Jim Bernstein: Ardent Advocate for Community-Based Care

Community Care of North Carolina owes an enormous debt of gratitude to James D. Bernstein (1942 – 2005), founding director of the North Carolina Office of Rural Health and Community Care (ORHCC). In addition to helping establish more than 80 health centers across the state, ORHCC — under Jim’s dedicated leadership — paved the way for medical home-based programs like Community Care.

A former Peace Corps volunteer and Public Health Service officer, Jim came to North Carolina in the early 1970s, drawn by the opportunity to serve rural areas without access to medical care. He began in Walstonburg, piloting a program in which a local nurse practitioner ran the town’s health clinic. A respected physician in a neighboring area supervised her work remotely and accepted referrals from her center.

Before long, word of the program — and its success — reached then-Gov. Jim Holshouser, who wanted to expand the approach statewide. So in 1973, the North Carolina General Assembly established the Office of Rural Health with a $456,000 appropriation, a directive to start five rural community health clinics and a goal to launch 10 more within about two years. Thirty-year-old Jim Bernstein was tapped as its first director.

Jim did a little of everything. He mentored a field staff and built coalitions. He created provider recruitment programs that brought 2,500 health professionals to underserved communities. He championed health care demonstration projects, like the one from which Community Care grew, and he advocated for health care initiatives at local and state levels. Most important, Jim used hard data and logical arguments to convince those who had doubts.

Dedicated to the people of North Carolina, Jim served the citizens for more than three decades, both as director of ORHCC and as president of the organization that later became the North Carolina Foundation for Advanced Health Programs — a private, non-profit group that has partnered with public and private groups to pilot and develop care improvement initiatives like Community Care. Jim also served as an Assistant Secretary for Health in the N.C. Department of Health and Human Services.

Jim’s work was guided by three fundamental principles:

• Every person deserves health care.
• Health care should be delivered efficiently and with respect.
• The people of a community and their providers should have ownership of their health care system.

Those same principles guide the work of Community Care today. Just as Jim worked within existing systems to create new ones — systems that were sustainable and addressed problems effectively — we are working with partners and providers to bring quality health care with dignity to those who need it most.