Thursday, February 11, 2010

NC Legislative News: LOC Meeting Update

On Wednesday the members of the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services met for the second time of 2010.
The oversight committee agenda contained multiple topic issues of interest to people with developmental and intellectual disabilities, their families and advocates.

Among the issues discussed was the implementation and development of the planned Community Alternative Program (CAP/MR-DD) waivers, the establishment of the Developmental Disability Waiting List, and a report on the state wide North Carolina-Systematic, Therapeutic, Assessment, Respite and Treatment Crisis program (NC-START).
The Arc of North Carolina would like to extend its thanks to the members of the legislative oversight committee for recognizing the need to address the concerns of constituents regarding services for people with developmental and intellectual disabilities.

CAP-MR/DD Waiver-Development and Implementation.

Background: The design of these waivers has taken multiple years. The legislative budget of 2007 included the special provision language to begin the process of developing and implementing the tiered waivers. The impetus behind tiering the waiver was to improve efficiency in funding and to identify and meet the needs of people with DD/ID who are eligible for waiver services. The strategy to create tiered waivers was part of the recommendations made in The Arc of North Carolina’s Road Map to Success. This comprehensive vision of a system of delivering services to people with developmental and intellectual disabilities was created with the input of stakeholders and advocates.

In 2008 the legislature appropriated 10 million dollars to begin the process of opening new Tier 1 support waiver slots and in the special provisions included the break down of CAP/MR-DD funding limits by tiers.

In 2009 by an order of the governor all funding for CAP/MR-DD Slots and other items in the budget were frozen. The members of the North Carolina legislature during the 2009 budget did re-allocate 8 million dollars from state service dollars for CAP/MR-DD recipients to the CAP/MR-DD waiver program. Of the 8 million dollars re-allocated, 4 million went to the opening of the Tier 1 Waiver slots and 4 million went to create a soft freeze on the existing comprehensive waiver slots.

LOC Presentation Synopsis: Rose Burnette of the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services presented an update to members regarding the current status of the CAP/MR-DD waivers. In great detail she explained the federal regulations requiring each of the waivers to be “stand alone” with its own quality assurance plan, eligibility criteria, financial tracking and reporting. Each of these waivers is being defined to meet the needs of the intended participants based on the intensity of need, financial limits and services/supports offered in the specific waiver. There will be three waivers the Tier 1 support waiver, the Comprehensive Waiver that will be broken into two bands, and the community intensive waiver. Currently our state is operating two waivers, the support waiver and the comprehensive. LMEs have received information regarding the amount of slots for the new tier 1/support waivers that are now available to be filled. In total there are 1,000 new waiver slots in this category that have been distributed through the system.
For more information please review the power point presentation.

Establishment of the DD Waiting List.

Background: The Arc of North Carolina included legislative agenda for 2009 a bill that would re-establish a statewide waiting list for people with developmental and intellectual disabilities. Representative Beverly Earle introduced this legislation which passed both chambers and was signed by Governor Bev Perdue on June 26,2009. (HB 673)

LOC Presentation Synopsis: Leza Wainwright with the Division of MH/DD/SAS presented an update on the establishment of the waiting list. The division has done research on waiting lists with the National Association of State Directors of Developmental Disabilities Services, has consulted with Celia Feinstein of Temple University and has conducted a survey of sister states. The information that they have collected from 31 states shows that 26 have a statewide waiting list and five do not. Of the 26 states with waiting lists fifteen of them are based on “urgency of need” while 11 are on a “first come first serve” basis. Many of the states only collect information regarding people who are waiting for waiver slots. The legislation that passed in North Carolina is broader in scope. It also includes the collecting of information regarding people with DD waiting for residential services and other DD services.

Currently all LMEs except PBH have been using a standardized prioritization tool that takes into place both urgency and waiting time. The current data only is collected for those waiting for waiver services. The Division will be convening a stakeholder group comprised of LME staff, providers, consumers and family members to design both short term and long-term waiting list implementation processes.

For more information please review the power point presentation.


Background: The Arc of North Carolina During the 2008 legislative session the General Assembly appropriated $1,876,243 dollars to open six crisis teams to serve people with developmental disabilities. The crisis teams were to be distributed across the state. In 2009 members of the General Assembly appropriated the additional sum of $579,084 to fully funding this critical service. This was one of the few appropriations made during a very difficult budget year and it clearly showed a commitment to addressing crisis services for people with intellectual and developmental disabilities.

LOC Presentation Synopsis: Christina Carter with the Division of MH/DD/SAS presented on the current status of NC-START. NC START is an evidenced based model of community based crisis prevention and intervention services for people with Intellectual/Developmental Disabilities. The services are available to people who are 18 years or older experiencing a crisis due to mental health and or complex behavioral issues. This model was co-authored by Dr. Joan Beasley and Dr. Robert Sovner. The model aims to keep people in crisis in their home or residential setting. North Carolina is the only state to be using this model statewide. NC-START provides both crisis and clinical support. The state funding is currently supporting six crisis/clinical teams in three host LMEs. Those LMEs are Western Highlands Network, The Durham Center, and East Carolina Behavioral Health.

For more information please review the power point presentation.

On Wednesday, all of the presentations made to the Legislative Oversight Committee were consistent with the broader vision advocated for by The Arc of North Carolina. As an organization we continue to work to promote a secure, sustainable, and comprehensive service delivery system that supports the individuals needs.

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