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NC Counties Care: Access Within Reach

On August 23, 2025, during the NCACC 118th Annual Conference, President Wallace Nelson announced his presidential initiative, NC Counties Care: Access Within Reach, aimed at improving access to health care services across North Carolina.

At the 118th North Carolina Association of County Commissioners (NCACC) Annual Conference in Pitt County, 2025-2026 NCACC President and Perquimans County Commissioner Wallace Nelson announced his presidential initiative: NC Counties Care: Access Within Reach. This initiative is focused on improving access to health care services across North Carolina, with particular attention to the needs of rural and underserved communities. It responds to the increasing challenges counties face due to hospital closures, reduced access to primary care, and the loss of local pharmacies and health care providers.

President Nelson, a lifelong resident of Perquimans County and a licensed pharmacist, brings both personal experience and professional insight to the issue. Perquimans County, like many rural areas, has no hospital and limited medical infrastructure. In his remarks, Nelson highlighted that 142 pharmacies have closed across North Carolina since early 2024. Additionally, eight rural hospitals have closed since 2010, and 12 in total have either shut down or been repurposed since 2006. These trends have raised statewide concerns about the ability of residents to access essential healthcare services. As President Nelson emphasized, “This is not just a revenue issue — bottom line, it is a barrier to health care. Whatever the impact, we should be concerned. We need to be concerned.”

To address these challenges, the presidential initiative will focus on three primary areas: (1) publishing research and policy briefs that explore healthcare access issues across the state; (2) hosting three regional forums in early 2026 to bring together local officials, health care providers, and policy experts; and (3) supporting counties in developing strategies to improve local health care delivery systems. The initiative aims to promote collaboration across sectors, inform state and federal policy discussions, and ensure that all North Carolinians have access to care — when and where they need it.

View the Issue Brief
  • Register Now: Statewide Forums

    As part of the NC Counties Care: Access Within Reach presidential initiative, the Association is hosting three statewide forums for county officials, health care providers, researchers, and policy experts to explore solutions and share best practices. The first forum will bring together state leaders to discuss the landscape of rural health care, the importance of rural hospitals, and the challenges these facilities face as they work to continue to provide critical care services. This event will feature a keynote speaker, an interactive panel, and will include time to share your perspective and experience.

    • Thursday, June 18, 2026
      • 2:00-3:30 p.m.
      • Virtual Event
      • Topic: Innovations in Health Care
      • Click here to register.

    Additional details and the agenda will be shared soon. These forums will explore key health care issues impacting counties, with opportunities for participants to engage, share perspectives, and learn from peers and subject matter experts. More information about participation opportunities will be released in the coming weeks.

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  • Initiative Objectives

    The NC Counties Care: Access Within Reach presidential initiative will focus on three primary areas:

    • Research and Publications — NCACC will commission and release a series of articles highlighting health care access issues and potential solutions. These will be shared with NCACC members, the General Assembly, state and federal partners, and other stakeholders.
    • Statewide Forums — Three regional forums will be hosted in 2026. The forums will convene county officials, health care providers, researchers, and policy experts. Topics will include rural hospital closures, disparities in health care delivery, and opportunities for county-level engagement.
    • County Support and Engagement — The initiative will encourage counties to take an active role in addressing health care access. NCACC will support policy development, facilitate partnerships, and promote strategies to improve local health care delivery systems.
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