The public health department serving Alleghany, Ashe and Watauga counties is laying off nearly two dozen employees.
AppHealthCare says it will eliminate 23 positions effective June 30.
The agency provides services including vaccinations, maternal health programs and infectious disease response across the three-county region.
In a post on social media, CEO Jennifer Greene said the cuts are due to budget constraints that “stretched our organization and many like ours beyond what is sustainable.”
Public health agencies across the state have been struggling to make up for recent federal grant losses, along with changes affecting Medicaid and SNAP benefits.
Greene closed her statement by calling on legislators and funders for support, writing, "because the work of public health cannot wait, and it cannot be done without the resources to sustain it."