NC News: Press Release From DRNC-Challenges Construction at New State Hospital.

Thursday, September 30, 2010
Disability Rights NC Challenges Construction of New State Hospital

Raleigh, NC-

One day before the ground breaking ceremony of the new Cherry State Hospital Disability Rights North Carolina calls on Governor Perdue and the N.C. General Assembly to halt construction on the new Cherry Hospital in Goldsboro pending a thorough review of the need for this construction. “The plan developed to build this facility is over 10 years old,” said Vicki Smith, executive director of Disability Rights NC. “Given the devastating cuts across the full continuum of mental health services triggered by the State’s economic crisis, proceeding with new construction of a large institution is fiscally irresponsible. More importantly, even if the state were in better budget times, is this new facility still a wise investment?"

Disability Rights NC believes this construction highlights the state’s institutional bias - that it is willing to spend more money on bricks and mortar than on more appropriate, community-based services for people with mental illness. In light of the Americans with Disabilities Act, the U.S. Supreme Court’s Olmstead decision and the fact that the U.S. Department of Justice is already looking into North Carolina’s institutional bias and its continuing failure to provide community services, constructing a new hospital is particularly short-sighted, the agency’s director said. “It is time for North Carolina to act progressively and maximize its resources to benefit the state and all its citizens. Putting our resources into community services rather than institutions will be more cost-effective and humane. North Carolina’s citizens deserve a better vision,” Smith said.

Smith believes that construction of the new hospital may jeopardize the state’s compliance with the American with Disabilities Act by focusing more resources on institutionally-based care than on community-based services. “It is certainly contrary to the spirit and intent of the ADA and the Olmstead decision,” she said. “If people with mental illness receive the community services they need, it may entirely eliminate the need for hospitalization for many individuals.”

Smith warns that if the new Cherry Hospital is built, her agency will be carefully watching the new hospital’s services. “If the hospital cannot find appropriate staff, and if it does not provide appropriate, evidence-based treatment, we will take action,” she said.

Smith said the state should take the time to fully explore and answer the following questions before proceeding with any new construction:
· Would the hospital be necessary if the state had adequate community-based services?
· If additional hospital-based beds are found to be necessary, what type of beds is needed – adult acute care, adult long term care, forensics (for those involved in the criminal justice system), etc.?
· Given the history of problems the state faced when building Central Regional Hospital, including significant needs for retrofitting the building prior to admitting patients to ensure a safe and therapeutic environment, what assurance can the state give the public that there will not be similar problems with the proposed construction at Cherry?
· Will the state be able to staff the new hospital adequately? There is a long-standing history of difficulty in staffing the current Cherry Hospital.
· How will the construction of a new building address the hospital’s long and troubled history of abuse and neglect of patients?
· Should the state consider moving any new construction to a setting more conducive to attracting qualified staff, such as Greenville, which has a medical school?
# # #

Disability Rights North Carolina is the state’s federally mandated protection and advocacy system for people with disabilities. One of the P&A’s primary federal mandates is to protect and advocate against the abuse and neglect of people with disabilities.

NC News: WRAL Reports NC Departments Struggling with Budget Cuts

N.C. departments struggling with budget cuts

Posted: 12:44 p.m. Monday
Updated: 7:10 p.m. Monday
Facing an estimated $3 billion shortfall for the 2011-12 budget year, North Carolina's state's budget director has asked all state department heads to plan for spending reductions of up to 15 percent.

Those suggested cuts are due Oct. 29, but department leaders say they are struggling with where to cut.

Since 2009, the Department of Health and Human Services, for example, has cut $2 billion from its budget. The juvenile justice department has cut $22 million, which is 15 percent of its original budget.

With nine juvenile detention centers and eight youth development centers across the state, it's quite likely at least one may close, says William Lassiter, with the Department of Juvenile Justice and Delinquency Prevention.

"We've already had to lose after-school programming. We've already had to lose mentoring programs," Lassiter said. "This year, if we have to take additional cuts, we have to look at facility cuts."

An additional 15 percent cut would bring the department's budget allocation to the lowest level ever.

"If you cut anymore, you'll be cutting into core services that will affect public safety," Lassiter said.

Health and Human Services Secretary Lanier Cansler says facilities are safe. What's in jeopardy are the services.

"There may be some services that we say we can't do anymore," Cansler said. "There may be some services (where) we reduce the scope and do less."

Cansler wouldn't specify what could be eliminated but said everyone would likely be affected in some way. He says a 15 percent reduction for DHHS equates to roughly $600 million.

"We are searching right now on how to do it," Cansler said. "I don't know how we're going to accomplish it. We're reviewing everything."

Read more here: WRAL

Monday Quick Hits: Hot Policy Topics for This Week

North Carolina:

The interim committee meetings this week include the following:

Tuesday, September 28, 2010
2:00 PM Domestic Violence Taskforce Subcommittee 1425 LB

Wednesday, September 29, 2010
1:00 PM Information Technology, Joint Legislative Oversight Committee 1027/1128 LB

Thursday, September 30, 2010
9:30 AM Joint Select Committee on the Pteservation of Biological Evidence 643 LOB

We will be monitoring all of the listed meetings and will report on anything of interest to our community.


National:

The first deadline on the national budget front will come up this Friday, the start of Fiscal Year 2011. None of the FY 2011 appropriation bills have passed Congress. We are expecting to see the first Continuing Resolution pass Congress this week. This Continuing Resolution will keep all federal programs funded at current levels as the new fiscal year begins.

DPC- is reporting that some Democrats are expected to try to add a few additional provisions to the CR. All Republicans are voicing strong opposition to any add-ons to the CR.

Hill Report: BREAKING NEWS US House Passes Rosa's Law

This evening the United States House of Representatives passed Rosa's Law. S. 2781 known as Rosa's Law was sponsored by
U. S. Senator Barbara A. Mikulski (D-Md.) and Senator Mike Enzi (R-Wyo.)

The soon to be law, will eliminate the terms "mental retardation" and "mentally retarded" from federal laws that govern education, health and labor and will replace these terms with "intellectual disability". The bill will now go to President Obama's desk for his signature.

Advocates with intellectual disabilities have rallied against the use of the "r" word. Their hard work and dedication has yielded the successful passage of this legislation.


Press Release from U.S. Senator Barbara A. Mikulski on this historic vote:

WASHINGTON, D.C. – U.S. Senator Barbara A. Mikulski (D- Md.) announced that her bill introduced to eliminate the terms “mental retardation” and “mentally retarded” from federal education, health and labor laws passed the House on Thursday night by unanimous consent. It passed the Senate last month, and will now go to President Obama for his signature. Senator Mike Enzi (R-Wyo.), ranking member of the Senate Health, Environment, Labor and Pensions Committee, was one of the original co-sponsors.

“This law is about families fighting for the respect and dignity of their loved ones,” Senator Mikulski said. “This change will have a positive effect on more than 6 million Americans.”

A family in Edgewater, Maryland provided the inspiration for the law. Nina Marcellino is the mother of four children, including Rosa, a child with Down syndrome. Last year, Nina learned that Rosa had been labeled retarded at school. Nina didn’t allow the R-word in her house, and none of her children described their sister that way. Nina teamed up with other parents and her state delegate to introduce a bill to change the terminology in Maryland state law. Before the bill was brought up for consideration in the Maryland General Assembly, they held a hearing on the implications of changing the term.

There were several witnesses at that hearing, but the testimony that had the greatest impact was given by an 11-year-old boy: Rosa’s brother, Nick. “What you call people is how you treat them,” Nick said. “What you call my sister is how you will treat her. If you believe she’s ‘retarded,’ it invites taunting, stigma. It invites bullying and it also invites the slammed doors of being treated with respect and dignity.”

Senator Mikulski met Nina at a roundtable discussion on special education last April. Nina told the Senator about Rosa’s Law and their plans to bring it up for consideration in the state Assembly.Senator Mikulski promised Nina that if the state law passed the Assembly, she’d take it to the Senate floor. Two weeks later, Rosa’s Law was unanimously approved by the General Assembly and then signed into law by Governor O’Malley.

Rosa’s Law changes the phrase “mentally retarded” to “an individual with an intellectual disability” in health, education and labor law. It makes the language in federal law consistent with that used by the Centers for Disease Control, the health arm of the United Nations, and the White House through the President’s Committee for People with Intellectual Disabilities.

“I’m pleased that the House has approved Rosa’s Law, and hope the President will sign it quickly. This bill is simple in nature but profound in what it will do when it is enacted. For far too long we have used hurtful words like ‘mental retardation’ or ‘MR’ in our federal statutes to refer to those living with intellectual disabilities. While the way people feel is important, the way people are treated is equally important. Rosa’s Law will make a greatly-needed change that should have been made well before today – and it will encourage us to treat people the way they would like to be treated.”

“The Marcellinos’ story is a perfect example of effective citizen advocacy. They pulled together to pull us all to another way of thinking,” Senator Mikulski said. “The bipartisan support of this bill shows that this is an issue where we can tip our hats to boys and girls with intellectual disabilities by checking our party hats at the door.”

The House bill had 72 cosponsors. The law does not affect any services, rights, responsibilities or educational opportunities for people with intellectual disabilities.

NC News: N&O Article on Disabled Inmates

Disabled inmates deserve chance to earn time off, lawsuit says

RALEIGH Disabled inmates in North Carolina's prisons serve longer sentences than other inmates because they are unable to participate in programs used to earn time off for positive behavior, according to a class action lawsuit filed in federal court.

Brought on behalf of six d inmates with disabilities, the lawsuit contends that the system for rewarding "sentence reduction credits" violates the Americans With Disabilities Act and other federal laws. Inmates in North Carolina can shave up to six days a month off their sentences by performing work assignments and earning education credits.

"We don't think anybody in North Carolina should be serving additional time in prison simply because they're living with a disability," said Mary Pollard, the director of N.C. Prisoner Legal Services, which filed the suit.

Keith Acree, a spokesman for the N.C. Department of Correction, said Tuesday that he could not comment on a matter that is under litigation.

Among those named in the lawsuit is inmate Chad W. Bumgarner, who is serving an 83- month sentence for burglary. Bumgarner, 40, suffers from a neurodegenerative disorder that requires him to use leg braces to stand or walk. He also has been diagnosed with bipolar disorder, according to the lawsuit.

Read more here

After he entered the prison system in 2008, Bumgarner tried to get a job but was told there were no assignments suitable for him because of his physical disability. He tried to take classes to earn sentence reduction credits but could do so only with "extreme difficulty," the suit said.

Hill Report: US House of Representatives Set to Vote on Rosa's Law-Reports Disability Scoop

Update: Disability Scoop is reporting a vote that would significantly change terminology in federal law. North Carolina passed "People First" legislation in 2009.

House To Vote On Replacing ‘Mental Retardation’ With ‘Intellectual Disability’
By MICHELLE DIAMENT
September 21, 2010 Text Size A A
The House of Representatives is expected to vote as early as Wednesday evening on a bill to replace the term “mental retardation” with “intellectual disability” in many areas of federal government.
The legislation known as Rosa’s Law was approved by the Senate in August. Under the bill, terminology would be altered in federal health, education and labor policy.
The House is widely expected to pass the measure when it is brought up later this week alongside several other bills that are considered uncontentious under a suspension of the rules. This means that there will be limited debate and a simplified voting procedure.
If Rosa’s Law does gain House approval, it will go to President Barack Obama, who supports the measure. ”He looks forward to signing it into law after the House passes it,” a White House official told Disability Scoop on Monday.
Under the bill, individuals with disabilities would retain the same rights they currently have, but terminology would be swapped as laws and documents come up for revision over the next several years. As a result, Rosa’s Law is not expected to incur any cost.
Nearly all states and some federal agencies already use the term “intellectual disability.”


Want more information on Rosa's Law? Check out The Arc of the United State's Fusion Newsletter.

Monday Quick Hits: Hot Policy Topics for This Week

It will be another light week of interim meetings at the General Assembly. Of interest to our community, is the Tuesday, September 21st State Health Plan Blue Ribbon Task Force.

During last month's meeting of this task force, we learned that the state health plan has at least a $572 million deficit going into the next biennial budget cycle. This growing deficit is partially due to the continuing increase of health care costs. Another topic of interest in this committee is how our state health plan should prepare for the regulatory changes of health care reform legislation.

Tuesday, September 21, 2010
10:00 AM State Health Plan Blue Ribbon Task Force 1228/1327 LB

NC News: Disability Rights Group Fights Cuts to In Home Care

The News and Observer ran this story on Friday. The cuts and the new program to serve people with in-home care occurred during this biennial budget cycle. Advocates across the state have expressed concern regarding the depth of the cuts.


Disability rights group fights cuts to in-home care

The director of Disability Rights North Carolina has sent a letter to the U.S. Justice Department asking for an investigation of deep cuts to the state's Medicaid Personal Care Services program, which provides in-home care to those with disabilities.

Vicki Smith, the group's director, says the cuts will "endanger people with disabilities in North Carolina or force them into large, institution-like facilities." That would violate a U.S. Supreme Court ruling that requires the state to serve people with disabilities within their community when possible, Smith wrote.

More than 37,000 elderly and disabled residents in North Carolina rely upon the assistance of trained home-care aides for such basic activities as bathing, dressing, eating and using the toilet. The state Department of Health and Human Services signed a $24 million contract last year with a vendor tasked with determining which elderly and disabled persons can receive in-home assistance and how many hours of care they will receive.

The Association of Home & Hospice Care of North Carolina, which represents providers of in-home services, also wrote to the feds to ask that they stop the state cuts. Tim Rogers, the association's CEO, said the new state process for assessing who gets services and who doesn't is in violation of federal law.

Monday Quick Hits: Hot Policy Topics for This Week

It is going to be a slow week at the General Assembly. All of the meetings of interest in our community are today.

Monday, September 13, 2010
10:00 AM Child Fatality Task Force - Intentional Death Committee 1027/1128 LB

10:00 AM Joint Legislative Committee on Domestic Violence - Alamance Family Justice Center - Burlington N/A LOB

1:30 PM Child Fatality Task Force - Unintentional Death Committee 1027/1128 LB

Friday Wrap Up: Note from the LOC

Although the agenda for the Legislative Oversight Committee had not specific DD updates, we did think the following information would be of interest to members of our community.

The first Mental Health, Developmental Disability, and Substance Abuse Services Joint Legislative Oversight Committee of this legislative interim took place on Wednesday, September 8, 2010.
The meeting opened with the introduction of members and a review of the legislative changes that were made during the 2010 session.

Secretary of Health and Human Services Lanier Cansler addressed the members of the committee with a comprehensive review of the changes occurring inside the Division of MH, DD, SAS.
On the topic of Dorethea Dix, Secretary Cansler explained that there were no appropriations made to operate the Dix facility during this biennial. The proposal to close Dix will need to be presented to the Council of State. If approved by the Council of State a bill will be presented to the members of the legislature during the long session. A bill will need to pass the legislature for Dix to be closed.

When members of the committee questioned the dispersion of the Dix beds and the forensic unit, Secretary Cansler stated that the 26 bed minimum forensic unit will remain at Dix and that there will be no reduction in total state beds. There will be increases in beds at Cherry and Broughton that will reflect the number of beds that will close at Dix.
Secretary Cansler did state that even with the changes at Dix the state will be operative at 14 million over budget.

Deputy Secretary of DHHS Mike Watson gave an update on the implementation of CABHA (Critical Access Behavioral Health Agency). Watson began the presentation with a review of the basic CABHA service requirements and the certification process. Currently there are 67 certified CABHA’s (67%-for profit). In addition there are 30 CABHAs that are completing the Medicaid enrollment process and an additional 14 that are in the enrollment process.
In a review of the distribution of CABHA required services Deputy Secretary Watson stated the following:
5 counties=1 CABHA
50 counties=2-5 CABHAs
36 counties=6-10 CABHAs
2 counties=11-15 CABHAs
3 counties=16+ CABHAs
There are 4 counties that do not currently have consumers receiving CABHA required services. Watson specifically addressed the lack of CABHA services in the ECBH LME catchment area. Currently there are 170 new applications that are beginning the CABHA process.

One of the concerns that was brought up by Representative Earle was how do the providers that have completed the CABHA process merge into the two new 1915 b/c managed care waiver sites. Deputy Watson stated that the division would recommend that the LME accept all of the CABHAs in that catchment area. However, it is clear that there are no specific guidelines on how to make this merger or how to protect the CABHAs during the transition.

The final presentation of the day was on the transition of youth from the Level III and Level IV group homes. The presentation began with a review of the legislation and the state guidance offered on how to transition youth out of Level III and Level IV homes.

Prior to the legislation, there were 2532 youth in Level III homes and now there are 620 remaining. This is a difference of 2608 youth in this placement. For Level IV homes there were 133 youth in these residential services and currently there are 29 youth remaining. There is a concern over where the youth went and did the child succeed in the transition back to the community. To address these concerns DMH is working with UNC Behavior Health Research to follow up and study the status of the youth who were discharged from the Level III and Level IV residential settings.

Tuesday Quick Hits: Hot Policy Topics for This Week

Our legislative week starts today! Here are the Hot Policy topics for the week. There will be two meetings of interest this week for our community. The first one is today when the Health Care oversight committee meets. The second meeting of interest is tomorrow when the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services meets.

Here is the schedule for these meetings:

Today, Tuesday, September 7, 2010
10:00 AM Joint Legislative Health Care Oversight Committee 544 LOB

Wednesday, September 8, 2010
10:00 AM Mental Health, Developmental Disabilities and Substance Abuse, Joint Legislative Oversight Committee 643 LOB

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

Next Wednesday will be the first Joint Legislative Oversight Committee MH, DD, SAS meeting of the 2010 interim. Here is the agenda for the meeting:



Joint Legislative Oversight Committee on
Mental Health, Developmental Disabilities, & Substance Abuse Services
AGENDA
September 8, 2010 10:00 A.M.; Room 643, Legislative Office Building
Representative Verla Insko, Co-Chair, Presiding



Welcome and Opening Comments Senator Martin Nesbitt, Co-Chair
Representative Verla Insko, Co-Chair


Secretary's Remarks Lanier Cansler, Secretary, Department of Health and Human Services

Overview of 2010 Legislative Actions Lisa Hollowell, LOC Staff
Joyce Jones, LOC Staff


Expenditures and Utilization Tracking Update Craigan Gray, MD, Medical Director, Division of Medical Assistance, DHHS

Community Supports Information Michael Watson, Deputy Secretary, DHHS


CABHAs Update Michael Watson, DHHS



Lunch



Status Report on the Changes to Level III and IV Mark O’Donnell, Program Manager Facilities for Children DMHDDSAS, DHHS



Second Mile Project – LME Presentation Roy Wilson, Director, East Carolina
Behavioral Health (ECBH) Lisa Bonnett, Executive Director of the Recovery Education Unit, ECBH

Wrap Up and Discussions

News: NC Panel Analyzes Health Care Reform

The Daily Tar Heel has an interesting article regarding health care reform and how North Carolina is preparing for the changes. Here is part of the article and a link to read on.

N.C. panel analyzes health care reform
Will localize national policy changes

By JESSICA SEAMAN | The Daily Tar Heel

President Barack Obama might have succeeded in passing comprehensive health care reform last spring, but actually implementing the hundreds of pages in legislation is a daunting task that the state is preparing to tackle.

Even though most of the laws don’t go into effect until 2014, North Carolina has formed a panel of health care experts to make sure the transition to the new law is as smooth as possible.

The panel, which began meeting this month, will make recommendations not only to Gov. Bev Perdue but also to the N.C. General Assembly and executive branches on how best to adjust to the new laws.

Read More: Daily Tarheel.

News: Psychology Today Article on Disability and Unemployment

Jobless rate for adults with disabilities stagnant for 20 years
Employment rates haven't changed since Americans with Disabilities Act passed.
Published on August 23, 2010
The United State Department of Labor reported earlier this month that the national unemployment rate for July 2010 was 9.5 percent, about the same rate as June.

When you look at the finer details, though, things are better for some people, worse for others.

The unemployment rate for white people was 8.6 percent. For African American people it was 15.6 percent and for Hispanic people, 12.1. Unemployment among teenagers was at 26.1 percent. This is all to say that, depending on where you are sitting, 9.5 percent might look pretty good.

How about a 79 percent unemployment rate? A recent survey from the National Organization on Disability reported, "Of all working-age people with disabilities, only 21% say that they are employed, compared to 59% of people without disabilities."

The survey also states that little progress has been made in the area of employment or other quality of life indicators for people with disabilities in the 20 years since the passing of the Americans with Disabilities Act.

Read more at: Psychology Today

Friday Wrap Up: Interim Committee Meetings Update

The legislative interim committee schedule is now under way. 

Over the past two weeks there were several meetings of interest to our community. The first dealt with the state employee health plan and the benefits for hospital employees. The major announcement in each of these meetings was that the state health plan is going to be short at least $572 million for FY 2011-2012 budget.The second major discussion was if the current state health plan should apply for grandfather status as we transition into the new rules instituted by health care reform. Not holding on to grandfather status could increase the short fall for the health plan to over 1 billion dollars. 

Then on Monday, August 16, we received a budget update at the Child Fatality Task Force from Barry Boardman, Phd. fiscal research staff.

Here is the state of upcoming budget for fiscal year 2011.

The outlook for the next fiscal year is more drastic than this year. This is due to three different factors the first is the termination of stimulus dollars provided in this current budget. The second factor is the termination of the sales tax and corporate tax that was passed in the 2009 session. Third is the extremely slow economic recovery that our state is experiencing.

FY 2010-2011 budget had a 11% shortfall. In actuality it was closer to a 15% shortfall due to a significant reduction in revenue collection. In the coming biennial budget we will see a deficit of 3.2 billion. The deficit consists of 1.6 billion in stimulus money, 1.3 billion in sales tax revenue and the remainder of the deficit is created by 300 million in non-recurring cuts.

These figures do not include the $572 million deficit in the state health plan. Two year ago the budget was 20.8 billion, we are looking to create a budget for the upcoming biennial of 16 billion.

Arc NC: Remarks from the Deputy Secretary of the Department of Health and Human Services

Deputy Secretary of the Department of Health and Human Services, Mike Watson, addressed a packed room of advocates, providers, parents, and Arc chapter executives today at The Arc of North Carolina’s state conference. Deputy Secretary Watson provided the attendees with a state of the state on services for people with developmental and intellectual disabilities.

He opened his remarks by complimenting the hard work and dedication of the many members of The Arc of North Carolina and its chapters. He stated that many of the legislative successes including the return of the $40 million in funding for state funded services was due to their advocacy.

Watson also laid out the values that the Department of HHS and the Division of MH, DD, SAS are operating under as they move forward. Watson stated that “these values are the goals for how we act. We want to keep these values out in front of us and make sure they are translated into action”.

The values included being customer focused. Who are your customers and who are you trying to serve. To create a department and division that are anticipatory. Knowing what are the consequences of our actions and evaluating the outcomes and what can happen because of our policy decisions. The values include a division and department that is collaborative. The goal is to include interested parties in the journey and to ask the consumers, providers, advocates the important questions “what do you think” and “what is the impact”. Transparency and being more results oriented rounded out the new guide for the division and department.

Mike Watson touched on many of special provisions that were included in the budget including the utilization of the SIS tool and the waiver special provision. In addition he highlighted a special provision that addressed making CAP/MR-DD high need consumers be able to access the top tier of the CAP by addressing the need for higher levels of residential supports through re-writing the definition in the waiver.

Watson then gave the attendees the facts about what to expect in next years budget. “The stark reality is that the budget the last two years was extraordinarily difficult. The next year will be the low water mark of our funding issues.”  Mr. Watson set out the deficit in these terms, there will be a reduction in overall stimulus funding. The sales tax and the additional taxes that were part of the 2009 revenue package will sunset in 2011. There will also be a reduction in the non-recurring funding through cuts and through cuts of one time money. The overall budget deficit will be between 2 and 3 billion dollars.

In addressing the Medicaid Rate Reduction cause by not receiving the full 500 million in additional FMAP extension funding, Deputy Secretary Watson stated that “this week providers learned of a 1.35% cut in rates effective September 1. The decision the department made to start as early as possible was that if we waited till later in the year that cut would have increased to 2.7%. Whatever we put in place I can guarantee will continue next year. We would rater have a 1.35% reduction next year than a 2.7%.”

As for the managed care waiver issue, it is clear that the department and division are telling LMEs to expect and get ready for a move into the waiver environment “one way or another Medicaid will be managed”.  Watson stated that the shift to managed care waivers is a multi year process that must include competence and readiness. 

Arc of NC: Deputy Secretary of DHHS Mike Watson Presenting on State of the State DD/ID

Deputy Secretary of HHS Mike Watson is now presenting on the state of the state of DD/ID services in North Carolina.

The Arc of North Carolina State Conference

The Arc of North Carolina state conference is underway! On the calendar for today is a presentation by Deputy Secretary of the Department of Health and Human Service, Michael Watson will be delivery the plenary session at 2:15pm.

Topic today is "State of the State for People with Developmental Disabilities". We will be live blogging his remarks.

NCGA: Legislative Wrap Up #1

The short session was very short this year. Totaling only seven and a half weeks there was an abundance of policy changes that took place through bills and the state budget. This is the first of a series of posts that will guide you through what happened this session. The first and most difficult part of the short session was how to adjust the state's biennial budget. Here then is the budget wrap up.

Budget Background:

This year members of the General Assembly had to balance an 800 million dollar budget deficit as well as a possible 500 million additional deficit if FMAP was not extended.  The key to this year’s budget was how to fill the gap without cutting critical services and without passing a comprehensive revenue/tax package. Overall the members of the appropriation committees did just that.

The final budget reflected very targeted cuts and very targeted expansions. Leadership on HHS appropriation in the House and the Senate did worked diligently to limit cuts for critical services. At the same time we did see targeted expansions in crisis beds and a restoration of the $40 million service dollar cut that was made in the previous budget to LME state dollar service funding.

A major area of concern for the developmental disability community was the full state expansion of the managed care model that is currently in use at PBH. During this session a broad coalition worked diligently to limit the expansion of the 1915 b/c waivers. The final special provision limited the expansion and also included language that directs the department to look at alternatives and to do a thorough customer service study of the existing and two new waiver sites.

As the budget and session came to a close it became clear that the US Congress was going to be unable to pass the necessary FMAP extension. During the last hours of the session a budget technical corrections bill was passed that included a list of eight proposed cuts to fill the 518 million dollar deficit caused by losing FMAP money. The cuts are proposed throughout the state system as opposed to only targeting Medicaid. The list is prioritized and includes language regarding the process of implementing the cuts depending on the amount of FMAP dollars received by the state.

Money Report:

 

Division Management Funds ($7,180,807) NR

Reduces unobligated funding available at the Division's discretion for

one-time needs of community providers or LME system needs.  The total

includes $1,169,355 for mental health, $3,398,534 for developmental

disabilities, and $2,612,918 for substance abuse services.  These funds

have historically been spent to address specific one-time needs; these

funds are not allocated to LMEs for service provision.

 

Leadership Academy: $250,000 NR
Provides funds for a Mental Health Leadership Academy for training for
Mental Health managers, finance/budget officers, and other leaders
within Local Management Entities.

Local In Patient Bed Capacity/Crisis Beds $9,000,000 R

Increases funds available for the three-way contracts to purchase local 

hospital bed capacity for crisis response within communities.  These 

funds will support additional community hospital beds, bringing the 

total funding to $29 million annually.

Community Service Funds $40,000,000 NR
Provides funding for community services administered through Local
Management Entities. This funding fully restores the mental health,
developmental disabilities, and substance abuse services funding
reduced for FY 2010-11.  This amount includes $30,559,012 of funds
transferred from Department of Public Instruction's Office of Early Learning.

                        Special Provisions:

CAP-MR/DD SERVICE ELIGIBILITY (Page 52)
SECTION 10.7A.  Section 10.21B of S.L. 2009-451 reads as rewritten: "SECTION 10.21BSECTION 10.21B.(a)  Except as otherwise provided in this section subsection for former Thomas S. recipients, CAP-MR/DD recipients are not eligible for any State-funded services except for those services for which there is not a comparable service in the CAP-MR/DD waiver. The excepted services are limited to guardianship, room and board, and time-limited supplemental staffing to stabilize residential placement. Former Thomas S. recipients currently living in community placements may continue to receive State-funded services.

"SECTION 10.21B.(b)  The Department of Health and Human Services, Division of Medical Assistance, shall work with stakeholders to develop a new service definition within the CAP-MR/DD waiver to better meet the needs of individuals who (i) have a high intensity of behavioral needs, (ii) reside in small licensed residential placements, and (iii) require supervision 24 hours per day, seven days per week, three hundred sixty-five days per year. The Division shall apply to the Centers for Medicare and Medicaid Services (CMS) for an appropriate amendment to the CAP-MR/DD waiver if CMS approval is necessary to implement the new service definition. Not later than October 1, 2010, the Department shall report to the Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services, the House of Representatives Appropriations Subcommittee on Health and Human Services, the Senate Appropriations Committee on Health and Human Services, and the Fiscal Research Division on the development of the new service definition and the status of any necessary approval from CMS to implement the new service definition."

STUDY MEDICAID PROVIDER RATES (page 67)

SECTION 10.25.(a)  The Department of Health and Human Services, Division of Medical Assistance, shall initiate a study or contract out for a study of reimbursement rates for Medicaid providers and program benefits. The study shall include the following information: 

(1) A comparison of Medicaid reimbursement rates in North Carolina with reimbursement rates in surrounding states and with rates in two additional states; and (2) A comparison of Medicaid program benefits in North Carolina with program benefits provided in surrounding states and with rates in two additional states. Selected provider rates shall be studied for the initial report.

SECTION 10.25.(b)  The Department shall report its initial findings to the Governor, the Senate Appropriations Committee on Health and Human Services, the House of Representatives Appropriations Subcommittee on Health and Human Services, and the Fiscal Research Division by April 1, 2011.

SECTION 10.25.(c)  Funds appropriated to the Department of Health and Human Services may be used to complete this study.

 

STATEWIDE EXPANSION OF CAPITATED 1915(B)/(C) BEHAVIORAL HEALTH  
WAIVERS  (page 67)
SECTION 10.24.(a) The Department of Health and Human Services Department shall select up to two additional Local Management Entities (LMEs) to implement the capitated 1915 (b)/(c) Medicaid waiver as a demonstration program during the 2010-2011 fiscal year. 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.
SECTION 10.24.(b) The Department shall conduct an evaluation of the 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 waiver 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, after which time the Department may expand the capitated 1915(b)/(c) Medicaid waiver to additional LMEs.
The Department shall not approve any expansion of the Piedmont Behavioral Healthcare LME (PBH) beyond its existing catchment area until after the Department has completed its evaluation and made its report pursuant to this subsection.

Hill Report: US House Set to Pass FMAP Extension Today

Speaker of the House Nancy Pelosi shortened the House break for an important vote on FMAP legislation. The vote is scheduled for today. House session will begin at 9:00AM.

We will provide an update on this vote once it is available.

Correction: House coverage on CSpan will begin at 10:00AM-

Hill Report: Senate Passes Critical FMAP Extension

Today the US Senate took up the final vote on HR 1586 today, the vehicle for the extension of necessary FMAP funding. There were two Republican amendments voted on that would have extended tax cuts for individuals and small businesses that are set to expire in December. Those two amendment, if they had passed, would have sent the bill with the FMAP extension back to the Senate Finance.

Both of these amendment failed. The final vote on HR 1586 is 61 yes and 39 no. The bill has now officially passed the Senate. The bill includes $26.1 billion in extension stimulus funding. $16.1 billion in FMAP funding. North Carolina will see $343 million dollars in Medicaid dollars and $300 million in funding for teachers and schools. Passage of this bill means that we will most likely not see the 1% across all department reduction as laid out in the budget technical correction bills.

The US House of Representatives has been called back to Washington, DC. This bill will be calendared for a vote on Tuesday.

Hill Report: FMAP Update Senate Votes to End Debate and Motion To Concur Passes

Today the US Senate vote 61 in favor and 38 opposed to end debate on the FMAP extension bill. This effectively stopped a GOP filibuster of the legislation and has paved the was for passage of this critical bill. The second vote taken today by the Senate was a motion to concur, this also passed with a 61 in favor and 38 opposed vote.

It is expected that the Senate will take up the final vote on the FMAP extension bill either later today or tomorrow. The House, which is in August break, will most likely be called back to DC to vote sometime this month.

So what does this mean for North Carolina? It means that NC will see $343 million in FMAP/Medicaid funding come into the state. This will be a big help in closing the $500 million deficit that would have occurred if this bill did not pass. In addition the state will see $300 million in education funding targeted to protect teacher jobs. Critical funding as we approach the start of a new school year.

Hill Report: Happening Now-US Senate is Debating the Teacher and FMAP Funding Bill

The US Senate is currently debating the last attempt to extend funding for Medicaid and teachers. The CBO report shows the new bill being debated actually reduces the deficit.

The vote on the bill is scheduled to take place at 10:40AM. The first vote to be taken will be to end debate and move the bill forward. The Senate rules require 60 votes to end debate.

There has been considerable debate over whether the Senate can get the 60 votes they need. If the vote fails today there will be no further attempts to get this extension before the Senate takes their August break.

Where have we been?

Well, we have been on a blogging vacation following a long "short session". Your lead blogger took some time off to travel to NCSL in Louisville and to wrap up some details from session.

We will be resuming our regular blogging this week.

Monday Quick Hits: Hot Policy Topics for This Week

North Carolina

Today begins the last week of the legislative session at the General Assembly. There are a several bills that will be "hot topics" in the press and at the building this week. These bills include reforming ethics, coming in line with a court decision on elections, and the Alcoa debate.

We will have a complete review of the session next week.

NCGA: Corporal Punishment Bill Passes Senate-Heads to Governor

Yesterday the Senate passed HB 1682: Corporal Punishment and Children with Disabilities. The vote was unanimous, 48 Senators voted in favor of this legislation. We greatly appreciated the efforts of advocates across the state who supported this bill. A special thanks to the ACLU of NC, Autism Society of NC, and Disability Rights North Carolina who worked tirelessly with The Arc of North Carolina on securing passage of this legislation.

Here is what the bill does:
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.

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.

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.

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.

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 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.

House Bill 1682: Corporal Punishment/Children with Disabilities.

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.

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 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.

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.  

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.

The Senate re-referred HB 1683 Amend Sunset for Children with Disabilities to Senate Rules.

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.

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.

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.

 

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.