Arc NC: Happy New Year

The Arc of North Carolina Policy Blog will be taking a short New Year Break. We wish all of you a very happy and safe New Year!
We will have all new posts on Monday!

NC Legislative News: Senator Tony Rand Leaves the Senate After 27 Years

Senator Tony Rand will be leaving the General Assembly after twenty seven years of service to our state. He has accepted an appointment from Governor Perdue to become chairman of the state Post-Release Supervision and Parole Commission.

Read more at The Fayetteville Observer.

Hill Report: President Obama Taps Lynnae Ruttledge to Rehabilitative Services Administration

'Voc-rehab' boss to lead fed program

Obama pick: She erased state waiting list for services
Here is the story from The Olympian.


BRAD SHANNON; The Olympian
Last updated: December 29th, 2009 06:19 AM (PST)

Lynnae Ruttledge, leader of Washington state's Division of Vocational Rehabilitation, is headed to a new job running the $4 billion federal "voc-rehab" program for the Obama administration.
Ruttledge hopes to start Monday in Washington, D.C., and says she wants to improve the federal program like she is credited with doing for Washington’s after she arrived in Olympia four years ago.

“At the federal level I want to be a part of the economic recovery of the country. I want people with disabilities to be identified as part of the solution and not a part of the problem,’’ Ruttledge, 60, said from her Lacey office this week.

President Barack Obama’s staffers recruited her from Olympia, just as the state Social and Health Services secretary at the time, Robin Arnold-Williams, had recruited her from Oregon. Ruttledge is to serve as commissioner in the Rehabilitative Services Administration, inside the U.S. Department of Education.

Read more: The Olympian.

Hill Report: Senate and House To Begin Discussion on Final Health Care Reform Bill

While Santa was delivering toys to all the good girls and boys, the US Senate was busy voting on their health reform bill. The final vote on partisan lines was 60 in favor to 39 opposed. The 60 vote win for Majority Leader Harry Reid came after several deals were cut with specific Senators to ensure their favorable vote. This process is far from over and the real battles will begin right after the new year. Here is a great run down on the differences between the two bills compliments of NACS Online and a very cool interactive model from Boston Globe.

NC News: WRAL Reports on Lawsuit

Patients in DHHS lawsuit to keep health services for now

Posted: Today at 2:07 p.m.
Updated: Today at 2:30 p.m.
A federal judge on Monday extended a temporary injunction that blocks the state from terminating two people's community-based mental health services until a lawsuit over the matter goes before the court in a full hearing.

Disability Rights North Carolina filed the complaint earlier this month against the secretary of the North Carolina Department of Health and Human Services and the Rocky Mount mental health facility Beacon Center, claiming the patients stood to lose state and federal services that allow them to live independently.

The cuts were supposed to go into effect Dec. 15, but a judge issued an injunction, which was set to expire Monday. It was extended until a full hearing on the matter. A date hasn't been scheduled.

Read more at WRAL.

News NC: National Article on DRNC Lawsuit

JUSTICE DEPARTMENT TO PARTICIPATE IN COMMUNITY INTEGRATION CASE IN NORTH CAROLINA  

Saturday, 26 December 2009

The Justice Department today filed a brief as a friend of the court in Marlo M., et al. v. Cansler, et al., a community integration case in federal court for the Eastern District of North Carolina. The government's brief supports the two plaintiffs, individuals with a developmental disability and mental illness, who are seeking to block the state of North Carolina from making major reductions in services offered to them, which could also affect similarly situated people.
The United States seeks to participate in this case as part of its ongoing commitment to enforcing the Supreme Court decision in Olmstead v. L.C., a ruling requiring states to eliminate unnecessary segregation of persons with disabilities and to move persons who can function in the community out of segregated facilities and into supported living situations.

North Carolina's planned reductions will directly impact individuals with disabilities, potentially forcing the plaintiffs and others out of community placements. The plaintiffs have successfully resided in the community for years. Cuts to the services provided by the state would put them and other individuals with disabilities at imminent risk of being placed in an institutional setting. The lawsuit alleges that the move to institutional placements will increase costs to the state.

"By supporting the plaintiffs in this case, we seek to ensure that the civil rights of individuals with mental illness and developmental disabilities in North Carolina are protected," said Thomas E. Perez, Assistant Attorney General for the Civil Rights Division. "North Carolina has provided critical services to disabled individuals with significant needs, allowing them to fully participate in their communities. Now cuts to these services threaten to take this away at a cost to the plaintiffs and the state."

The Supreme Court ruled in the Olmstead case that unnecessary segregation of individuals with disabilities wrongly stigmatizes them as unworthy of participating in community life. Today's filing follows new activity by the Justice Department to better enforce Olmstead's mandate of community integration. The Civil Rights Division has recently filed briefs in support of four separate Olmstead cases in Florida, Connecticut, Virginia and New York.

The full and fair enforcement of the ADA and its mandate to integrate individuals with disabilities is a major priority of the Civil Rights Division. The ADA protects individuals with disabilities from discrimination by public entities. People interested in finding out more about the ADA can call the Justice Department's toll-free ADA Information Line at 1-800-514-0301 or 1-800-514-0383 (TTY), or access its ADA Web site at http://www.ada.gov/.

Breaking News: Press Release DRNC-Judge Grants Preliminary Injunction.

Monday, December 28, 2009
Judge Grants Preliminary Injunction!
Raleigh, NC –

On Monday, December 28, 2009, Disability Rights North Carolina (DRNC) presented arguments in federal district court on behalf of two clients, Marlo M. and Durwood W., naming the Secretary of the North Carolina Department of Health and Human Services and the Director of the Beacon Center as defendants. The plaintiffs in the lawsuit are two individuals with disabilities who were notified that a large measure of the state-funded services that permit them to live in the community are being terminated.

“The loss of these services would have violated the mandate of the landmark Supreme Court decision Olmstead v. L.C., which held that unnecessary institutionalization of individuals with disabilities is a form of discrimination under the Americans with Disabilities Act,” said Vicki Smith, Executive Director of DRNC. “We are pleased that the court agreed with our concerns and protected services.”

For almost a decade, Durwood W. has lived in his own apartment as the recipient of federal and state dollars called Thomas S. funds, named after a class action lawsuit that successfully challenged scarcity of services available to individuals who were challenged by both intellectual disabilities and mental illness. Marlo M. has also lived in her own apartment for more than five years supported with a blending of federal and state dollars. Although the North Carolina General Assembly exempted individuals like Durwood and Marlo from the most severe budget cuts, the legislature did not make the preservation of these necessary services mandatory. Instead they delegated discretion to Local Management Entities such as the Beacon Center to preserve the services provided to this vulnerable population.

“These two individuals were caught in the tangle of a service delivery system that does not have clear lines of accountability between LMEs and the State and the State’s budget crisis,” stated Smith. “We fear that this is just the first of many such cases.”


Disability Rights North Carolina is the state's federally mandated protection and advocacy system for people with disabilities. One of the P & A's primary federal mandates is to protect and advocate against the abuse and neglect of people with disabilities.
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Monday Hot Topics: Hot Policy Topics This Week

North Carolina:

The General Assembly is still on its Holiday break. Meetings will resume in January. However, there were lots of news over the break regarding budget cuts, national health reform and updates on the Disability Rights North Carolina law suit.  We will posting those stories this week.

Here is a quick look into the future on the first round of committee and commission meetings for 2010.

Tuesday, January 5, 2010

10:00 AM Poverty Reduction and Economic Recovery - Subcommittee on Tax Issues 423 LOB
10:00 AM Poverty Reduction and Economic Recovery - Subcommittee on Jobs 424 LOB
10:00 AM Poverty Reduction and Economic Recovery - Subcommittee on State Programs 425 LOB
10:00 AM Poverty Reduction and Economic Recovery - Subcommittee on Persistent Poverty 643 LOB
11:00 AM Poverty Reduction and Economic Recovery Study Commission 643 LOB

Wednesday, January 6, 2010
9:30 AM Revenue Laws Study Committee 544 LOB

Thursday, January 7, 2010
10:00 AM Children and Youth, Legislative Study Commission on 415 LOB
10:00 AM Aging, North Carolina Study Commission on 544 LOB

Hill Update: Senate Health Care Reform Legislation

The U.S. Senate is poised to pass a historic health care reform bill. This legislation has been hotly debated with both pro and con voices speaking on issues of concern in the bill. As you all know there were several very important issues that advocates for people with disabilities were working on during this very long process. We just received an update from the Disability Policy Collaborative in DC and wanted to share the information with you our readers.

Here is the update:

Health Reform

On Saturday, December 19, Senate Majority Leader Harry Reid (D-NV) and Senator Ben Nelson (D-NE) reached agreement on a package of amendments to the Senate health reform bill. The agreement was reached after several days of debate and during a major snowstorm that blanketed Washington with over two feet of snow. The agreement, among other things, addresses Nelson's concerns regarding funding of abortions and Nebraska's Medicaid payments, thereby clearing the way for consideration of those and other revisions to the Patient Protection and Affordable Care Act. In addition, the Congressional Budget Office and the Joint Committee on Taxation released an estimate of the costs of the revised bill indicating that the package of revisions raises the cost of the bill by $10 billion over a decade, but also increases revenues by $12 billion, effectively lowering the deficit by an added $2 billion over the next decade. The revised package also includes an added $10 billion to build community health centers and increase the number of doctors in medically underserved regions, bringing the total cost to $871 billion.

The $871 billion bill includes the following provisions which are of major importance to people with disabilities:
· Major insurance market reforms including elimination of pre-existing condition exclusions and annual and lifetime caps;
· Coverage of rehabilitation and habilitation services and devices in the essential benefits package for the new insurance Exchange;
· An expansion of Medicaid eligibility up to 133% of the federal poverty level;
· The Community Living Assistance Services and Supports (CLASS) Act which will establish a new nation wide long term services insurance program that will help individuals and their families meet their needs without needing to be impoverished;
· The Community First Choice (CFC) Medicaid option which will make comprehensive community-based services available to Medicaid beneficiaries in states which choose the option (it would begin on Oct 1, 2010 with no sunset date); and
· A requirement for the development of standards for accessible diagnostic and other medical equipment.

Inclusion of the CLASS Act was a great victory for the disabiliy community. It had been uncertain in the last week as Senate Majority Leader Harry Reid (D-NV) worked to ensure the 60th vote from Senator Ben Nelson (D-NE). Nelson had mentioned the CLASS Act as a concern to him, but in the end, the CLASS Act was kept in.

Monday Hot Topics: Hot Policy Topics This Week

Happy Holidays everyone! There are no meetings this week at the General Assembly. Interim committee meetings will start up again on January 5th.

The big policy action this week will continue to be in Washington, DC as the Senate prepares to pass a health care reform bill before the Christmas break.  We will keep you up to date today through Tuesday as news breaks.

The Arc of North Carolina Policy Blog will be taking a holiday vacation from December 23-December 27th. We will resume our blogging of issues of importance to you on Monday December 28th.  Have a safe Holiday!

Hill Update: Senate and Health Care Reform

Looks like we will see a Senate vote today on health care reform. Over the very snowy DC weekend, Senator Reid did some major negotiating and came up with the 60 votes needed for cloture.

The health care debate is far from over however, we still need to see what comes out of the conference bill. 

We will keep you up to date as things progress.

NC Policy Watch Article: Fundamental Questions

Fundamental questions

Thursday, December 17th, 2009

By Rob Schofield

The need to confront some basic issues about our mental health, developmental disabilities and substance abuse systems

Imagine you are the family member of a person who for several years (perhaps most of their life) has been the subject of a "dual diagnosis" of developmental disabilities and mental illness. Not only is your loved one mentally retarded, but they are afflicted with a mental illness that prevents them from succeeding in a wide variety of social situations (like, for instance, a group home). There are several hundred of such persons in North Carolina - many of whom were the beneficiaries of a lawsuit brought during the 1990's referred to as the "Thomas S."case.

Imagine further that, after years of struggle and frustration, you finally managed to secure services for your child or sibling that allowed him or her to live in their own apartment. Now, for the past decade, your family member has been living in a reasonably stable and decent situation that features three enormous pluses:

1)    They receive decent, round-the-clock assistance,

2)    They are not institutionalized,

3)    You do not have to sacrifice your entire life and wellbeing in order to assure that they reside in a decent situation.

Read rest of article here: NC Policy Watch.

Hill Update: DPC Weekly Policy Update.

Here are the major updates from the Disability Policy Collaborative.


Fiscal Year 2010 Appropriations

The U. S. Senate yesterday passed the FY 2010 Omnibus Appropriations bill by a vote of 57-35. This action followed a vote of 60-34 on Saturday to end debate on the bill. The House of Representatives had passed the bill on December 10 by a vote of 221-202. The House and Senate votes clear the measure to be signed by President Obama.

The Omnibus bill is a package of six of the twelve appropriations bills. Five other FY 2010 appropriations bills had previously been enacted as separate bills. Passage of the Department of Defense bill is being held back so that last minute provisions such as an unemployment insurance extension and the raising of the federal debt ceiling can be added to that measure.

The Omnibus Appropriations bill contains virtually all federal spending for disability programs. Included in the Omnibus bill are all programs funded under the Departments of Labor, Health and Human Services, Education, Housing and Urban Development and Transportation. These departments are now funded for the remainder of the fiscal year which ends on September 30, 2010.

The Labor-HHS-ED bill contains a $8.5 billion increase for discretionary programs, slightly less than a 5% increase, after the economic stimulus funds are disregarded. The Transportation-HUD bill gets a 16% increase over FY 2009 funding, also excluding stimulus funding. The following link http://2010\final FY 2010 approps table conference.doc contains a table that compares FY 2009 spending with the Obama Administration FY 2010 request and the FY 2010 appropriations. Late this week, the DPC will publish an edition of National Policy Matters that will provide more detailed information on the FY 2010 Omnibus Appropriations bill.

Health Care Reform

As the Senate continued debate on the Patient Protection and Affordable Care Act (H.R. 3590), the Congressional Budget Office (CBO) began its analysis of an alternative to the public option developed by a group of ten liberal and moderate members of the Democratic caucus. Although details of the compromise have not been released, it reportedly includes allowing Americans between the ages of 55 and 64 to buy into Medicare. The proposal also reportedly creates a national health insurance plan to be run by nonprofit private insurance plans and supervised by the Office of Personnel Management. Some moderate Democratic senators are awaiting the cost estimate of this proposal before deciding on whether to support the health reform bill. In an unexpected setback, on Sunday, Sen. Joseph Lieberman (I-CT) formally notified Majority Leader Reid (D-NV) that he would filibuster the bill if it includes a Medicare buy-in. This increases the Majority Leader's challenge of securing the 60 votes necessary to pass the overall bill.

In addition, the CLASS Act continues to come under criticism as some private long term care insurance companies are working hard to have it dropped from the health reform bill. The CLASS Act would establish a national long term services and supports insurance program to assist people in meeting their needs without impoverishing themselves to become eligible for Medicaid. The CLASS Act would also help reduce the pressure on the Medicaid program which has become the default long term services system in the country. As of now, the CLASS Act remains in the bill.

Restraint and Seclusion

On Wednesday, December 9, The Preventing Harmful Restraint and Seclusion in Schools Act, HR 4247, was introduced by Representative George Miller (D-CA), Chair of the Education and Labor Committee, and Representative Cathy McMorris Rodgers (R-WA). (See text of HR 4247 )

Senator Christopher Dodd (D-CT), Chair of the Subcommittee on Children and Families of the Health, Education, Labor and Pensions (HELP) Committee, introduced companion legislation in the Senate on the same day. (See text of S 2860)Although there are minor differences, both bills would prevent and reduce harmful restraint and seclusion in schools. The Obama Administration has made clear its strong support for this legislation.

Two recent reports by the Government Accountability Office (GAO) and the National Disability Rights Network (NDRN) detailed instances of restraint and seclusion that were harmful and even resulted in deaths of children. During a press conference to introduce the legislation in the House, Representatives Miller and McMorris Rodgers introduced parents from Michigan who said that their child, who has autism and a speech delay, had been tied to a chair for up to three hours every day when he attended preschool as a three-year old. He could not tell his parents what was happening to him every day. His mother only found out when she visited the school for a holiday party. DPC staff attended the press conference.

Education

DPC staff participated in two events related to the future of the assessment of students with disabilities under the No Child Left Behind Act and its successor legislation that may be considered by the Congress next year.

DPC staff was one of five disability representatives who met with top leadership of the Department of Education and several leaders of the general education community to discuss the ongoing implementation of the so-called 1% and 2% rules that currently apply to the assessment of certain special education students under No Child Left Behind (NCLB). Participants basically agreed that the 1% rule, which applies to students with the most significant cognitive disabilities, should be maintained. There was also basic agreement that the 2% rule (alternate assessments based on modified achievement standards) is not based on scientifically based evidence and that many states are too slow in implementation or are simply refusing to create assessment instruments to comply. Assessments for some of the students who are academically well behind their non-disabled peers will need to be addressed in the next reauthorization of the Elementary and Secondary Education Act and possibly sooner with an interim revised rule.

DPC staff also participated in a briefing held by the Educational Testing Service (ETS). This briefing concentrated on the challenges to validity and accessibility of the NCLB assessments for students with disabilities.

Employment

Thursday, December 10th, the Senate Health, Education, Labor and Pensions Committee voted unanimously to move the nomination of Lynnae M. Rutledge, of Washington State, to be Commissioner of the Rehabilitation Services Administration, for a vote by the full Senate. She is not considered confirmed until the full Senate votes, which has not yet been scheduled.

The Labor Department's Office of Federal Contract Compliance Programs (OFCCP) recently announced that it will be reviewing its regulations regarding hiring people with disabilities and strengthening federal contractors' affirmative action compliance. OFCCP Director Patricia A. Shiu, in an online web chat, said the agency is focusing on strengthening the Rehabilitation Act rules to help federal contractors improve their recruitment and hiring of persons with disabilities.

Emergency Preparedness

Senator Mary Landrieu (D-LA), Chair of the Disaster Recovery Subcommittee of the Senate Homeland Security and Governmental Affairs Committee, held a hearing last week concerning emergency case management services. During the hearing, witnesses from the Department of Homeland Security's Federal Emergency Management Agency (FEMA), the Department of Housing and Urban Development (HUD), and the Department of Health and Human Services' Administration on Children and Families (ACF) testified about emergency case management services that were provided in Louisiana and Mississippi after hurricanes Katrina and Rita. Testimony from the US Government Accountability Office (GAO) concerned lessons learned and recommendations for future emergency case management. To see GAO's testimony.

Witnesses who actually provided case management in the two states explained that vulnerable people, including people with disabilities, have not been able to return to the lives they were living prior to the disasters. All agreed that case management was a critical component of recovery and offered many suggestions for improvements. During the hearing, DPC staff learned that FEMA hopes to have a new Federal Disaster Case Management Program in place by June 2010.

Olmstead

The Supreme Court decision in Olmstead v. L.C. required States to eliminate unnecessary segregation of persons with disabilities and to move persons who could function in the community out of segregated facilities. Earlier this year, President Obama issued a proclamation launching the "Year of Community Living," and directed the Administration to redouble Olmstead enforcement efforts. At the end of November, the US Department of Justice (DOJ) filed three "friend of the court" briefs in Olmstead cases in Virginia, New York and Connecticut.

DOJ is supporting an effort by The Arc of Virginia and the Virginia P&A to block the state from spending $23 million on a new, segregated facility for 75 individuals with intellectual disabilities. An independent review of the individuals found that none of them had needs any more complex than people already living in community settings.

In New York, the P&A won a lawsuit that found placement of persons with mental disabilities in "large adult homes" was in violation of the Americans with Disabilities Act. As a remedy in the case, P&A argued for 6,000 new community-based placements but the State proposed approximately 1,000 new community spaces in the state-run system. DOJ is supporting the P&A's proposed remedy.
In Connecticut, DOJ is supporting a suit brought by the Connecticut Protection and Advocacy (P&A) that challenges the unwarranted confinement of over 200 people with mental illness in three large, private nursing homes. The P&A and DOJ allege that these people could live in more integrated community settings.

These actions by DOJ represent a shift in focus. The previous administration would have supported building new institutions and making existing institutions better rather than pursuing the most integrated setting for people with disabilities. The Arc and United Cerebral Palsy applaud this policy shift.

UN Convention on the Rights of Persons with Disabilities

DPC staff participated in a White House event where officials from the Departments of State and Justice, as well as White House staff, held a listening session on concerns of the disability community regarding the ratification by the U.S. Senate of the UN Convention that was signed earlier this year. One issue that likely needs more consideration is guardianship. Some factions of the disability community reject any form of guardianship while others, including representatives of individuals with significant intellectual disabilities, acknowledge the need for limited forms of guardianship in certain circumstances.

Monday Hot Topics: Hot Policy Topics This Week

On the week before the Holiday break we are still seeing committee meetings taking place at the General Assembly. It's a bit slower this week but still lots happening. Of interest to our community is the 2pm meeting on Tuesday discussing economic recovery. With the significant budget cuts we are seeing providers laying off workers and this will lead to the job loss numbers that we are seeing rippling across the state.

So here are the meetings this week:


Monday, December 14, 2009
9:30 AM House Select Committee on High Speed Internet in Rural Areas   544 LOB

10:00 AM Child Fatality Task Force - Unintentional Death Committee  1027/1128 LB

10:00 AM Children and Youth, Legislative Study Commission on  415 LOB

1:00 PM Joint Task Force on the Consolidation of Early Childhood Education and Care
421 LOB


Tueday, December 15, 2009
2:00 PM Senate and House Select Committee on Economic Recovery    1027/1128 LB

NCGA: Joint Legislative Oversight Committee Meeting MH/DD/SAS Agenda

Tomorrow the Joint Legislative Oversight Committee on Mental Health/Developmental Disabilities/Substance Abuse Services will hold its December meeting.

Here is the agenda:

Joint Legislative Oversight Committee on 

Mental Health, Developmental Disabilities, & Substance Abuse Services
AGENDA

December 9, 2009 10:00 A.M.; Room 643, Legislative Office Building
Senator Martin Nesbitt Co-Chair Presiding

Welcome and Opening Comments
Senator Martin Nesbitt, Co-Chair
Representative Verla Insko, Co-Chair 10:00-10:15 

I. Expenditures and Utilization Tracking Update 

Tara Larson, Chief Clinical Operating Officer, DMA        10:15-10:30 

II. Critical Access Behavioral Health Agencies
Michael Watson, Assistant Secretary for MH/DD/SAS Development     10:30-11:30 

III. Committee Discussion - Direction for NC DHHS's presentation
on System Vision for MH/DD/SAS in January                  11:30-12:00 

Lunch 12:00-1:00

IV. Community Support Services with Other Enhanced Services
Leza Wainwright, Director, Division of MH/DD/SAS                  1:00-1:30

V. Developmental Disability Targeted Case Management
Tara Larson, Chief Clinical Operating Officer, DMA            1:30-2:00

VI. Residential Level III and IV Group Homes Update
Private Residential Treatment Facility Requirements
Christina Carter, LCSW, Implementation Manager, Division of MH/DD/SAS     2:00-2:30

VII. Cross Area Substance Abuse Programs
Flo Stein, Chief, Community Policy Management, Division of MH/DD/SAS       2:30-3:00

Final Comments and Adjourn 3:00-3:15

Next meeting Wednesday January 13th, 2010, 643 LOB

Central Regional Hospital Raleigh/Butner Campuses site visits Thursday January 14h

Monday Hot Topics: Hot Policy Topics This Week

North Carolina:

This week we are seeing more meetings at the General Assembly. Of specific importance to this blogger is the Legislative Oversight Meeting for MH DD SAS that will be held on Wednesday.

We are starting to see the predicted outcome of these severe budget cuts. Services for people with MH/DD/SAS are being cut and jobs are being lost. If you are in town on Wednesday, we encourage you to attend this meeting.

Interim committees that will be meeting this week are:

Tuesday, December 8, 2009
10:00 AM Transportation Oversight Committee, Joint Legislative 1228/1327 LB

10:00 AM Joint Legislative Study Committee on State Funded Financial Aid 421 LOB

1:00 PM Education Oversight Committee, Joint Legislative  544 LOB

Wednesday, December 9, 2009

10:00 AM  Mental Health, Developmental Disabilities and Substance Abuse, Joint Legislative Oversight Committee  643 LOB

1:30 PM Information Technology, Joint Select Committee on 544 LOB

Thursday, December 10, 2009
10:00 AM Youth Accountability Planning Task Force - NC Judicial Center

1:30 PM Dropout Prevention and High School Graduation, Joint Legislative Commission

643 LOB

National:

The Senate continues its work on health reform legislation this week. Over the weekend attempts to strip the CLASS Act from the final bill failed. This was due to the hard work of advocates on the Hill and to a concerted effort by advocates who called their Senators on the national day of action.

We will keep you up to date on what happens in the Senate as news becomes available.

Hill Update: Washington Post Article on Senate Actions

Senate pushes ahead on long-term care program
GOP fails in effort to cut key health-care reform funding sources

By Lori Montgomery and Shailagh Murray
Washington Post Staff Writer
Saturday, December 5, 2009
Republican senators continued their assault Friday on key funding sources for a health-care overhaul, targeting Democratic plans to cut payments to private insurers who serve Medicare patients and to create a new government insurance program for long-term care that would raise more than $70 billion over the next decade.

Hill Update: CLASS Act and Senate Actions

Senators heard your voices. Thursday was national call in day for the CLASS Act. On Friday the first two amendments on this Act hit the Senate floor.  The first was to direct the savings generated by the CLASS Act back into the CLASS Act. This amendment passed.

The second amendment was to strip the CLASS Act from the final bill. The Thune Amendment was withdrawn by Senator Thune (R-SD) when the votes were clearly not there. The Thune Amendment may come back for seconds at some point so we need to keep vigilant.

Here is the update from Pass the CLASS Act.

National News: Thursday was the International Day of Persons with Disabilities

Presidential Proclamation - International Day of Persons with Disabilities
THURSDAY, 03 DECEMBER 2009 16:14 PRESS RELEASE LATEST NATIONAL NEWS
1 2 3 4 5
(0 votes, average 0 out of 5)
Washington, D.C.--(ENEWSPF)--December 3, 2009.

This year, in an effort to renew our global commitment to human rights and fundamental freedoms for persons with disabilities, the United States became a proud signatory of the United Nations Convention on the Rights of Persons with Disabilities. This treaty represents a paradigm shift, urging equal protection and benefits for all citizens, and reaffirming the inherent dignity and independence of the 650 million people living with disabilities worldwide. Today, as we commemorate the International Day of Persons with Disabilities, we celebrate the skills, achievements, and contributions of persons with disabilities in America and around the world. We recognize the progress we have made toward equality for all, and we rededicate ourselves to ensuring individuals with disabilities can reach their greatest potential.

See rest of article here.

National Day of Action! Call In Tomorrow! Help Us Save the CLASS Act!

Do You Still Care About Long Term Services and Supports?	Take Action!
Tell Your Story and Call in for the CLASS Act
Background The U.S. Senate is now debating its health care reform bill, the Patient Protection and Affordable Care Act.  And while the Community Living Assistance Services and Supports (CLASS) Act has stayed in the bill this far, it could be stripped from the bill any day now.   In fact, we just learned that there will be an amendment to eliminate the CLASS Act from the bill.   Our contacts on Capitol Hill tell us that one of the biggest obstacles for the CLASS Act ismisperception among Members of Congress and their staff that people with disabilities belong in the Medicaid program and cannot work.  We must set the record straight and let our Senators know that, while Medicaid is an essential safety net, millions of people who now have or later develop disabilities work and want to take personal responsibility for their long term care needs. This is an empowerment issue - People should not be forced into poverty to get the support they need.   Take Action You can help by doing two things:   1) Plan to participate *tomorrow* December 3 in a national call in day.  Join advocates from around the country in making our voices heard!  Please call both of your Senators.  The toll free number is (800) 958-5374.  Here is a Sample Script: Hello. I am calling to ask Senator ___________________ to make sure the CLASS Act remains in the final health reform bill and to oppose any amendment to strip it from the bill. The CLASS Act will help people to remain independent at home.   2)   Tell us your long term services and supports story NOW.  Stories are being gathered to share during Senate debate on the health care reform bill. We are seeking personal stories that fall under two categories:   Retrospective - What could have been if the CLASS Act program had been available.  Story examples include: You worked for many years and discovered that you were financially unprepared for your long term services and supports needs after you became disabled in a car accident. If you had been able to pay into the CLASS Act program, you could have paid an attendant to help you remain in your own home and not been forced to move into a nursing home before it was necessary. Your sister who has a developmental disability held a job for several years until her health worsened and she required assistance with daily activities such as transportation and meal preparation. Had she been able to pay into the CLASS Act program, she could have paid an attendant to help her with these activities of daily living and remained employed. Your wife became disabled after having a stroke. Had she been able to pay into the CLASS Act program, she could have used the cash benefit to pay for services and supports in the state where you had planned to move to. Instead, she had to spend down all her savings to qualify for Medicaid and you and your wife were unable to move. Your father's retirement savings were depleted to pay for his long term care needs. If he had been able to pay into the CLASS Act program, he could have made the necessary modifications to his home to accommodate his wheelchair and covered his other needs instead of relying on you and your sibling who tapped into your own children's education funds to help pay for his care. Prospective - What could be if the CLASS Act program becomes available. Story examples include: You just started your career. If the CLASS Act program becomes available, you know that you can be take personal responsibility for your own care and be more self sufficient should you become disabled for any reason. Your son has a disability and is currently employed. If the CLASS Act program becomes available, he will be able use the cash benefit to purchase the services and supports that he needs to remain employed for as long as possible. Your husband is starting to plan for his retirement. If the CLASS Act program is available, you know that, if he becomes disabled, you will not have to divorce him in order to keep his household income below the Medicaid eligibility level to receive long term services and supports. Your mother is nearing retirement. If the CLASS Act program becomes available, she can start paying in and supplement her private long term care insurance plan that provides limited coverage. You can submit stories online at http://surveys.aahsa.org/EFM/wsb.dll/s/30g179 , or use the questions in this survey to help guide you in writing your story.   Thank you in advance for your advocacy and your commitment to improving the quality of life for millions of people with disabilities and older Americans. For more information, see: www.passtheclassact.org

Monday Quick Hits: National Hot Policy Topics for This Week

This information provided by DPC:

U.S. Congress

The Congress returns to work tomorrow.  There are about three and a half weeks remaining before a Christmas break is scheduled.  Passage of a health care reform bill in the Senate and continued work on the remaining Fiscal Year 2010 appropriations bills will dominate the House and Senate agendas in December.

 

Health Reform

 

The Senate returns this week to begin debating the health care reform bill, the Patient Protection and Affordable Care Act.  Currently the bill includes the following provisions which are of major importance to people with disabilities:

• Major insurance market reforms including elimination of pre-existing condition exclusions and annual and lifetime caps;
• Coverage of rehabilitation and habilitation services and devices in the essential benefits package for the new insurance Exchange;
• An expansion of Medicaid eligibility up to 133% of the federal poverty level;
• The Community Living Assistance Services and Supports (CLASS) Act which will establish a new nation wide long term services insurance program that will help individuals and their families meet their needs without needing to be impoverished;
• The Community First Choice (CFC) Medicaid option which will make comprehensive community-based services available to Medicaid beneficiaries in states which choose the option (it would begin on Oct 1, 2010 with no sunset date); and
• A requirement for the development of standards for accessible diagnostic and other medical equipment.

It is expected that a number of issues will be vigorously debated, including the overall cost of the bill and the role of a public program as an alternative to private health care coverage.  While debate may continue through most of December, Senate Democratic leaders hope to complete work on the bill before the Christmas recess.  It is unclear at this time whether the Democratic leadership has the votes necessary to pass the bill or to amend it in ways to garner the 60 votes necessary for passage.  The House passed its version of health care reform on November 7.

 

Monday Quick Hits: Hot Policy Topics for This Week

This week is a busy one at the General Assembly. The tax reform debate heats up again on Tuesday with more presentations on the direction that North Carolina may take to increase revenues in our state. This meeting comes on the heels of national news reporting that we may be slowly recovering from the Great Recession.

This committee will also be closely watching the holiday shopping trends to see if there is a spike in sales tax collection or a dip. Read more here.

Also this week the NC Council of Community Programs will be holding its conference to discuss the major effects of the current budget on community based programs for people with mental illness, developmental disabilities, and addictive disorders. We will be attending the conference and will report any information regarding the state cuts.

Schedule for this week at the General Assembly:

Mon, November 30, 2009
10:00 AM	Children and Youth, Legislative Study Commission on	415 LOB
Tue, December 1, 2009
10:00 AM	Poverty Reduction and Economic Recovery Study Commission	544 LOB
10:00 AM	Interim Joint Finance Committee Meeting on Tax Reform	643 LOB
Wed, December 2, 2009
9:00 AM	Blue Ribbon Task Force on State Health Plan	1228/1327 LB
9:30 AM	Corrections, Crime Control, and Juvenile Justice Oversight Committee, Joint Legislative	643 LOB
1:00 PM	Urban Growth and Infrastructure Issues Study	544 LOB

Later this week:

National: The Senate will begin again the debate on health reform legislation. It does not look like we will see a vote any time soon.

International: December 3, 2009 is International Day of Persons with Disabilities.

Thanksgiving Holiday

We at The Arc of North Carolina Policy Blog wish you all a very happy Thanksgiving holiday! We will not be updating this blog again until after the holiday. 

Hill Report: Senate Introduces Bill on Intellectual Disability Terminology

Intellectual Disability Terminology

 

On Tuesday, Senators Barbara Mikulski (D-MD) and Michael Enzi (R-WY) introduced "Rosa's Law"(S. 2781) a bipartisan bill to substitute outdated, stigmatizing terms in federal health, education and labor laws.  The terms "mental retardation" and "mentally retarded" would be substituted with the terms "intellectual disability" and "individual with an intellectual disability."  The change in terminology would in no way alter the eligibility requirements for services and supports.  Click here to read Senator Mikulski's statement to the U.S. Senate upon introduction of the bill.

Thanks to DPC for this update.

 

Hill Report: Senate Begins Debate on Health Reform Bill

On Saturday the US Senate managed to get the needed 60 votes to begin the debate on their Health Care Reform bill.

No one is expecting a final vote on the bill before the Thanksgiving holiday.  The CLASS Act did make it to the final product in both the Senate and the House bills.

Here is the comparison of the two bills.

Monday Quick Hits: Hot Policy Topics for This Week

This week there are no meetings scheduled at the General Assembly. The General Assembly will get back to its busy interim schedule right after the Thanksgiving Break.

National Reports: First Study on Crime Against People with Disabilities

The U.S. Department of Justice Bureau of Justice Statistics has released the first special report looking at the prevalence of violent crime against people with disabilities.  

Here are some of the findings from the report:

Persons age 12 or older with disabilities experienced 

approximately 716,000 nonfatal violent crimes and 2.3 mil- 

lion property crimes in 2007 as measured by the National 

Crime Victimization Survey (NCVS). Nonfatal violent 

crimes include rape, sexual assault, robbery, aggravated 

assault, and simple assault. Property crimes include 

household burglary, motor vehicle theft, and property theft.* 

About one third (34%) of the crimes against persons with or 

without a disability in 2007 were serious violent crimes 

(rape/sexual assault, robbery, or aggravated assault). Per- 

sons with disabilities were victims of about 47,000 rapes, 

79,000 robberies, 114,000 aggravated assaults, and 

476,000 simple assaults. 

• Age-adjusted rate of nonfatal violent crime against 

persons with disabilities was 1.5 times higher than the 

rate for persons without disabilities. 

• Persons with a disability had an age-adjusted rate of 

rape or sexual assault that was more than twice the rate 

for persons without a disability. 

• Females with a disability had a higher victimization rate 

than males with a disability; males had a higher rate 

than females among those without a disability. 

• Persons with a cognitive functioning disability had a 

higher risk of violent victimization than persons with any 

other type of disability. 

• Persons with more than one type of disability accounted 

for about 56% of all violent crime victimizations against 

those with any disability.

Read the report here: Bureau of Statistics.

NCGA: Legislative News-Senator Nesbitt New Majority Leader

Today the Senate Democratic Caucus unanimously elected Senator Martin Nesbitt as their new Majority Leader. Senator Nesbitt will fill the position most recently held by Senator Tony Rand. Senator Rand announced recently that he would be accepting the position of chairman of the state Post-release Supervision and Parole Commission.

Senator Nesbitt is the chairman of the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities and Substance Abuse Services.

Read more about the vote today on WRAL.

NC News: Recent News On the Cuts to Medicaid/and MH DD SAS

We are now three months into the new state budget and the severity of the cuts for people with mental illness, developmental disabilities, and addictive disorders is being felt in every corner of the state. The reality is that the cuts to state funded services compounded with the cuts to Medicaid reimbursement rates has created the perfect storm of lost services and lost jobs.

Here is a sample of some of those articles:

Asheville Citizen Times: Mental-health provider Alpha Omega exits Madison, Mitchell and Yancey counties

Winston Salem Journal: Many Fear Health Cuts

Monday Quick Hits: Hot Policy Topics for This Week

This week we are looking at a very busy schedule for the General Assembly.  There is a full schedule of committee and commission meetings and on Tuesday the Senate Democratic Caucus will elect its new Majority Leader.  Last week Senate Pro Tempore Marc Basnight sent out a letter to caucus members asking for their support of Senator Martin Nesbitt.  We will let you know if the caucus follows that request.

Until then here is the upcoming schedule:

Mon, November 16, 2009
3:00 PM Domestic Violence, Joint Legislative Committee 544 LOB

Tue, November 17, 2009
9:30 AM Joint Interim House and Senate Finance Committees on Tax Reform 643 LOB

10:00 AM Transportation Oversight Committee, Joint Legislative  1228/1327 LB

1:00 PM Gov Ops Subcommittee-Education/Health and Human Services 421 LOB


Wed, November 18, 2009
9:00 AM  State Health Plan Blue Ribbon Task Force  1228/1327 LB

9:00 AM Joint Legislative Study Committee on State Funded Student Financial Aid  421 LOB

11:00 AM Governmental Operations, Joint Legislative Commission on  643 LOB

1:00 PM Joint Legislative Joining Our Businesses and Schools (JOBS) Study Commission - Williamston, NC


Thu, November 19, 2009
10:00 AM  Children and Youth, Legislative Study Commission on  415 LOB

NCGA: Update Joint Legislative Oversight Committee MH/DD/SAS

The Joint Legislative Oversight Committee for Mental Health, Developmental Disabilities and Substance Abuse services met this week.

It is becoming more clear to the committee members that the cuts to this budget are extremely significant and that community based services are struggling to continue to serve the most needy in our state.

In response to the 40 million dollar cut to state funded services that the LMEs are trying to manage Senate Martin Nesbitt stated that "we can not sugar coat what is happening out there. We did a bad deed and we cut them (LMEs) too much." "After all the meetings they had they still can't serve folks. Our first order of business is to tell our fellow members that we need to fix this. When you make a mistake and we made a mistake we need to fix it."

This 40 million dollar cut is in addition to a 16 million dollar cut to state funded services directed toward people who are also receiving CAP/MR-DD waiver services.

The committee members listened to numerous reports on how the LMEs are managing their budget reductions, how the budget reduction is affecting people with CAP/MR-DD waiver services that were also receiving state funded dollars for ADVP or support services, and finally they heard about the changes to case management.

It is clear to the members that the cuts in the current budget are quickly dismantling the community based delivery system for people with mental illness, developmental disabilities and addictive disorders.

It was also alluded to during this meeting that next years overall general fund will face a growing deficit. It is therefore the goal and the responsibility of the committee members to ensure that MH/DD/SAS receive very few additional cuts.  The top priority for this committee is to educate their peers on the importance of restoring as much funding to these services as possible or face a collapse in the system.

NCGA: Joint Legislative Oversight Committee Meeting MH/DD/SAS Agenda

The Joint Legislative Oversight Committee will be meeting tomorrow at 10AM. Here is the agenda:

Joint Legislative Oversight Committee on

Mental Health, Developmental Disabilities, & Substance Abuse Services

AGENDA

November 10, 2009; 10:00 A.M.; Room 643, Legislative Office Building

Representative Verla Insko, Co-Chair Presiding

I. Welcome and Chair's Opening Comments
• Representative Verla Insko, Co-Chair
• Senator Martin Nesbitt, Co-Chair 10:00

II. Secretary's Remarks
• Lanier Cansler, Secretary, Department of Health and Human Services 10:00-10:30

III. Local Management Entities: Update on Service Funds Reductions
• DHHS Perspective: Michael Watson, Assistant Secretary for MH/DD/SAS Development
• LME Perspective: W. Rhett Melton, Director of Pathways LME (serving Gaston, Cleveland, and Lincoln) 10:30-11:00

IV. Funding for Former Thomas S. Class Members
• Leza Wainwright, Director, Division of MH/DD/SAS 11:00-11:30

V. Changes in Funding for CAP-MR/DD Recipients
• Leza Wainwright, Director, Division of MH/DD/SAS 11:30-12:00
LUNCH 12:00-1:00

VI. Community Support Services
• Curtis Venable, Pisgah Legal Services 1:00-1:15

VII. Report on Consumer and Family Advisory Committees
• Kathy Crocker, State Consumer and Family Advisory Committee 1:15-1:45

VIII. Update on State Psychiatric Hospitals
• Luckey Welsh, Director, Division of State Operated Healthcare Facilities 1:45-2:15

IX. Report on Local Inpatient Psychiatric Community Hospital Contracts
• Michael Watson, Assistant Secretary for MH/DD/SAS Development 2:15-2:45

X. Case Management Follow-up
• Tara Larson, Chief Clinical Operating Officer, DMA 2:45-3:30

XI. Final Remarks & Adjournment 3:30-3:45

Monday Quick Hits: Hot Policy Topics for This Week

North Carolina:

The following meetings will take place this week at the General Assembly. If you are interested in attending the "big ticket" event this week, then head over to the Joint House and Senate Finance Committee meeting on modernizing the state tax code.

Taxes and revenue adjustment were the buzz words throughout the last session. The House and Senate each introduced their tax package. Most of the time they were worlds apart. The calling of the Joint House and Senate Finance committee during the interim is to work out the differences so that there is one bill going into the short session.

We will be monitoring this committee's work.

Schedule for the week:

Mon, November 2, 2009
1:00 PM	Perinatal Committee of the Child Fatality Task Force	1027/1128 LB
Tue, November 3, 2009
10:00 AM	House and Senate Finance Committees on Tax Reform	643 LOB
Wed, November 4, 2009
10:00 AM	Justus-Warren - Legislation and Resource Development	1027/1128 LB
10:00 AM	Justus Warren Heart Disease & Stroke Prevention - Prevention	1124/1224 LB
10:00 AM	Justus-Warren Heart Disease & Strok Prevention - Management	1228/1327 LB
10:00 AM	Justus Warren Heart Disease & Stroke Prevention - Public Awareness	1425 LB
1:00 PM	Justus-Warren Heart Disease and Stroke Prevention Task Force	1027/1128 LB
Thu, November 5, 2009
9:00 AM	Urban Growth and Infrastructure Issues	544 LOB
1:00 PM	Public Health Study Commission	643 LOB

Monday Quick Hits: Hot Policy Topics for This Week

North Carolina:

The interim continues at the General Assembly but as you will see in the next few weeks there are many committee meetings that will be happening.

Quick reminder, these committees do produce policy that we will see during the short session.

So this week we have the following on the calendar:

Monday, October 26, 2009
10:00 AM Child Fatality Taskforce - Unintentional Death Committee 1027/1128 LB

Tuesday, October 27, 2009
10:00 AM Poverty Reduction and Economic Recovery Study Commission 643 LOB

Wednesday, October 28, 2009
10:00 AM House Select Committee on High Speed Internet in Rural Areas 605 LOB

A bit of extra information on the Poverty Reduction and Economic Recovery Study Commission. Currently our state is witnessing major job losses in the area of health services. Many of these job losses are directly tied to the current state budget cuts. The members of this commission need to look at not only national data but at the realty of our state's budget cuts on creating a slower economic recovery in our state.

Hill Report: Senate Passes Hate Crimes Bill That Provides for Disability-Awaiting Obama's Signature

Yesterday the U.S. Senate by a vote of 68-29 passed the Defense Authorization bill.  Included in the defense authorization bill was the Matthew Shepard Hate Crimes bill.  This bill expanded the categories protected by federal hate crimes legislation to include people with disabilities. In addition language in the bill also extends protections to crimes that are motivated by a persons gender, sexual orientation, or gender identity.

Read more at Disability Scoop.

NCGA: Joint Legislative Oversight Committee Meeting MH/DD/SAS

Tomorrow legislative members of the Joint Legislative Oversight Committee for Mental Health, Developmental Disabilities, and Substance Abuse Services will return to Raleigh for their second meeting of the interim.

The severity of the budget cuts is being felt in every corner of our state. This is a crisis of historical proportions. Families are receiving the word that their children's support services will be cut drastically or eliminated completely. Providers across the state are facing massive lay offs of employees and in some cases they are closing their doors completely. Families already struggling during this tough economic downturn are being plunged into emotional and further economic distress. 

We are calling on our leadership to act as if this is a natural disaster. We are calling on our leaders to take action now and not wait for the start of short session.

We need you to join this effort! If you are in Raleigh tomorrow or if you can plan to be in Raleigh tomorrow, we need you to attend the Legislative Oversight Committee meeting.

Here are the details:

Joint Legislative Oversight Committee Meeting MH/DD/SAS

10:00 AM    Legislative Office Building Room 643.

Here is the agenda:

Joint Legislative Oversight Committee on

Mental Health, Developmental Disabilities, & Substance Abuse Services

October 14, 2009, 10:00 A.M.; Room 643, Legislative Office Building

Senator Nesbitt, Co-Chair Presiding

AGENDA

I. Introductions  10:00

II. Secretary’s Remarks

III. Reduction in Level III and IV Residential Facilities
-DHHS Presentation
-LME Perspective

IV. Status of CAP-MR/DD Supports Waiver

V. Report on Community Supports – Follow-up from September Meeting

Lunch 12:30-1:30

VI. Child Mental Health Project – Sarah Sabornie

 
VII. Funding for Former Thomas S. Class Members

VIII. Case Management For Persons with Mental Illness, Developmental Disability or Substance Abuse Disease

IX. Final Remarks and Adjournment                            3:30-4:00 

NCGA: Agenda for Legislative Oversight Committee MH/DD/SA

Joint Legislative Oversight Committee on

Mental Health, Developmental Disabilities, & Substance Abuse Services

October 14, 2009, 10:00 A.M.; Room 643, Legislative Office Building

Senator Nesbitt, Co-Chair Presiding

AGENDA

I. Introductions 10:00

II. Secretary’s Remarks

III. Reduction in Level III and IV Residential Facilities
-DHHS Presentation
-LME Perspective

IV. Status of CAP-MR/DD Supports Waiver

V. Report on Community Supports – Follow-up from September Meeting

Lunch 12:30-1:30

VI. Child Mental Health Project – Sarah Sabornie

 
VII. Funding for Former Thomas S. Class Members

VIII. Case Management For Persons with Mental Illness, Developmental Disability or Substance Abuse Disease

IX. Final Remarks and Adjournment                            3:30-4:00

Hill Report: US House Passes Hate Crimes Bill That Provides for Disability

The US House of Representatives voted yesterday to extend the protections of the four decades old hate crimes law to people with disabilities.

Reuters is reporting that the vote in the House was 249 in favor to 175 opposed. The bill will broaden the law by extending "hate crimes" to mean "those attacks based on a victim's sexual orientation, gender identity or mental or physical disability".

The legislation will now move to the Senate where it is expected to see little opposition.

This is a long time coming and it has not been easy. Previous attempts were blocked by President George W. Bush. 

Read More: Reuters , US House, and Disability Scoop.