The article describes North Carolina's precedent setting Office of Rural Health Services, its background and design, and its significant role in the development of primary health care clinics such as that in Balsom Grove which is staffed by a family nurse practitioner and enjoying wide community support. (SB)

Under the Smart Start program, 19 of North Carolina's Appalachian counties have qualified for competitive state funding to improve community services to young children and their families. Programs tailored to local needs provide subsidized child care to children of working parents, preventive health screenings, literacy and high school equivalency…