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North Carolina seems like an unlikely laboratory for health care reform. It refused to expand Medicaid coverage under the Affordable Care Act, and ranks in the bottom third among states in measures of overall health. But the state has embarked on one of the country’s most ambitious efforts to transform how health care is defined and paid for. North Carolina is in the early stages of turning away from the traditional fee-for-service model, in which doctors and hospitals are paid for each office visit, test or operation. (Lohr, 8/26)

For the past eight weeks, Gov. Roy Cooper and the General Assembly have been locked in a budget stalemate largely over the governor’s desire to expand the Medicaid program to cover an estimated additional half million people, while the Republican majority in the legislature have staunchly refused to move on the question. State government continues to function on last year’s spending levels, but special projects and new programs lack funding to move forward. (Hoban, 8/26)

Puerto Rico is on alert as Tropical Storm Dorian moves toward the island. But Puerto Rico is still heavily in debt and suffering from infrastructure damage after Hurricane Maria nearly two years ago. Puerto Rico native and University of Connecticut professor Charles Venator-Santiago said people with the means are stocking up on water and canned food in anticipation of the storm. Unfortunately, most Puerto Ricans don’t have the means. (Uhler, 8/26)

Three former nursing-home workers facing criminal charges surrendered to authorities in Florida in connection with the deaths of 12 elderly patients at a sweltering facility after Hurricane Irma in 2017, according to attorneys involved. The three former employees—administrator Jorge Carballo, supervising nurse Sergo Colin and nurse Althia Meggie—presented themselves at Broward County jail in Fort Lauderdale on Monday, said Lawrence Hashish, an attorney for Ms. Meggie. A fourth former employee was taken into custody in Miami-Dade County and will be moved to Broward County, he said. (Campo-Flores, 8/26)

A California union is financing a statewide health reform initiative that would ensure protections for Arizona residents with preexisting conditions. The ballot proposal titled Arizonans Fed Up with Failing Healthcare could appear on the November 2020 election ballot. (Innes, 8/26)

As some districts begin welcoming students for the start of the school year this week, leaders at the state Department of Public Health remain tight-lipped about whether they plan to release the latest assessment of school vaccination rates in Connecticut. Lawmakers in May said they were expecting to see figures from the 2018-19 year that show what percentage of students at each school claimed the religious exemption to mandatory immunizations. But a lawsuit filed later that month put a stop – at least temporarily – to the disclosure of that data. (Carlesso, 8/26)

Tens of thousands of University System of Georgia employees will face average increases in their 2020 health care premiums of 5.5 percent to 7.5 percent. Also starting next year, a university employee will have to pay a $100 monthly surcharge for spousal coverage if the spouse has health insurance offered by an employer but does not take it. (Miller, 8/26)

St. Louis County’s top public health officials want more medical workers at the county jail. The facility needs about 20 more full-time nurses to reach its ideal staffing level of 60, they say. Currently, the jail is relying on nurses hired through short-term contracts to fill the gaps in staffing, said Dr. Emily Doucette, co-director of the county’s public health department. (O'Donoghue, 8/26)

Minnesota must pay back an estimated $48 million to the federal government because it improperly dealt out money to certain state chemical dependency treatment providers. The Centers for Medicare and Medicaid Services told the Minnesota Department of Human Services in May that it must “immediately cease” payments to a group of substance abuse treatment providers formally known as “institutions for mental diseases.” These institutions include hospitals, nursing homes or other facilities that have more than 16 beds and treat people with mental illness or chemical dependency. Federal Medicaid money generally cannot be used to cover treatment in these facilities. (Faircloth, 8/26)

Post-9/11 veterans and their family members now have a new, more affordable option for mental health services. The Steven A. Cohen Military Family Clinic at Aspire Health Partners, which officially opened Monday at a ceremony attended by Gov. Ron DeSantis, U.S. Rep. Kathy Castor and Mayor Jane Castor, offers treatment plans to veterans for conditions such as post-traumatic stress disorder, anxiety and depression. Services also are available to their spouses and children, either on campus or in their homes through telehealth options. (Najarro, 8/26)

A Frisco home health care company is boosting its hospice services with a $130 million cash purchase of a Birmingham, Ala., firm that serves 1,000 patients a day. Addus HomeCare Corp. announced the deal Monday with Hospice Partners of America LLC, which has 21 locations in Texas, Idaho, Kansas, Missouri, Oregon and Virginia. Closing is subject to regulatory approvals. (O'Donnell, 8/26)

Mental illness is a severe problem among Sacramento’s homeless, according to a federally mandated census conducted in January. According to Sacramento Steps Forward, the nonprofit that conducts the point-in-time count every two years, 22 percent of homeless people report having a mental disability, and 21 percent have a psychiatric disability. Experts overwhelmingly agree that homelessness and mental health issues can be intimately linked. According to an informal survey by Loaves & Fishes, the common denominator among homeless people is past experience with trauma – and homelessness is itself a traumatic experience. (Wang and Chalermkraivuth, 8/26)

For nonsmokers like Nelson, it’s easy to find apartments where you shouldn’t catch a whiff of tobacco. Thousands of apartment buildings in Minnesota have declared themselves smoke-free. West Side Flats is owned by Sherman Associates, which has 5,000 apartment units in the Twin Cities. Senior vice president Chris Sherman said the company snuffed out smoking in its buildings about eight years ago. (Moylan, 8/27)

In the latest jolt to hit the Minnesota Department of Human Services, Deputy Commissioner Claire Wilson has resigned for the second time in less than two months. Wilson first submitted her resignation in early July along with Deputy Commissioner Chuck Johnson, an event that sparked a series of unprecedented changes at the top of the $18 billion agency. Both rescinded their resignations the following week, after then-commissioner Tony Lourey announced that he was stepping down. (Howatt, 8/26)