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Belting one out: First beltway segment opens this fall

From Kernersville to the outskirts of Rural Hall, folks are watching N.C. 74 take shape.

N.C. 74, you say?

That’s what the Winston-Salem Northern Beltway will be called, at least until sometime in 2024, when the last segment of the eastern leg of the beltway is finished.

After that, N.C. 74 becomes Interstate 74 and will form part of a future Midwest-to-Atlantic coast freeway.

“That will be the point where we get to sign that as I-74,” said Pat Ivey, the division engineer for the N.C. Department of Transportation in Forsyth County. “You will be able to go all the way from (the existing) I-74 to U.S. 52.”

A lot of people have been waiting a long time for the beltway. And not just motorists: Hundreds of landowners in the path of the project are finally getting bought out, after many of them filed suit earlier in the decade.

“The (transportation) department and the owners have been able to negotiate settlements acceptable to both sides,” landowners attorney Matthew Bryant said.

Bryant represented hundreds of clients who won a victory in 2016 at the N.C. Supreme Court, which declared that landowners had lost property rights by being designated in the path of the roadway.

Big road

The beltway will be a 35-mile freeway running some three-quarters of the way around Winston-Salem, from I-74 on the southeast side, north to U.S. 52 near Rural Hall, and back south to U.S. 158 near Clemmons.

The freeway will have three lanes in each direction on the eastern side, and two in each direction on the west.

Motorists have been watching the first segment of the beltway under construction between Business 40 and Reidsville Road since 2014, when the $154 million contract was awarded to Dragados USA Inc.

Ivey said people will be able to start driving on the 3.4-mile segment in November, although he doesn’t expect many drivers to use the road until the next segment opens between Reidsville and New Walkertown roads.

Scheduled for completion in June of 2021, that segment could open as early as the end of 2020, Ivey said. E.S. Wagner Co. LLC is handling that $33 million part of the beltway.

“That contractor is way ahead of schedule,” Ivey said, “In fact, right now the project is about 43% complete. All the major bridges, with the exception of the one right off 158, they’re done. That is actually the smallest of all the beltway projects.”

When the beltway is open between New Walkertown Road and Business 40, Ivey expects truck traffic especially to begin moving over to the new road.

Truck shift

Norfolk Southern railway operates a big auto distribution center in between Old Walkertown and New Walkertown roads in Walkertown. According to the Norfolk Southern web site, the 68-acre center has a capacity of 6,700 cars and operates 24 hours a day.

Ivey said that now, trucks from the center often travel on N.C. 66, going through Walkertown and Kernersville to get to Business 40 and points beyond. When the section of the beltway opens, linking New Walkertown Road with Business 40, Ivey said a lot of that truck traffic will use the new road.

“That will help us as we begin on widening N.C. 66 in Walkertown,” Ivey said.

The N.C. 66 widening starts construction in 2022.

The longest stretch of the beltway currently under contract for construction runs all the way from New Walkertown Road to University Parkway. It’s a 7-mile stretch being built by Flatiron Constructors, one of the companies doing the Business 40 renovation in downtown Winston-Salem.

Houses in the way are being torn down and land is being cleared. A lot of clearing can be seen on Germanton Road north of the Old Hollow Road intersection.

New intersection

One convenience store at the intersection is closed and soon to be torn down. The Speedway store on the southwest corner of the intersection will stay open until sometime in the last quarter of the year, according to Tony Williams, who was working at the store one day earlier this week.

“Three Fridays ago, a group came by to appraise the building,” Williams said. He added that the location is a good one, and stays busy. Customers are always asking how long it will be before construction takes the store away. The store is the kind of place where some people do more than just buy something and leave.

“You build relationships with people who have been here a long time,” Williams said. “People come by and hang out and converse. It is like a mini-Wal-Mart to people out in the country.”

Bobby Shore, dropping by the store one day last week, said he wishes the construction didn’t affect the side of the road where the Speedway sits.

“I like coming here because the employees pick on you and cut up with you,” Shore said. “They don’t treat you like a customer, they treat you like family.”

The work that takes out the Speedway includes a radical change for N.C. 8 where it will intersect the new beltway.

Start with the current intersection of Old Hollow and Germanton roads. The stoplight will be replaced with a roundabout, the first of three that drivers will encounter crossing over the beltway on N.C. 8.

Traffic circles at each end of the bridge carrying N.C. 8 over the beltway will allow motorists to get on and off.

That’s similar to the arrangement where the beltway crosses Baux Mountain Road — roundabouts on both ends of the bridge.

Once the beltway is complete from Business 40 to University Parkway, it will be another year until the interchange is ready that connects the beltway to U.S. 52 on the north side of Winston-Salem. The $134-million interchange is supposed to be ready by September of 2022.

And even that “is an aggressive timeline,” Ivey said.

Still farther out are the last two sections of the eastern leg of the beltway, the sections running south from Business 40 to I-74 on the southeast side of Winston-Salem.

New names

When that last link on the east is done, N.C. 74 becomes I-74, and I-74 will be a step closer to completion in North Carolina. Of course, Business 40 will be Salem Parkway and U.S. 421 when the downtown freeway renovation is complete in 2020.

When the beltway gets its I-74 designation, there will be a short leftover piece of freeway running from where I-74 now splits from I-40. Transportation officials say that short section of freeway will be designated N.C. 192.

That’s not the only new road number folks will have to remember: When sections of the western beltway leg start opening up during the next decade, they will initially be designated parts of N.C. 452.

But maybe not for long: the state is hoping to eventually designate the western leg as I-274.

Work on that western leg will go on into the 2030s, with the last segment scheduled — tentatively — to start construction in 2029. That last segment will connect the beltway to U.S. 158 on the southwest side of Winston-Salem toward Clemmons.

Before that, other western segments will be under construction from north to south: From U.S. 52 to N.C. 67 starting in 2023; from N.C. 67 to U.S. 421 west of Winston-Salem, in 2026; and from U.S. 421 to I-40 southwest of Winston-Salem, in 2028.

Beltway lawsuits

Bryant said that almost 210 of the more than 300 beltway property lawsuits have now been settled through negotiations with the N.C. Department of Transportation. Although the state for many years fought landowner claims, the 2016 Supreme Court ruling in favor of the landowners paved the way for settlements that are still going forward.

Landowners argued that when the state designated their lands as being in the path of the beltway, in 1997 and in 2008 under what was called the Map Act, it effectively took the properties from the landowners without any compensation.

Even after the 2016 Supreme Court ruling, the state was penalized in 2018 by a local superior court judge for foot-dragging on the property cases. Since then, Bryant said, the state has cooperated.

“They made a sound decision in our opinion to cooperate with the landowners and not fight them,” Bryant said.

South of Business 40, where most of the beltway property case owners live, Ivey said that the state has bought 62% of the properties it needs to acquire in between Business 40 and I-40. Further south, from I-40 to I-74, about 32% of the property needed for the road has been bought. Ivey noted that area does not have a lot of property owners.

Many residential areas along the future road are getting noise walls, and Ivey noted that even one farm bisected by the freeway is getting a noise wall, after highway officials went back and determined that the farm qualified.


Along with new freeway miles and highway designations, state highway officials are gearing up to install new signs.

One project will involve re-signing the split between I-40 and Business 40 in Guilford County, Ivey said.

Currently, he said, drivers bob and weave as they try to figure out which way they want to go: Winston-Salem is given as a destination on both signs. Not to mention the confusion that the two 40 designations creates, Ivey said.

That’s changing. I-40 will be signed as the way to Winston-Salem, and what is now Business 40 will be signed as U.S. 421 and Salem Parkway.

Ivey said a “supplemental sign” for Salem Parkway will note that the road also leads to downtown Winston-Salem, Wake Forest University and Winston-Salem State University.

With the completion of the beltway, I-74 will be complete from Winston-Salem southeast to the outskirts of Rockingham. Near Mount Airy, a completed section of I-74 connects to I-77.

Ivey said the hope is to eventually upgrade U.S. 52 between Winston-Salem and Mount Airy.

“At the very least, (we should have) enough ‘future’ signage to where everyone will know this is I-74,” Ivey said.

Ad campaign and personal attacks escalate in dispute over State Health Plan

A more personal approach is being used in the dispute over the State Health Plan’s bid to lower reimbursement rates paid to hospitals and medical providers.

State Treasurer Dale Folwell wants to move the SHP and its more than 727,000 participants away from a commercial model to a government-pricing model.

Folwell has been promoting his Clear Pricing Project contract since October.

Hospitals and medical providers that do not sign the contract could become out-of-network providers for SHP participants starting Jan. 1. Only four of the 126 hospitals in the state have signed, along with 27,000 providers.

The State Employees Association of N.C., also known as SEANC, recently launched a Facebook public-relations campaign and placed statements on its website aimed at persuading the boards of the state’s major health care systems to sign the contract.(tncms-asset)31d3282a-afd1-11e9-956b-00163ec2aa770 —(/tncms-asset)

The Facebook messages tell the health care systems’ boards to “do the right thing ... sign the State Health Plan contract.”

“Are you really going to turn your back on the 130,000 teachers, troopers and civil servants in your community? Tell them we’re done paying for overpriced care and our SHP is no longer their piggy bank.”

Folwell’s plan is opposed by the N.C. Healthcare Association, which is backing a public-relations campaign urging state legislators to prevent Folwell from completing the transition.

The initial SEANC targets are Novant Health Inc., UNC Health Care and WakeMed. SEANC urges SHP participants to call the board members, including listing a phone number.

Besides Novant’s chief executive Carl Armato, other board members include: Dave Plyler, chairman of the Forsyth County Board of Commissioners; Elwood Robinson, chancellor at Winston-Salem State University; and Vi Lyles, Charlotte’s mayor.

Plyler could not be reached for comment on the SEANC campaign. Winston-Salem State deferred Robinson’s comment to Patrick Phillips, chairman of the Novant board. Novant declined to comment.

Robert Broome, SEANC’s executive director, said that if the health care systems’ management and boards won’t offer viable solutions for resolving the dispute, “perhaps they will talk to SHP participants personally.”

Broome said “we’ll have to wait and see” when asked if there are plans for similar campaigns against the leaderships and boards of Cone Health and Wake Forest Baptist Medical Center.

Cone said July 1 it was rejecting the contract. Wake Forest Baptist said it will not discuss its plans.

Authority for cuts

The Republican-controlled state legislature has given the treasurer the authority to decide on reimbursement cuts to hospitals and providers as part of a mandate to reduce overall SHP expenses.

The SHP is North Carolina’s largest purchaser of medical and pharmaceutical services at $3.2 billion in 2017.

Folwell’s Clear Pricing Project contract proposal would pay about 61,000 providers based on a percentage above current Medicare rates, along with a substantial additional and adjustable profit margin.

A second enrollment period authorized by Folwell began Friday and ends Aug. 5. The first period ended July 1.

SHP participants’ decision-making process begins in early fall when they chose which providers they want for 2020 coverage.

As an enticement to the systems and providers, the SHP and Folwell agreed last week to raise reimbursement payments again.

The new proposal increases payments from 182% to 196% of Medicare rates on average. Urban hospitals will see their combined inpatient/outpatient ratios go from 178% to 200% of Medicare on average.

Cynthia Charles, the NCHA’s communications and public relations director, said that decisions “about whether or not to opt-in to the treasurer’s new offer remain up to individual hospitals and health systems.”

“At this time, it is unclear whether this new proposal will result in any movement. We are not surprised by the treasurer’s (new sign-up period) announcement. He had to address the network inadequacy issue.”

Fingers pointed

Folwell, the SHP and the NCHA have been butting heads since Folwell unveiled his Clear Pricing Project initiative in October.

Each claims the other side has not been willing to engage in earnest negotiations.

A group called Affordable Healthcare for N.C. has targeted Dr. Michael Waldrum, Vidant Health’s chief executive and NCHA chairman, for a political-style attack ad.

The “Million Dollar Mike” campaign questions Waldrum’s financial motives, contrasting his $1.2 million annual compensation with his refusal to sign the contract.

Both the Novant and WakeMed campaigns cite the latest available compensation for their respective chief executives. The Novant campaign mentions how much money the system has in unrestricted reserves at $3 billion.

“While North Carolina hospitals, health systems and doctors have been locked in a heated debate with the state treasurer about the future of the State Health Plan, none of the parties have taken the attacks to a personal level,” the NCHA said in a statement.

“This attack, sponsored by the State Employees union, is a step too far.”

However, a Cone official, on his own accord, blasted the state lawmakers, SHP and Folwell for its reimbursement cuts.

“Your plan to cut payments to hospitals could possibly be the most moronic idea I have ever seen come out of our state government,” Frank Kauder, Cone’s assistant finance director, said in his blunt critique that closed by urging the recipients to “burn in hell you sorry (SOBs).”

Broome called “ludicrous” any suggestion that the Waldrum campaign is personal. “This is strictly business, presenting the facts,” he said.

PR campaign launched

The NCHA-backed public-relations campaign has included local radio advertisements by the Cary-based nonprofit Partners for Innovation in Health Care.

Folwell’s plan is called a “risky scheme” several times in the spot.

“The (public-relations campaign) in no way compares to the level of petty personal attacks we’ve seen this week from the State Employees union,” Charles said.

Charles said the NHCA’s public-relations ads “describe concerns about potential impacts on state employees and retirees of the state treasurer’s proposed changes to the State Health Plan.”

“They also explain how House Bill 184 can delay those effects and set the stage for a better approach. They focus on the policy concern and issue at hand for our state.”

House Bill 184, which would halt Folwell’s initiative for at least a year in favor of a legislative study report, cleared the state House by a 75-36 vote April 3.

It has yet to be acted upon in the Senate since being sent to the Rules and Operations committee April 4. Senate leader Phil Berger, R-Rockingham, has signaled he has no desire to address HB184.

Sen. Joyce Krawiec, R-Forsyth, and a Senate health committee co-chairwoman, said she has heard from constituents frustrated with not being able to price health care services and procedures before having them done, particularly if they were attempting to self-pay for their care to lower their expenses.

“Most of us don’t have a clue what we’re paying, and if we don’t have transparency, we’re never going to get costs going down,” Krawiec said. “We have to get together and talk and cooperate to get something done.”

NHCA president Steve Lawler said that “while we may disagree with treasurer Folwell on his approach to reduce costs, we respect his position as the state treasurer.”

“I call on treasurer Folwell and the Senate and House leadership to condemn these attacks on Dr. Waldrum and other North Carolina hospital leaders.”

Folwell said his office has “nothing to do with” the SEANC campaign.

Negotiated rates

Employers and health insurers negotiate rates that provide in-network discounts to individuals covered by an employer-based plan.

Without the negotiated discount, out-of-network costs can be significantly higher for most medical procedures.

The SHP said that hospitals statewide will receive an additional combined $116 million over the rate proposal announced in March.

State taxpayers are projected to save $166 million under the latest proposal, and SHP members save $34 million in reduced costs.

By comparison, Folwell’s initial proposal in October aimed to save SHP members up to $60 million initially and $300 million overall.

“The decision to readjust rates comes after many meetings and discussions with hospital officials and others,” Folwell said. “We realize that our members need to have additional hospitals for the plan to have coverage.”

Folwell said that the SHP will provide increased reimbursement payments to most independent primary-care physicians, behavioral-health specialists and to many rural hospitals.

“We believe what we’re offering is extremely fair,” Folwell said.

Folwell said he and the SHP have not received a firm counter-proposal from the NCHA.

“All the hospitals and NCHA want is to keep the status quo, allowing them to continue to overcharge SHP participants for their health care,” Broome said.

“If we don’t make a change now, we’re staring down the barrel of a 266% increase in premiums for state employees in just four years — that’s $133 a month for health insurance in a robust economy.

“Ten years ago, there was no premium.”

Winston-Salem doctor issued criminal summons on false insurance claim

A Winston-Salem doctor, Anne Litton White, has been issued a criminal summons on a misdemeanor charge of making false statements on an insurance claim application.

Meanwhile, White is awaiting the second of two N.C. Medical Board hearings into her professional conduct, currently set for Oct. 17 in Raleigh.

White has been the operator of Carolina Laser and Cosmetic Center since 2004.

The summons for White was issued May 13 by the criminal investigation unit of the N.C. Insurance Department. The summons lists the offense as taking place Jan. 11.

White’s court appearance at Forsyth County Courthouse initially was set for May 28, but was postponed until Tuesday.(tncms-asset)23dee934-afbd-11e9-91ea-00163ec2aa770 —(/tncms-asset)

According to the summons, White filed a claim of $28,327 to Hartford Accident & Indemnity Co. for reimbursement for a piece of equipment reported as damaged and considered as a financial loss. White also claimed a loss on equipment upgrades and installation costs.

Insurance investigator B.E. Maness reported the claim contained false information, including citing damages to equipment that was determined to be “in proper working condition.”

Hartford Accident & Indemnity said it spent $900 on investigating the claim, which it did not pay.

The father-son attorney team of Dan Blue II and Dan Blue III, who represented White in the first Medical Board hearing, could not be reached for immediate comment on the insurance case.

The second Medical Board hearing is set to take place almost a year after it was originally scheduled for Oct. 18, 2018.

Brian Blankenship, the board’s deputy general counsel, said in his Sept. 21, 2018, delay request that he had received “additional information and intends to issue a second amended notice of charges and allegations” against White.

Since delaying the second hearing, the board has not disclosed the second amended notice, or indicated when it would be made public.

The second hearing is expected to center on three allegations against White’s practice: having 40 containers of expired medication and solutions that were more than 10 years old; having an unlicensed physician assist White with a procedure; and a patient who wanted a tattoo removed filing a complaint that he or she had been burned because the setting on a laser was alleged to have been set too high.

It is the fifth time White has been subject to a Medical Board notice of charges and allegations, the others occurring in 2004, 2005, 2008 and 2017.

Her license has been suspended for a combined 110 days since 2004, the last times from May 7-16, 2018, and from July 16-26, 2018. Her practice has been operational since the second suspension ended.

The latest suspension was handed down by the board in June 2018 following an intense two-day hearing.

A charge of unprofessional conduct was at the heart of the medical board’s notice in which it decided on a summary judgment against White.

The N.C. Medical Practices Act defines unprofessional conduct, in part, as “departure from, or the failure to conform to, the standards of acceptable and prevailing medical practice, or the ethics of the medical profession, irrespective of whether or not a patient is injured thereby, or the committing of any act contrary to honesty, justice or good morals.”

That notice listed charges and allegations, among them that White reused syringes and dermatological products on multiple patients. Those actions would violate state medical standards.

White also was accused of giving her approval to keep, for months and in non-biohazard settings, small plastic bags of human fat and blood that had been drawn during liposuction procedures. Employees complained of a sickening smell as the residue decomposed over time.

The board determined that White acted with unprofessional conduct in not meeting acceptable standards for medical care at her practice.

The board did not determine she acted with “immoral and dishonorable conduct” with her practices and procedures during a period from June 2014 to February 2018.

The board gave White an indefinite suspension, but chose to issue a stay outside a 20-day active sentence.

Blue II said in June 2018 that White has chosen to comply with the decision and that the 20-day active suspension was acceptable in that the board recognized White’s efforts to resolve the concerns the board had expressed.

Among previous charges raised against White was that she marketed herself as a board-certified dermatologist when she wasn’t, and that she used medications that at the time the U.S. Food and Drug Administration hadn’t approved.

Photos by Bernard Thomas/Special to the Journal