Tuesday, April 29, 2008

NC Legislative Update-Bi Monthly Summary

The Arc of North Carolina Legislative Update: April 14 – April 25, 2008

As we get nearer session you, the reader, will have two options to keep up with the happenings downtown. The first is our Friday Wrap Ups and the second is this abridged version called our Bi Monthly Summary. We are looking for a jazzier name so if you have a suggestion send me an email.

Election 2008:
Last session the General Assembly passed Same Day Voter Registration Legislation. During this primary season you can register to vote and vote in all early voting sites across our state. Early Voting sites are now open. These sites will remain open until May 3, 2008.  

Mental Health/Developmental Disabilities/Substance Abuse Legislative Oversight Committee:

Mental Health/Developmental Disabilities/Substance Abuse Joint Legislative Oversight Committee released its legislative proposals on Wednesday.

Governor's Proposal:

The proposal was heavy on mental health policy. It included funding for the State’s share of a 60 bed adult admission unit at Dorothea Dix following the Dix merger. It also included funding for additional staff at the State psychiatric hospitals and proposed that the department retain a consultant to follow up on the staff to patient ratio issue.

In the hot topic issue of Crisis Services the Governor did include a proposal to establish a statewide network of DD START Crisis Teams. A total of 9 were proposed. In addition there would be the procurement of 187 community inpatient beds to assure availability on a 24/7 basis and 24 DD crisis respite beds. The Arc of North Carolina was pleased to see the Governor include people with developmental disabilities in his crisis services proposal.

The most hotly debated proposal coming from the Governor was the proposal to do a voluntary regionalization of Local Management Entities. The proposal is to merge down from the current 25 LMEs to 9 LMEs over three regions.

Oversight Committee's Proposal:

The final legislative proposals for the Joint Legislative Oversight Committee were also heavy on mental health policy.

The committee did recognize the importance of the Housing 400 Initiative and its success in moving people with developmental disabilities/mental health/ substance abuse into independent living options in their communities. The committee is proposing to appropriate $10 million to the Housing Trust Fund and $2.5 million to DHHS for recurring operating support for approximately 500 units.

CAP/MD DD Waiver:

The Arc of North Carolina has been participating in a Department lead workgroup around the issue of the tiered waivers. The MH/DD/SA Legislative Oversight Committee included in its draft their proposal for a tiered waiver and the monetary caps of each waiver. The proposal looks like this:

-Tier One – up to $10,000
-Tier Two- between $10,001 and $25,000
-Tier Three – between $25,001 and $75,000
-Tier Four – greater than $75,000

There was NO money appropriated by the members of the Legislative Oversight Committee to create these new tiers.

IOM (Institute of Medicine) Study:

Also included in the proposal is a request to study and report on the transition for persons with developmental disabilities from one life setting to another. This study would include barriers to transition and best practices for successful transitions. Some of the topics would include transition for adolescents leaving school including adolescents in foster care. The study will also look at the growing problem of people with developmental disabilities living in aging homes. Also studied is the transition from developmental centers to other settings.

Proposed Appropriations:

$6 million for FY 2008-2009-support MES in establishing additional regionally-purchased and locally hosted substance abuse programs.

$675 thousand for FY 08-09 to LMEs to contract with outside vendors for technical assistance to meet standards for single-stream funding

$1 million for FY 08-09 to retain an independent consultant to perform a gap analysis of the Mental health, Developmental Disabilities and Substance Abuse system.

$5,274,000 for FY 08-09 in one time funding to be used to support the temporary opening and operations of the Central Regional Wake Unit on the Dix Campus.

Death Reporting appropriations: 
This appropriation address the proposal of more timely and accurate reporting of deaths in hospitals/institutions.
$155, 226 FY 08-09 additional public health nurse positions and other costs associated with increased investigatory requirements.

$30 million for FY 08-09 to expand the Hospital Utilization Pilot

$1,1134 for FY 08-09 to implement three pilot programs of the Transitional Residential Treatment Program

Housing 400 Initiative:
$10 million for FY 08-09 to the Housing Trust Fund
$2,500,000 for FY 08-09 to operating support for 500 units

Dropout Prevention:

Second hot topic during the interim is the number of students who dropped out of high school in North Carolina this year. (There were 23,000 students who dropped out this year. Of that number 4,050 students had a disability). The Joint Legislative Commission on Dropout Prevention and High School Graduation released its recommendations this week. The recommendations are as follows:

• System of Sharing Information about Dropouts
• Early Intervention Programs
• High School Redesign
• Parental Involvement and Communication Between Schools and Parents
• School Climate and School Safety
• Rigorous Academic Courses and Less Remediation
• Career and Technical Education Courses
• Impact of Raising the Compulsory Attendance Age
• Differences in Risk Factors that Lead to Males and Females Dropping Out
• Dropout Prevention Grants

Public School Funding:

Another issue at the General Assembly, is how to we fund the schools so that our children receive the educational supports they need. The real question here is do all the funding formulas need to be reviewed and possibly changed. Well on Wednesday of this week the Public School Funding Formula Committee presented its proposals.

The short-term recommendations are:
• Low Wealth (technical changes)
• Mentoring (program design)
• Textbooks (growth)
• Transportation of Pupils (fuel reserve, maximum ride times)
• Academically or Intellectual Gifted (funding level, identification)
• At-risk (treatment centers)
• Disadvantaged Student Supplemental Funding (funding level)

Although there was no specific request to change funding for children with special needs, we did receive confirmation that there will be a separate bill during the short session to address the need for increased funding for children receiving services through Exceptional Children programs. Once we have more details we will post on The Arc Policy Blog and include it in a separate update.

TASER Safety Project:
The Arc of North Carolina is one of the founding partners for the TASER Safety Project. We participated in a press conference regarding the use of TASERs by law enforcement in North Carolina. Our concern is that there is no standard regulation in North Carolina restricting the use of TASERs on people with disabilities. We are also advocating for more comprehensive disability awareness training for law enforcement personnel.

Medicaid CMS Rules:
The Arc of North Carolina sent out an e-alert regarding H.R. 5613 Medicaid Safety Net Act of 2008. This important legislation will put a moratorium on the CMS rules regarding habilitation, school administration and transportation, and targeted case management. These three rules will have a significant affect on people with developmental disabilities. H.R. 5613 passed the House with a veto proof vote. It will now head to the Senate. Out of our Congressional delegation only Virginia Foxx voted against this important legislation.

Federal Budget:
House and Senate negotiators working on the Fiscal Year 2009 Budget Resolution (BR) have made little headway in resolving key differences between their two versions. Most problematic is whether or not to offset the lost revenues when adding another one year “patch” to the Alternative Minimum Tax (AMT). The House is insisting on the offsets while the Senate remains resistant. An approximately $3.5 billion difference in domestic discretionary spending also remains unresolved. As in recent election years, the Congress may give up on passing the FY 2009 BR, instead approving a “deeming” bill that sets a cap on spending for the next fiscal year. Once passed, the “deeming” bill allows House and Senate appropriators to begin working on the twelve FY 2009 appropriations bills. There is little expectation that all twelve appropriations will be sent to the President given the recent history of President Bush vetoing any appropriations bills that increase spending beyond the levels he wants. FY 2009 spending for disability programs hang in the balance as the larger political struggles around revenues and spending unfold.

1 comment:

Lori Owen said...

I am a social worker; I live and work in Michigan. The Protecting Medicaid Safety Net Act of 2008 (H.R. 5613) will place a one-year extension on the current moratorium set to expire June 30, 2008.

As your readers know, Medicaid is a support for millions of low-income people, many with disabilities and very serious health conditions.

Medicaid services are slated to be cut by over $7 billion over the next 5 years by just three of the Administration’s Medicaid regulations. Cuts in three regulations alone will severely reduce access to social work services under this program.

States are in fiscal crises and do not have the money to make up the lost funding forced by the Administration’s Medicaid regulations. States will be forced to cut Medicaid eligibility and services to people who need it the most.

There is not time this year to pass changes in Medicaid law. We need this moratorium on the Administration’s Medicaid regulations now to protect vulnerable individuals’ access to social work and other critical Medicaid services.

I urge you to get involved by asking your House Representative to halt the Medicaid Rule and support the war supplemental appropriations bill that would keep all seven Medicaid rules.