Western Carolina Medical Society, recounts their organization's impactful response. Through a robust philanthropic mission and diverse service programs, patients in need received vital support, including access to free medical and specialty care, along with language interpretation services post-storm and into the future.

Host: Jean Fisher Brinkley, Communications Director, North Carolina Medical Board
Guest: Karen Wallace-Meigs, Executive Director of the Western Carolina Medical Society
Producer: Sylvia French-Hodges, Communications Specialist, North Carolina Medical Board

Click here to access our show page resources and information.

Follow the North Carolina Medical Board on Facebook, Instagram, LinkedIn, and X.

Email your questions to:  podcast@ncmedboard.org.

Transcript

Jean Fisher Brinkley 0:00

Earlier this year, the National Weather Service predicted a busy hurricane season for the Atlantic Basin with as many as 19 named storms. While some of these will remain tropical depressions, up to 10 of 2025's predicted tempests are expected to be full-blown hurricanes. We are already on storm number three, Chantel. That particular storm, which made landfall in South Carolina as a tropical depression, still managed to flood Moore County into a state of emergency when it blew through North Carolina. It's an excellent time to think ahead and prepare for the worst if the next storm blows in the direction of your home, or if you are a medical professional, your practice. This is Jean Fisher Brinkley, Communications Director for the North Carolina Medical Board, and this is MedBoard Matters. On this episode of the podcast, We are remembering last year's devastating Hurricane Helene, which hit Western North Carolina in late September of 2024. Helene smashed all previous records in North Carolina and currently ranks as the state's deadliest and costliest hurricane of all time. What made Helene especially difficult was where she hit. Western North Carolina, being pretty far inland, rarely sees significant hurricane damage. But Helene was like nothing anyone had seen before, and pretty much no one was prepared. It wasn't something anyone could have prepared for, says my guest, Karen Wallace-Meigs. Karen is executive director of the Western Carolina Medical Society, the professional membership group for physicians and PAs in 16 Western North Carolina counties. The organization has a strong philanthropic mission, with service programs that help patients in need access free medical and specialty care, as well as free language interpretation services. I spoke with Karen a while ago about her experiences with the Western Carolina Medical Society during and after Hurricane Helene. Please note that our conversation was recorded in late May, so some circumstances may have changed since we spoke. I think you'll find the story compelling and informative just the same. Karen, thank you so much for joining me here today. I really appreciate your time.

Karen Wallace-Meigs 2:27

Thank you so much. I'm glad to be here.

Jean Fisher Brinkley 2:29

Now, as you know, I've asked you here today for us to check in all these months after Hurricane Helene hit Western North Carolina. But I always like to begin a conversation like this by asking my guests to just introduce themselves a

Karen Wallace-Meigs 2:43

Absolutely. Thank you. I am Karen Wallace-Meigs, the Executive Director of Western Carolina Medical Society. I started this position in June of 2024, so it's been, I'd say, a little bit of a busy several months here. I have lived all over the state of North Carolina, grew up in southeastern North Carolina, spent many years in the Triangle area and moved to western North Carolina. almost 22 years ago. And my background is in education, nonprofit management, and fundraising. So I've been very fortunate to live across our beautiful state. And I think you'll find I have quite a story to tell today.

Jean Fisher Brinkley 3:26

I am looking forward to it. First, I understand that the Western North Carolina Medical Society is a little bit different than a lot of other medical societies. I wondered if you could just sort of describe your model, how your medical society works.

Karen Wallace-Meigs 3:41

Absolutely. We are unlike any other medical society, I think, in the United States. So we have 685 members spread across 16 westernmost counties of North Carolina. And with that, we are truly their philanthropic arm. I don't do a ton of advocacy work, but we are their, as I said, their philanthropic arm, and that's my favorite part. It's what attracted me to the position. So we have multiple programs. We do have a health healer program so that our members, physicians and physicians assistants, can get six brief therapy or coaching appointments per year. And then reduce therapy after that. That's in response to a very high suicide rate nationwide among care providers. We want to take good care of those folks. So we have Healthy Healer. But our signature program is Project Access. Project Access serves those individuals who do not qualify for Medicaid and do not otherwise have insurance. And we coordinate free specialty care for them. That program will be 30 years old next year. It was the first of its kind in the United States. It's been replicated. Yes, we are so proud of that. Last year, we had 1,480 patients. And again, those are people who Medicaid expansion didn't touch them. We had people before, obviously, who also didn't have Medicaid. Medicaid expansion hit a wonderful 650,000 people in this state, but we have folks who do not qualify. So we coordinated $400,000 in free specialty care. I cannot say enough about our medical partners, hospitals, medical practices who donate their time. We make sure that those folks can get to the doctor with transportation. We help pay for medications. So that's Project Access. I love that program. It was the main thing growing up in southeastern North Carolina with a mother who had cancer. And we would have to cross county lines to get care. And knowing what that did to my family financially, that was really what drew me to this position. Part of that, and even an extension beyond that, is we run the largest interpreter network in western North Carolina. By that, I can tell you we did almost 7,000 appointments last year, 6,700 appointments plus in 38 different languages. So 38 different languages. We can send our project access patients to the doctor and every project access patient can have a free interpreter so that they can communicate with their doctor in a language they understand. It's powerful. And I have powerful stories about that. I'm sorry. Go ahead.

Jean Fisher Brinkley 6:37

That could be a whole podcast on its own. I was just going to ask you where you get your interpreters.

Karen Wallace-Meigs 6:42

Everywhere. We recruit from schools, community fairs, advertise. But for example, my Korean interpreter, I bring up from Georgia and I pay the mileage. They are all contracted employees with us and community members. That program is 20 years old this year. Obviously, they can interpret in other medical practices, not just for project access patients, sometimes for some other events, such as when we had the community event, when we were finally able to get together in downtown Asheville after Hurricane Helene. But primarily, they do medical appointments. So special training, special certifications. And one of the languages is also American Sign Language for the deaf. So we have ASL. Yeah, that's great. So Project WIN, which is our interpreter program, supports Project Access and other programs. We do scholarship programs for high school seniors who complete a one-semester internship at MAHEC, which is our local AHEC in the mountains. We want to encourage homegrown medical personnel in various fields. So we do small scholarships for high school seniors who do that. We run a colorectal cancer screening program, and we are very proud of that program. It's one of our newer ones. It's run by Dr. Michael Newcomer, and it's incredible to know how many, it really, colorectal cancer is becoming more and more prevalent among people under age 40. So last year, we saw 391 patients across 13 counties. We provided 29 free colonoscopies after doing fit tests for the other 391. And those were all our major programs, but Hurricane Helene threw us also into emergency relief. And we had been providing emergency relief for the last several months to meet social determinants of health. So that could be anything from paying your utilities, putting groceries on the table, to paying rent. We did all of this with a staff of 10. I'm about to add my 11th person, but we've done all of this with a staff of 10 and uh...its pretty much been around the clock, so...

Jean Fisher Brinkley 8:51

Thank you very much for that overview. I know we're going to get to talking about this, but that last program you mentioned, the direct assistance program, that actually grew out of Hurricane Helene, correct?

Karen Wallace-Meigs 9:12

It did. We had said last fall before it hit, we knew we needed to do emergency assistance given the population we serve. But when you have something like that hit, which is a thousand year storm and so utterly devastating, it became a necessity, an immediate necessity, and it will be something we continue.

Jean Fisher Brinkley 9:36

So late September, the news is forecasting this massive, massive storm. Pretty soon it becomes clear that it is headed straight for western North Carolina. Where were you and what were you doing?

Karen Wallace-Meigs 9:48

It really wasn't clear to all of us. We knew there was going to be rain, but it really wasn't clear to all of us what was coming. And we've heard sometimes, why didn't more people evacuate? Well, because nothing like this had ever happened before. The last three days of the month, it was pouring, or I guess the 26th, 27th. And ironically, this is kind of a personal note, ironically, I realized I was having a dental issue. And apparently had had an abscess. So as it poured rain on Wednesday night of that week, my dentist is like, you know, I don't know if we're going to be able to get downtown tomorrow. Let me call in an antibiotic for you. And my husband drove in the pouring rain and the pharmacy stayed open late. And I got an antibiotic. Well, it's a good thing. Yes, absolutely. The next day and nonprofit folks all over the state will get this. The next day I was writing a grant all day long and it was pouring and I got it turned in late day. The next morning I woke up and the power was out and it had truly hit overnight. So our team was thinking we're going to need an emergency fund going forward. I had been adamant that we needed to spread out to more counties, that we needed project access in more counties, more people needed our help. We needed to find more providers who would help us across county lines. It was part of what I was writing the grant for. And then it hits. And I have to tell you, the first day or two, I didn't know how bad it was. And it was tough. You could look at this neighborhood. My neighborhood, for the most part, looked great. You could look at this neighborhood. It looked great. The next one wasn't. Phone service was spotty. I couldn't get my daughters, who were back in the triangle for school, on the phone. So internet gone. Street lights out. You know, you think, okay, you'll go get some gas. You had to have cash. When the grocery store is open, I'll go get food. To start with, you had to have cash. ATMs do not work. in that situation. So in modern life, with all of our conveniences and here, let me get my debit card, people weren't prepared.

Jean Fisher Brinkley 12:06

Absolutely.

Karen Wallace-Meigs 12:07

You got to see people, you know, people would hand each other the cash in their pockets and say, pay it forward. And it was pretty amazing. I mean, that happened to us. And somebody paid forward to my husband, wouldn't give the name. And then a few days later, my husband paid forward and the kid at the next gas pump happened to have graduated with one of my daughters. So that was what was pretty immediately.

Jean Fisher Brinkley 12:29

As you speak, I guess, absolutely. How would you know, right? Because power was out. You didn't have news. Phones didn't work, right? Because the satellites were down. And yeah, wow. Okay. So you mentioned you have a staff of 10. You were writing a grant the very next day. Where was everybody else? And how quickly did you sort of spring into action with all of your service programs?

Karen Wallace-Meigs 12:54

That part kind of makes me emotional recalling it. It took me probably five or six days to account for all of my employees. One of them had had their home split down the middle as they ran out with their pets. And the insurance company relocated them, and thankfully they had insurance, but relocated them to Greenville, South Carolina, which is an hour away. It took several days. And as soon as we knew, the first thing I said is we have to start calling all of the practices and see what's going on. At some point, I was contacted by the North Carolina Medical Society on behalf of you all, the North Carolina Medical Board to say

Jean Fisher Brinkley 13:33

Right.

Karen Wallace-Meigs 13:33

Any information you can get, please get to us. We need to know. And we started calling practices. And for the most part, it was just lovely to hear people's voices. You know, people were trying their very best trying to get back on. Nobody had clean water in many spaces. We formed toilet brigades where you had to go get water from wherever you could get it just to flush your toilet. if you weren't on well water. So it was a fascinating experience, but we started doing that. So we started from our homes. As soon as we could get any internet or phone service, we were calling practices, filling out forms, reporting that back to people, giving interviews like this to various groups, and simply trying to figure out where we needed to be. And I cannot say enough about people all over the state and all over this country who came to us. I think people pretty much know World Central Kitchen came into town. Many groups came and are still coming. Groups of Amish folks coming to help rebuild towns, various people, but I saw, because I've lived all over this state, it made me emotional every time. So many fire rescue police cars coming from all over the state and Vermont, you know, other states. And you would look and you would see where they were from. And they were in there in dangerous situations. But we quickly knew we needed the emergency fund in place. Also, we immediately wrote and got a grant to expand our Healthy Healer program because they were facing just the hardest road ahead, taking care of people who were absolutely traumatized while many of them were traumatized at home in that work.

Jean Fisher Brinkley 15:23

Absolutely.

Karen Wallace-Meigs 15:23

So people responded beautifully to that.

Jean Fisher Brinkley 15:26

So, I'm interested in, given what you've said about how important it was to have cash, I mean, you could see for yourself just from your personal experience and from talking with others, how difficult it was just to do basic daily things like putting gas in the car, getting food, flushing the toilet, things that we take for granted. And you'd seen how difficult that was. So you knew the importance of having assets that you could trade with so you could get what you needed. Did you provide cash to people or how did it work?

Karen Wallace-Meigs 15:54

Yeah. We've provided, and I still have folks doing that, we have spent about $40,000 and we had to come up with the best ways we could do it. So you find new partners. We found a group that was doing a lot of rental assistance. So they had almost a triage center and they brought people in, did interviews, and we partnered with them to do rental support because Asheville, prior to this, was the single most expensive place in the state to live. And so people lost their jobs for weeks on end. Some aren't back yet. And so what we did was we found a partner to do the rental support. Then we obviously had funds, the North Carolina Medical Society Association, which is essentially spouses of people with the North Carolina Medical Society, members of that they gave us funds and said anybody who's in a jam help them and then some people said well only for your project access patients because they are already so vulnerable so we were running multiple funds that's quite a accounting undertaking there but we were running multiple funds we started reaching out to project we had to find part of our project access patients some of them had moved some were in shelters you know but people's housing literally went down what had been a little creek now became a raging river. And so we were having to find people. We figured we give people money for transportation if they need it to get to the doctor. We also figured out we could go to our federally qualified health centers. And we, I think it was 10,000, I believe in gas cards alone, that we got to federally qualified health centers so they could get people to the doctor, project access patients and otherwise. We handed out $500 food cards to our project access patients. Again, in so many ways, you don't have a job, you can't buy groceries. What do you do? How do you choose between your medicine, your light bill, if you've got your lights back on and that? And I would like to just say at this juncture now, if you come visit us and we're a tourist area, we hope you'll come visit. But what you see in one area may not reflect what is otherwise true. We've got people in food deserts and we're more than seven months out. And this is in the state of North Carolina. I think that's important to know. But we did a lot with utilities. We had a pregnant woman with no transportation and her phone was about to be turned off because she couldn't make the phone bill. And this is, what, $140 we were able to pay that because you clearly can't have a pregnant woman at home alone without a phone and no way to get somewhere. So there have been a lot of different ways that we've supported. And then we've just found the need to pay for more and more medication, too. So it became a multi-pronged approach using new community partners, working even more strongly with our federally qualified health centers than we ever have before. Right. Absolutely. Absolutely.

Jean Fisher Brinkley 19:38

realize that this was something that needed to continue even after the hurricane. Although to hear you talk, it's clear that there are still after effects that are affecting many communities there.

Karen Wallace-Meigs 19:48

Yes, thank you. We're still responding to the hurricane. But as I was saying, we knew that we had such a vulnerable population we served to begin with that we really needed to be moving in that direction. We knew that cognitively before the storm, but this proved it to us. So I don't know that there was any one moment after the storm, just as you continue to see the need. And working with this population. So what we're doing now is we are hiring a community health worker to really address the social determinants of health, to make sure that folks are connected with other services in the community, community partners, or that, okay, we got you to the doctor. You know, we've had whatever specialty care you need, but do you have food? Do you have safe housing? How can we do that? So we're excited. One of the things that we really born of this, there was a mobile clinic working with the unhoused population. And one of my employees, Julie, who is so community oriented, left her home in West Asheville and went to help at this mobile clinic, kind of a pop up in a parking lot during the storm. And through those relationships, we've decided, OK, the mobile clinic is going to keep going. We needed it anyway. So we're going to help them purchase an A1C reading machine. And then we're going to get baseline readings for folks who come into the clinic, connect them with food boxes, and then be able to do A1C testing again to see how that goes. But we're doing more to connect people with the healthy food resources, get it delivered to them. Public transportation was an issue to begin with before all of this. And by the way, road closures for months. I mean, we had so many roads down, people were having to make handmade signs. The state didn't even have enough signs and couldn't get to us to get them out. So when you're thinking about all the multiple transportation issues, if I can have someone dedicated to, do you have these other needs met to get you through? As healthy as we possibly can, hopefully optimally healthy, but as healthy as we possibly can. Are we meeting that? Are we connecting you to the services? Do you have healthy food that you can access? So if we need to take it to you. So that's why we're hiring that community health worker. It's also, and I have to say this, it's made us look at things differently. as well as some of our community partners. We've signed a three-year MOU with a wonderful community agency, All Souls Counseling Center. And now all of our Project Access patients for the next three years can access free therapy. Oh, wow. Yeah, it's great that the agreement is if they feel they need it, we can refer them to it. They can make a call and they can have this free therapy. And very often after an event like this, it's six months, a year or more later before it hits, because we are working on adrenaline to begin with. Everybody, they can access this free care. And I don't even need a referral from a primary care provider for that. You need it. There it is. Let's get it to you. So it's been a truly, as I said, multi-pronged approach, but we were feeling it. I mean, we were feeling the anxiety. I have always wanted to live by a lake my entire life. I'm rethinking that after this. But the thing is, as we're thinking through all of this, we're trying to think, what would we need? What does somebody need? And then we're listening, trying to really listen in our client's native tongue to see what's truly needed.

Jean Fisher Brinkley 23:43

Wow. I'm absorbing everything that you just said. For listeners who may not know the term social determinants of health, would you just briefly define what it is that you're talking about and why that fits in with an organization like yours? Absolutely.

Karen Wallace-Meigs 23:57

I always think that's an important thing. So thank you for giving me the opportunity to explain that. I'll give you an example. So we recently had a patient who had breast cancer. They had no insurance, didn't qualify for Medicaid. So we helped them. We coordinated for them with our providers, free, obviously, mastectomy, then free reconstructive surgery. But in talking to this woman, we found out she simply didn't have enough food at home. And she was going to have to choose between food, medication, rent. And How is she supposed to get better? And will she ever truly get better? And even if she were to somehow get around then her cancer. then, you know, is she ever going to be truly healthy and trying to figure out. So we were able to connect her with those food resources. That's a social determinant of health, your shelter, your food, you know, all of those things. Do you have the things to make it through life in a healthy way? We were able to connect her and I'm so thankful and happy to say that she is doing well. She is healthy and her life in some ways has improved beyond what it was before that diagnosis. And again, we're the coordinators. We're kind of conduits here, but we're not the doctors and the community places providing all of that. I cannot say enough about the providers who gave her the care she needed, and then we were able to connect her with that food. It not only changes her life, When you meet a social determinant of health like that, it changes the trajectory of a family. I mean, if you can't afford food, what about the kids in the house? If you can't afford the rent, then everybody's out. And when kids are out of school, they actually lose learning. So it's something that we knew we were going to need to do. We just didn't know how fast we were going to have to put that together.

Jean Fisher Brinkley 26:00

Well, thank you for addressing that. Yeah. So what were the busiest programs during the immediate aftermath of Helene? You've talked about this new area, social determinants of health, talked a little bit about Project Access, and you mentioned healthy healers. I don't imagine there was a whole lot of activity in colon cancer screening, given the more pressing

Karen Wallace-Meigs 26:19

needs. Right. Slowed a bit there with that. I think, first of all, you've got to find your people, your clients, your providers. So we were really busy making those phone calls to practices, seeing what was their situation. Were they up? Were they running? What about their staff? What about any number of things? Did they have electric? Did they have clean water? Getting back to my story about my dentist, for example, my dentist wound up in another town. So, P.S., I didn't see the dentist for another three months. And when I did, I had a raging infection, which made me understand that Our clients, all the better. We were calling, trying to find out about that. We were trying to get the money raised as quickly as possible. So my development person was really working around the clock, as was I. We were trying to get money in the door and tell the story, as I am now, so that people would respond so we could get money in the door to give out. in a program we had never done. We had to put parameters around that. How much per person, per family, how are we going to do this? What information did we need? And how are we going to account for it to make sure that we were good stewards? Those were things that had to happen and had to happen almost overnight. So the first time we went to buy gas cards, that's not something we normally do. And we jammed down the credit cards. Okay. wait, let's go the other way, deal with the bank and write checks. And now people know what we're doing and how we're doing it.

Jean Fisher Brinkley 27:58

Going back to, I'm just curious sort of what you found when you were doing that outreach to your members and reaching out with practices. If you had to estimate what percentage of people were affected in some material way among your members by the storm?

Karen Wallace-Meigs 28:15

A percentage would be hard for me to give you. I would say many, many practices were. A great many practices did not have water. They had the same problem I had. They were trying to find their employees and they were frightened. When they would find their employees, in some cases, those employees were going through their own housing issues, transportation. I mean, you know, cars smashed by trees. And so it was hard. And, you know, for months, Mayhek had porta-potties out in the parking lot. So that went on. But I was also amazed at the resilience. And people seemed grateful to hear from us. And I say that thinking back, one of our federally qualified health centers, so many of those places run with emeritus docs. volunteers. And one of our FQHCs lost a pharmacist who died in the storm. That's hard. It's hard on the remaining, their family and the remaining staff. And yet to see people rally, I mean, many, many practices were back up in some form or another pretty quickly. That does not mean that they do not still need help with buildings and staffing and we didn't have enough primary care providers anyway, especially in rural areas, but people's resilience. And I sign almost every email now standing together for a healthier community. And resilient

Jean Fisher Brinkley 29:56

Western North Carolina. That's been impressive. be able to direct patients to care. And we were very happy to help, grateful to have something that we could do that was tangible in that way. But, you know, just in my very small role in getting that directory up and running and watching the data come in, it was amazing to read in the comments the things that people were saying that they're like, no power, no water. Yes, we're seeing patients in the parking lot. And it was just seeing entry after entry, not just individual physicians or individual medical practices we had. hospitals, healthcare facilities, dialysis clinics, you know, we pretty much anybody who was open in the realm of healthcare, we allowed them to be in the directory. And it was just amazing to see how many people had really experienced some very significant interruption to their normal way of doing business. And yet they were out there trying to take care of patients. So it really was, obviously didn't see it with my own eyes, but that was our little window into seeing what was going on in Western North Carolina. And it really was inspiring to see our licensees really doing everything they could to take care of their patients.

Karen Wallace-Meigs 31:29

You know, when you fan your face so you don't cry, that's what I'm doing while you're talking. Because, I mean, there were Dr. Bill Hathaway, I would hear he runs Mayhek here, and he would be on the road going up to farther out counties. in Western North Carolina with groups of people to meet needs. Yes, there were people practicing in parking lots. And I know for a fact that there were people doing, if they couldn't do anything else, it was almost like a first aid center, like last road between North Carolina and Tennessee or North Carolina and Virginia that was open. And they would almost just have band-aids and supplies and try to look at people and try to say if they needed something more. And sometimes at the same time be handing out water, food, clothing, whatever they can take. It was amazing seeing how people rallied together in so many different ways. But the medical community, and I tell my board this and our membership, I am proud. awed by what they do for all the things that you hear about medical care, sometimes good and bad in the way it works in this country. The hearts were amazing. I mean, the effort people put in, truly.

Jean Fisher Brinkley 32:47

That makes me think of your Healthy Healers program. You increased the availability, you said, of therapy to providers. Did they take you up on that? Did Absolutely.

Karen Wallace-Meigs 33:00

I'm glad to hear that. Yeah, absolutely. Running through that funding like crazy. And let me say that's confidential. I nor none of my staff, the way we've got it set up, that it's just the healer, the patient in this case, and the therapist know who. The only single piece that I do have is the main folks taking us up on it were our residents, our medical interns. And that was interesting because we would love for them to stay in Western North Carolina. We want to keep them. What a trial by fire. If you're just out of medical school and you come, yeah, and you have that happen. But we were thrilled. They have taken us up on it. It's a program we have had for some time now. But yes, it was definitely used. That was Western North Carolina Bridge Foundation who really said, yeah, we're interested in giving you more money right now for this, knowing that this is a particular issue. And we're just so grateful for that.

Jean Fisher Brinkley 33:59

Right. Well, how great that you were already there, well-established, ready to receive that money and immediately turn around and make those services available.

Karen Wallace-Meigs 34:06

The hardest, greatest honor of my professional life has been this last seven plus months. Yeah.

Jean Fisher Brinkley 34:13

You know, I was going to ask you how going through all of this changed your organization. You've talked about, gave you a new program, you know, fifth program, the social determinants of health. What other changes would you say? And feel free, personal changes, your own feeling about your work and life, but also the organization. How did the society change because of this?

Karen Wallace-Meigs 34:35

Well, you're right. It's changed so that we're going to do more social determinants of health work, and that's the right thing to do. It was going to be the right thing to do, but it certainly is. But I think what it made us all more aware of is how much we need our community partners. to both expand that care provider base for Project Access, but also other community partners, perhaps food networks. As I said, the mental health care with All Souls Counseling, you know, for our patients. And we wound up really having to find, okay, who else can help us be able to clearly and methodically go through these requests for help and get support, get money, get whatever is needed to the people who need it most. So I hadn't thought a lot about the police department with our work, but they called me and they collected all of this equipment, durable medical equipment, which is not cheap and wasn't easy to get. because it was hard initially for people to get to us. They brought it all to us. And then, as I mentioned, my employee, Julie, Julie's out there getting it out there to people. It gave us so many opportunities to find new partners and partnerships so that as we go forward, we can not only respond to emergencies better, we can respond to the day-in, day-out lives of our clients better. And so I can't say enough about those community partners. The day, I guess the day before the storm, I was supposed to go visit Bounty in Seoul, which is a food program in Black Mountain, North Carolina. I haven't got there yet, but, you know, we knew we needed to do that. And the reason I haven't got there yet is they and we have been blasted trying to get through this. But it was just so good to be able to reach out and explore new ways that you can work with a bounty and soul or a man of food bank, all souls counseling. Is it a house of faith that we need to work with? And so we were able to look across so many different sectors to figure out how can we get the care we need to the people we need to get it to. And in some ways, when your programs, you know, we started as a society for doctors in the mountains in 1885. Project Access, which, as I said, has been replicated many times, but is almost 30 years old. In some ways, in the nonprofit world, we're not shiny and new, but it's let us reclaim our vision, our shared goals. of equitable access to health care for everyone and find new partners who care about that and work on it together in a more holistic way. So I think that this six, seven months has changed us in many ways for the better. And it's given us new ways to think about our work and what we need to do. Yeah.

Jean Fisher Brinkley 37:39

So you've made more connections. It sounds like you're stronger than ever.

Karen Wallace-Meigs 37:42

In so many ways, I feel like we are. And that is... Absolutely. Let me say we've had some beautiful leadership here in the past. We've just not had a situation like this that called us to be better in a way that maybe we hadn't thought about before. As I said, this has not been easy, but I am so grateful to the folks who work alongside me. Those other nine people, I'd be in any trench with them. And And my board for being visionary and saying, do what you need to do, because how great is that? It has given me truly seven of the most difficult months of my professional life, but seven of the most rewarding. And I've had a great career. So it's been really amazing. And to see people grow in their positions to the folks I work alongside every day, to see them grow in their positions and think, how can we do this better? How can we make this project access application better and faster and get to what we need to know? It used to be you were only in project access for six months and you had to renew. Now you're in it for 12 months. And we made it streamlined. How can we make it make more sense? You know, have it in multiple languages, all of that.

Jean Fisher Brinkley 39:01

And these were things that came out of seeing the need firsthand? Yes.

Karen Wallace-Meigs 39:05

Absolutely. And moving it, moving it faster, seeing we need to be more responsive every day. And we certainly need to be when something like this happens, because you've got to find the silver lining. There are still days and road will open up and I'll go down it for the first time and cry. And my kids couldn't come home for months because we didn't have clean water. My oldest daughter came back home. And we went down a road together for the first time. And she said, they should have filmed The Last of Us here. It looks apocalyptic. Oh, wow. This is six and a half months after the storm, when people have worked their backsides off to get it to look that good and get the road open. So it's really been, it changes you personally, but it also has given us a chance to change in ways that we needed to change and be more responsive.

Jean Fisher Brinkley 39:59

So what would you say are the most pressing areas of continuing need in Western North Carolina right now?

Karen Wallace-Meigs 40:06

Housing was an issue beforehand. Housing remains one. I serve on the long-term recovery group for Buncombe County. We were told about a month and a half ago that we still have 1,000 completely destroyed or basically uninhabitable homes in my community, small community of Fairview. It's 23. That is a true social determinant of health. If you do not have a safe place to be. It floored me when I was hearing people are holding parts of their homes together with duct tape. And I heard about an elderly couple who had to duct tape the ceiling to keep the elements from falling on them in their bed at night. We just went through winter in the mountains, folks. That gets cold. So housing is a huge issue. We still need tourism dollars if you want to come into town. But for some people, it's food if they're in a food desert. Certainly a living wage so folks can meet those social determinants of health, be it their rent, their food, their transportation. But medical remains an issue. As I said, it was. We had the lowest uninsured rate in the state. We need Medicaid expansion to continue. Imagine my program if Medicaid expansion falters. I'm going to be swamped, just swamped. And I need to be able to find more providers. So my staff and I are working towards that goal, finding more providers. But we want to take care of our folks. And we're doing that, all of us together, not just Western Carolina Medical Society, all of us working together to that in the very best way we can. And I'm grateful for everything everyone's done for us, but asking not to forget us. It's complicated in many places still. We are remote and we've got roads out. We still have damaged areas, damaged businesses where people couldn't go back to work. So it's not a seven-month process. This is going to be a multi-year and very expensive process.

Jean Fisher Brinkley 42:12

Absolutely. I was just going to say, what is next, do you think, for your organization? Are you going to continue to grow? You're going to write more grants, find more partners. What do you see on the horizon? All of the above. We are

Karen Wallace-Meigs 42:26

writing grants. We are trying, you know, I'm kind of in a position of, do I try to cross more county lines, which was my goal? Do I wait and see what's going to happen with Medicaid expansion? And will I be swamped in where I already am? So we will write more grants. We are hiring this community health worker. We are really advertising and pushing for more interpreters. We're looking at all of this in any number of myriad ways that any nonprofit would look at what they're doing. How can we find more, not only healthcare providers, but community partners to which we can make referrals? So we're looking at all of that. I have to tell you pre-storm that When somebody says, well, you know, what about this interpreting and medical and how necessary is it? We got an emergency call from a hospital saying there's a woman here. She's very, very upset. She needs to make final decisions for her husband. This is irreversible. He's not going to come around. She can't understand a word we're saying, and we don't know what to say, and she's hysterical. Well, given, that was fair. We managed to figure out what language and get an interpreter there. And in the worst moment of her life, we had someone there in her native tongue. It did not change the outcome at all, but she was able to feel like someone was there for her. make decisions she had to make, understand what was being said to her. And what struck me so deeply at the end of that day, I had some really sad staff. As you can understand, it was difficult. And what I said to her is what I just said to you. We were there for her at the worst moment of her life. We couldn't change anything. Maybe that made it a little bit better, but at least she had that dignity of hearing somebody in her native tongue. That was important. And we've seen that throughout this process as more and more people come to our doors or are referred by primary care providers. Yeah, absolutely. Yeah. Absolutely. And you also get better outcomes if we can get people in earlier. And so that's what we want to be able to do by finding new partners and finding additional caregivers is to be able to treat things and nip it in the bud early and let people be able to go on and lead productive lives and be productive community citizens. It's unbelievable to me that I get to be in this realm every day because I tell people I'm not a doctor. I know how to run a nonprofit. But as the child of someone who is not well, it makes me respect this work and these physicians, these physicians assistants even more.

Jean Fisher Brinkley 45:48

Well, Karen, thank you so very much for sharing your story. I feel like I could talk to you for hours. We barely touched on the work that your wonderful programs do. Again, thank you for being part of this podcast episode. Could I just ask if people listening want to help, you know, want to make a donation, want to volunteer in Project Access, if it's a licensee of ours, what is the best way for people to get involved?

Karen Wallace-Meigs 46:12

I would always be honest and say there are many, many great organizations that have been on the ground here. We would be especially grateful for a donation, and it would go directly to any of these programs that you mentioned you can designate or we can use it in the area that's most needed. But if someone is interested, they just go to mymywcms.org. And they can find the donation button. It's MyWCMS, which of course stands for Western Carolina Medical Society, MyWCMS.org. And you can see online, we are a vetted agency. We really use money well. And we would be incredibly grateful because there is so much left to do on a day in, day out basis. There was so much to do before the storm. This ramped it up so many thousand times fold, I can't even say. But we are so appreciative for what has been done. But as I said, please remember us. And if you would like to give, we would be most grateful. There's a lot still to do.

Jean Fisher Brinkley 47:23

Yes. Well, thank you for that. We are happy to put that information on our show page so people could find it. Did you have anything else that you wanted to add before we close?

Karen Wallace-Meigs 47:32

I wanted to thank you for this opportunity. I have been so happy and grateful to live across the state of North Carolina. But, you know, it's strange when you grow up an hour inland. And then live in the triangle. This is my fourth hurricane. I've never seen anything like this in my life, except maybe on television. And so we're here. We are a part of this state. We are your neighbors. We are grateful for all that everyone has done. And please remember, it's going to be a long haul, but we're here and we need your partnership. So thank you.

Jean Fisher Brinkley 48:10

Well, it's been wonderful to have you.

Karen Wallace-Meigs 48:11

Thank you so very much.

Jean Fisher Brinkley 48:13

That brings us to the end of this episode of Medboard Matters. If you are interested in more hurricane stories, I hope you'll join us again later this summer to hear reflections on Helene from medical professionals across Western North Carolina. If the dedication and determination of these physicians and PAs to care for patients in the wake of Hurricane Helene does not make you feel good about the medical profession, I don't know what will. To help listeners face this year's hurricane season with as much confidence as possible, we have collected some resources on disaster preparation, which you can find on our show page at www.ncmedboard.org. We've done our best to find information that is specific to medical practices. So if you are a medical professional or help to run a practice or healthcare facility, take a look. There's some good practical advice there. After speaking with Karen Wallace-Miggs, when the next major storm heads towards North Carolina, I know I'm going to gas up my cars, have some cash on hand, and make sure I've got several days of drinking water in my pantry. If Helene taught us nothing else, it's that disaster can strike anywhere. If you have comments, questions, or perhaps a hurricane story of your own to share, please send them to podcast at ncmedboard.org. Thanks for listening. I hope you will join me again. This podcast produced by the North Carolina Medical Board.

Amy Williams 49:53

The North Carolina Medical Board exists for the benefit and protection of the people of North Carolina.