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Evaluating the capacity of the health workforce to adopt team-based health care delivery models, nationally or in North Carolina, requires a nuanced approach that explores educational and clinical environments, payment, health systems, and regulatory levers. This paper discusses workforce challenges to team-based care and how best to train, prepare, and retool an equipped health workforce to meet the needs of team-based care.

In 2014, North Carolina had 4,681 actively practicing dentists and ranked 47th among US states in dentist-to-population ratio. The need for dentists is increasing as the population grows, and underserved areas persist. This commentary discusses the impact of the state's 2 dental schools and external factors on dental workforce trends.

There have long been rural health care workforce shortages; however, the urgency to find real solutions has increased with the changing health care landscape. The evidence makes a compelling case to be intentional in the candidates we support and to align educational resources across multiple systems. Programs need to continually evolve, utilizing workforce data, best practices, and new technological advances. This leads the Office of Rural Health (ORH) to secure funding for therapists practicing in integrated settings and to expand loan repayment to general surgeons and providers creating access through telehealth. While access is ORH's core mission, North Carolina's rural health plan reframed the discussion around creating healthy rural communities. This will require further refinement of the critical workforce definition, and it brings to the forefront the fact that a variety of new partnerships will be key to achieving the objective of healthy rural communities.

The Community Practitioner Program seeks to improve access to quality health care for North Carolina's most vulnerable people by providing educational loan repayment grants to primary care physicians, physician assistants, and nurse practitioners in return for their service in rural and underserved communities.

In addition to providing a well-prepared and diverse workforce of allied health professionals, North Carolina universities are helping to improve access to care and outreach to underserved communities. This commentary will discuss workforce preparation initiatives and innovations that help all North Carolinians access timely and high-quality services.

East Carolina University School of Dental Medicine is responding to the changes in today's health care system by implementing an innovative model of community-based dental education that prepares tomorrow's dentists to meet North Carolina's future oral health challenges while also providing much-needed care in many underserved areas.

Wake Forest School of Medicine and the College of Health Sciences at Appalachian State University are partnering to train physician assistants to practice as primary care providers in medically underserved parts of Western North Carolina. The partnership will also develop interprofessional education and team-based training activities for health professions students.

Access to preventive and oral health care services in many areas of our state remains problematic. This paper discusses oral health needs of North Carolinians and how a new model of dental education at East Carolina University addresses these issues by providing care where it is most needed.

This study sought to determine the availability of tobacco cessation services in free clinics.In fall 2007, a survey was e-mailed to free clinics that asked respondents to indicate the availability of13 different services recommended as part of the Treating Tobacco Use and Dependence guidelines set by the United States Public Health Service (USPHS). Seventy-two percent (n=51) of clinics responded to the survey.The majority of clinics enforce a "no tobacco use" policy inside the clinic (98%), encourage health care providers to advise patients to quit (90%), ask patients about tobacco use behavior on intake (78%), provide self-help materials (70%), and offer pharmacotherapy (e.g., bupropion) for quitting (60%). Fewer clinics offer fee nicotine replacement therapy (35%), display counter-advertisements in waiting areas and patient rooms (35%), have a designated staff person or volunteer to help patients quit (26%), evaluate whether health care providers offer tobacco cessation advice (30%), or have onsite tobacco cessation classes (22%). One out of 3 free clinics offer comprehensive (at least 9 of 13) tobacco cessation services using the USPHS Treating Tobacco Use and Dependence guidelines.Small sample size limits analytical techniques that can be applied, as well as interpretation of results.Free clinics offer an excellent opportunity to reach the uninsured population for tobacco cessation. Although 1 in 3 clinics is comprehensive in its approach to reduce tobacco use among their patients, many have yet to undertake the breadth of clinic-based strategies that can promote quitting. This study serves as an opportunity and a challenge to free clinics to expand their service delivery into the area of behavioral health.

Rural North Carolina hospitals are a treasure to be valued, nurtured, understood, and embraced. Just as Jim Bernstein understood and envisioned many decades ago, rural hospitalsand health networks are vital components of the rural communities they serve. Attention must be given to the value of preserving, enhancing, and investing in rural hospital and healthcare networks in order to ensure that effective, quality healthcare services remain consistently available and accessible for North Carolina's rural residents and communities.