Thursday, April 16, 2009

Friday Wrap Up: Bills, Committee Reports, and Other legislative Stuff.

This week the House began reviewing the Senate's $21 billion dollar budget proposal.  The
Senate's proposed budget for MH/DD/SA closely tracks the Governor’s proposed budget. During the Health Appropriation meeting Senator Doug Berger stated that the budget reflects at 5% decrease from the continuation budget in fiscal year 2009-2010 and a 6% decrease for fiscal year 2010-2011. 
The budget does support the Governor’s proposal to close the Wright and Whittaker schools. The Senate’s proposed budget does not reflect any cuts to the CAP/MR-DD Waiver program or to the START Crisis program.
The Senate budget special provisions did include direction to the Division to begin the process of applying for a TBI Waiver and a direction to the Institute of Medicine to study Veteran Mental Health services. The Senate budget also continued to support the medically fragile child care center located in Raleigh. The Senate budget did include a one time cut to the Housing 400 Initiative program, the funds affected with this cut are the housing subsidy appropriation. 

Committee Meetings:

Senate Judiciary I:
Senate Bill 602: Medicaid False Claims/Qui Tam Actions-Kinnaird.
This bill would strengthen the prosecution of Medicaid fraud by increasing criminal penalties for provider fraud, create criminal penalties for obstruction and making false entries, establish a private civil action for provider false claims, and authorize a subpoena for documents in cases of provider fraud and abuse.

The request for this bill came from the Attorney General’s office and the Department of Health and Human Services. The impetus for this bill comes from the Deficit Reduction Act. The bill is trying to conform to the current federal laws on Medicaid fraud. All states have been requested to pass legislation similar to this in order to draw down additional Medicaid funding.

This bill was not voted on during the committee meeting. There was a healthy debate dealing with issues regarding parts of the legislation that would extend authority for DMA to subpoena documents outside of a request from the attorney general’s office.

This bill will continue to be worked on and will be back in committee next week.

House Health:
House Bill 925: Data Sharing/DHHS Agencies-Alexander.
This bill would authorize the sharing of confidential information among agencies f the Department of Health and Human Services in order to conduct quality assessment and improvement activities and coordinate appropriate and effective care, treatment or habilitation of DHHS clients.
Representative Alexander spoke on behalf of this legislation. This bill would permit better coordination of care and would still follow HIPPA regulations. There was no debate on the bill. It was passed out of committee.

Senate Health Care:

Senate Bill 331: MH/National Accred. Benchmarks-Berger
This bill would make changes to national accreditation benchmark requirements for certain Medicaid enrolled facilities.
This bill was pulled from the calendar.

House Mental Health Reform:
House Bill 672: Accountability for State Funding/MHDDSA-Earle.
The committee had a vigorous debate regarding this bill but did not vote on it. It will be taken up next week. The bill would require LMEs to hold a public meeting at one of their board meetings before moving funding from one disability group to another. It does not limit the LMEs ability to move funds but it does give the disability advocates an opportunity to voice their concerns on the front side of changes as opposed to after the fact. The bill also had language that would require LMEs to meet Division benchmarks prior to moving funds. This language caused considerable debate and in the last few minutes of the meeting Representative Alexander proposed an amendment that would require the public hearings but remove the benchmark language. In addition her amendment would require the Department to report to the Legislature on how single stream LMEs were using funds by January 2010.

On Wednesday, April 15, 2009 a compromise bill was negotiated. Representative Alexander was asked to withdraw her amendment and the new committee substitute passed unanimously out of committee.

The following is the compromise language:
Section 1:
A LME that utilizes single stream funding must, on a biannual basis, report on the allocation of service dollars and allow for public comment at a regularly scheduled LME Board of Directors meeting.

Before an LME proposes to reduce State funding to HUD group homes and
HUD apartments below the original appropriation State funds, the LME
must: a. Receive approval of the reduction in funding from the Department,
and b. Hold a public hearing at an open LME board meeting to receive
comment on the reduction in funding.

Section 2:
The Department of Health and Human Services shall analyze the effectiveness of single stream funding in the expenditure of state funds and review the allocation of service dollars to specific disabilities of those LME utilizing single stream funding for a year or more and report its findings to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services, the House of Representatives Appropriations Subcommittee on Health and Human Services, the Senate Appropriations Committee on Health and Human Services, and the Fiscal Research Division by June 30, 2010.

Bills that Passed the House:

House Bill 218: Parent & Student Involvement Act
This legislation begins the process of looking at our states policies for long term suspension. The bill will require written notification including a description of the incident leading to the recommendation for expulsion or suspension for more than ten days. The specific provisions of the student conduct policy or rule alleged to have been violated and the specific process to request a hearing to contest the expulsion or suspension for more than ten days including the number of days within which to request a hearing. This bill passed the Juvenile Justice and Education committee and was on the House floor for a vote on Wednesday, April 15, 2009.
This bill passed the House second reading with a vote of 107 in favor to 7 opposed. Third reading was scheduled for Thursday, April 16th and the bill is expected to pass.

Bills that Passed the Senate:

Senate Bill 208: People First
On April 9, 2009 the Senate passed Senate Bill 208: People First legislation with a vote of 47 in favor and none opposed, three Senators were absent for the vote. This bill was debated in the Senate Health committee where Senators questioned if this bill would have any unintended consequences. Some of the concerns raised were with the changing of language that could affect Medicaid funding, criminal laws that contain specific federal or state definitions, and civil laws that contain specific rulings that incorporate definitions. These concerns are the same that were raised in all of the states where this legislation has been presented. After multiple negotiations a compromise bill was presented on the Senate floor. This bill directs Legislative Services to include in legislative draft training a section on the use of People First language. This bill also directs the General Statutes Commission to recommend to the 2010 and 2011 General Assembly any statutory changes and drafting policies needed to make the General Statutes and administrative rules refer to a person with a disability as a person first. This bill will now go to the House.  

No comments: