When Tropical Storm Helene hit North Carolina in September 2024, heavy rainfall caused flash flooding and mudslides in the state’s mountainous Appalachia region. More than 70,000 homes were damaged or destroyed and 107 people lost their lives—the costliest natural disaster in North Carolina history.
In the wake of the storm, the North Carolina Department of Health and Human Services (NCDHHS) needed support coordinating its emergency response and beginning the transition to recovery. Fortunately, the mechanism to fill that position quickly was already in place through a master services agreement with the CDC Foundation’s Workforce Services, a program designed to help health departments across the country hire qualified health professionals.
“NCDHHS was one of the first state funded projects initiatives,” said Brian Kirk, project manager for the state funded projects at CDC Foundation. “After many years renewing contracts on an annual basis, they established a five-year master service agreement for NCDHHS staffing, which allowed for each division or branch within the department to hire staff quickly without needing to wait for the lengthy administrative renewal or amendment process.”
When Helene hit western North Carolina as a tropical storm in September 2024, it caused massive flooding that damaged or destroyed tens of thousands of homes and claimed the lives of 107 people (Photo by William Krepp).
Through Workforce Services, Sandra Bridges was hired as the response and recovery chief by the North Carolina Department of Health and Human Services in November 2024.
Helene caused widepsread damage and became the costliest disaster in North Carolina state history (Photo by WIlliam Krepp).
North Carolina state health officials reached out to Sandra Bridges about filling their open response and recovery chief position. With prior experience as the human services branch manager for North Carolina Emergency Management and with county-level emergency management experience in both North Carolina and Florida, Bridges was well-suited to the role. With the master service agreement in place, a hiring process that may have taken as long as nine months through standard state hiring procedures was reduced to less than three weeks. Bridges immediately put her years of emergency management experience to work streamlining communication between all involved parties.
“In emergencies, communication is the biggest challenge,” Bridges said. “Is everybody getting the same information? Is the information correct? And then when you have a situation like Helene where all of that communication infrastructure is no longer there, then you have even another layer on top of that.”
Launched originally in 2021 during the COVID pandemic, Workforce Services works with state, local, tribal and territorial health departments across the country to identify and hire public health professionals to support health initiatives. Leveraging a national network, the CDC Foundation handles every aspect of the recruiting and on-boarding process, developing job descriptions, managing requisitions, screening candidates and scheduling interviews to get the best qualified health professionals in place as quickly as possible. Through Workforce Services, the CDC Foundation has helped health departments across the country fill key positions in areas such as environmental public health, chronic disease and injury prevention, information technology and infectious and communicable disease control. As the employer of record, CDC Foundation continues to support these staff throughout the lifecycle of their contracts, providing an enhanced layer of management and support through high-quality benefit packages, professional development and strategic engagement opportunities.
“Jurisdictions that have a more immediate staffing need or a specialized staffing need can come to CDC Foundation for support as we leverage our experience to find really great candidates and bring them to the table,” Kirk said. “It provides a tool jurisdictions can utilize to make sure they can meet their capacity needs in a timelier manner.”
Emergency response in the wake of Helene was complicated in the state's mountainous Appalachia region by widespread damage to infrastructure like roads and bridges (Photo by William Krepp).
Brian Kirk, project manager for state funded projects at the CDC Foundation.
Emergency distributions after Helene destined for those impacted by flooding (Photo by WIlliam Krepp).
In the aftermath of Tropical Storm Helene, meeting those deliverables required focusing all available resources on the response effort, a particularly challenging task in the rugged mountains of western North Carolina. With bridges and roads washed out, accessing affected areas could mean hours of detours. When Sandra Bridges came on board in late November 2024, local response staff were exhausted from nearly two months of high intensity operations. As the emergency phase began to wind down, these teams needed to begin the transition to recovery efforts to avoid burnout and address long-term problems created by the flooding.
“People were having a lot of well issues, so, once the response activities transitioned to our team, we spent a lot of time trying to help people test their wells and having inspectors deploy from other parts of the state,” Bridges said. “We also focused a lot on trying to find out from the local health departments what their needs were.”
In the months that followed, Bridges says she and her team also coordinated with state and federal partners to disseminate information about mental health resources for the impacted communities and staff, and coordinated community trainings to help county-level agencies tackle longer term issues like dealing with mold in houses impacted by flooding.
“Recovery is really a big animal and very complex,” Bridges said. “So when I stepped into this role I really started looking for what we needed to think about from the public health side, and how we needed to start the transition to recovery.”
When I stepped into this role I started looking for what we needed to think about from the public health side.
Since launching in 2021, Workforce Services has filled over 6,000 positions in the public health sector, among them Sandra Bridges’ position in North Carolina. Switching in June 2026 to a new role, Bridges is now the division-wide preparedness and response coordinator within North Carolina Division of Public Health. Applying lessons learned from the Helene response, Bridges says her focus is primarily on internal coordination to ensure all involved sections are working together effectively when the next crisis arises. As complex and challenging as advanced planning can be, Bridges says, its impact when a disaster does strike can’t be overrated.
“You get to see how a year or two of planning impacts the population, because it's the worst day of their lives,” Bridges said. “But all of that planning that you did and all of the work you did in advance can help make their lives a little bit easier and a little bit better.”
Supported by the Centers for Disease Control and Prevention (CDC) of the U.S. Department of Health and Human Services (HHS) (Award No. 93.967), with 100% funding from CDC/HHS totaling $411,852. The contents are those of the authors and do not necessarily represent official CDC/HHS or CDC Foundation views.
