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.

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

Today we received the agenda for the upcoming Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services. The current service dollar cuts are destroying our community. We need you to make your presence known at this meeting. If you are in town please plan to attend and if you can drive in please do so. 

Joint Legislative Oversight Committee on

Mental Health, Developmental Disabilities, & Substance Abuse Services

 

AGENDA

 

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

Senator Nesbitt, Co-Chair Presiding

 

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

 

News: Disability History and Awareness Month

October is Disability History and Awareness Month in North Carolina and Disability Employment Month Nationally.

Today CNN ran a story on the dedication of a Helen Keller statue at the capitol building. Each state is able to have two statues at the capitol. Today Alabama will dedicate this new statue in honor of this great disability rights leader.

The article quotes Nancy Starnes, director of external affairs for the Washington-based National Organization on Disability.

"It's always good to realize how much of an impact people with disabilities have made on the history and landscape of our country. "I'm excited that they're going to be doing this. I think it's going to be a wonderful addition."

Read more at CNN.

Monday Quick Hits: Hot Policy Topics for This Week

Monday Quick Hits:

North Carolina:
Although this is a slow interim week at the General Assembly, we do want to give you a heads up on next week’s meetings.

Monday, October 12th
8:30am The JOBS Commission meets, 544 Legislative Office Building.
10:00am The Child Fatality Taskforce-Intentional Death Committee, 1027/1028 Legislative Building.

Tuesday, October 13th
8:30am The JOBS Commission meets, 544 Legislative Office Building.
1:00pm The Joint Legislative Education Oversight Committee meets, 544 Legislative Office Building.

Wednesday, October 14th
9:00am The Joint Legislative Education Oversight Committee meets, 544 Legislative Office Building.
10:00am The Joint Legislative Oversight Committee Mental Health, Developmental Disabilities, and Substance Abuse meets, 643 Legislative Office Building.

NCGA: Legislation You Can Use

This is the second in our series of "Legislation You Can Use". 

Legislation 2009- Information You Can Use

Parent Student Involvement Act
History:
On June 2, 2009 the governor signed this bill into law. This bill is meant to provide clear due process for students who are expelled or suspended or recommended for expulsion or suspension for more than 10 days.

What this law provides for students who are expelled or suspended or recommended for expulsion or suspension for more than 10 days:

This law requires local board to give written notice to the student’s parent or guardian by certified mail, telephone, telefax, e-mail, or any other method reasonably designed to achieve notice of the recommended expulsion or suspension.
This law defines “parent” as parent, guardian, caregiver, or other person legally responsible for the student.

Written notice will be provided to the student’s parent by the end of the workday during which the suspension/expulsion is recommended.

Written notice must include the following information at minimum:
(1) A description of the incident leading to the recommendation that the student be expelled or suspended for more than 10 days;
(2) The specific provisions of the student conduct policy or rule alleged to have been violated;
(3) The specific process by which the parent may request a hearing to contest the suspension for more than 10 days or expulsion, including the number of days within which the hearing must be requested;
(4) The process by which a hearing will be held, including, to the extent provided by law, the student's opportunity to examine evidence and present evidence, to confront and cross-examine witnesses supporting the charge, and to call witnesses to verify the student's version of the incident;
(5) The parent is permitted to retain an attorney to represent the student in the hearing process;
(6) The extent to which the local board policy permits the parent to have an advocate to accompany the student to assist in the presentation of his or her appeal instead of an attorney; and
(7) The parent has a right to review the student's educational records prior to the hearing.

What if my child receives specialized instruction under IDEA and is recommended for suspension/expulsion of more than ten (10) days?

When a child with a disability receives specialized instruction under IDEA and has an IEP,a suspension/expulsion of more than ten days is considered a change in placement. A student with an IEP has additional rights before the student may be suspended or expelled.
If there is a change in placement, the relevant members of the IEP team must conduct a manifestation determination review within 10 school days of the suspension. The team must decide if the behavior was caused by the student’s disability or by the school’s failure to follow the IEP. If one of these things caused the behavior, then the behavior is a manifestation of the student’s disability. If the behavior that caused the suspension/expulsion was a manifestation of the student’s disability then the suspension must end and the student must return to school. 

The IEP team must develop a Functional Behavior Assessment and Behavior Intervention Plan for the student.

If the behavior that caused the suspension/expulsion was not a manifestation of the student’s disability then the suspension/expulsion may stand. If the suspension/expulsion stands then the student must be provided FAPE during the suspension. The IEP team is not required to develop a Behavior Intervention Plan, but you can ask that one be developed anyway.

If the determination is that the student’s 10 day suspension/expulsion stands, you may still appeal the decision using the due process rules established by the Parent Student Involvement Act.  

What You Can Do To Make This Law Effective:
1. Make sure that your child’s IEP team is aware of the due process rights of your child under the IDEA and the Parent Student Involvement Act.
2. If your child has an IEP and is recommended for suspension/expulsion for more than ten days you need to know your rights. Make sure that your IEP team meets to address the recommendation for suspension/expulsion and conducts a manifestation determination review. Ask for a functional behavior assessment and behavior intervention plan.

Arc Federal Update: Hot Topics from the Hill

FY 2010 Appropriations

 

The House passed a one month Continuing Resolution (CR) to keep most federal programs operating at current FY 2009 levels through October 31.  The Senate is expected to pass an identical CR this week.  None of the twelve FY 2010 appropriations bills will be signed into law prior to the start of the fiscal year.

 

Health Care Reform

 

The Senate Finance Committee began to mark up the America's Healthy Future Act of 2009. The following provisions, which are of particular interest to persons with disabilities, were included:

• Addition of the Community First Choice Option (CFC) to the package. The CFC Option would allow states to provide individuals with disabilities who are eligible for Medicaid institutional settings with a broad array of community-based services and supports. Services under this option would include supports to assist individuals with activities of daily living (ADLs), instrumental activities of daily living (IADLs), and health-related tasks through hands-on assistance, supervision, or cueing. States choosing to use the CFC Option would enjoy a 6 percent increase in the federal Medicaid match rate. The Option would sunset after 5 years. This provision was added by Chairman Max Baucus (D-MT) as part of his modifications to the Chairman's Mark. Senator Schumer (D-NY) had submitted the provision as a proposed amendment, but did not need to offer it during the Committee mark-up since it was included in the Chairman's modified Mark. Advocates believe that the CFC Option would support the Olmstead decision and help address state waiting lists by giving people the choice to leave facilities and institutions for their own homes and communities with appropriate, cost effective services and supports.
• An elimination of Medicare Part D co-pays for dual eligibles (those who receive both Medicare and Medicaid benefits) residing in home and community based settings and covered under Sec. 1115 and 1915 waiver programs. This amendment was offered by Sens. Bill Nelson (D-FL), Jeff Bingaman (D-NM) and Jay Rockefeller (D-WV).

Medicare

 

The House of Representatives, by a vote of 408-18, approved the Medicare Premium Fairness Act, (H.R. 3631), a one year fix that will avert a premium increase for the Medicare Part B (outpatient) program. Its $.2.8 billion cost will be offset by cuts to the Medicare Improvements Program.  The Senate could act on the premium bill soon. 

 

Information contained in this update is from The Arc of the US and the Disability Policy Collaborative

DHHS Implementation Update: Division of MH/DD/SAS

In our on going effort to keep you up to date with information regarding the consolidation of case management and the budget cuts to community support we have two documents that you might want to see.

The first is the implementation update.  The second is a special communication regarding community support.

The Arc NC: Paul Marchand Is Reviewing Federal Legislative Issues

Paul Marchand is the director of the Disability Policy Collaboration (DPC). DPC is at the center of virtually all of the major policy improvements for people with disabilities in the United States.

The Arc of NC: State Conference 2009 Underway

The Arc of North Carolina is hosting its state conference this weekend in Concord, NC. There will be several dynamic speakers sharing their insight on the state of developmental disability services and policy.

This has been an extremely difficult year in our state. The budget cuts were deep and the services they affect will be changed dramatically.

We will be updating this blog with information today that will give you more insight to the state of the state.

NCGA: NC Policy Watch-Chris Fitzsimon Article on Oversight Meeting

Wanted to share with all of you this article on the Mental Health, Developmental Disabilities, Substance Abuse Service Legislative Oversight Committee. Check it out at NC Policy Watch.

NCGA: MH/DD/SAS Legislative Oversight Meeting Report

Yesterday the Mental Health, Developmental Disabilities, Substance Abuse Services Joint Legislative Oversight Committee met for their first meeting during the legislative break.
The meeting opened with a review of bills, budget cuts, and special provisions that were included in the last budget.

For the first time it was made clear to all members of the committee and to the public that the cut to state funded services for MH/DD/SAS was not $60 million. The $60 million cut was what was presented in the budget prior to Governor Perdue’s executive directive stating that an additional 5% cut needed to be made by all departments. The actual cut to state funding is $75 million dollars.

Here is the break down of this cut:

• State Funded Services $40 million for fiscal year 2009-2010 and 2010-2011. (This is the appropriation that goes to LMEs)
  
• CAP MR/DD Funds $16 million for fiscal year 2009-2010 and 2010-2011.
  
• Non-core Community Services Reduction $4 million for fiscal year 2009-2010 and 2010-2011.
  
• Governor’s Reduction of $15 million.
  
• Total Reductions: $75 million
  

It was also clear that members of the legislative oversight are just now feeling the reality of these draconian cuts.

During the introduction of Secretary Cansler, Senator Nesbitt stated that we may be hearing about more than just MH/DD/SAS in the secretary’s comments. Nesbitt stated that “we made so many changes that interact with each other and we need to hear that.”
Secretary Cansler’s comments encompassed the cuts to state funded dollars, the consolidation of case management, and community support.

These topics also received the majority of questions and concerns from members of the oversight committee. There was also a sense of what the legislators intended to do did not necessarily match up to what was happening, especially with community support.
Lets take a look at the cuts to state funds. Secretary Cansler stated that “if you look at all the cuts, the $40 million state dollar cut, and then the Medicaid cuts, the cuts to community support, case management consolidation and the provider rate cuts you are looking at a $350 to $400 million dollar impact on the system. We are challenged on how to achieve the savings without a major impact to the system.”

LME State Funded Cuts:
The main questions related to the way the cuts were distributed to LMEs. There were many questions regarding the allocation formula and the equity of that formula. Expect this to be a hot topic in all of the meeting of this committees.

In an interesting moment at the meeting, Senator Nesbitt went through the politics of this cut. He stated correctly that the $40 million cut was included in the House budget not the Senate budget and that during conferee discussions this $40 million dollar cut was restored. The final budget that was presented to the Full Appropriation Chairs from the HHS Conference Committee did not include this cut. In the last hours of budget debates the Full Appropriation Chairs reinstated the $40 million dollar cut without consultation of the HHS Conference Chairs.

Regardless of where the cut came or the politics of the final cut, this cut coupled with the additional $15 million will destroy many of the community services currently being received by people we advocate with.

Community Support:
This service has been much maligned in the press but for people receiving community support, this service has kept people out of emergency rooms and state institutions.

The budget cut to Community Support is $65 million for fiscal year 2009-2010 and $97.5 million for fiscal year 2010-2011. The understanding of members of the legislative oversight committee was that there would be appropriations remaining in the continuation budget that would be used to create an underlying service that would then emerge and replace community support.

The budget did clearly state that DHHS would submit a new service definition for the case management and peer support components of community support. In peer support it would emerge as a Medicaid billable program.

There was a lot of discussion regarding this service. Part of the discussion was that there was confusion over how this service transitions. We heard in the presentations that there is no underlying service at this time and that new enrollment was stopping. Members wanted to ensure that there would be a new service coming on line in January of 2010. There was also confusion on the remaining appropriation in the continuation budget.

Expect to see this topic come up frequently during the next few months.

Consolidated Case Management:
The budget that passed this session included at $41 million dollar cut in fiscal year 2009-2010 and a $72.9 million dollar cut in fiscal year 2010-2011 to case management. This cut represents for this fiscal year a 50% cut in funds to case management. There has been strong push back from public health departments regarding this cut. So strong that Secretary Cansler mentioned them specifically in his remarks to committee members.

During session advocates for MH/DD/SAS spoke strongly against this consolidation and stated that the cut was severe enough that it would upend the system of case management that is currently in the field.

Throughout the presentations yesterday, it was clear that there was concern on how to make this transition from members of the committee, Secretary Cansler, DMA and the Division of MH/DD/SAS.

There has been a workgroup working on a plan and they are set to release a “plan” today regarding this consolidation. We will comment more on this pending receipt of information from this workgroup later today.

This budget as it stands today will significantly impact people, families, and providers in North Carolina. There will be services lost, jobs lost, and people sent into crisis. There is no silver lining to these cuts. The idea that we will emerge into a better system has yet to be shown to advocates across this state. In the meantime, we will continue to track the cuts and report that information to the leaders in our General Assembly who made these decisions in the hope that we can work with them to ensure that funding is restored in the next budget.

National Arc Alert: Take Action Now!

Health Care Reform: Now it’s Personal

More Info:

Help Bring Desperately Needed Improvements in Health Care and Long Term Services for People with Intellectual and Developmental Disabilities

Do you know anyone who has been denied health insurance because of a pre-existing condition?

Do you know anyone who has been unable to access quality affordable health care?

Do you know anyone who has been waiting a long time for Medicaid home and community based services?

Then you need to get involved right NOW.

Why Now?

The stakes have never been higher. National health care reform is hanging in the balance.

From early August through Labor Day, Members of Congress are back in their home districts hearing from their constituents about health care reform. Many will be making their decisions on whether or not to support an overhaul of our health care system.

The chance to make meaningful improvements in health care only comes along every few decades. There are strong opponents to reform, such as the insurance industry. If we don't speak now .....

What Do People with Intellectual and Developmental Disabilities Most Need in Health Care Reform?

1) No Pre-existing Conditions Exclusions
Insurance companies will be prohibited from refusing coverage because of medical history.

2) No Annual or Lifetime Caps on Coverage
Insurance companies will be prevented from placing annual or lifetime caps on coverage.

3) Coverage for Durable Medical Equipment, Prosthetics, and Orthotics
These products will be included in any new health plans.

4) Increased Medicaid Reimbursement Rates for Primary Care Physicians
More doctors will serve Medicaid patients when their reimbursement rates are increased to match to those of Medicare.

5) Improved Home and Community Based Services
When the institutional bias is removed from Medicaid, more states will serve more people and allow them to choose where they receive long term services and supports.

6) Reduced Demand for Medicaid Long Term Services and Supports
Medicaid will be strengthened when a national voluntary long term care insurance program (from the CLASS Act) is implemented and people can receive support without having to use Medicaid.

Take Action

Many Members of Congress will spend the August recess in their home districts. Please participate in one or more of the following types of events over the recess from now through September 8:


Town Halls meeting sponsored by your Members of Congress. You may be able to find a list of town halls on your Senators' and Representatives' web sites. Locate your Senators websites by selecting your state at the top of http://www.senate.gov/ and your Representative's website by entering your zip code at the top of http://www.house.gov. If you cannot locate this information on the web sites, please call their main offices and ask to speak to the scheduler.


In-district meetings with your Members of Congress. Please contact your local Members offices NOW to schedule a meeting. Guidance on requesting in-district meetings is usually provided under a "Constituent Services" section of your Senators' and Representatives' websites. Again, you can also call their district offices and ask to speak to their schedulers.


Other Community calendar events. Most local newspapers, chambers of commerce, and other civic organizations have extensive listings of fairs, parades, concerts, and other community events in which Members of Congress may be participating. Find your local newspaper's web site by entering your zip code at: http://capwiz.com/thearc/dbq/media/


Calls to district offices and local radio programs. Phones are already ringing off the hook. Constituents are calling to voice strong opinions for and against health care reform. Only you can make sure your ideas and opinions are heard. Find the district office phone numbers at http://www.senate.gov/ and http://www.house.gov. Find your local radio stations' call in shows by entering your zip code at: http://capwiz.com/thearc/dbq/media/

Please use the following materials to guide your discussions:
Fact Sheet
Talking Points
Placards
Personal stories from your community, such as:
* being on a waiting list for home and community based services
* having to quit a job to care for a loved one at home
* having to take a second job to pay a care provider
* not being able to move to another state due to loss of Medicaid services
* having to move a loved one into an institution due to lack of home and community based services
* being unable to find appropriate medical care

Thank you in advance for your great advocacy during this historic opportunity to improve the quality and accessibility of health care and long term services.

NCGA: MH/DD/SAS Legislative Oversight Meeting Live Update

The meeting is happening now and the legislative staff is reviewing the cuts to the budget and also the bills that passed this year that affect MH/DD/SAS.

NCGA: MH/DD/SAS Legislative Oversight Meeting

Today the MH/DD/SAS Legislative Oversight Meeting is being held at 10:00am in room 643 today.

We encourage you to attend the meeting if you are in town. If not please listen in on the legislative website or follow along with us on this blog and our twitter.

Important numbers for today: The Legislature's budget cuts were $60 million dollars, the Governor cut an additional $15 million after the budget was signed by using an executive order. This is a total of $75 million in cuts to people with mental health needs, developmental disabilities, and addictive disorders. These cuts are draconian and for many in these communities these cuts will end critical services, put families into crisis, and could send people out of their communities and back into institutions. 

These cuts must be addressed by legislative leadership in an honest and open way and there needs to be real plans to restore this funding in the next budget cycle.

NCGA: First Legislative Oversight Meeting MH/DD/SAS

The first Mental Health, Developmental Disabilities and Substance Abuse Services Joint Legislative Oversight meeting will be held tomorrow, Wednesday September 23, 2009.  

This year leaders in the General Assembly passed a budget that severely cut funding for people with mental health needs, developmental disabilities and substance abuse services. These cuts are draconian in nature and they will send members of these three communities into serious crisis. We as advocates must be vigilant in telling our elected leaders that they must work to restore these cuts during the next budget cycle.

If you are in Raleigh we encourage you to come to this meeting. If you are not in Raleigh we encourage you to listen on line by visiting the NC General Assembly Legislative website.

Joint Legislative Oversight Committee on
Mental Health, Developmental Disabilities, & Substance Abuse Services
AGENDA
September 23, 2009, 10:00 A.M.; Room 643, Legislative Office Building
Representative Verla Insko, Co-Chair Presiding

I. Greetings, Opening Comments and Introduction of Members
Representative Verla Insko, Co-Chair
Senator Martin Nesbitt, Co-Chair 10:00-10:15
II. Overview of 2009 Legislative Actions
Lisa Hollowell and Shawn Parker, LOC staff 10:15-11:00

III. DHHS Response to Budget Cuts and Enacted Legislation
Lanier Cansler, Secretary, DHHS 
11:00-12:30

Lunch 12:30-1:30

IV. Community Support Services
• Status of Community Support Services
Dr. Craighan Gray, MD, Director, DMA
• Overview for Transition
Leza Wainwright, Director, Div. of MH/DD/SAS 1:30-2:30

V. CAP-MR/DD Supports Waiver 
Leza Wainwright, Director, Div. of MH/DD/SAS 2:30-3:00

VI. DHHS- Divisions and Offices Organizational Structure
• Division of Medical Assistance
• Division of Mental Health, Developmental Disabilities, and Substance Abuse Services
• Division of State Operated Healthcare Facilities 
3:00-3:15
VII. Closing Comments and Adjourn
Representative Verla Insko, Co-Chair
Senator Martin Nesbitt, Co-Chair 
3:15-3:30

The Arc of NC: Legislation 2009-Information You Can Use

Today we begin our series on legislation that passed in 2009 and how you as an advocate, parent, provider or supporter can use the legislation effectively.

We begin today with the School Violence Prevention Act.

Legislation 2009 – Information You Can Use

School Violence Prevention Act

History:
This bill establishes clear definitions of bullying and harassment and requires each public school district to adopt policies and procedures for dealing with incidents when they occur. The bill includes an enumerated list of categories/characteristics that, real or perceived, have been statistically shown to make students, teachers and staff more likely targets of school violence, including verbal, social and emotional bullying as well as physical harassment, threats, and beatings.

The governor signed this bill into law on June 23, 2009.

How this law defines bullying behavior and what this law requires of local school administrative units:

The School Violence Prevention Law defines “bullying or harassing behavior” as any pattern of gestures or written, electronic, or verbal communications, or any physical act or any threatening communication, that takes place on school property, at any school-sponsored function, or on a school bus.

Bullying or harassing behavior is a behavior that
(1) Places a student or school employee in actual and reasonable fear of harm to his or her person or damage to his or her property; or
(2) Creates or is certain to create a hostile environment by substantially interfering with or impairing a student's educational performance, opportunities, or benefits. For purposes of this section, "hostile environment" means that the victim subjectively views the conduct as bullying or harassing behavior and the conduct is objectively severe or pervasive enough that a reasonable person would agree that it is bullying or harassing behavior.

This law goes on to state that “bullying or harassing behavior includes, but is not limited to, acts reasonably perceived as being motivated by any actual or perceived differentiating characteristic, such as race, color, religion, ancestry, national origin, gender, socioeconomic status, academic status, gender identity, physical appearance, sexual orientation, or mental, physical, developmental, or sensory disability, or by association with a person who has or is perceived to have one or more of these characteristics.”

The enumerated list reflects the findings of numerous studies that point to certain populations of individuals being more vulnerable to bullying or harassing behavior.

The law does require each local school administrative unit to adopt a policy prohibiting bullying or harassing behavior before December 31, 2009. This policy must contain the following components. The local school administrative unit can go beyond the minimum policy requirements set out by this law.

(1) A statement prohibiting bullying or harassing behavior.
(2) A definition of bullying or harassing behavior no less inclusive than that set forth in this Article.
(3) A description of the type of behavior expected for each student and school
employee.
(4) Consequences and appropriate remedial action for a person who commits an
act of bullying or harassment.
(5) A procedure for reporting an act of bullying or harassment, including a
provision that permits a person to report such an act anonymously. This shall
not be construed to permit formal disciplinary action solely on the basis of
an anonymous report.
(6) A procedure for prompt investigation of reports of serious violations and
complaints of any act of bullying or harassment, identifying either the
principal or the principal's designee as the person responsible for the
investigation.
(7) A statement that prohibits reprisal or retaliation against any person who
reports an act of bullying or harassment, and the consequence and
appropriate remedial action for a person who engages in reprisal or
retaliation.
(8) A statement of how the policy is to be disseminated and publicized,
including notice that the policy applies to participation in school-sponsored
functions.

The School Violence Prevention law also requires that the local policy appear in any school publication that “states the rules, procedures and standard of conduct for schools within the school unit and in all student and school employee handbooks”. The policy for anti-bullying and anti-harassing behavior is also mandated as part of the employee- training program. Schools must also develop and implement methods and strategies for creating environments that promote safe environments free of bullying or harassing behavior.

What You Can Do To Make This Law Effective:

1. Check to see if your child’s school currently has a policy regarding bullying and harassing behavior and make sure it is as comprehensive as the new law outlines.

2. If your school does not have a policy in place, contact your school administrator and educate them on the law using the information in this handout. Ask your school administrator when your local school board plans to create and approve their policy that will protect all children from bullying and harassing behavior.

3. Talk to your child’s teacher to see if there are currently any programs in your school that educate children on how to deal with bullying or harassing behavior or any programs that teach children about creating a safe environment that is free of bullying and harassing behavior. If there are no programs in place, encourage your teacher to start that discussion with his/her peers and administrators.

4. If your child is being bullied or harassed, use this law to educate your child’s teacher or administrator that they need to take action to stop the bullying or harassment.

Monday Quick Hits: Hot Policy Topics for This Week

North Carolina:

On Wednesday the Mental Health/Developmental Disabilities/Substance Abuse Services Joint Legislative Oversight Committee meets for the first time since session ended. The agenda is posted on this blog. We encourage you to attend this meeting if you are in Raleigh.

MH/DD/SAS Legislative Oversight Committee-Upcoming Meeting September 23, 2009and Agenda

Joint Legislative Oversight Committee on
Mental Health, Developmental Disabilities, & Substance Abuse Services
AGENDA
September 23, 2009, 10:00 A.M.; Room 643, Legislative Office Building
Representative Verla Insko, Co-Chair Presiding

I. Greetings, Opening Comments and Introduction of Members
Representative Verla Insko, Co-Chair
Senator Martin Nesbitt, Co-Chair 10:00-10:15
II. Overview of 2009 Legislative Actions
Lisa Hollowell and Shawn Parker, LOC staff 10:15-11:00

III. DHHS Response to Budget Cuts and Enacted Legislation
Lanier Cansler, Secretary, DHHS
11:00-12:30

Lunch 12:30-1:30

IV. Community Support Services
• Status of Community Support Services
Dr. Craighan Gray, MD, Director, DMA
• Overview for Transition
Leza Wainwright, Director, Div. of MH/DD/SAS 1:30-2:30

V. CAP-MR/DD Supports Waiver
Leza Wainwright, Director, Div. of MH/DD/SAS 2:30-3:00

VI. DHHS- Divisions and Offices Organizational Structure
• Division of Medical Assistance
• Division of Mental Health, Developmental Disabilities, and Substance Abuse Services
• Division of State Operated Healthcare Facilities
3:00-3:15
VII. Closing Comments and Adjourn
Representative Verla Insko, Co-Chair
Senator Martin Nesbitt, Co-Chair
3:15-3:30

Coming Up Next Week

Next week we will post the first "Legislation 2009-Information You Can Use" tool sheet! These handy dandy guides will let you know how to use the important legislation that passed this session. First up, the School Violence Prevention Act!

Also, we will be live blogging sections of The Arc of NC State Conference next week!

More on that Monday!  

One more hot topic: Don't forget that Wednesday, September 24th is the first MH/DD/SAS Legislative Oversight Committee next week! If you are in Raleigh we need you to attend this committee meeting.  LMEs have received letters regarding the serious and deep cuts that they are facing and we need you there to show that these cuts will hurt people in our state!

NCGA: When do they start oversight meetings?

Excellent question blog readers!  We will see the first Mental Health, Developmental Disability, Substance Abuse Services Legislative Oversight Committee is on Wednesday, September 23 at 10:00am in room 643 of the LOB.

When we get an agenda we will post it here.  If you are in town that day, we encourage you to come to this committee meeting. 

The budget cuts this past session have been amplified by the governor's mandate for an additional 5% cut of all departments. These cuts will have a devastating affect on families, children, and people living in our communities. We need to be vigilant and we need to be clear to leadership at the General Assembly that they must work to restore services to people with developmental and intellectual disabilities. 

Monday Quick Hits: Hot Policy Topics for This Week

Return For Veto Override?

Speaker of the House Joe Hackney stated this week that members will not be returning to Raleigh this week for a veto override of HB 104.

Speaker Hackney sited the cost of brining everyone back and stated that they would work with the governor's office and be ready with legislation for the short session.

Governor Perdue vetoed HB104 last week.

National News: CEPR (Center for Economic and Policy Research) Disability and Poverty Article

The Center for Economic and Policy Research recently released this report on poverty and disability. Excellent read.

NC News: News and Observer Story On Uninsured

The News and Observer is reporting that new census numbers show that 15% of North Carolinians are uninsured.  This report comes on the heels of President Obama's address to Congress on health care reform.

Policy Blog Notice: Labor Day Weekend

The Arc of North Carolina Policy Blog will be taking Monday off in honor of Labor Day. We will see you all on Tuesday! Have a great holiday weekend!

NCGA: Legislative Update 5- The Arc of NC Legislative Agenda Wrap Up

Here is the last bill review of the week.

House Bill 218/Session Law 2009-64: Parent and Student Involvement Act-Glazier

This legislation begins the process of looking at North Carolina’s policies for long-term suspension. This bill requires written notification, including a description of the incident leading to the recommendation, for any suspension or expulsion for more than 10 days. It also would allow the student to request a hearing to contest the expulsion.

This legislation provides the following procedures:
(1) A description of the incident leading to the recommendation that the student
be expelled or suspended for more than 10 days;
(2) The specific provisions of the student conduct policy or rule alleged to have
been violated;
(3) The specific process by which the parent may request a hearing to contest
the suspension for more than 10 days or expulsion, including the number of
days within which the hearing must be requested;
(4) The process by which a hearing will be held, including, to the extent
provided by law, the student's opportunity to examine evidence and present
evidence, to confront and cross-examine witnesses supporting the charge,
and to call witnesses to verify the student's version of the incident;
(5) The parent is permitted to retain an attorney to represent the student in the
hearing process;
(6) The extent to which the local board policy permits the parent to have an
advocate to accompany the student to assist in the presentation of his or her
appeal instead of an attorney; and
(7) The parent has a right to review the student's educational records prior to the
hearing.

This bill was important to The Arc of NC because students with disabilities have a high suspension rate, often due to emotional and/or behavior issues related to the disability. Students who frequently have long-term suspensions are more likely to drop out of school, and the drop-out rate for students with disabilities is already high. The process identified in this bill will bring parents and administrators together to talk about why the child is being suspended. Parents will be explained their rights and have the opportunity to appeal the suspension or expulsion. The process may also lead to identification of services the student may need or possibly the identification of a disability.

Vote History: This bill passed the House 108 in favor to 5 opposed and passed the Senate 48 in favor to 0 opposed. The governor signed this bill into law on June 2, 2009

NCGA: Legislative Update 4 - The Arc of NC Legislative Agenda Wrap Up

Part 4 is up today! As you can tell with the hard work and dedication of many advocates across the state we were able to make real positive change for North Carolina.

Senate Bill 526/Session Law 2009-212: School Violence Prevention Act-Glazier

This legislation was a hot issue throughout the session. This bill took the advocacy of multiple organizations working for almost three years but we achieved a significant victory with the signing of this bill into law.

This bill establishes clear definitions of bullying and harassment and requires each public school district to adopt policies and procedures for dealing with incidents when they occur. The bill includes an enumerated list of categories/characteristics that, real or perceived, have been statistically shown to make students, teachers and staff more likely targets of school violence, including verbal, social and emotional bullying as well as physical harassment, threats, and beatings.

Vote History: The Senate passed this bill 26 in favor 22 opposed and the House passed this bill 58 in favor 57 opposed. Speaker of the House Joe Hackney broke the tie in the House. The governor signed this bill into law on June 23, 2009.

NCGS Legislative Calendar: When are they coming back?

For those of you who are missing our elected officials and are curious about when they are coming back, we have the following information to share with you. Study committees and oversight committees are currently being appointed and some are already releasing their meeting dates. So far we have a few starting up in the next two weeks. As we get more information we will post it here. Monday, September 14, 2009
10:00 AM	Child Fatality Task Force	1228/1327 LB
Wednesday, September 16, 2009
11:00 AM	Employee Hospital and Medical Benefits, Committee on	421 LOB
Wednesday, September 23, 2009
10:00 AM	Mental Health, Developmental Disabilities and Substance Abuse, Joint Legislative Oversight Committee	643 LOB

NCGA: Legislative Update 3 - The Arc of NC Legislative Agenda Wrap Up

In today's installment we are going to highlight a joint advocacy effort with the Self-Advocates of North Carolina, the People First bill:

Senate Bill 208/Session Law 2009-264: People First-Dorsett

This legislation required bi-partisan negotiations with key Senators. 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 model bill was created. The Arc of North Carolina feels that our legislation will answer many of the questions that other states are debating regarding People First and can become a model for other states.

This bill directs the Legislative Services Office to incorporate into its drafting training of legislative drafters the preference to avoid language that implies that a person as a whole is disabled, equates a person with his or her condition, or is regarded as derogatory or demeaning.

To avoid any unintended consequences of altering existing legislation or creating legislation that would be in conflict with existing legislation; this bill will direct the General Statues Commission to recommend to the 2010 reconvened session of the General Assembly and to the 2011 Regular Session of the 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.

Vote History: This bill passed the Senate 45 in favor to 0 opposed and passed the House 114 in favor and 2 opposed. The governor signed this bill into law on July 2, 2009.

NCGA: Legislative Update 2 - The Arc of NC Legislative Agenda Wrap Up

Our second edition of the Legislative Update: The Arc of NC Legislative Agenda will look at a bill designed to bring more transparency to single stream funded local management entities. This bill also protects funding on HUD projects for people with developmental or intellectual disabilities.

House Bill 672/Session Law 2009-191: Accountability for State Funding/MHDDSA-Earle.

-The first section of this bill requires LMEs that use single stream funding to on a bi-annual basis to receive to report on the allocation of service dollars and receive public comment during a regularly scheduled board of directors meeting.

-The second section focuses on HUD group homes and apartments. The General Assembly appropriates state funding to group homes to be used in conjunction with federal HUD funding. After the biennial this funding can be moved. However, in some cases the removal of our state funding to these group homes and apartments can jeopardized our agreement with the federal matching money and the HUD contracts.

This section of the bill will require LMEs to seek approval for the reduction in funding from the Department of Health and Human Services prior to adjusting any funding associated with HUD group homes or apartments.

-The final section of this bill will direct the Department of Health and Human Services to analyze the effectiveness of single stream funding in LMEs that have been working with single stream for a year or more. These findings will be reported to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services as well as the Health and Human Services Appropriations Subcommittee in the House and Senate.

Vote History: This bill passed the House 117 in favor 0 opposed and the Senate 45 in favor 0 opposed. The governor signed this bill into law on June 29, 2009.

NCGA: Legislative Update - The Arc of NC Legislative Agenda Wrap Up

This week we will be reviewing several key bills that were passed during this legislative session.  The Arc of North Carolina presented a very robust and comprehensive legislative agenda to our legislators.  With the work of many leaders, our policy platforms were recognized and many of the bills we worked on became laws. This week we are going to highlight the first three of these new laws.

So today we start with

House Bill 673/Session Law 2009-186: Support for Developmental Disability Services-Earle.

This legislation will create a statewide data collection system that will reflect how many people with developmental disabilities are currently waiting for services and what services they are waiting for. The bill also permits the Department to ensure that State-funded developmental disability services are authorized on an annual or semi-annual basis depending on the services, and will also give direction to the Department to develop developmental disability service definitions that allow for funding of a person-centered plan.

This bill was also debated with many of the committee members stating that a statewide data collection system will present to the legislature any gaps in services that may need legislation.

-HB 673 includes many of the recommendations from the Institute of Medicine Study on Developmental Disabilities. The Institute of Medicine Study on Developmental Disabilities was legislated by the General Assembly during the 2008 short session.

-This bill will re-establish a standardized waiting list for people with developmental disabilities who are seeking services. This wait list will provide the necessary data collection to be used by the state and members of the General Assembly to effectively serve people with developmental disabilities.

The waiting list will collect data for people with developmental disabilities who may qualify for the following targeted services
a. Waiting for residential services.
b. Potentially eligible for CAP-MRDD.
c. In need of other State-funded services and supports for people with developmental disabilities.

-This bill directs the Secretary of DHHS to develop and adopt rules governing a statewide data system that will be used to for statewide planning.

This bill was voted on and passed out of committee with a favorable report.

Vote History: The bill passed the House (112 in favor 0 opposed) and the Senate (48 in favor and 0 opposed). The governor signed this bill into law on June 29, 2009.

The Arc of NC Mourns The Loss of Senator Edward "Ted" Kennedy

The Arc of North Carolina joins with The Arc of the United States to express our deepest gratitude and most sincere sympathy at the passing of a champion for people with intellectual and developmental disabilities, Senator Ted Kennedy.

Senator Ted Kennedy worked tirelessly for the inclusion of people with disability in all aspects of life.  His passion and determination to make our nation a model of civil rights, equality in education and equality in health care for people with disabilities will be missed deeply.

The Arc Mourns the Loss of its Greatest Legislative Champion
8/26/2009
The Arc Mourns the Loss of its Greatest Legislative Champion

The Arc of the United States and all children and adults with intellectual and developmental disabilities and their families lost its all time legislative champion with the death last night of Senator Edward M. Kennedy (D-MA). His legislative achievements in the field of disability were many and far reaching. Civil rights, education and health care were the cornerstones of his efforts to help all Americans live decent and productive lives. In the rights arena, his most notable achievement was the enactment of the Americans with Disabilities Act in 1990. He played an instrumental role in the passage of Public Law 94-142 in 1975 (now known as the Individuals with Disabilities Education Act) which gave every student with a disability the right to a free appropriate public education. Senator Kennedy was one of four Members of Congress who, along with former President George W. Bush, crafted the No Child Left Behind Act. He was instrumental in assuring that all students with disabilities would be part of the student achievement assessments under this law. Last year, he co-authored the Higher Education Opportunity Act which, for the first time in Federal law, will afford higher education opportunities for students with intellectual disabilities. Other major civil rights accomplishments that helped people with disabilities enter the mainstream of our society include the Fair Housing Act and the Voting Rights Act.

As a steady voice for comprehensive, quality and affordable health care reform, Senator Kennedy pushed hard over his decades of Senate service to expand the National Institutes of Health, created programs to protect pregnant women and children, the Children’s Health Insurance Program (SCHIP), the Genetic Information Nondiscrimination Act and the recently enacted Medicare prescription drug expansion. As many have observed, his absence from the Senate this year has significantly hindered the passage of health care reform.

In his role as a member, Ranking Minority Member, and Chairman of the Health, Education, Labor and Pensions Committee, he authored the Developmental Disabilities Act, established Protection and Advocacy Systems in every state, and oversaw several extensions of the Rehabilitation Act, including the addition of Supported Employment and steady increases in the minimum wage.

Senator Kennedy was first elected in 1962 and served six terms. He ranks third in total service in the U. S. Senate. He was often referred to as the “Lion of the Senate.” A consummate deal maker, many of his legislative successes were due to his ability to reach across the aisle and secure bipartisan support, sometimes with the most conservative of Senators. He was an electrifying orator, his booming voice resounding off the walls of the Senate chamber. Senator Kennedy did his homework, always exceptionally well prepared for his Committee hearings, bill markups and floor speeches. He was often noted as having the best and most loyal staff on Capitol Hill.

Senator Kennedy often described his interest in disability policy due to his family history. Late in life, his father suffered from a serious stroke. His sister Rosemary was born with an intellectual disability and was sheltered during her adulthood in a private institution. His sister Eunice, who died only two weeks ago, headed up the Joseph P. Kennedy Jr. Foundation and created the Special Olympics. The Senator’s two sons also experience disability. Ted Jr. lost a leg to cancer as a child. Patrick, a U. S. Congressman from Rhode Island, has a mental illness.

Senator Kennedy spoke at several events sponsored by The Arc, most notably the Disability Policy Seminar. In 2001, he was the recipient of The Arc’s John H. Chafee Leadership in Public Policy Award. Last month, The Arc’s President, Lynne Cleveland, announced that Senator Kennedy would be this year’s President’s Award recipient. This award will now be given posthumously at an event in the near future.

August 26, 2009

We Are Back From Vacation

The Arc of North Carolina Policy Blog has been taking a much needed vacation.  The 2009 Session of the General Assembly is over. Tomorrow we will be posting a legislative review of policy that was included on The Arc of North Carolina's legislative agenda.

During this session break we will also be updating you on study committee activities and on how the budget cuts are affecting people with developmental disabilities and those who work with them.

Thanks for reading the blog during this session, we appreciate it.

NCGA: State Budget Update for Wednesday

Both the House and the Senate will take up the budget again today. This will be the last vote on the budget. 

We will be posting a full analysis of the cuts to HHS later this week.  Until then we suggest reading this article by WRAL on the budget and Governor Perdue's comments regarding the budget.  The Governor has stated she will sign the budget with "serious reservations".

NCGA: State Budget Update The Vote and Devastating Changes to HHS

Today the House and Senate are voting right now on the state budget.  In a last minute turn of events, House and Senate Appropriation chairs choose cut $40 million dollars from state funded services for people receiving services in Mental Health, Developmental Disabilities, and Substance Abuse Services.  

This was an extremely unexpected cut, not only to advocates monitoring the budget but also to the HHS Appropriation Chairs.

Just last week advocates had been told that the original cut of $50 million dollars would reduced to a $10 million dollar cut. 

As of this evening, the Senate passed has voted 27 Yes to 17 No to pass the budget. The Senate will vote for the third time on the budget tomorrow. The House, as of 5:00pm are continuing to debate the budget.

This cut of $40 million dollars in state funded services will be devastating to a community based system of care. You will not find in the budget equally as severe cuts to state institutions.

We will send updates when they become available.

NCGA: State Budget Update

WRAL and other news outlets are reporting that there will be a budget roll out tonight. On Friday, we started receiving updates from the General Assembly that the House and Senate Appropriation chairs were nearing the end of negotiations on the finance package and the budget.

By late Friday evening we had a tentative deal. There are still rumors that Governor Perdue may not be happy with everything in the finance package or the way class sizes are being managed.

We will be in the building later today and will update you when more details become available.

Until then we invite you to check out this story: WRAL.