1. Home
  2. ›
  3. About
  4. ›
  5. Presidential Initiatives
  6. ›
  7. NC Counties Care: Access...

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
  • Statewide Forums

    As part of the NC Counties Care: Access Within Reach presidential initiative, the Association hosted three statewide forums that brought together county officials, health care providers, researchers, and policy experts to examine pressing health care challenges facing North Carolina counties. Through expert presentations, panel discussions, and participant engagement, the forums provided opportunities to share best practices, explore innovative solutions, and elevate county perspectives on critical health care issues.

    • Rural Hospitals Forum
      • Friday, March 27, 2026
      • 1:30-4:30 p.m.
      • Quorum Center, Wake County
        • The inaugural forum focused on the state of rural health care, highlighting the vital role rural hospitals play in their communities and the challenges these facilities face in sustaining access to care. Participants explored the impacts of hospital closures and discussed strategies to support the long-term viability of rural health services.
        • White Paper: Impacts of Rural Hospital Closures on North Carolinians
    • Health Care in Jails Forum
      • Wednesday, May 20, 2026
      • 2:00-3:30 p.m.
      • Virtual Event
        • This forum examined the growing challenges counties face in providing health care services within local detention facilities. Discussions centered on rising costs, operational considerations, and opportunities to improve health outcomes while managing county responsibilities.
        • White Paper: North Carolina County Jail Health Care Costs
    • Innovations in Health Care Forum
      • Thursday, June 18, 2026
      • 2:00-3:30 p.m.
      • Virtual Event
        • The final forum highlighted emerging innovations and promising practices in health care delivery that can improve access, efficiency, and outcomes for North Carolina residents. Participants explored creative approaches and successful models that may help address current and future health care challenges.
        • White Paper: [Coming soon!]

    Together, these forums informed the initiative’s ongoing work to identify challenges, elevate local perspectives, and advance solutions that improve access to health care across North Carolina counties.

    Close accordion
  • 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.
    Close accordion