Early this month, North Carolina’s Governor Roy Cooper proposed a $25.2 billion two-year state spending plan that aims to close many of the spending gaps that currently exist in the state’s services. One of the biggest changes in the proposal would expand Medicaid coverage to as many as 625,000 low-income North Carolinians, a move that would do much to help our poorest residents to access quality healthcare services. According to state health advocates, the Medicaid expansion is a necessary step in fixing the healthcare system here in the Tar Heel State, but it doesn’t go far enough to help one critical segment of the population: the state’s growing number of elderly residents.

According to UNC demography data, North Carolina, much like the rest of the United States, is experiencing the effects of population aging at an accelerating pace. Their statistics project that a full 20.6% of the state’s population will be age 65 or older by the year 2035. That demographic shift is going to not only change the face of the state but will also put a tremendous strain on the state’s healthcare system.

The problem, as it relates to the state budget proposal, is that North Carolina’s elderly population currently has a poverty rate of 9.1%. That number, even if it doesn’t increase, is going to ramp up demands on the state’s variety of services for the elderly. Programs like Meals on Wheels, allowances for personal needs, and the Adult Protective Services system are all already facing shortfalls, and advocates say the budget proposal all but ignores the expected increases in demand.

If the budget makes no further allowances to fund additional services for the elderly, advocates project that it will create a cascade effect that places ever-larger burdens on family members, many of whom are living in poverty themselves. Without the needed resources to provide in-home care for their aging relatives, many would be forced to turn to nursing home services, which is a healthcare sector that’s already on the verge of crisis due to staffing shortfalls that show no signs of abating.

That’s a situation that’s already playing out in many parts of the nation, with disastrous consequences. In many places, nursing homes that are stretched beyond their ability to care for their charges resort to tactics like hospital dumping, which is the practice of refusing to readmit residents once they’ve been taken to hospitals for acute care. According to attorney Matthew L. Sharp, a specialist in such cases, “Hospital dumping affects mostly low-income nursing home residents who have lost the ability to pay for care, except through Medicaid. Ironically, those abandoned in expensive hospitals cost Medicaid more than twice the cost of nursing home care.”

Since the new budget proposal includes an expansion of Medicaid services in the state, an increase in hospital dumping of elderly nursing home residents would cause a corresponding spike in Medicaid costs, which would either cause a severe funding shortfall or a sharp decline in the quality of services provided to patients. Either of those outcomes would be undesirable, and would likely cause the state to have to resort to even more costly fixes to the system.

So far, the budget proposal is just that: a proposal. There’s still time for some more careful reflection and changes to the plan. Examining the projected impact that the budget would have on the state’s elderly would be an excellent place to start. By increasing funding to the necessary services, it’s still possible to avert the worst outcomes that may result from ignoring the needs of a very vulnerable population. It’s a case where the old axiom should apply, that an ounce of prevention is worth a pound of cure. Now it’s up to state lawmakers to supply that ounce.

Ever since the advent of cellular phones, and smartphones, in particular, state and local governments all over the country have been puzzling over what to do to prevent phone-related distracted driving deaths. In recent years, much of the debate has centered on texting while driving, since it’s an obvious example of an activity that’s incompatible with safe driving. That’s why several states, including North Carolina, now have laws banning texting while driving, including severe penalties for those that violate the law.

Texting, however, isn’t the only cellphone-related activity that can distract a driver. Talking on the phone while driving, although it doesn’t always take the driver’s eyes off the road, does slow down reaction times and makes it much more difficult for the driver to monitor ever-changing traffic conditions. It’s no small problem, either. According to some estimates, cellphone-related distraction causes one in four traffic accidents in the US each year.

Here in North Carolina, the problem is especially severe. Over the past several years, there’s been a pronounced increase in distracted driving crashes and fatalities all across the state, with public awareness campaigns seeming to have little impact on the problem. Now, the state legislature appears poised to take action to end the menace once and for all.

In late February, Representatives Corbin, Torbett, Hardister, and Pierce introduced a new bill, HB 144, which would make talking on the phone while driving explicitly illegal statewide. The proposed law would introduce an escalating series of fines and punishments for drivers caught violating the ban, including adding insurance points to the driving records of repeat offenders.

The law would also include exceptions for drivers that use hands-free devices such as Bluetooth headsets and dashboard phone mounts, so it wouldn’t amount to a complete prohibition of cellphone use while driving. It also won’t apply to drivers making calls while parked or off of the roadway. In that way, the bill mirrors similar legislation that has passed in other parts of the country.

That’s a good sign when you consider that similar bans have had good success in other states in reducing distracted driving and preventing accidents and fatalities. In Illinois, a near-duplicate of the North Carolina proposal has worked especially well. According to the Ankin Law Office, a local firm that specializes in auto accident related cases, “The law is working and there has been a considerable drop in the number of fatalities over the past year. In 2014, the state experienced 685 fatalities by this time, whereas this year it has decreased to 636. Further, the number of accidents is decreasing as well, to just under 290,000 across the state.”

If the proposed bill becomes law here in North Carolina, it would take effect in January of 2020. Drivers would then have a grace period that lasts until July, during which officers would only issue warnings for violating the law, with citations beginning afterward. State troopers insist that they’re ready to enforce the new law if it passes, noting that they’ve had plenty of experience already in spotting drivers that are distracted due to cellphone use. The law would merely give them the tools to stop distracted drivers before they hurt themselves or others.

The bottom line is that it looks as though the days of North Carolina roads being inundated with drivers that have their minds on everything but the road may be nearing a merciful end. It comes too late for scores of state residents who have already suffered injuries or lost loved ones due to distracted drivers, but it should provide some comfort in knowing that more won’t be joining their ranks.