Friday, February 29, 2008

Breaking News: New Leadership Team Set for MH/DD/SAS

New Leadership Team Set for Mental Health, Developmental Disabilities, and Substance Abuse Services

RALEIGH – N.C. Department of Health and Human Services Secretary Dempsey Benton today announced a new leadership team for the N.C. Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (DMH/DD/SAS). The division will be led by two co-directors, one in charge of clinical activities and the other handling administrative duties.

Mike Lancaster, M.D., who has been DMH/DD/SAS clinical policy chief since June 2004, and Leza Wainwright, who has been DMH/DD/SAS deputy director since December 2003, will fill the new roles.

“This is a large division with a complex mission,” said Benton. “It is clear that we need to have strong, focused leadership on both the clinical and the administrative sides of the operation. These two professionals are uniquely qualified to fill those roles. I don’t think any one individual would have the skill set to give both the clinical and administrative functions the attention they deserve at this time.”

Dr. Lancaster will provide guidance on clinical policy throughout the entire public mental health, developmental disabilities, substance abuse services system. Lancaster, who has more than 25 years clinical experience as a Board-certified Adult, Child and Adolescent Psychiatrist, will work with clinical staff to ensure that quality services are delivered consistently across the system.

Wainwright will focus her attention on day-to-day administrative operations of the division, including overseeing budgeting, personnel and relationships with the local management entities that manage community service delivery.

The N.C. Division of Mental Health, Developmental Disabilities, and Substance Abuse Services oversees delivery of services to over 315,000 people a year and has an annual budget of $2.3 billion. It is by far the largest division in DHHS, accounting for almost 12,000 of the department’s 19,000 employees. The Division also oversees four regional psychiatric hospitals, four developmental disabilities centers, three substance abuse treatment centers, a specialty nursing facility for consumers with mental illness, a specialty nursing facility for consumers with developmental disabilities and two residential facilities for children with emotional disturbances.
Public Affairs Office
101 Blair Drive, Raleigh, NC 27603
(919)733-9190
FAX (919)733-7447
All Press Releases
Debbie Crane
Director

Thursday, February 28, 2008

N&O Editorial: Out of Touch on Down Syndrome

Ellen Russel,Director of Advocacy and Chapter Services for The Arc of North Carolina, expresses the feelings that we all share regarding UNC-Chapel Hill's professor Albert Harris' recent class lecture.

Ellen Russell
RALEIGH - A recent news story quoted a UNC-Chapel Hill professor's lecture notes as saying "In my opinion, the moral thing for older women to do is to have amniocentesis, as soon during pregnancy as is safe for the fetus, test whether placental cells have a third chromosome #21, and abort the fetus if it does." I know Albert Harris has heard from many angry family members. At The Arc of North Carolina, we, too, have been contacted by people who are angry, disturbed and repulsed that a man of science and professorial influence would make such a statement and assign to it a moral imperative. Although Harris suggests that he made this statement to encourage discussion, there is no indication that he asked the students to react. In the apparent absence of soliciting comment, what he said could be perceived as professional wisdom.
Harris was quoted as saying that he knows "somebody who had a child like this and it ruined their life." This singular experience clearly had such a profound personal effect that he feels compelled to make a moral judgment on the extinction of all fetuses whose chromosome counts exceed the norm.

The Arc's mission and values, my recent e-mails and my personal experience would indicate that Harris is out of touch with several decades of civil and social activism for the rights of people with disabilities. The struggle for acceptance, respect, adequate services and supports goes on.

Perhaps that family could never access what it needed in the educational, social, day-care, employment or medical systems. Perhaps it didn't have the encouragement of family, neighbors and friends. It is impossible for me to accept that it was the child who ruined their lives. I can give a hundred personal examples of families whose lives have flourished and benefited from the experience of having a child with Down syndrome.

Those of us who work in this field are painfully aware of a time when people with Down syndrome and other developmental disabilities were warehoused in horrible places, relegated to existences of neglect and squalor. The decades of reform that followed this national shame led to an emphasis on higher developmental and social expectations. Lo and behold, given humane treatment, respect for individual preferences, and the belief that everyone can succeed, people excelled and took their places in the community.

Experiences, options, participation, inclusion with nondisabled peers and, yes, common sense have opened doors to real lives for people with disabilities. Today families seek and demand educational, recreational, vocational, residential options in the community for their family members with Down syndrome. They do so because real life makes a difference.

Twenty-nine years ago, my second child was born. An hour after the exciting birth, my husband and I were informed that Emily had Down syndrome. Gone, we thought, were our dreams and hopes for this darling child. How would we make those calls to the grandparents? What was going to happen to us?

On Emily's second day of life, we stood peering through the hospital nursery window. My husband said, "What does anyone know about any of these babies and what their futures will be?"

As parents we all have dreams and hopes. A diagnosis at birth made me think I had to alter my dreams. But the truth is that as life goes on all our children have experiences and influences, good and bad that shape their lives and affect their families. In the end, we all want our children to be happy, successful, kind, respected, loving and loved human beings. None of those things requires a particular number of chromosomes.

Emily was married four months ago to a wonderful man. Our family and friends helped celebrate this event as they have celebrated her life.

(Ellen Russell is director of Advocacy & Chapter Support at The Arc of North Carolina.)

NC Election 2008: Primary Filing Update

Friday, February 29th is the last day for candidates to file to run for office. The North Carolina State Board of Elections has posted the following link so you can see who is running in your district. http://www.sboe.state.nc.us/NCSBE/Cand/Filed/CandidateList.pdf

As always, we encourage you to register to vote, learn about the candidates and vote!

Tuesday, February 26, 2008

Tuesday's Quick Hits: This Week's Hot Policy Topics

North Carolina:

Tuesday, February 26, 2008



10 a.m. The Joint Legislative Commission on Dropout Prevention and High School Graduation meets, 643 LOB.

Today’s meeting focused on the Department of Public Instructions Dropout Report. Over 23,000 students dropped out of our public school system last year. This report comes on the heels of DPI’s cohort graduation report. That report revealed a four year cohort graduation rate of 48% for students with disabilities.


12:30 p.m. The House Select Committee on Rising Home Foreclosures meets, 421 LOB.

Home foreclosure rates in North Carolina have increased 14%. North Carolina has some of the strongest laws to prevent predatory lending but foreclosures are still on the rise. During this meeting several organizations addressed the need for housing counseling services.



Wednesday, February, 27, 2008



10 a.m. The Joint Legislative Transportation Oversight Committee meets, 1228 LB.

As you could tell by yesterday’s candidate forum, transportation is going to be a hot topic during the short session. This is one of two committees that are meeting on this important topic. How we utilize resources to address road repairs, bridge repairs, and at the same time build transit options will be a major debate throughout the legislative break.


10 a.m. The Joint Legislative Oversight Committee on Mental Health, Development Disabilities and Substance Abuse, 643 LOB.

See agenda in separate post.



Thursday, February, 28, 20089 a.m.



The Joint Legislative Oversight Committee on Mental Health, Developmental Disabilities and Substance Abuse meets, 643 LOB.


See agenda in separate post.



Federal:


Appropriations

On Tuesday, the Senate Banking, Housing & Urban Affairs Committee, chaired by Senator Chris Dodd (D-CT), will hold a hearing on the Administration’s FY 2009 budget for the Department of Housing and Urban Development. HUD Secretary Alphonso Jackson will testify.

Also on Tuesday, the Labor-HHS-Education Subcommittee of the House Appropriations Committee will hold a hearing on the Administration’s FY 2009 budget for the Department of Labor, Health and Human Services, and Education. Education Secretary Margaret Spellings will testify.

On Thursday, U.S. Department of Health and Human Services Secretary Michael Leavitt will testify on the Administration’s FY 2009 budget proposal before the House Energy and Commerce Committee, which is chaired by Rep. John Dingell (D-MI).

Medicaid

On Tuesday the Senate will vote on final passage of the Indian Health Services reauthorization legislation (S. 1200) today. The bill includes a one year moratorium on the Medicaid case management interim final rule.

On Wednesday, Steve Larson, Director of Public Policy for The Arc of Minnesota, will speak at House and Senate staff briefings on the impact of the Centers for Medicare and Medicaid Services case management interim final rule on persons with intellectual and developmental disabilities.

Medicaid/State Fiscal Conditions

On Tuesday, the Senate Finance Committee, chaired by Sen. Max Baucus (D-MT), will hold a hearing on “Economic and Fiscal Conditions of the States”. Several governors are expected to testify.

Joint Legislative Oversight Committee On MH DD SAS Agenda

The Joint Legislative Committee on Mental Health, Developmental Disabilities, and Substance Abuse Services Oversight will hold a two day meeting this month. Many of the topics being discussed will focus on the needs of people with developmental disabilities. We will post an update after this meeting concludes.

AGENDA
February 27, 2008 10:00 a.m. – 3:00 p.m.
Room 643, LOB

Representative Verla Insko, Co-Chair, Presiding
Greetings and Introductions 10:00 – 10:15
Representative Verla Insko, Co-Chair
Senator Martin Nesbitt, Co-Chair

MH/DD/SA System Indicators and Update on Construction Projects 10:15 – 10:30
Andrea Poole, Fiscal Research Division

Review of Piedmont Behavioral Healthcare and Medicaid Waivers 10:30 – 11:15
Dan Coughlin, Area Director/ CEO
Pam Shipman, Deputy Area Director
Craig Hummel, M.D., Medical Director
Piedmont Behavioral Healthcare

Status of Application for Additional Medicaid Waivers 11:15 – 11:45
Tara Larson, Acting Deputy Director for Clinical Affairs
Division of Medical Assistance, DHHS
Leza Wainwright, Deputy Director
Division of MH/DD/SAS, DHHS

DHHS Appeals Process 11:45 – 12:15
Gann Watson, Bill Drafting Division
Emery Milliken, General Counsel
DHHS

Lunch 12:15 – 1: 15

Update on Parents as Providers (Implementation Updates 35 & 40) 1:15 – 1:30
TBD, DHHS

Update on Regionally-Focused, Locally-Hosted Substance 1:30 – 1:45
Abuse Programs
Flo Stein, Chief of Community Policy Management

Division of MH/DD/SAS, DHHS
Update on Data Collection 1:45 – 2:00

Phillip Hoffmann, Chief of Resource/Regulatory Management
Division of MH/DD/SAS, DHHS
Public Comment 2:00 – 3:00

Adjourn 3:00
AGENDA
February 28, 2008 9:00 a.m. – Noon
Room 643, LOB

Senator Martin Nesbitt, Co-Chair, Presiding

Greetings and Introductions 9:00 – 9:15
Senator Martin Nesbitt, Co-Chair
Representative Verla Insko, Co-Chair

Crisis Services for the Developmentally Disabled 9:15 – 10:15
Flo Stein, Chief of Community Policy Management
Division of MH/DD/SAS, DHHS

Developmental Center Downsizing Report 10:15 – 10:30
Carol Donin, Developmental Center Team Leader
Division of MH/DD/SAS, DHHS

Status of Cost-Sharing Under the CAP Program 10:30 – 10:45
Tara Larson, Acting Deputy Director for Clinical Affairs
Division of Medical Assistance, DHHS

Status of Waivers to Create Tiered CAP-MR/DD System 10:45 – 11:00
Rose Burnette, Tiered Waiver Project Manager
Division of MH/DD/SAS, DHHS

DHHS Recommendations to the LOC 11:00 – 11:30
Secretary Dempsey Benton, DHHS

Discussion of Potential LOC Recommendations 11:30 – 12:00
LOC Members

Adjourn 12:00

Vote Update: CMS Case Management Update

The Senate voted today and passed the Indian Health Services reauthorization legislation (S. 1200). The bill includes a one year moratorium on the Medicaid case managment interim final rule.

Vote Count:
YEAs 83 NAYs 10 Not Voting 7

How did our North Carolina Senators vote?
Both Senator Burr and Senator Dole voted in favor of this important legislation.

Important CMS Rules Update: The Clock Is Ticking

As we have reported before on this blog, the proposed CMS Rule Changes that affect reimbursement on case management services. Here is a brief recap of the proposed changes.

Background:
The proposed rules will drastically cut Medicaid funding for case management services that provide adults and children with long term supports, social, medical, educational and other services. The rules would change current CMS policy in the following ways:
*Transition case management services would be limited to 60 days. Current policy allows for up to 180 days. It often takes up to 180 days to secure housing and necessary support services for a person to transfer into a community independent living environment.
*Providers will only be paid for transitional case management services when the person successfully transitions into the community. This rule can be a financial hardship on service providers who do not have a financial capacity to wait for a reimbursement. Sometimes a transition is not successful for various reasons such as the availability of appropriate support services. In this case if the persons transition is not successful the provider will not receive reimbursement, again creating a financial hardship for the provider.

On February 14th Senator Norm Coleman (R-MN), Barbara Mikulski (D-MD), and Amy Kobuchar (D-MN) introduced an amendment to the Indian Health Services Act reauthorization bill. This amendment will impose a moratorium on the targeted case management interim final rule until April 1, 2009. The Senate approved the amendment to this reauthorization bill. The Senate will be back in session on February 24th.

UPDATE:
Today the Senate will vote on final passage of the Indian Health Services reauthorization legislation (S. 1200) today. The bill includes a one year moratorium on the Medicaid case management interim final rule.

On Wednesday, Steve Larson, Director of Public Policy for The Arc of Minnesota, will speak at House and Senate staff briefings on the impact of the Centers for Medicare and Medicaid Services case management interim final rule on persons with intellectual and developmental disabilities.

The clock is ticking on the new CMS rules which are set to go into effect on March 3, 2008.

We will keep you up to date on the vote and the progress of this important one year moratorium.

Monday, February 25, 2008

Coalition Candidate Forum Is Over but the Primaries Are Not

All day today we heard from candidates for Governor and Lieutenant Governor. We have blogged a large part of thier responses to questions and comments about transportation, housing, and Mental Health/Developmental Disabilities/Substance Abuse Reform.

We encourage you to visit each of their websites and learn more about their positions. We also encourage you to register to vote and vote. This is an important election year and we need you to get involved.

During the next few weeks we will be posting more information on this blog about voting and about this candidate forum.

We will be posting Monday's Quick Hits tomorrow.

Walter Dalton Talks Partnerships

Comments from Walter Dalton on Mental Health/Developmental Disabilities/Substance Abuse:

"One thing I have heard from different providers is that we need a louder voice at the table. We need a place at the table. We need to define that table we need to make that table big."
We need a comprehensive task force to amplify that voice.


On solving problems:
"In solving the prolems we have and the problems we have are great. We can talk about policies.
I want to listen to you I want to hear what you say. You put the right person in the right place at the right time and policy will happen."

On the issue of community crisis centers:
"We need more community crisis centers. Patient case management is a huge problem when someone is in distress they need to know where their care is going to be."

On the issue of Medicaid:
"Medicaid is an issue in every state. In North Carolina we moved 5 year olds from SCHIP to Mediciad to access more state dollars. The High Risk Pool will help access other private money so we can maximize Medicaid dollars."


On Mental Health Parity:
Do you think the General Assembly should go back in and amend the law to include substance abuse?
"I think that is a great idea. You have to take everything one step at a time. Need to see the bill so we can expand coverage."

Candidate for Lt. Governor Walter Dalton is Speaking Now

Here is his website http://www.walterdalton.org/

Richard Moore Answers Questions from the Audience

As governor would you support a MH DD SAS cabinet of leaders to recommend to the governor actions to take? And would you include famlies and consumers?

"Only if that cabinet has real say over something. I have been at this for a while. I have seen every game that is played. Yes I will do it but I will do more than just that."

The Division of MH/DD/SAS is big and some say unwielding. Do you think it is time for separate divisions?
"I do not know what the right thing to do there is. I think some of our problems is a lack of strong management. We have siloing of duties, this person is only concerned with this, that person is only concerned with that. If they just once a year glanced over we would have better communication." "Stronger management and less divisions."

On the topic of alternative sentencing or do you support diversion?
"I was once a federal procesutor. I was on the national crime prevention board. The amount of research out there on what can be done in prevention versus what we actually do. It is a lot easier to get votes if we talk about locking folks up and throw away the key."
"There are programs out there that actually work."


What types of organizations should provide community care?
"Providers should be well qualified and the public should know that they are well qualified and paid for at a reasonable rate."

At one point the speaking dias almost fell off the platform. Richard Moore quickly grabed the table to stop it from falling and with quick with stated "Ifixed that problem."


What to do with Dix?

"I will stay out of that one."


On transportation:
"Access means being able to get there"
"We made a lot of progress in the 80s and 90s we seem to be slipping backwards."


On Housing:
"No one else is more focused on affordable housing than I have been. I have been very active with the affordable housing folks in North Carolina. To create real affordable housing we need recurring funding for the Housing Trust Fund."

Gubernatorial Candidate Richard Moore is Speaking Now

Richard Moore's website is: http://www.richardmoore.org/

Gubernatorial Candidate Bev Perdue address MH/DD/SAS

Here are some comments from Bev Perdue:

"Mental Health System in North Carolina is failing our most vulnerable citizens. You need to have an unwavering commitment by North Carolina's next leader and I am that leader."
"Many of my remarks will speak to Mental Health but developmental disabilities and substance abuse will never take a back seat in my mind in the services that we provide."

Speaking about her granddaughter:

"Delivered our first granddaughter almost 12 her name is Rachel. She is beautiful with long brown hair big brown eye. She was born with CP and she is very disabled. I am someone who cares deeply about Rachel and understands the challenges for my family. I see that young couple with two other children struggling. We can afford some respite care but at night I worry about all of those people in North Carolina who have no one else to help them. The caregiver that has no one else to help them."


On the concept of the medical home:

"Expand the concept of the medical home to include folks in the mental health system and we need to agree on a basic corps services for mental health".


On the role of inpatient care:
"We can not neglect the need for strong inpatient services for people with mental health, developmental disabilities and substance abuse services." "We have to have strong inpatient services for crisis management and for long term illnesses."
"North Carolina can’t walk away from our corps responsibilities."

"In North Carolina the quality of mental health care will not be dictated by your zip code.
Every person in this system mental health/developmental disabilities/substance abuse all of those folks are people they are real living people they are not some number or profile or someone who does not matter. My North Carolina has an obligation to ensure that services are available in all corners of NC to meet peoples needs."

"I really believe that all of us here today want a mental health system that works. There is not one person in this state who is involved in the system who will say it is going to be easy. Fix it we will and we will do it together with community based and inpatient options and a mental health home a corps set of services and you will help me make that home."

Bev Perdue is Addressing the Issues of MH DD SAS Right Now!

Her website is http://www.bevperdue.com/.
Some comments from Gubernatorial candidate Dennis Nielsen:

On the topic of Mental Health/Developmental Disabilities/Substance Abuse Reform; "Sad to report that the system is in free fall. I have traced the problem back to 2001. It is clear to me that no one ncluding some of the candiates for governor want to take responsibility. To add insult to injury the mental health trust fund was raided in 2002 and 2003."

In reference to who to vote for in 2008:
"The real question is do you trust what they (the candidate) say look at all these candidates make up your mind who do you trust in the process the future of mental health care is not in my hands but in yours and who you choose."

In regards to where we stand nationally:
I"n a national scoring system we in north Carolina get only a D in Mental Health care."

On the drop out rate for children with developmental disabilities:
"We need more school counselors to catch the problems earlier."

Neilsen asked of the many representatives of TROSA if their program is working and if it should be expanded?
The representatives unanimously responded "Yes!" and stated this program needs more funding.

Candidate for Governor-Dennis Nielsen

Next up is Dennis Nielsen a candidate for governor. Here is his website http://www.votenielsen.com/.

Besse on Transportation

"I would look at transportation services as a comprehensive program. One thing I am working on now is improving our bus system in Winston Salem. Our Winston Salem Transporation chair is a professional in the area of MH/DD/SAS. He understands that issue and we are allies. It needs to happen in every urgan area and we need to fill in the gaps in our rural areas to get people to their health care needs. We need to expand rural bus services to more of our rural areas so it is more possible for people without a car to get to where they can go."

Candidate Dan Besse Lays Out the Problems with Mental Health/Developmental Disabilities/Substance Abuse Services Reform

"In recent years the state of North Carolina has taken a broad effort to promote deinstitutionalization. The state has also simultaneously been undertaking private and government control, to government contracting with local providers. This transition while well intended has been inadequately planned, funded and administered. The results are the current system breakdown." He went on to list the systemic problems, included are the absence of overall planning for care delivery, care delivery not uniform across the state, major gaps in geographic coverage for community services with rural communities being the most lacking.

"We have many sick and suffering individuals not recieivng care. We have an increase in homelessness. We have continuing and worsening problems."

"Most incompetent administration in American history they are still trying to undermine key services. Mediciad rule changes would further limit coverage of rehabilitiative services moving us precisiely in the wrong direction a hallmark of this administration.

"We need to fund services state wide. Stronger commitment to substance abuse services and chronic mental health illnesses. We need to fund community based system across the state before continuing or resuming the deinstiutitonaliziation." "We can not be sending people out of our hospitals if there is no where for them to go in our community."

Lt. Governor Candidate - Dan Besse Is Speaking Now

Here is his website http://www.danbesse2008.org/.

Bill Graham on Transportation

Audience question regarding transportation. Transportation is a real issue for people with mental health/developmental disabilities. What is your plan for transportation?

"Trasportation is a mess. Third most congested state in the country next to Califoria and New Jersey. I would open up the interstates and second arteries. More funding to roads and bridges. My main focus will be on interstates and secondary roads."

Clarification of the issue was this follow up question. A particular problem that this community has is the inability to get to services. Tthey do not have a car.

Graham's response:
"We should make available to any one who need to get to a facility a van or a bus to get to the facilities that they need to get to. "

Comments from Gubernatorial Candidate: Bill Graham

Bill Grahams comments on how to insure the uninsured in our state:

"In order to get at the number of uninsured, 1.4 million people. and deal with the ever increasing cost in health care I would establish a tax credit pool to take the top risk off the top and there by lowering the premiums for everyone who needs access to health care." The program outlined by Graham would include allowing you to spread out your medical deductible over a year and the insurance plan would cover mental health disorders including those caused by injury. The plan proposal would also allow for small and medium sized businesses to spread out their risk.

On an audience question regarding the needs of people with developmental disabilities and long term services and supported employment and what as a governor he would do to support these needs Graham's response was, "That would fall under the catastrophic case-anything that is not covered under Medicaid or insurance would fall under catastrophic. If a person has significant life long expenses and it would then become a tax credit case. They would be fully covered. There is no exclusion in the tax credit pool for a pre existing condition. As science goes on everyone here will have a pre existing condition."

Welcome Back to the Live Candidate Forum

First up this afternoon is Bill Graham! Here is his website http://graham2008.com/.

Dellinger on Mental Health Parity

Hampton Dellinger would like to see an extension of the legislation passed in 2006. He would like to see that more diagnosis are covered.

After Lunch There Is More from the Coalition Candidate Forum at the RBC Center!

After the lunch break the following candidates will step up to the mike!

Bill Graham, Beverly Perdue, and Richard Moore. If you are in Raleigh, Durham or Chapel Hill you still have time to drive here and be a part of this event. If you are unable to get here, we will be blogging the second half.

Lt. Governor Candidate-Hampton Dellinger

Here are some of Hampton Dellinger's comments:
"North Carolina is number one when it comes to our business climate. We are not number one when it comes to making our MH/DD/SAS climate just as good as our business climate.
We should be number one on those issues and not just number one for business."

"I came out with Dorethea 365, a year round commitment to MH DD SAS."

"I worked month after month and year after year so that what we have Disability Rights NC an independent Protection and Advocacy organization that will take the lead and aggressively hold the governments feet to the fire."

"Thomas S and Willie M we have got to live up to the settlement agreements. We failed initially in those cases and we need to live up to the state's commitment."

I was so disappointed with our state legislature this past year knowing that we did not provide compensation to the living victims of the forced sterilization that our state over saw. These are people dealing with a developmental disability. At the least we should provide compensation to them. Our state legislature decided to cut taxes on the richest North Carolinians. I do not get it."

Dellinger also recognized that there is insufficient funding for our veterans who are returning with traumatic brain injury.

Hampton Dellinger is Live Now!!!

Hampton Delinger's website is http://www.hdforltgov.com/.

More from Judge Bob Orr

"Prior to Mental Health Reform the state never had a mental health plan. Part of the excitement of reform was a mental health long term plan. We need to step back. I would submit we need to step back at this point and redevelop a mental helath plan for this state. One that we all participate in. An open process that we try and look at a long term approach to get us out of this mess to delvier the servies that your clientellye and families memebers need-it needs to be done in an efficient manner. I am a pretty open guy I will sit down and talk to anyone. I am interested in good ideas in workable ideas. I have said in my opinion it is not about the next four years it is about the next 20 years. Substantial reforms to have the type of quality of life. There are a lot of huge challenges in North Carolina government. "

Governor Candidate-Bob Orr is Talking Right Now

Rebublican gubernatorial candidate Bob Orr stated that

"No more humiliating experience in state government then what we have experienced in Mental Health reform. We need to find solutions that deliver the kind of services needed to the people who need them. Second we need to find the right concept of care. This might sound strange coming from a Repubublican but I do not think this has worked. There needs to be some convincing of me that privatization was the most effective way to devliver this type of service. Whatever reform we come up with we need to develop or strengthen the publics confidence in the system".

Lt. Governor Candidate - Pat Smathers

Some of you may not know anything about this candidate here is his link: http://www.patsmathers2008.com/

Pat Smathers has a background in trial law. He has worked extensively in the court systems and in estate planning for people with developmental disabilities.

Beliefs:
"I believe that North Carolina is a chain of communities."

Slogan
"My campaign slogan and my belief is Local Leadership, State Wide". "That slogan is not about a mayor running for a state wide office, it is about empowering local people to take charge."
"Raleigh can help but it is we who have to get a grip on these issues."

Motto
"Our state motto is 'To be rather than to seem'. "Don’t say one thing and do another."

After going through his beliefs, motto and slogan Pat Smathers got down to business by sating that the "legislation passed in 2001 dismantled our system, outsourced care to local agencies and compounded existing issues and problems." Smathers stated that we rank 43 in the nation on capital spending for MH/DD/SAS.

We rank 43 in the nation on capital spending in MH we have MH professionals leaving MH beause it is hap hazard and underfunded for years


When asked specifically about the status of DD services in our state Pat Smathers got two very direct questions. One regarding if DD in his adminstration would get the short stick, since the media is focused so closely on the Mental Health crisis?

"They will get the short stick if we do not concentrate on it. You need to raise awareness
You need to raise awareness. You need to be there asking for the funds. That is the only way it is going to happen. The squeaky wheel gets the grease. We have not done a good job addressing these issues."

On the issue of emergency services during a natural disaster the reply was, "In the first 48 hours you are on your own. That is why it is important that local people be prepared."

Last came a question from the audience. "What do you know about developmental disabilities?"

"I am not an expert. What I know most about developmental disabilities is my invovlement of estate planning. This is another issue that is not being realized or addressed by the state."

Pat Smathers is Up Now

More from Senator Fred Smith

Senator Smith answers questions from The Coalition:

#1-Regarding breaking down communication barriers.

"We need a governor who is hands one. A governor who will work with good managers." "We need to use information technology to improve communications." "There are over 200 different systems in DHHS and these departments need to be able to talk together."


#2 Medicaid
"We need program integrity. The dollars are not plentiful."

#3 Funding
"People have to have conficdence that the money they are investing is being used well . They are willining to put more money in the system if it is being used well."

#4 Econcomic stimulus in our state as it relates to direct provision of services.
"That is taking your eye off the ball." "But that is a side effect-we need to meet the needs of people here-we need to stay focused on the needs of people."


Senator Smith's website http://www.joinfred.com/

(Edited to include website-we started adding websites after Senator Smith spoke. So..here is his information)
Senator Fred Smith's comments regarding the state of Mental Health/Developmental Disabilities/Substance Abuse Reform:

"Leaders decide what road to get on and where we are going. We have seen in MH Reform the failure of leadership it is a textbook case for the failure of leadership."

"Seven or eight years ago in MH reform-this administration had good intentions they wanted to reduce the use of state MH Hospitatls they wanted people to return to their communities
All of those intentions are good-hope is not a strategy while hope is important to accomplish the mission takes strategic planning and it takes hard work."

"We did not have a clear strategy as a state we did not have the right tactics and we rushed the implementation of the program. As a result we created a crisis in this state."

Good Morning from the RBC Center Candiate Forum

We are live and first up is Republican candidate for Governor Senator Fred Smith.

Sunday, February 24, 2008

Live Blog Event: Coaltion Candidate Forum

The Arc of North Carolina Policy Blog will be updated LIVE from the RBC Center during the Coaltion Candidate Forum.

Friday, February 22, 2008

NC Election 2008: Coalition Candidate Forum

THE COALITION CANDIDATE FORUM
FEBRUARY 25, 2008
8:30 am - 5:30 pm
Lunch break - 12:10 pm to 1 pm
RBC CENTER - Arena Club


LIST OF CANDIDATES ATTENDING
Dan Besse
Walter Dalton
Hampton Dellinger
Bill Graham
Richard Moore
Dennis Nielsen
Bob Orr
Beverly Perdue
Pat Smathers
Fred Smith

SPECIAL INFORMATION
Please come for as much of the day as you are able. However if you are not able to attend, Julia Leggett, Policy Coordinator for The Arc of NC, will be blogging the Candidate Forum live throughout the day.

INFORMATION
FORMAT - Each candidate has his or her own 40-minute time period. We have invited each candidate to make an opening statement and then address four pre-written questions, leaving 5-10 minutes at the end for audience questions. The audience will submit questions on cards that will be distributed. Due to an agreement with the candidates, we are not able to furnish a schedule of the specific candidate time slots.


LOCATION
RBC Center in Raleigh - Arena Club. Park in the lot by Carter-Finley Stadium, and follow the signs to the VIP Entrance which is next to the box office. Take the elevator to the second floor and the event is in the Arena Club.

The RBC Center is easily accessible and conveniently located adjacent to Carter Finley Stadium and the NC State Fairgrounds just off I-40 and I-440. There will be RBC personnel who can direct you once you enter the facility. For directions to The RBC Center visit the website at: www.rbccenter.com. There is no charge for parking.

LOGISTICS
Lunch will be available for purchase in The Deck during the lunch break. There will be beverages available throughout the morning and afternoon portions of the Forum.

This event is free and open to the public - registration not necessary.

Please join us to hear and be heard during this important election year!

The Coalition consist of individuals and organizations working together to meet the needs of North Carolinians living with mental illness, developmental disabilities, and the disease of addiction.

NC Breaking News: Moseley Retires as State MH/DD/SAS Director

RALEIGH –North Carolina Division of Mental Health, Developmental Disabilities, and Substance Abuse Services (MH/DD/SAS) Director Mike Moseley today announced that he is retiring.
“I’ve accomplished a great deal in my three decades of public service to the State of North Carolina,” Moseley said. “There have been a lot of changes in the state system during my tenure, and I’m proud of what I’ve done to move things forward for the people who depend on this system for their care.”
Moseley has served in a number of roles with the MH/DD/SAS Division including: Director of the Caswell Center in Kinston, Director of the NC Special Care Center (now called Longleaf Neuro-Medical Center) in Wilson, Assistant Director of Cherry Hospital in Goldsboro, Chief of the Residential Services Branch and founding head of both the Thomas S. and Crisis Services sections at the state division. In addition, he is the first North Carolina MH/DD/SAS Director to be elected to the Board of the National Association of State Program Directors.
Among his many accomplishments, Moseley:
· Led the state’s efforts to move toward systemwide implementation of person-centered planning as well as efforts to expand Medicaid coverage to serve more developmentally disabled people in a more flexible manner.
· Spearheaded the creation of the Alzheimer’s Unit at the NC Special Care Center in Wilson.
· Expanded community-based services while at the Caswell Center, allowing for a reduction in residential treatment at the center.
· Led the effort to move away from a focus on just a patient’s psychiatric and medical needs to looking at all of the patient’s needs in a more holistic and integrated manner as Assistant Director of Cherry Hospital.
· Upgraded Caswell Center’s physical plant after more than two decades of no improvements. Moseley’s plan is still being used today on additional upgrades.
· Led the state’s effort to provide the full range of Medicaid-funded substance abuse services in accordance with the criteria of the American Society of Addiction Medicine.
Moseley is a graduate of UNC-Chapel Hill, where he was recognized in 2000 as its “Outstanding Black Alumnus”, and he received his graduate degree from East Carolina University. He is a previous recipient of the Arc of North Carolina’s and the NC Community Living Association’s Distinguished Services Award. Moseley has also been honored in “Who’s Who in Business,” “Personalities of the South,” “Who’s Who in the South and Southwest” and “Outstanding Young Men of America.” Among the most prestigious of his many awards and honors was his selection as Kinston-Lenoir County’s 2004 “Citizen of the Year.”
Moseley will leave the Division effective Feb. 29, but he plans to work another 90 days at the department level as part of the transition starting March 3.


Public Affairs Office101 Blair Drive, Raleigh, NC 27603(919)733-9190FAX (919)733-7447

All Press ReleasesDebbie CraneDirector

Wednesday, February 20, 2008

NC Election 2008: Coalition Candidate Forum

Coalition Candidate Forum
Monday, February 25
8:00-5:00 PM
The Arena Club
RBC Center Raleigh, NC
Please come and represent the developmental disability community. Let the candidates know that the DD community matters, and VOTES. The candidates need to see a full house so that they recognize that earning the disability vote matters!The Coalition is hosting a Candidate Forum from 8:00 AM - 5:00 PM at the RBC Center in Raleigh. All major party candidates for Governor and Lt. Governor are being invited to attend and participate in this forum.Each candidate will be offered 30-45 minutes to come before those attending the forum and address various issues relating to mental health, developmental disabilities, and substance abuse. Candidates will be given time for a brief statement, be given four questions on topics we suggest they address, and will then have some time for moderated audience questions. This is NOT a debate. Candidates will each have their own time slot. Please join us to hear and be heard during this important election year.
This event is free and open to the public - registration not necessary.
Candidates scheduled to attend:
Dan Besse
Walter Dalton
Hampton Dellinger
Bill Graham
Richard Moore
Dennis Nielsen
Bob Orr
Beverly Perdue
Pat Smathers
Fred Smith
Even if you cannot attend the entire day, please come for a few hours. It is critical that the candidates see a good turnout so they understand how important disability issues are and that the disability community VOTES!While registration is not required, The Arc of NC would like to know if you are planning on attending.
Please e-mail lguzman@arcnc.org to let her know you are coming.
Directions to the RBC Center are available on the RBC Center web site at: http://www.rbccenter.com/%20In the top right hand corner, you will see a link to directions. You can also find maps etc from that link.
Thank you again for your advocacy!

Tuesday, February 19, 2008

Election 2008: Presidential Primary Update

CNN is reporting that Senator John McCain will win the Republican Primary in Wisconsin and Senator Barack Obama will win the Democratic Primary in Wisconsin.
Results from Hawaii's Primary and Michigan's caucus will be posted tomorrow morning.

Tuesday Quick Hits: Federal Policy Topics for this Week

U.S. Congress:

The Congress is in a week long Presidential Day recess. During the recess, Congressional leaders will be devising strategy to move priority bills, including the Fiscal Year 2009 Budget Resolution, in a bipartisan manner.

Medicaid:

The Arc and UCP will submit comments today on a notice of proposed rulemaking (NPRM) published by CMS which addresses the new Section 1915(j) state option for self-directed personal assistance services, also known as "cash and counseling". The new state option was added to the Medicaid program through the Deficit Reduction Act of 2005. The purpose of the proposed regulations is to spell out the requirements that states must meet in offering the self-directed, or cash and counseling, option to eligible Medicaid beneficiaries. DPC staff notes that the NPRM is generally very positive, but that there are a few areas which would benefit from clarification or data collection. The NPRM can be viewed at: http://a257.g.akamaitech.net/7/257/2422/01jan20081800/edocket.access.gpo.gov/2008/pdf/08-115.pdf

NC Legislative Update: Agenda for Joint Study Committee on Autism Spectrum Disorder, Law Enforcement, Public Safety, and First Responders

Tomorrow the Joint Study Committee on Autism Spectrum Disorder, Law Enforcement, Public Safety, and First Responders will meet at 10:00am in room 643 LOB. Here is the agenda for the second meeting since session break.

Agenda:

"Take Me Home" Program

-- Dennis Debbaudt, Autism, Advocates and Law Enforcement
Professionals: Recognizing and Reducing Risk Situations for People
with Autism Spectrum Disorders

-- Officer Jimmy Donohoe, Pensacola Police Department

Overview of Existing Training on Autism

Law Enforcement
-- Pam B. Pope, Training Manager, NC Justice Academy

School Resource Officers
-- Claire Greer, Consultant, Severe/Profound, Autism, Multi-Handicapped Exceptional Children Division, NC Department of Public Instruction

First Responders
-- Wayne Goodwin, Assistant Commissioner and Assistant State Fire Marshall, NC Department of Insurance



Overview of Existing Training Mechanisms for Other Groups

District Attorneys
-- Peg Dorer, Director, NC Conference of District Attorneys

Judges, Magistrates & Public Defenders
-- James C. Drennan, Albert Coates Professor of Public Law and Government, UNC School of Government

Guardian ad Litems
--Jane Volland, Administrator, Guardian ad Litem Program

Election 2008: Washington, Wisconsin, and Hawaii Primary and Caucuses Today

Citizens in Wisconsin and Washington state will be heading to their polling places today to vote in Democratic and Republican primaries. There will also be a Democratic caucus in Hawaii today. We will be tracking the results of these primaries and caucuses. Results from voting in Hawaii will probably not be available until late this evening or early tomorrow morning.

Monday, February 18, 2008

Monday's Quick Hits: This Weeks Hot Policy Topics

Monday’s Quick Hits: This Weeks Hot Policy Topics

North Carolina:

Tuesday, February 19, 2008

Criminal Justice:
10:00 AM Corrections, Crime Control, and Juvenile Justice Oversight Committee, Joint Legislative 544 LOB
No agenda was posted regarding the work of this committee for this sessions break.
Wednesday, February 20, 2008

Autism:
1:00PM Autism, Spectrum Disorder, Law Enforcement, Public Safety and First Responders, Joint Study Committee 643 LOB

This will be the second meeting of this committee. Although this committee is specifically looking at issues related to Autism and Law Enforcement, we are hoping that the findings will be broad enough to address issues in the larger disability community.

Thursday, February 21, 2008

Transportation:
9:00 AM 21st Century Transportation Prioritization and Efficiency Subcommittee - UNC Wilmington

10:00 AM 21st Century Transportation Intermodal Subcommittee - UNC Wilmington

12:15 PM 21st Century Transportation Committee - UNC Wilmington

The 21st Century Transportation Committee is moving its meeting to Wilmington. Previously this committee went to Charlotte to take a first hand look at the new light rail system. In Wilmington we will hear about the NCDOT Debt Affordability Study, Public Private Participation, Future Federal Funding and an presentation by the Highway 17 Association.

Federal:

We will be doing a separate posting this week on federal hot policy topics. Expect that information to be up on this blog by tomorrow. Have a great President’s Day!

Julia's Musings: In Honor of President's Day - President Bush's Budget Leaves Us All Behind

In honor of President’s day, I thought it would be fitting to take a look at President Bush’s final budget proposal of his presidency. The total budget comes in at $3.1 trillion dollars.

The Bush budget does provide a slight increase in funding for the U.S. Department of Housing and Urban Development but it freezes funding for child care assistance for low-income families, funds most Special Education related programs at the level set in the FY 2008 budget. No Child Left Behind Act and the Individuals with Disabilities Education Act State Grant Programs will see a slight increase but the IDEA Preschool and Early Intervention programs received cuts. It also reduces the Social Services Block Grant by $500 million and funds Developmental Disabilities Programs at the FY 2008 funding level. In the area of Protection and Advocacy for People with Traumatic Brain Injury the Bush budget cuts all funding.

Let’s start with education. The North Carolina Department of Public Instruction released two reports this year. The first report was on the 4 year and 5 year cohort graduation rates. For children with disabilities the four year cohort graduation rate was 48% and the five year rate was 50%. These were the lowest rates of any group tracked in this report. The second DPI report focused on drop out numbers. Last year 23,000 students dropped out of school in North Carolina. This report did not detail the numbers of students with disabilities that dropped out. What we do know is that early intervention for students with disabilities is critical for their academic and social development. President Bush may not be reading these reports since he will be cutting the IDEA Preschool and Early Intervention programs.

Affordable housing for people with disabilities is a critical need in our state and in the nation. Bush’s housing budget request has a few positives and a bunch of negatives.
The Tenant Based Rental Assistance account has a requested $39 million worth of new vouchers for elderly and people with disabilities who lost their homes due to Hurricane Katrina. At the same time there is a 32% of $77 million cut to Section 811 housing for people with disabilities. According to the U.S. House of Representatives Committee on the Budget, the overall cuts to the Public Housing Capital Fund could be as high as $11,669,000 or more importantly these cuts could potentially affect 75,616 citizens of our state. With the rising numbers of foreclosures (WRAL reports that foreclosures in Raleigh/Cary are up 122%) and the success of state programs like the Housing 400 Initiative and the Housing Trust Fund, the federal government should be investing more in affordable housing not less.

Then there are the cuts to the Social Services Block Grant. This grant takes a whopping $500 million cut and ends up providing only $1.2 billion for 2009 and eliminating the grant starting in FY 2010. This means serious cuts to epilepsy and injury programs including TBI (traumatic brain injury). Social Services Block Grants provide discretionary funds for child care, child welfare, prevention and intervention programs, and special services for the disabled. North Carolina could possibly see a cut of $14,708.000.

More bad news for people with TBI, the funding for their Protection & Advocacy Grants has been zeroed out in President Bush’s proposed budget. Apparently the connection between military men and women returning home with TBI and the needs of these brave soldiers has not been pointed out to President Bush.

Last we come to the proposed cuts in Medicaid and the children’s health insurance programs. The Bush budget would cut Medicaid by $1.8 billion in FY 2009 and by more than $18 billion over the next five years. In addition to these proposed cuts is the additional $14.7 billion in five year cuts that will come from new Medicaid regulations. If you have been reading this blog, we have been discussing the targeted case management changes and the reimbursements for school administration and transportation for children with disabilities. SCHIP would see a $19.7 billion funding increase but this increase does not keep up with the rising cost of health care. To simply continue the current services provided by SCHIP we would need to see funding increased to $21.5 billion. In North Carolina we currently have over 1,300 children with special needs enrolled in our state children’s health insurance plan. Current 2008 funding shows North Carolina having a shortfall in SCHIP funding by June.

President Bush’s budget clearly does not address the needs of the disability community. It does not speak to the need for equitable well funded education, affordable housing options, and quality health care. The Bush administration budget leaves us all behind.


Want to read more:
WRAL-Foreclosure Rates Soar
http://www.wral.com/business/story/2429648/

U.S. House of Representatives Committee on the Budget State Report
http://budget.house.gov/pres_budgets/09S_by_sFINAL.pdf

Children’s Defense Fund-Health Child Campaign
www.childrensdefense.org/health-child

US Department of Housing and Urban Development
News Release-Bush Administration Seeks $38.5 billion HUB Budget in 2009
http://www.hug.gov/

Coalition on Human Needs-FY 2009 Budget
http://www.chn.org/issues/budget/

Friday, February 15, 2008

Federal Update: Targeted Case Management CMS Update

On February 4th we posted an action alert regarding the Center for Medicare and Medicaid Services rule changes for case management services. The proposed rules will drastically cut Medicaid funding for case management services that provide adults and children with long term supports, social, medical, educational and other services. The rules would change current CMS policy in the following ways:

*Transition case management services would be limited to 60 days. Current policy allows for up to 180 days. It often takes up to 180 days to secure housing and necessary support services for a person to transfer into a community independent living environment.

*Providers will only be paid for transitional case management services when the person successfully transitions into the community. This rule can be a financial hardship on service providers who do not have a financial capacity to wait for a reimbursement. Sometimes a transition is not successful for various reasons such as the availability of appropriate support services. In this case if the persons transition is not successful the provider will not receive reimbursement, again creating a financial hardship for the provider.

Advocates and legislators have been working on legislation to place a moratorium on these CMS rules. Currently the CMS regulations will go into effect on March 3, 2008.

On Thursday February 14th Senator Norm Coleman (R-MN), Barbara Mikulski (D-MD), and Amy Kobuchar (D-MN) introduced an amendment to the Indian Health Services Act reauthorization bill. This amendment will impose a moratorium on the targeted case management interim final rule until April 1, 2009. The Senate approved the amendment to this reauthorization bill. The Senate will be back in session on February 24th. The clock is ticking on the new CMS rules which are set to go into effect on March 3, 2008.

We will continue to track this legislation and bring you updates as we receive them. We will also bring you action alerts as they are issued.

Read More:

http://wjz.com/local/barbara.mikulski.medicaid.2.654566.html

Special thanks to DPC for the information.




Wednesday, February 13, 2008

Election 2008: North Carolina Update

The race is on! Campaign season in North Carolina is underway. This week candidates will be flocking to the State Board of Elections to file their intent to run for office. These candidates will come with papers, family members and lots of cameras clicking to record the moment. We wish them all well.

So, while they are doing there part, it is time for you the reader to do your part. If you have not already registered to vote we encourage you to register today. You can download the necessary forms at the State Board of Elections website.

And what about our state’s primary? Good question. In the last few national primaries both the Democratic and Republican nominee for President has been settled way before our state primary happens. Not so this year. This year North Carolina may hold the necessary votes to lock up a solid victory for the candidates. It’s time to get ready! Our state will hold its primary on May 6th.

What if I am an independent can I vote in our state primary? Yes you can! If you are registered in our state as unaffiliated you can vote in the primary. You declare your intention to vote Democrat or Republican when you arrive at the polls on primary day.

If you are interested in how the Presidential Candidates are polling in North Carolina check out USA Election Polls.

To register to vote go to the State Board of Elections website and download the forms.

Election 2008: Race for the White House Update

With the Potomac Primary is over here is the update:

Maryland
(D) Senator Barack Obama Votes: 457,053 60%
(D) Senator Hillary Clinton Votes: 277,941 37%

(R) Senator John McCain Votes: 160,574 55%
(R) Governor Mike Huckabee Votes: 84,961 29%

Virginia
(D) Senator Barack Obama Votes: 623,141 64%
(D) Senator Hillary Clinton Votes: 347,252 35%

(R) Senator John McCain Votes: 244,135 50%
(R) Governor Mike Huckabee Votes: 198,247 41%

District of Columbia
(D) Senator Barack Obama Votes: 85,534 75%
(D) Senator Hillary Clinton Votes: 27,326 24%

(R) Senator John McCain Votes: 3,929 68%
(R) Governor Mike Huckabee Votes: 961 17%

Thanks to CNN Election 2008 for the vote counts.

Current Delegate Count:

Democrats:
NBC: Obama 1,078, Clinton 969
CBS: Obama 1,242, Clinton 1,175
ABC: Obama 1,232, Clinton 1,205
CNN: Obama 1,215, Clinton 1,190
AP: Obama 1,223, Clinton 1,198

Thanks to politicalwire.com for this summary.

Republicans:
McCain 827
Huckabee 217


The primaries now head to Wisconsin and Hawaii.

Monday, February 11, 2008

Monday Quick Hits: Hot Policy Topics for this Week

North Carolina:


Child Health:

Monday, Feb. 11, 200810 a.m.

The North Carolina Child Fatality Task Force meets, 1228/1327 LB.



Education:

Tuesday, Feb. 12, 2008

10 a.m. The Joint Legislative Education Oversight Committee meets, 643 LOB.


The agenda for this meeting will begin with a presentation on The Collaborative Project: A 21st Century Initiative of the North Carolina General Assembly. This will be followed by a presentation on Collaborative Leadership for Global Competitiveness. Included in this presentation is a presentation by Learn and Earn Online and the iSchool at the University of North Carolina Greensboro. The afternoon session will continue discussing school connectivity and the day will end with a discussion regarding business education technology.

Education:

Wednesday, Feb. 13, 20089 a.m.

The Joint Legislative Education Oversight Committee meets, 643 LOB.


This will agenda for this meeting includes Professional Development Funding, Centralization of Professional Development, Teacher Academy and Development offering of the community college system.

Education:

Thursday, Feb. 14, 2008

10 a.m. The Joint Legislative Study Committee on Public School Funding Formulas meets, 643 LOB.

The agenda for this meeting includes presentations by National Education Experts including Kati Haycock, President-Education Trust, Greg Greicius, Senior Vice President-Educational Initiatives Turnaround for Children, and Michael Griffith-School Finance Analyst-Education Commission of the States.
During the last meeting of this committee, many members expressed concerns regarding the numerous formulas used to allocate funding to our school system.

Federal:

FMAP:

Key House leadership introduced legislation on February 7 to provide a temporary increase in the Medicaid federal medical assistance percentage (FMAP), or federal matching rate, to states. Rep. John Dingell (D-MI), Chairman of the Committee on House Energy and Commerce, and Frank Pallone, Jr. (D-NJ), Chairman of the Energy and Commerce Subcommittee on Health, joined by Republicans Peter King (R-NY) and Thomas Reynolds (R-NY), introduced the bill to assist states facing potential declines in tax revenue as a result of the economic slump. This bipartisan legislation would provide:
· a temporary increase of the Medicaid FMAP of 2.95 percent for five quarters - April 1, 2008 through June 30, 2009;
· a similar temporary increase of the Medicaid FMAP of 5.9 percent for the territories;
· protection for States against a decline in their Medicaid FMAP during the same five quarters of the 2008 and 2009 fiscal years;
· a requirement for States to maintain their Medicaid eligibility at current levels in order to receive the 2.95 percent temporary increase in the Medicaid FMAP; and
· a requirement for States to adjust payments by localities and counties to account for additional federal funding.

FY 2009 Budget

On Thursday, the Senate Budget Committee, chaired by Sen. Kent Conrad (D-ND), will hold a hearing on the Administration’s FY 2009 budget.



President Bush has already threatened a veto for any appropriations bill that goes over his target funding.

Friday, February 8, 2008

NC Election 2008: Coalition Candidate Forum

Coalition Candidate Forum
February 25
8:00-5:00 PM
The Arena Club
RBC Center Raleigh, NC


Please come and represent the developmental disability community. Let the candidates know that the DD community matters, and VOTES. The candidates need to see a full house so that they recognize that earning the disability vote matters!

The Coalition is hosting a Candidate Forum from 8:00 AM - 5:00 PM at the RBC Center in Raleigh. All major party candidates for Governor and Lt. Governor are being invited to attend and participate in this forum.

Each candidate will be offered 30-45 minutes to come before those attending the forum and address various issues relating to mental health, developmental disabilities, and substance abuse. Candidates will be given time for a brief statement, be given four questions on topics we suggest they address, and will then have some time for moderated audience questions. This is NOT a debate. Candidates will each have their own time slot. Please join us to hear and be heard during this important election year. This event is free and open to the public - registration not necessary.

Already scheduled to attend are: Fred Smith, Pat Smathers, Bob Orr, Hampton Dellinger, Walter Dalton, and Bev Perdue

Even if you cannot attend the entire day, please come for a few hours. It is critical that the candidates see a good turnout so they understand how important disability issues are and that the disability community VOTES!

While registration is not required, The Arc of NC would like to know if you are planning on attending. Please e-mail lguzman@arcnc.org to let her know you are coming.

Directions to the RBC Center are available on the RBC Center web site at: www.rbccenter.com/ In the top right hand corner, you will see a link to directions. You can also find maps etc from that link.

Thank you again for your advocacy!

Thursday, February 7, 2008

Federal Update: Economic Stimulus Package

CNN is reporting that this evening the Senate passed its economic stimulus package. The Senate Economic Stimulus Package is a $170 billion dollars compared to the House/Bush package at $150 billion. The final Senate package keeps the House rebate check amounts and adds checks for more than 20 million Social Security beneficiaries and 250,000 disabled veterans and their widows. The Senate and House Economic Stimulus Packages do not increase state FMAP. The House will take up the Senate’s package this week and President Bush is expected to sign the bill.

Arc NC Announcement: Waiver Update

The Arc of NC attended the Waiver Development External Stakeholder Workgroup
meeting held in Raleigh on January 31 and February 1, 2008.
The External Stakeholder Workgroup that attended consisted of many family
members, the NC Council on Developmental Disabilities, provider agencies,
advocates, The Arc, The Autism Society, LME staff, CFAC members, and many
more people.

The Division shared lots of information about the process but perhaps more
importantly, asked for, and received feedback from the group. Every question
and issue raised by the stakeholders was listened to and written down for
consideration.

The Arc of NC applauds the Division on their transparency of the new waiver
development as well as their obvious intent to add services that are
self-directed and person-centered. Additionally, services are being proposed
to address gaps in the current waiver. Some of those services include:
nursing respite, incremental levels of behavioral intervention, and crisis
services.

The need for training for all components of the system was stressed often.
Training for case managers/support brokers, providers, families and
self-advocates, plan approvers etc.

There are some exciting proposed service definitions that are being worked
on and as they are developed we will be sure that you get the information as
well as how to provide feedback on the proposals.
The information below is pasted from Implementation Update # 39 just posted
today on the Division website. To read the entire Update please go to:
http://www.dhhs.state.nc.us/mhddsas/servicedefinitions/servdefupdates/index.
htm

The following is a brief summary of the proposed framework for the tiered
waivers:

Tier # 1:
* For individuals who live on their own or with their family and who
have low intensity support needs and/or have access to unpaid supports that
can meet a substantial portion of their overall needs
* Will support individuals whose needs can be met within the range of
$0 to $25,000
* Will include a tier specific service array designed to meet the
needs of this population
* Allows for self-direction of services for consumers living on their
own or with their family.

Tier # 2:
* For individuals who live in their own home, with their family, or in
a congregate residential setting in the community
* Will support individuals whose needs can be met within the range of
$25,001 to $60,000
* Will include the current service array with some revisions
* Allows for self-direction of services for consumers living on their
own or with their family.

Tier # 3:
* For individuals who live in their own home, with their family or in
a congregate residential setting in the community
* Will support individuals whose needs can be met within the range of
$60,001 to $91,000
* Includes the current service array with revisions to include
enhancement of services to meet the higher intensity of service needs
* Self-direction is not an option in this waiver

Tier # 4:
* For individuals who experience severe medical fragility, and/or
severe behavioral challenges
* Will support individuals whose needs can be met within the range of
$91,001 to $135,000
* Includes a specific service array designed to meet the medical
and/or behavioral needs of this population
* Self-direction is not an option in this waiver

The Arc wants to continue to provide feedback on how to make the waivers
work best for individuals and families. To that end, we really want to know
your thoughts. For now the feedback that would be most helpful are your
thoughts on what is currently working, what is hopelessly broken, and what
needs to be repaired with the current waiver. Please let us know what you
want to see in the new waivers so that we can formulate our advocacy
position.

Send an e-mail to <mailto:lguzman@arcnc.org> lguzman@arcnc.org with your
feedback.

As drafts of the new waiver plan begin to emerge we will make sure you have
the information and we'll make sure you know how to provide your input and
feedback.

(Special thanks to Linda Guzman-Chapter Advocacy Specialist, The Arc of North Carolina)

Wednesday, February 6, 2008

North Carolina Election 2008: UNC-TV Gubernatorial Forum/Health Care

With Super Tuesday over its time to shift focus from the national political competition to what is happening in North Carolina politics. This year we will be electing a new Governor for North Carolina. UNC-TV will be presenting the second Gubernatorial Forum on Thursday, February 7 at 8:00pm. The topic for this forum is healthcare. Check your local listings and tune in.

Election 2008: Super Tuesday Round Up

Yesterday twenty-two states held either primaries or caucuses. This was the closest thing our nation has seen to a national primary. The results are in and here they are:

Republican Party Results:
Delegate Count – 1,191 Delegates Needed for Nomination
Senator John McCain 615
Governor Mitt Romeny 268
Governor Mike Huckabee 169

State Breakdown:
Senator John McCain:
Arizona, California, Connecticut, Delaware, Illinois, New Jersey, New York.

Governor Mitt Romney:
Alaska, Massachusetts, Minnesota, Montana, North Dakota, Utah.

Governor Mike Huckabee:
Alabama, Arkansas, Georgia, Tennessee, West Virginia.

Democratic Party Results:
Delegate Count- 2,025 Delegates Needed for Nomination
Senator Hillary Clinton 825
Senator Barack Obama 732

State Breakdowns:
Senator Hillary Clinton:
Arkansas, Arizona, California, New York, Massachusetts, New Jersey, Oklahoma, Tennessee.

Senator Barack Obama:
Alabama, Alaska, Colorado, Connecticut, Delaware, Georgia, Idaho, Illinois, Kansas, Minnesota, Missouri, North Dakota, Utah.

Too close to call:
New Mexico.

Monday, February 4, 2008

ACTION ALERT: Protect Medicaid Reimbursement for Case Management

Protect Medicaid Reimbursement for Case Management

Ask your Senators and Representative to Cosponsor Legislation Delaying Medicaid Regulations


Background

Last month, the Centers for Medicare and Medicaid Services (CMS) issued an interim final rule (CMS-2237-IFC). This regulation will drastically cut Medicaid funding for case management services that currently assist Medicaid-eligible children and adults with disabilities to access essential long term supports, social, medical, educational and other services.

We are opposed to a number of the provisions of this rule, particularly the following new restrictions:

Transition case management services, which are critical to assisting individuals in moving from institutions to the community, are limited to a maximum of 60 days. Current CMS policy allows for up to180 days, which is often necessary to find housing and necessary supports for an individual to live in the community.

Providers can only be paid for transitional case management services once an individual has successfully transitioned into the community. Unfortunately, due to circumstances well beyond the control of service providers (e.g., the availability of appropriate support services), transition can occur long after the necessary case management services have been provided. Many service providers do not have the financial capacity to wait for reimbursement or to sustain the financial losses if an individual’s transition is not successful.

Status

February, 2005 - The Deficit Reduction Act (DRA) was signed into law. The DRA provided new definitions of case management under the Medicaid program.

December, 2008 – CMS published its interim final rule in response to the DRA which restricts Medicaid reimbursement for case management services. Medicaid experts believe that the interim final rule goes well beyond Congress’ intent in passing the DRA.

January, 2008Representative Keith Ellison (D-MN) introduced H.R. 5173, a bill to temporarily delay application of proposed changes to Medicaid payment rules for case management services until April of 2009. Senator Norm Coleman (R-MN) introduced S. 2578, the Senate version of the bill.

March 3, 2008- The Medicaid Case Management Regulation will go into effect unless legislation is passed.



Take Action


I. Call Your Representative

1) If your Representative is not one of the cosponsors of H.R. 5173 listed below, please call your Representative (contact information is available at http://www.house.gov/house/MemberWWW.shtml).
Cooper, Jim (D-TN)
Cummings, Elijah E. (D-MD)
Duncan, John J., Jr. (R-TN)
McCollum, Betty (D-MN)
Oberstar, James L. (D-MN)
Peterson, Collin C. (D-MN)
Ramstad, Jim (R-MN)
Walz, Timothy J. (D-MN)

2) Ask to speak to the Medicaid staff person and say:

The Medicaid case management regulation:
*greatly exceeds Congress’ intent when it passed the Deficit Reduction Act.
*will put service providers at great financial risk by severely restricting Medicaid
reimbursement for critical services.
*ultimately harms our most vulnerable citizens – children and adults with disabilities.

I am asking for Representative __________ to cosponsor H.R. 5173, the bill to delay implementation of the Medicaid case management regulation.



II. Call Your Senators

1) If your Senators are not among the list of cosponsors of S. 2578 listed below, call your Senators’ offices (contact information is available at http://www.senate.gov/general/contact_information/senators_cfm.cfm.)
Alexander, Lamar (R-TN)
Bingaman, Jeff (D-NM.)
Cardin, Ben (D-MD)
Casey, Bob (D-PA)
Clinton, Hillary (D-NY)
Corker, Bob (R-TN)
Domenici, Pete (R-NM)
Klobuchar, Amy (D-MN)
Leahy, Patrick (D-VT)
Mikulski, Barbara (D-MD)
Salazar, Ken (D-CO)

2) Ask to speak to the Medicaid staff person and say:
The Medicaid case management regulation:
*greatly exceeds Congress’ intent when it passed the Deficit Reduction Act.
*will put service providers at great financial risk by severely restricting
Medicaid reimbursement for critical services.
*ultimately harms our most vulnerable citizens – children and adults with
disabilities.

I am asking for Senator __________ to cosponsor S. 2578, the bill to delay implementation of the Medicaid case management regulation.