Wednesday, June 30, 2010

NCGA: Bill Update-Corporal Punishment and Children with Disabilities

The Senate Education committee debated House Bill 1682: Corporal Punishment and Children with Disabilities today. The bill passed with a favorable report. The Senate will vote on the bill tomorrow.

NCGA: Bill Update

House Bill 1682: Corporal Punishment and Children with Disabilities will be debated today in the Senate Education Committee. The committee will meet at 10:00 AM in room 643 LOB.

This bill passed the House with a vote of 113 in favor and no votes in opposition.

This bill would offer parents of children with disabilities, as defined by Section 504 of the Rehabilitation Act and IDEA, the ability to opt out of corporal punishment if it is practiced by their school. This bill will also direct the state to collect specific data regarding the practice of corporal punishment. If this bill passes the House it will be heading to the Senate.

NCGA: Budget Review #1

Yesterday the House and Senate tentatively approved the adjusted state budget for fiscal year 2010-2011. The last of the votes is expected to happen today followed by the governor's signature. The new fiscal year begins July 1. This will be the first time in seven years.

The budget being voted on totals just under $19 billion and does include a special provision for how the state will handle not receiving the additional $500 million from the federal government in FMAP money.

The budget does restore the $40 million cut to state funded community based services for people with developmental disabilities. mental illness, and addictive disorders. The budget also allocates $9 million in recurring funding to purchase more crisis beds. Both of these items reflect the continuing need for more community based services.

A more detailed budget analysis will be posted later in the week.

Tuesday, June 29, 2010

NCGA: Budget Debate Underway in House and Senate

The budget is now being debated in both the House and the Senate chambers. Second vote is expected today.

Monday, June 28, 2010

NCGA: Budget Update-9:29PM-Monday

The House has read in the budget. Final votes are scheduled for Tuesday and Wednesday.
Here is the link to the budget and the money report.

NCGA:Budget Update at 6PM-Monday

Special Thanks goes out to Mark Binker with the Greensboro News and Record for supplying us with this updated post on the budget!

Budget proofreading
UPDATE: I have re-written this post to reflect the final version of the budget cemented at 4:45 p.m. Monday afternoon. The order of FMAP cuts were rewritten, but the cuts themselves stay the same.

Update: Click here to read the FMAP cut language as it will be in the budget.

The House and Senate budget negotiators have completed their final run-through on the budget today (previously). What was really kind of a funny is they had a budget deal Saturday, but still had to figure out Monday what exactly they agreed to.

One of the last points of contention was what will happen if they don’t get the $525 million in FMAP Medicaid money. They had identified the eight items that might be cut, but memories seem to be a bit hazy on the order of operations for how it’d work.

They have since figured out (with help from Gov. Bev Perdue) that they'll make the followin eight cuts, in this order, depnding on how much money is forthcoming from the federal government:

1) Transfer from the disaster relief fund ($30 million)
2) Transfer of unclaimed lottery prize money and excess receipts. ($35 million)
3) Use of interest from all other funds. ($50 million)
4) Use of balance in General Fund Availability left over from current year ($23.5 million)
5) Reduction of Medicaid provider rates ($26.6 million)
6) Use of Funds from the Savings Reserve (rainy day) Fund ($37.3 million)
7) Reduction in retirement system contributions. ($139 million)
8) One percent management flexibility cut. ($177.5 million)
Regarding Item 8: agencies will be required to start planning for that cut and setting money aside July 1, even if they don't end up taking it.

Also noted: Negotiators gave Gov. Bev Perdue $10 million forher handheld diagnostic devices for improving instruction in early grades.

Read more on Mark Binker's blog.

NCGA: Budget Update from Jones St.

Budget writers are proof reading and finalizing last minute details on the $19 billion budget and the FMAP contingency to make up the $525 million in FMAP. One sticking point is when to take the FMAP contingency dollars-do we make the cuts now or hold off until January 1 to see what happens.

Mark Binker with the Greensboro News and Record is reporting the finally information on the details of the contingency dollars:



1) $177 million flexibility cut for all state agencies. It doesn’t deal with salaries. (There was a question among budget negotiators whether this was supposed to go into effect immediately or on Jan. 1.)
2) Reducing Medicaid provider rates. $26.6 million.
3) Reducing the general fund balance from the current year by $23.5 million
4) Transfer from the disaster reserve by $30 million
5) Use of interest from other funds: $50 million
6) Unclaimed lottery prize money $35 million
7) Reduce savings reserve by $37 million
8) Reduce the retirement fund contribution by $139 million

Read the rest of Mark Blinker's blog here.

Sunday, June 27, 2010

NCGA: Budget Negotiators Say They Are Done

Mark Binker, reporter with Greensboro News and Record, is reporting that budget writers have finished their work. Here are some highlights from his blog post on how they were able to close the $500 million deficit:
  • 1 percent across the board cut worth $177 million that would go into effect Jan. 1.
  • withholding $130 million in contributions to the state employee retirement fund.
  • taking money out of reserves.
  •  Read the blog post here.

    Friday, June 25, 2010

    Friday Wrap Up: NC State Budget, Bills and FMAP

    It's Friday and we are heading in the last weekend before the new fiscal year starts here in North Carolina. That clock you are hearing is getting louder by the second.

    First up in the wrap up-the state budget:

    Budget: 
    The House and Senate full appropriation chairs continued their work on the budget this week. There were no public meetings held to show any of the changes or adjustments to the budget. In the background of these negotiations was the US Senate vote on the FMAP extension. Without passage of the extension the budget writers will need to fill close to a $500 million dollar deficit in the state budget. On Thursday evening, US Senate Harry Reid tried one more time to get passage of the omnibus unemployment bill extender that contained the FMAP extension. Senate Democrats failed to get the needed 60 votes to stop a GOP filibuster and the bill has now been pulled.  Due to the continued delay, best bet says that the budget that will be released next week will show the additional cuts to make up the $500 million deficit or a budget that has the $500 million in cuts slated to start on January 1, 2011.

    Regardless of how the budget writers choose to handle the additional $500 million deficit, they will need to roll out their budget no later than Tuesday of next week.

    While sitting in the building today observing the happening on the budget, one this is very clear. No one is sure that the NC Congressional folks fully understand the significant  impact of not passing some form of FMAP extension. 

    Bills:
    Several bills of interest to people with developmental and intellectual disabilities had action taken on them this week. Here is the re-cap of those bills.

    House Bill 1683: Amend Sunset/Children with Disabilities. This bill passed the Senate on Thursday with a vote of 43 in favor and none opposed. This bill would delay the sunset of G.S. 115C-107.7. This general statute provides that a local educational agency is deemed to have a "basis of knowledge" that a child is a child with a disability if past behavior and behavior of the child clearly and convincingly established the need for special education. This bill passed the Senate Education committee with a unanimous favorable report. If this bill passes the Senate it will be heading to Governor Perdue for her signature.

    This bill has been scheduled to be heard in the Senate Education Committee on Wednesday, June 30th at 10:00 AM.  This bill passed the House with a vote of 113 in favor and none opposed. This bill would offer parents of children with disabilities, as defined by Section 504 of the Rehabilitation Act and IDEA, the ability to opt out of corporal punishment if it is practiced by their school.  This bill will also direct the state to collect specific data regarding the practice of corporal punishment. If this bill passes the House it will be heading to the Senate.

    House Joint Resolution 2076: Honor ADA 20th Anniversary was presented on the House floor on Thursday. This joint resolution acknowledged the passage of the historic civil rights legislation for people with disabilities that was signed into law twenty years ago.


    Tuesday, June 22, 2010

    NCGA: Update from Jones St.

    Budget:
    We are still waiting to get official word on when the budget will roll out. We are thinking maybe Friday. Everyone still believes we will have it all wrapped up in time for the new fiscal year. That magic date is July 1.

    Bills:
    Two House Joint Resolutions will happen this week. The first is today, it honors the life and work of Myrna Miller. The second one is on Thursday, it honors the 20th Anniversary of the ADA and the work and lives of many North Carolina disability rights leaders.

    Monday, June 21, 2010

    Monday Quick Hits: Hot Policy Topics for This Week

    North Carolina:

    Budget:
    The House and Senate Appropriation Chairs continued working on finalizing the budget last Friday. They will return to work today.  The major concern facing our legislative budget leaders is the continual delay of Congress to pass the FMAP extension. If the FMAP extension is not passed prior to the close of our fiscal year, leaders will need to grapple with cuts to cover a $500 million budget deficit.

    The target for the NC General Assembly to wrap up their budget is by June 29th. Both chambers want a new budget in place by the start of the new fiscal year on July 1.  That would mean a possible release of the budget and vote on the budget scheduled for some time this week.

    The big question? Which budget will we see. The one that has the additional cuts to make up the $500 million deficit or the budget that leaves the $500 million in federal money in with the hope those dollars will show up.

    We will continue to follow the action as it unfolds.

    Bills To Follow:
    On Tuesday the House will honor the life and work of Myrna Miller. Here is the link to the House Joint Resolution.

    Congress:
    On Friday the US Senate passed only a small portion of the Medicaid extension packages that had been coupled with the Unemployment bill.
    The only part that this chamber could get passed was emergency help to doctors that actually came to late for many of them. On June 1 Medicare reimbursement rates were drastically reduced by 21%. A cut this deep will cause many doctors to rethink treating Medicare and Medicaid patients.
    On Friday the US Senate passed a provision that will temporarily remove the 21% cut to Medicare rates. However, it may be too late. This smaller Medicare provision still needs to return to the House for a vote.

    As for the larger FMAP extension that close to 40 states are now relying on to balance their budget, there seems to be yet another delaying in passage of the bill. It is still connected to the unemployment insurance extension bill.  

    We will continue to follow this story.

    Wednesday, June 16, 2010

    NCGA: NC Budget Update

    The budget is still being debated by the House and Senate HHS Appropriation conference committee. Yesterday we learned that they may be reporting their budget to the full appropriation chairs as soon as Friday.  


    Thursday, June 10, 2010

    NCGA: Bill Update

    Today the House voted on HB 1682: Corporal Punishment and Children with Disabilities passed the House with a vote of 113 Yes and 0 Nayes.

    This bill will now move to the Senate Education Committee.


    NCGA:Bills on the Floor Today

    Today the Senate will vote on passage of HB 1683 Amend Sunset/Children w Disabilities. This bill would delay the sunset of G.S. 115C-107.7. This general statute provides that a local educational agency is deemed to have a "basis of knowledge" that a child is a child with a disability if past behavior and behavior of the child clearly and convincingly established the need for special education. This bill passed the Senate Education committee with a unanimous favorable report. If this bill passes the Senate it will be heading to Governor Perdue for her signature.

    The House will be voting on HB 1682 Corporal Punishment and Children with Disabilities. This bill would offer parents of children with disabilities, as defined by Section 504 of the Rehabilitation Act and IDEA, the ability to opt out of corporal punishment if it is practiced by their school.  This bill will also direct the state to collect specific data regarding the practice of corporal punishment. If this bill passes the House it will be heading to the Senate.

    Wednesday, June 9, 2010

    Hill Report: Senate Puts FMAP Back Into Tax Extender Bill

    Marketwatch reported today that the US Senate has added the FMAP/Medicaid six month extension back into the tax extender bill. 
    Looks like there will be a Senate vote next week and some media outlets are saying House has the votes to pass it.
    This may be very welcomed news for the thirty states that are currently holding their breath as they are working on their budgets.
    North Carolina currently is looking at a 500 million dollar deficit if the FMAP extension fails to pass Congress.

    Tuesday, June 8, 2010

    NCGA: House Bill 1682 Corporal Punishment and Children with Disabilities

    Today the House JII committee took up the discussion HB 1682 a bill that would permit parents of students with disabilities to opt out of corporal punishment for their child.  The bill had previously passed the House Education committee.

    Included in this legislation is specific reporting requirements regarding the number of students who received corporal punishment, the number of students who received corporal punishment and were also students with disabilities and were eligible to receive special education and related services under the federal Individuals with Disabilities Education Improvement Act, the grade of the students who receive corporal punishment and the race of the students who received corporal punishment. 

    During the House JII committee today an amendment was passed that added to these reporting requirements. The amendment added requires data collection to include ethnicity of the student receiving corporal punishment and the reason for the corporal punishment.

    The bill passed the JII committee with a unanimous vote and will now be calendared for a full House floor vote later this week.




    NCGA: Senate/House Special Provisions on Managed Care Waivers

    Of importance to the developmental disability community has been the expansion of the managed care waivers being managed in the PBH catchment area. The House and the Senate have both put out their Special Provision on these waivers. They are in conflict and we continue to work to stress the concerns of the DD/ID community.

    Senate/House Budget-Special Provisions

    Senate:

    STATEWIDE EXPANSION OF CAPITATED 1915(B)/(C) BEHAVIORAL HEALTH

    WAIVERS

    SECTION 10.24.  The Division of Medical Assistance and the Division of Mental Health, Developmental Disabilities, and Substance Abuse Services may expand the capitated 1915(b)/(c) waivers which have been operating in the Piedmont Behavioral Healthcare Local Management Entity (LME) catchment area as a demonstration program since April 2005.  The Divisions shall add additional LMEs to the waiver program as they demonstrate readiness to participate through a request for proposal process.  The waiver program shall include all Medicaid-covered mental health, developmental disabilities, and substance abuse services.  Expansion of the waiver to additional LMEs shall be contingent upon approval by the Centers for Medicare and Medicaid Services.

     

    House:

    STATEWIDE EXPANSION OF CAPITATED 1915(B)/(C) BEHAVIORAL HEALTH

    WAIVERS

    SECTION 10.24.(a)  The Department of Health and Human Services (Department) shall select one additional Local Management Entity (LME) to implement the capitated 1915 (b)/(c) Medicaid waiver as a demonstration program. The waiver program shall include all Medicaid-covered mental health, developmental disabilities, and substance abuse services.  Expansion of the waiver to one additional LME shall be contingent upon approval by the Centers for Medicare and Medicaid Services. The Department shall not approve any expansion of the Piedmont Behavioral Healthcare LME beyond its existing catchment area.

    SECTION 10.24.(b)  The Department shall conduct an evaluation of the two capitated 1915(b)/(c) Medicaid waiver demonstration program sites to determine the programs' impact on consumers with developmental disabilities.  The evaluation shall include a satisfaction survey of consumers.  The Department shall consider the impact on ICF/MR facilities included in the waiver to determine and, to the extent possible, minimize potential inconsistencies with the DMA-ICF/MR rate plan and the requirements of G.S. 131E-176 and G.S. 131E-178 without negatively impacting the viability and success of the waiver program.  The Department shall consult with stakeholders and evaluate all other waiver options, including the possibility of a wavier without a 1915(b)/(c) combination.  The Department shall report to the House of Representatives Appropriations Subcommittee on Health and Human Services, the Senate Appropriations Committee on Health and Human Services, the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services, and the Fiscal Research Division no later than April 1, 2012.

     

    Monday, June 7, 2010

    NCGA: Senate/House Budget Comparison

    Senate/House Budget Comparison:

    Senate Only

    State Service Funds  ($4,461,202) NR

    Replaces State funding with the Division of Mental Health, Developmental Disabilities and Substance Abuse Services with federal Mental Health and Substance Abuse block grant funds for FY 2010-11. The total includes $1,731,432 from the Mental Health Block Grant and $2,729,770 from Substance Abuse Block Grant. (This is a one time swap of state with federal funds).

    Local In-Patient Bed Capacity $12,000,000 R

    Increases funds available for the three-way contracts to purchase local hospital bed capacity for crisis response within the community. These funds will support the purchase of an estimated 50 beds, bringing the funding to $32 million.

    Training in Facilities $534,795 R

    Increases funds available for training direct care staff and front line leaders in patient care. Training will include on medication, on administration, on clinical and legal aspects of documentation, and cultural awareness.

    Leadership Academy $250,000 NR

    Provides funds for a Mental Health Leadership Academy for training for Mental Health managers, finance/budget officers, andother leaders within Local Management Entities.

    Special Olympics $100,000 NR

    Provides funding for a grant-in-aid to Special Olympics.

    House Only

    ALS Association $300,000 NR

    Provides a non-recurring grant-in-aid to the Jim "Catfish" Hunter

    Chapter of the ALS Association for services provided in North Carolina

    House/Senate Conflicting Appropriation Amounts

    Community Service Funds

    Senate: $23,000,000 NR

    Provides funding for community service funds administered through Local Management Entities. An additional $17 million of TANF funds is allocated to fully restore the $40 million non-recurring reduction for FY2010-11.

    House: $18,809,089 NR

    Provides funding for community services administered throughLocal Management Entities. Funding is transferred from the Officeof Early Learning within the Department of Public Instruction.  This partially restores the $40M NR reduction for FY 2010-11.

    NC Health Choice Enrollment

    Senate: $6,500,000 R

    Provides State appropriation to increase enrollment in Health Choice by 2% of 2,750 children for a total of 137,789 children served by the program.

    House: $3,250,000 R

    Provides additional State appropriations for Health Choice.

    In-Home Personal Care Services

    Senate: ($59,805,207) R

    Reforms the In-Home Personal Care Services program to provide care to those individuals at greatest risk of needing institutional care. Reform includes the elimination of in-home PCS services for adults and the creation of a new program for adults with the most intense needs-those needing assistance with thre or more activities of daily living (ADLs).

    House: ($34,519,278) R

    Reduces General Fund appropriations to reflect the continued use of independent assessments for In-Home Personal Care services.

     

     

     

     

     

     

     


    NCGA: Senate Vote to Not Concur with House Budget

    Tonight the NC Senate vote to not concur with the House budget. Conference committees will now takeover as we wait on the federal government to decide the fate of the FMAP legislation.

    Monday Quick Hits: Hot Policy Topics for This Week

    North Carolina:

    Today the House and Senate will convene at 7:00pm.
    7:00 PMSession Convenes (House)House Chamber
    7:00 PMSession Convenes(Senate)Senate Chamber
     
    Budget:
    The budget debate is far from over. The House passed their budget at 12:01AM on Friday morning. The Senate will receive the budget this week and will vote to not concur with it. This will quickly set up the conference committees for the appropriation subcommittees.
    We will be posting here the list of items that are in conflict between to the two HHS budget items.

    Hanging over the budget process is the significant delay in getting the US Congress to take up and pass the all important FMAP extension. This delay is causing House and Senate leaders to try and find a way to cover a 500 million dollar hole in the budget. Some options mentioned so far are to keep the budget as it is now, and hope that FMA gets passed. If it does not get passed then there will be a special session to handle the deficit.  A second option would be significant cuts to the HHS budget that would eliminate some optional Medicaid programs. The third option would be to cut in other departments or use some of the limited rainy day funds.

    None of these options sounds good for the people who are receiving necessary services. 

    House/Senate Calendar items of interest:

    Tuesday-House Calendar

    HEALTH 544 12:00 Noon

     H.B. 1692 Medicaid Dental/Special Needs Population.

     H.B. 1693 Develop Special Needs Dental Care Workforce.

     H.B. 1757 Physical Education and Activity in Schools.

     H.J.R. 2004 Study 'Most Favored Nation' Clauses/Insurers.  S.B. 675 Amend Public Health-Related Laws.

    Wednesday-Senate Calendar

    HEALTH CARE 11:00 AM 544  LOB

     HB 382 Authorize Voluntary Medical Registry Program

     HB 1694 Commission on Children with Special Needs-Dentist

     SB 1265 Treatment of Autism Disorders 

    Thursday, June 3, 2010

    NCGA: House Budget Update

    Yesterday the House Appropriations committee ran approximately 60 amendments on the budget.

    For the most part, no money really moved in the HHS appropriations budget. One thing of interest was added, an amendment was passed to add money to put Project C.A.R.E into the House HHS budget and put the funding in controversy with the Senate budget.

    Today, the House budget will be on the floor for its second of three votes. The debate on the budget will begin at 10:00AM and is expected to last until 5:00PM. The third and final vote will take place at 12:01AM on Friday morning.

    Wednesday, June 2, 2010

    NCGA: House Appropriation Update

    The subcommittee chairs are continuing to present their budgets to the full appropriation committee members.

    HHS and Education have completed their presentation.

    House rules have stated that all amendments must be received and reviewed by staff by 12 noon. We will be having multiple amendments offered this afternoon.

    We will keep you updates as to if any of these amendments affect our budget issues.

    As expected there have already been multiple conversations regarding the fact that Congress has not passed the stand-alone FMAP enhanced bill that is in the House and that the Senate has not yet added FMAP back to the jobs bills.

    The sense here is that this budget will continue to move forward and there will be contingency plans if the FMAP does not show up. Special Session? Maybe or maybe not.

    NCGA: House Budget in Appropriation Committee

    The House budget will be debated today in the House Appropriation committee. The meeting will begin at 9:00 AM. You can listen on line by clicking on www.ncleg.net and going to audio.

    We are expecting a good debate.

    Tuesday, June 1, 2010

    NCGA: House Budget Heads to Full Appropriations Committee

    Today the budget passed the House Finance Committee and will be in the House Appropriations Committee at 9:00 AM tomorrow.

    Lingering over the budget is the delay of passage of the ARRA FMAP-enhanced federal medicaid matching money by the U.S. Congress. All of the budgets presented so far include a 500 million dollar medicaid match to balance the budget. Today we are hearing that approximately 20 states are also waiting to see what happens with the enhanced match as their budgets are also relying on this infusion of money from the federal government.

    The House budget seems to be moving on with out addressing this issue. It may become a situation where both House and Senate leadership look to the conference committee to find options. The reality is there is no good way to try to cut an additional $500 million out of HHS or anywhere else in the budget.

    House Budget: What it did not include

    The House HHS Appropriation budget was passed last week. Among the things that it did not include was an expansion for SCHIP the children's health insurance program in our state.
     
    The budget also did not provide for the full restoration of the $40 million cut to community based state funded services for MH, DD, SAS.  This $40 million restoration was included in the governor's budget as well as in the Senate's budget.  The House chose only to restore $18 million. This is a big concern for advocates and people receiving community services who have seen critical services drastically cut due to the $40 million cut that occurred in the current state budget.

    Monday Quick Hits: Hot Policy Topics for This Week

    Today:
    Advocates from across the state will attend the Coalition Rally Day to discuss with legislators their concerns over cuts in services for people with mental illness, addictive disorders and developmental disabilities. The rally begins at 9:00AM.

    Budget:
    This week the House will wrap up its work on their budget proposal. On Tuesday the events starts at 9:00AM with a full Appropriation meeting. The budget will be voted on Wednesday-Friday.