Monday, February 28, 2011

Monday Quick Hits: Hot Policy Topics for This Week

This week will be mostly about the budget. Joint Appropriation Subcommittee on Health and Human Services will meet Tuesday, Wednesday and Thursday to begin the process of reviewing the governor's budget. On Wednesday and Thursday the committee will receive a briefing on Medicaid and health choice.

All of the budget meetings will take place at 8:30AM in room 643 of the Legislative Office Building. You can listen to the appropriation debate on line at the legislative website.

Wednesday, February 23, 2011

NC News: GOP Leaders Set Budget Targets

We are about to head straight into the state budget debate. This year the House of the North Carolina General Assembly gets first crack at creating a state budget for the biennial. In an interesting development, all of the House and Senate appropriation subcommittees have been meeting jointly this year. This is good planning for the new leadership, everyone gets the same information at the same time.

So here is how the budget process in our state goes. First the governor releases her budget. That happened on February 14th. Her Valentine's to the state you could say. Then the House leadership would set their budget targets. This year the budget targets were released jointly, so both the House and the Senate are operating under the same fiscal constraints.

Now the real work begins. How do you adjust the governor's which was set at 19 billion down to a budget that is a bit closer to 17.5 billion (According to the News and Observer Story-see link)? How do you do this without deep and devastating cuts to core programs? How do you do this without holding on to the sales tax that is set to expire on July 1? These are the questions that will be bouncing around the General Assembly as the process to create a new state budget gets into high gear in the coming week.

Here are two news story links on the new budget targets. WRAL and The News and Observer.

Want to see the budget targets? Check out News14 link.

Tuesday, February 22, 2011

The Arc of NC News: The Arc of North Carolina Releases Position Statement on Developmental Disability System Design

Today The Arc of North Carolina formally releases our organization's position statement on a system design that will clearly address the real needs of people with developmental disabilities in our state.

The Arc of North Carolina's Position on Developmental Disability System Design was passed by our board of directors at our January meeting. It reflects our serious concerns about the direction our state is heading.

The position calls for Developmental Disabilities to be managed separately from Mental Health and Substance Abuse Services. In addition, The Arc calls for statewide management of the DD system. The position further states that if North Carolina is insistent on moving to Managed Care for the DD System, that it should only be done through a separate Developmental Disability specific 1915(b) waiver.

Though our organization has continually supported local systems management it is clear to us that the current movement toward Mega "Local" Management Entities running a Behavioral Health System is neither local, nor consistent with the values our organization holds.

The Arc of North Carolina
Position on Developmental Disability System Design

For too long North Carolina has attempted to run Mental Health, Developmental Disability and Substance Abuse Services through a one-size-fits-all system. This design limits the ability to create a cohesive vision. It obstructs the implementation of services and supports that are specific to people with developmental disabilities. In recent years the crisis in Mental Health (mental illness) services has substantially altered our system so that a “recovery” model has overshadowed the habilitative and support model valued by the developmental disability community.

Additionally, the reckless pursuit of a Behavioral Health Managed Care system threatens the core supports of people with developmental disabilities. The rush to turn Local Management Entities into Medicaid vendors of Prepaid Capitated Health Services is not only inconsistent with the Core Values of our organization, but it assures that North Carolina will no longer have a local management structure.

Our Goal
The Arc has consistently asked for North Carolina to manage its developmental disability system differently from the Mental Health and Substance Abuse system. Though many leaders have given lip service to such a plan no substantial coordinated action has taken place. The recent actions by DHHS and Local Management Entities indicate to us that continued integrated management will only amount to reduced service for people with developmental disabilities and a recovery oriented emphasis on supports that must be habilitative in nature.

The Arc wants a system that responds to the unique needs of people with developmental disabilities by providing support and habilitation in community settings based upon individual needs. We want a system that responds to the unique funding opportunities for people with developmental disabilities and rejects the behavioral health language of “recovery”. Our system should value and provide the choice to utilize self-direction options to those individuals and families interested.

The Arc believes our system must be fiscally responsive, efficient and accountable. Dollars appropriated for service should not be subject to duplicative administrative cuts. Providers should not be subject to duplicative monitoring. Families and people with disabilities should receive the supports necessary to live in communities but we must work toward a system that creates equity and efficiency.

Recommendations – North Carolina should:

• Create a separate Developmental Disability management structure within DHHS.

• Cease efforts to create additional 1915(b)(c) Managed Behavioral Health Care entities with developmental disabilities included

• Apply for 1915(i) State Plan services for adults with developmental disabilities targeting supports that currently utilize state general fund appropriations and utilizing those funds as Medicaid match

• If Managed Care is inevitable, consider a statewide 1915b Developmental Disability Only Managed Care Waiver with 1915i services included

• Add an additional CAP-DD Waiver for people with developmental disabilities who have significant behavioral and /or medical needs

• Raise the Supports Waiver limit to 25 thousand dollars

• Utilize the Supports Intensity Scale (SIS) as an initial eligibility tool for entrance into the CAP waivers with a reconsideration process utilizing other information

• Manage all of developmental disability services from a state system utilizing existing local structures where appropriate

The Arc wishes to work with all stakeholders to create a more effective, responsive and efficient system to support people with developmental disabilities and their families. We believe our proposal is sound and will meet these goals but welcome constructive conversation about these proposals.

NCGA: Public Hearing on HHS Budget Happening Now

Today the Joint Appropriation Subcommittee on HHS is hosting a public hearing to receive input from the community on issues of the budget.

Dave Richard, Executive Director of The Arc of NC, addressed the committee regarding the need to take a hard look at the 1915i option that is provided by changes through Medicaid in the health reform act. He also spoke of creating a state wide system that will address the needs of people with developmental disabilities, as well as make the system more streamlined.

Monday, February 14, 2011

NCGA: State of the State Wrap Up

Governor Bev Perdue has completed her second state of the state speech this evening. The governor stated that the budget she will be presenting on Thursday is 2.2 billion less that the budget she inherited in 2009.

The governor proceeded to explain that she will reduce the size of state government from 12 departments and agencies into 8. She will reduce state jobs by the thousands and will offer early retirement packages to those state employees who are eligible.

Governor Bev Perdue stated that she will reduce the corporate tax rate to 4.9 percent, the lowest in the south east to continue to recruit new jobs to our state.

In addition Governor Perdue unvieled her NC Career and College program. She will offer a full two year community college degree or training to any qualified student who meets a set core of requirements.

She stated that she will in her budget fully fund all exisitng teaching and teacher aide positions.

In an interesting moment, Governor Perdue stated that the current budget is now at a 2.4 billion dollar deficit. That is down from both the 3.7 billion that we started with on January 28 and it is lower than the 2.7 billion of last week.

Here is what was missing from her speech, how does she pay for all of this. She also did not touch on Medicaid or the retention of critical support services for people with mental illness, addictive disorders or developmental disabilities. In addition she did not discuss how she would include the hunderds of students with developmental disabilities in her career preparation programs.

On Thursday we will get a first hand look at the details of the 2011 budget.

NCGA: State of the State is about to begin

Governor Bev Perdue has entered the chamber to give her state of the state address. This is her second address. The governor is currently being greeted by members of the House, Senate, Judiciary and Council of State members.

You can watch live at

NCGA: State of the State Tonight

Tonight, Governor Bev Perdue will give her state of the state address. This is an opportunity for her to give us some clues regarding what may be in her upcoming budget.

The good news for the governor was the release last week that the budget deficit had fallen to 2.7 billion, down from 3.7 billion. The difference came for an additional 700,000 in increased revenue, 200,000 in Medicaid savings (most likely tied to under utilization) and the remainder was found within state health plan savings and other program savings.

The legislature is also waiting to see what Governor Bev Perdue does with SB13-the bill that directed her to cut specific department spending in order to achieve an additional 400.000 in savings during this current fiscal year. Of the items targeted to be cut were the One NC Fund, Golden LEAF fund, and JDIG-three programs that the governor has stated bring jobs to NC through incentives.

While listening today we expect to hear her touch on several topics, education, jobs and hopefully health care. We will be watching, listening and reporting.

Monday, February 7, 2011

Monday Quick Hits: Hot Policy Topics for This Week

After discussing the budget and the deficit for over three months, the actual legislative work on the budget for FY 2011 begins this week. All of the appropriation subcommittees will be meeting jointly to receive staff overview reports. Of interest to our readers is the appropriation subcommittee on Health and Human Services and the appropriation subcommittee on Education. Also in the mix this week is a committee meeting on state personnel issues.

Three bills of interest are on the calendar this week also. This evening the Senate will complete its debate on S13: Balanced Budget Act. This bill targets specific line items of the current budget that will be targeted for additional cuts. This bill hopes to get an additional savings of $400 million to add a cushion for the next budget cycle.

Senate Judiciary II will take up H2: Protect Health Care Freedom Act. This bill which past the House last week will add North Carolina to the 28 state federal lawsuit that seeks to exempt states from the Affordable Health Care Act individual mandate.

Also this week, Senate Education will take up H8: No Cap on Number of Charter Schools. This bill seeks to remove the cap that currently exists on charter schools in our state. There will be a committee substitute for the current bill that is listed on line.

We will be following all of these committee meetings this week.

Here is the calendar for the week:

Monday, February 07, 2011

5:30 PM Session Convenes (Senate)

6:00 PM Session Convenes (House)

Tuesday, February 08, 2011
8:30 AM Appropriations Subcommittee on Education (Joint) 421 LOB

8:30 AM Appropriations Subcommittee on Health and Human Services (Joint) 643 LOB

10:00 AM Judiciary II (Senate) 1124 LB
Protect Health Care Freedom. (H2) 1124 LB

10:00 AM Education (House) 643 LOB

Wednesday, February 09, 2011
8:30 AM Finance (Senate) 544 LOB

8:30 AM Appropriations Subcommittee on Education (Joint) 421 LOB

10:00 AM Education/Higher Education (Senate) 544 LOB
No Cap on Number of Charter Schools. (S8)

12:00 NOON State Personnel (House) 544 LOB

Thursday, February 10, 2011
8:30 AM Finance (Senate) 544 LOB

8:30 AM Appropriations Subcommittee on Education (Joint) 421 LOB

Wednesday, February 2, 2011

NCGA: Wednesday and Thursday.

Committee meetings start in earnest this morning. Of interest today is the House floor debate and vote on HB 2: Protect Health Care Freedom, SB8: No Cap Charter Schools and finally SB13: Balanced Budget Act.

Some quick information on SB13: Balanced Budget Act. This bill will give Governor Perdue the ability to go into this years current budget (FY2010) and cut an additional $400 million dollars. This action was something that Governor Bev Perdue has been asking for and according to Senate leadership the figure of $400 million is what the governor said she could raise. This additional savings in theory would create more of a buffer for the upcoming budget process.

Here is the calendar:

Wednesday, February 02, 2011

8:30 AM Finance (Joint)544 LOB

8:30 AM Joint House and Senate Finance
Informational presentations by staff 544 LOB

10:00 AM Education/Higher Education (Senate) 643 LOB
No Cap on Number of Charter Schools. (S8)

10:00 AM Judiciary Subcommittee C (House) 415 LOB

10:00 AM Judiciary Subcommittee B (House) 421 LOB
Exclusionary Rule/Good Faith Exception. (H3)

1:00 PM Rules, Calendar, and Operations of the House (House) 1228 LB
Permanent House Rules. (H19)

2:30 PM Appropriations/Base Budget (Senate) 643 LOB
Balanced Budget Act of 2011. (S13)

Thursday, February 03, 2011
8:30 AM Finance (Joint) 544 LOB

10:00 AM Judiciary I (Senate) 1027 LB

10:00 AM Judiciary II (Senate) 1124 LB
Make Synthetic Cannabinoids Illegal. (S4)
Ban Mephedrone. (S7)
Make Synthetic Cannabinoids Illegal. (S9)