Health and Human Services Board Meeting | April 24, 2026

Key Decisions

The Buncombe County Health and Human Services Board held a virtual public meeting on April 24, 2026. The Board took two formal votes during the session. Board member Jennifer Horton motioned that the February Board minutes be approved, and the motion passed. Board member Jennifer Henderson motioned that the agenda be approved as presented, and this motion also passed. No other formal votes were recorded.

Discussion Highlights

The meeting featured updates from three program committees. The Community Opportunity Committee discussed methods for gathering customer service feedback and improving employee engagement through storytelling. The committee also brainstormed support strategies for residents potentially impacted by upcoming changes to Medicaid work requirements, noting that approximately 30% of the county’s 16,000 Medicaid recipients may be affected. The Community Safety Committee reported on the implementation of the Path NC program, a shift in funding for the Transformation Village contract to opioid settlement dollars, and ongoing challenges with hiring within the social work department, including vacancies in investigations, APS, and permanency planning. The Community Health Committee received an update on wastewater disposal regulations and the county’s compliance with state guidelines.

A significant portion of the meeting was dedicated to a presentation by Chris Frink of the Riverview Housing Coalition. Frink highlighted the financial struggles of 13 small businesses operating 46 residential living facilities (group homes) in Buncombe County. He explained that rising costs and reduced Medicaid revenues are causing facilities to close, putting vulnerable residents at risk of housing instability. The coalition, a 501c3 NAMI-sponsored initiative, aims to support these operators by seeking grant funding and developing a small business incentive program.

Ellis Matheson, chair of the Child Fatality Review Team, presented the 2025 annual report. The report indicated there were 14 child fatalities in 2024, a decrease from the previous year. Key recommendations included developing more robust emergency notification systems for drowning prevention, establishing parent support groups for families of children with behavioral health needs, and increasing the number of residential treatment facilities and Intensive Outpatient Programs locally and statewide.

In the Director’s Report, David Sweat, the Health and Human Services Director, reported that the department is working to close out budgets for the next fiscal year. He also issued a proclamation honoring social workers and community partners, noting that April is Child Abuse Prevention Month. Chair Dan Frayne provided an update on Certificate of Need results, detailing upcoming hospital projects: Advent Health is building a 93-bed community hospital in Weaverville, HCA Mission is building a 95-bed facility, and Novant is building a new 34-bed hospital for cancer and specialty care. Frayne also noted that new board members attended orientation on April 20 and that the Board will need to fill positions for a Physician, a Psychiatrist, an Engineer, and two Public/Consumer Advocates as terms expire.

Community Input

No direct public comments were recorded in the transcript.

Follow-ups

The Riverview Housing Coalition stated it will continue its efforts to support small business operators, seeking grant funding and developing a small business incentive program. The Board stated it will continue to monitor and discuss strategies for supporting residents facing potential changes due to Medicaid work requirements. The Health and Human Services Department stated it will continue efforts to address staffing shortages within various divisions. The Board stated it will continue to support the Child Fatality Review Team's recommendations, including promoting safe sleep practices and addressing mental health needs. The Board stated it will begin the process of nominating and selecting replacements for expiring terms, including a physician (psychiatrist) position and potentially seeking community members with expertise in housing. The Board stated it will continue budget work sessions next Tuesday to finalize the county's budget.

Impact

This meeting provided residents with updates on critical local health and social service issues. The discussion on Medicaid work requirements highlights potential impacts on a significant portion of the county’s population, while the Riverview Housing Coalition presentation sheds light on the economic pressures facing small-scale residential care providers and the resulting risks to vulnerable residents. The Child Fatality Review report offers data on child safety trends and specific recommendations for improving community resources related to drowning and suicide prevention. Finally, the Certificate of Need updates inform residents about the expansion of hospital capacity in the region, which may affect future healthcare access.