Monday, April 7, 2008

Monday Quick Hits: Hot Policy Topics for This Week

North Carolina

The storm is officially here. This week we will see a up spike in appropriation subcommittee meetings as the budget debate begins. There will be a lot to balance between pressing budget needs especially for people served by the Developmental Disability, Mental Health, Substance Abuse Oversight Committee. Add to this the concern that North Carolina is seeing a significant increase in drop out rates for all students. Then you have transportation and infrastructure as we continue to address the boom in North Carolina’s population. The budget will surely take center stage on this blog, stay tuned.

Tuesday, April 8, 2008

10 a.m. The House Select Committee on High Speed Internet in Rural Areas Committee meets, 1124 LB.
During this committees last meeting the discussion centered on improving access to rural communities through private/public partnerships. There were several questions brought up by members on how best to develop these partnerships. This meeting will most likely continue that conversation. As we continue to move toward a more streamlined internet bases medical records system and as we continue expansion of on line courses, we will need to be able to connect all areas of our state to the information highway.

10 a.m. The Joint Appropriations Health and Human Services Subcommittee meets, 643 LOB.
This will be the first meeting of the HHS Appropriations Subcommittee. There was no agenda available at time of posting but it is clear that funding for mental health crisis services will be on everyone’s mind. It is important to people with developmental disabilities that the START Model, our crisis service model, receive full funding.

10 a.m. The Joint Legislative Education Oversight Committee meets, 544 LOB.
During the last committee meeting members received comments from state superintendents. The committee also learned during their last meeting that 4 LEAs had a 100% drop out rate of students with disabilities. This week the committee will receive reports on child nutrition, the Farm to School program. They will also hear a report regarding disadvantaged student supplemental funding and gang violence.

Wednesday, April 9, 2008

9 a.m. The Joint Legislative Education Oversight Committee meets, 544 LOB.
The committee second day will open with a welcome from Chair Senator A.B. Swindell followed by draft committee recommendations and legislative proposals.

2 p.m. The Joint Legislative Health Care Oversight Committee meets, 544 LOB. No information available at this time.

Thursday, April 10, 2008

9 a.m. The Joint Select Committee on Economic Development Incentives meets, 414 LOB.
This committee continues its work addressing the way North Carolina creates economic incentive packages for businesses to relocate to our state. No agenda was available at this time.


10 a.m. The North Carolina Study Commission on Aging meets, 421 LOB.
This committee will hear a report from the Adult Protective Services Taskforce. To read a summary of the report please go to the following link:
http://www.ncleg.net/documentsites/committees/NCSCA/2007-08%20Interim%20Committee%20Meetings/4-10-08%20Meeting/APS%20Fact%20Sheet.pdf


2:30 p.m. The House Select Committee on the Legal Aspects of Using Lottery Proceeds for Charter School Funding meets, 1425 LB.
No agenda available at this time.

Federal:

FY 2009 Budget Resolution

Work continued on resolving the differences between the House and Senate versions of the FY 2009 Budget Resolution (BR). The war and domestic policy will be taking center stage during this negotiation. There are scheduled to be numerous hearings on the war effort and due to the sagging economy, recent job loss data, foreclosures and an overall feeling that we have not paid enough attention to the home front, members of Congress are beginning to press for the White House to negotiate a second economic stimulus package. This second package would be directed at helping states deal with budget shortfalls. So far the Bush Administration has not signaled its intent to consider a second stimulus package. It wants to asses the first economic stimulus package impact before starting a second package.

Medicaid:
Several important developments on Medicaid and CMS Rules Moratorium. (The following information comes from DPC)

Medicaid Regulations House Moratorium Bill

The House Energy and Commerce Committee’s Health Subcommittee, chaired by Rep. Frank Pallone (D-NJ), held a hearing on the Protecting the Medicaid Safety Net Act of 2008 (H.R. 5613). This bill imposes a one year moratorium on Medicaid regulations including the case management, rehab option and school based administration/transportation rules. Witnesses representing the National Association of State Medicaid Directors, the National Conference of State Legislatures, the American Academy of Pediatrics, the American Hospital Association, and the American Association of School Administrators urged passage of the bill stating that the individual and cumulative impact of the regulations would be devastating to states, beneficiaries, and the providers who serve them.

The Centers for Medicare & Medicaid Services’ (CMS) Director of Medicaid and State Operations testified that the regulations are intended to curb abuses in the program, and that many Medicaid programs are inappropriately drawing down federal funds and claiming services that should not be covered by Medicaid. The Acting Director of the Government Accountability Office (GAO) stated that the agency has documented methods used to inflate the federal payments drawn down by the states. But, when questioned by Energy and Commerce Chairman Dingell, he acknowledged that the GAO had not studied or made any specific recommendations with regard to the regulations being addressed in the legislation.

Under “Pay-As-You-Go” budget rules Democrats implemented last year, lawmakers must couple proposals that cost money with legislation that would save or raise an equal amount. This means that the Congress must find funding to pay for the Medicaid Safety Net Act of 2008, which the Congressional Budget Office (CBO) estimates at $1.65 billion in fiscal 2008 and 2009. The CBO says the moratoria will cost money because it has already assumed in its “baseline” financial projections that the regulations take effect, a routine practice for the agency.

Medicaid Regulations Senate Moratorium/State Fiscal Relief Bill

Sens. John Rockefeller (D-WV), Olympia Snowe (R-ME) and Edward Kennedy (D-MA) introduced the Economic Recovery in Health Care Act of 2008 (S. 2819) which imposes a one year moratorium on all seven CMS regulations. The bill also imposes a moratorium on the August 2007 State Children’s Health Insurance Program (SCHIP) guidance (which restricts eligibility) and provides approximately $12 billion in targeted state fiscal relief, equally divided between an increase in federal Medicaid matching payments and targeted grants to states.

Medicaid

On April 4, the Centers for Medicare and Medicaid Services published proposed rules in the Federal Register to implement the Home and Community-Based State Plan Services. The new Section 1915(i) HCBS services are now available as an option to states for their Medicaid state plans as a result of enactment of the Deficit Reduction Act of 2005 in February 2006. The optional services, which are in addition to similar services provided under the Home and Community-Based Services waiver (Section 1915(c)), are simultaneously more limited than and more expansive than services available under the waiver program. For example, states may not use the option to provide the full range of services available under the waiver, yet the states may serve people under the new option who do not meet the level of need required for the waiver (otherwise eligible for institutional services). The public comment period will close at 5:00 pm on June 3. The DPC will work with other advocates to analyze the proposed regulations and send information to affiliates and chapters in advance of the closing date for comments. The proposed regulations can be found at: http://edocket.access.gpo.gov/2008/pdf/08-1084.pdf.


ADA Restoration

The ADA Restoration Act is moving forward in preparation for an anticipated mark-up in the House of H.R. 3195. Disability and civil rights groups have kept a high profile on the Hill with continued regular Congressional staff meetings. Meanwhile, the business and disability communities are maintaining productive and instructive dialogue on the bill and perspectives held by varying constituencies.

Prevention

On Tuesday, the House of Representatives is expected to vote on the Newborn Screening Saves Lives Act of 2007 (H.R. 3825) under suspension of the rules. This bill authorizes funding to help states expand and improve their screening programs, provide educational materials to families and improve follow-up care and treatment of newborns who screen positive.

The House is also scheduled to vote, under suspension of the rules, on the reauthorization of the Traumatic Brain Injury Act (H.R. 1418) which authorizes research and public health activities related to trauma and traumatic brain injury.

Health Care

On Wednesday, the Senate Finance Committee, chaired by Sen. Max Baucus (D-MT), will hold a hearing on the State Children’s Health Insurance Program (SCHIP).

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